The proposal to include Parental Alienation Disorder (PAD) in the new proposed Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V) creates a host of problems. The first major problem is the labeling of children with a mental disorder who may simply be reacting with anger to the changes in their lives from the separation and divorce of their parents by rejecting one parent and aligning with the other. Diagnosis may bring with it shame and have a chilling impact on parents report of domestic violence. Although proponents of PAD are aware that it is inappropriate to diagnose children who have been exposed to child abuse and/or domestic violence with PAD, they do not clarify how to make such differential diagnoses. It is suggested that there are insufficient empirical data to differentiate abused and traumatized children from those who are alienated or estranged from the rejected parent. Nor are there sufficient scientific data to account for other child vulnerabilities such as neurological immaturity, Attention-Deficit/Hyperactivity Disorder (ADHD), other anxiety and mood disorders, or oppositional defiant disorder. There are too few comparisons between the risks and benefits of adding a new diagnosis of childhood disorders to justify its inclusion in the DSM-V. Appropriate intervention strategies recommended for PAD children include contact with the rejected parent, which differ widely from trauma victim/survivors who need assurance of safety and healing before contact is re-established. Ethical standards that may be impacted by this new diagnosis and admissibility issues raised by its predecessor, Parental Alienation Syndrome (PAS), are also discussed by the authors.