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Pituitary-Adrenal,Autonomic Responses to Stress in Women After Sexual/Physical Abuse in Childhood.

from moon beam - Wednesday, July 20, 2005
accessed 1884 times

Introduction: The following article was initially broadcast on the National Public Radio. The radio segment nicely reviewed the material contained in the article. The data derived from careful clinical testing supports the thesis that the developing brain of children are affected by the stresses that those of us who attended boarding school were subjected to. The changes in the brain make us more susceptible to depression and stress related disorders later in life. While the clinical data can be difficult for the untrained to understand, it is important because it proves that the changes that were examined are real, and not just a random phenomena that can be explained away by "chance." It's can be difficult to accept the reality that the "programming" we were subjected to can greatly increase the changes of becoming depressed later in life, but it's also can be reaffirming to realize why many of us have had these types of stress related disorders,including men.

Christine Heim, PhD; D. Jeffrey Newport, MD; Stacey Heit, MD; Yolanda P. Graham, MD; Molly Wilcox, BA; Robert Bonsall, PhD; Andrew H. Miller, MD; Charles B. Nemeroff, MD, PhD

Context Evidence suggests that early adverse experiences play a preeminent role in development of mood and anxiety disorders and that corticotropin-releasing factor (CRF) systems may mediate this association.

Objective To determine whether early-life stress results in a persistent sensitization of the hypothalamic-pituitary-adrenal axis to mild stress in adulthood, thereby contributing to vulnerability to psychopathological conditions.

Design and Setting Prospective controlled study conducted from May 1997 to July 1999 at the General Clinical Research Center of Emory University Hospital, Atlanta, Ga.

Participants Forty-nine healthy women aged 18 to 45 years with regular menses, with no history of mania or psychosis, with no active substance abuse or eating disorder within 6 months, and who were free of hormonal and psychotropic medications were recruited into 4 study groups (n = 12 with no history of childhood abuse or psychiatric disorder [controls]; n = 13 with diagnosis of current major depression who were sexually or physically abused as children; n = 14 without current major depression who were sexually or physically abused as children; and n = 10 with diagnosis of current major depression and no history of childhood abuse).

Main Outcome Measures Adrenocorticotropic hormone (ACTH) and cortisol levels and heart rate responses to a standardized psychosocial laboratory stressor compared among the 4 study groups.

Results Women with a history of childhood abuse exhibited increased pituitary-adrenal and autonomic responses to stress compared with controls. This effect was particularly robust in women with current symptoms of depression and anxiety. Women with a history of childhood abuse and a current major depression diagnosis exhibited a more than 6-fold greater ACTH response to stress than age-matched controls (net peak of 9.0 pmol/L [41.0 pg/mL]; 95% confidence interval [CI], 4.7-13.3 pmol/L [21.6-60.4 pg/mL]; vs net peak of 1.4 pmol/L [6.19 pg/mL]; 95% CI, 0.2-2.5 pmol/L [1.0-11.4 pg/mL]; difference, 8.6 pmol/L [38.9 pg/mL]; 95% CI, 4.6-12.6 pmol/L [20.8-57.1 pg/mL]; P<.001).

Conclusions Our findings suggest that hypothalamic-pituitary-adrenal axis and autonomic nervous system hyperreactivity, presumably due to CRF hypersecretion, is a persistent consequence of childhood abuse that may contribute to the diathesis for adulthood psychopathological conditions. Furthermore, these results imply a role for CRF receptor antagonists in the prevention and treatment of psychopathological conditions related to early-life stress.

JAMA. 2000;284:592-597

The relative contribution of genetic and environmental factors in the etiology of psychiatric disorders has long been a hotly debated area of investigation. Considerable evidence from a variety of studies suggests a preeminent role of early adverse experiences in the development of mood and anxiety disorders. One study1 composed of almost 2000 women revealed that those with a history of childhood sexual or physical abuse exhibited more symptoms of depression and anxiety and had more frequently attempted suicide than women without a history of childhood abuse. Women who have been abused in childhood are 4 times more likely to develop syndromal major depression in adulthood than women who have not been abused, and the magnitude of the abuse is correlated with the severity of depression.2

Early parental loss predominantly due to parental separation has also been found to increase the risk for major depression in case-control and epidemiological studies.3-8 Twin studies9, 10 have provided concordant findings. Childhood abuse also predisposes to the development of anxiety disorders in adulthood, including panic disorder and generalized anxiety disorder.11, 12 In addition, posttraumatic stress disorder (PTSD) may be a direct consequence of childhood abuse, and, moreover, such trauma early in life also appears to increase an individual's risk of developing PTSD in response to other traumas in adulthood.13 Depression and anxiety disorders, including PTSD, are often comorbid in individuals with a history of diverse early adversities.14

There is evidence that central nervous system (CNS) corticotropin-releasing factor (CRF) systems are likely to mediate the association between early-life stress and the development of mood and anxiety disorders in adulthood. Corticotropin-releasing factor neurons are found not only in the hypothalamus, but also in the neocortex and the central nucleus of the amygdala, which are believed to be involved in cognitive and emotional processing and in brainstem nuclei that contain the bulk of the noradrenergic and serotonergic perikarya that project to the forebrain.

These CNS CRF systems have also been strongly implicated in the pathophysiology of both depression and anxiety disorders.15 Thus, when administered directly into the CNS of laboratory animals, CRF produces many physiological and behavioral changes that closely parallel symptoms of depression and anxiety, such as elevations of peripheral adrenocorticotropic hormone (ACTH), corticosterone, and catecholamine concentrations, increases in heart rate and mean arterial pressure, changes in gastrointestinal activity, decreased reproductive behavior, decreased appetite, disruption of sleep, increased grooming behavior, increased locomotor activity in a familiar environment, suppression of exploratory behavior in a novel environment, potentiation of acoustic startle responses, facilitation of fear conditioning, and enhancement of shock-induced freezing and fighting behavior.16-20

Enhanced release of CRF from 1 or more CNS circuits may, thus, account for many of the symptoms of depression and anxiety and for the frequent comorbidity between these disorders.21, 22 Indeed, our group and others have repeatedly measured increased CRF-like immunoreactivity in cerebrospinal fluid (CSF) of untreated depressed patients compared with healthy controls and patients with other psychiatric disorders.23-26 Moreover, increased numbers of CRF-positive neurons and increased CRF messenger RNA (mRNA) expression have recently been measured in the paraventricular nucleus (PVN) in postmortem hypothalamic tissue of untreated depressed patients.27, 28 Similar to findings in depression, increased CSF CRF concentrations have been reported in patients with PTSD and obsessive-compulsive disorder.29-31

Of particular relevance to the current study is evidence from preclinical studies that suggests that increased activity of CRF circuits may be the persisting neurobiological consequence of stress early in development. Adult rats repeatedly separated from their dams for 180 min/d on postnatal days 2 to 14 demonstrate increased CRF concentrations in the median eminence, hypothalamohypophysial portal blood, and CSF and increased CRF mRNA expression in the hypothalamic PVN under resting conditions. In response to a variety of stressors, these maternally separated rats exhibit increased CRF mRNA expression in the hypothalamic PVN and increased ACTH and corticosterone responses.32, 33 Similarly, nonhuman primates reared as neonates with their mothers in a variable foraging demand condition for 12 weeks demonstrate significantly elevated CSF CRF concentrations along with stable traits of anxiety as adults.34, 35 We hypothesize that stress early in life results in a persistent sensitization or hyperactivity of CNS CRF systems to even mild stress in adulthood, contributing to the development of mood and anxiety disorders. This study sought to test this hypothesis in human subjects.



A total of 49 subjects, ages 18 to 45 years, distributed into 4 groups participated in the study. Presuming a moderate effect size (10%) according to Cohen,36 the power to detect a significant interaction effect among 4 groups and a time series of 8 repeated measurements at the .05 level of significance is 0.98.37

We recruited women without a history of significant early-life stress and no psychiatric disorder (controls: n = 12; mean age, 29 years; 95% confidence interval [CI], 24-34 years), women with a history of childhood sexual and/or physical abuse (repeated abuse, once a month or more for at least 1 year; sexual abuse, having been forced to touch another person's intimate parts, having been touched in intimate parts, attempted or completed vaginal, oral, or anal intercourse; physical abuse, having been spanked, kicked, or choked in a way that left bruises or injuries, having been attacked with a weapon or tied up or locked in a room or a closet; or both sexual and physical abuse, before the first menstrual period) without a Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV)38 diagnosis of current major depression (n = 14; mean age, 30 years; 95% CI, 27-33 years), women with a history of childhood sexual and/or physical abuse and a DSM-IV diagnosis of current major depression (n = 13; mean age, 32 years; 95% CI, 27-36 years), and women with a DSM-IV diagnosis of current major depression but without a history of significant early-life stress (n = 10; mean age, 34.6 years; 95% CI, 28.59-40.60 years).

All participants were recruited via newspaper advertising from the general population and were remunerated for the time required for participation. Exclusion criteria for the study were irregular menses, significant medical illness, past or current presence of psychotic symptoms or bipolar disorder, and current presence of substance abuse or dependency or eating disorders. All subjects were free of hormonal (except for oral contraceptives) or psychotropic medication and were admitted as inpatients to the General Clinical Research Center of Emory University Hospital, Atlanta, Ga, after providing written informed consent. The study was approved by the Institutional Review Board (Human Investigation Committee) of Emory University School of Medicine and was conducted from May 1997 to July 1999.

Early Trauma Inventory

The presence or absence of childhood trauma was assessed using the Early Trauma Inventory (ETI).39 The ETI is a structured interview that assesses the number, frequency, duration, and subjective impact of different types of traumatic experiences (physical, sexual, emotional abuse and general traumas). The ETI scale ranges from 0 to 524 for physical abuse and from 0 to 1017 for sexual abuse. High test-retest reliability, internal consistency, and external validity have been reported for the ETI.39 We additionally made an effort to obtain independent validation of the abuse from court, social service, or medical records and from family or friends, although not all subjects included in the study were able to provide such validation. For the diagnosis of depression and other psychiatric disorders, the Structured Clinical Interview for DSM-IV40 was used.

Cohort Characteristics

There were no significant differences in age, educational status, or ethnicity among the 4 comparison groups; however, there was a trend for fewer African Americans in the group of abused women with current major depression compared with the group of abused women without major depression (Fisher exact test P = .08). The 4 comparison groups did not differ with respect to the distribution of women using oral contraceptives (4 of 49) or women withdrawn from therapy with psychotropic medication (11 of 49). The magnitude of the abuse did not differ between abused women without major depression (mean ETI sexual abuse score, 131.71; 95% CI, 20.97 to 284.39; mean ETI physical abuse score, 199.36; 95% CI, 37.07-361.64) and abused women with major depression (mean ETI sexual abuse score, 70.84; 95% CI, 7.53-140.94; mean ETI physical abuse score, 173.84; 95% CI, 88.86-258.83).

The mean severity of the depression was in the moderate range for abused women with major depression (mean Hamilton Depression Rating Scale41 [range, 0-38] score, 19.0; 95% CI, 15.56-22.44) and nonabused women with major depression (mean Hamilton Depression Rating Scale score, 21.1; 95% CI, 19.30-22.89). There were no significant differences with respect to the prevalence of past major depression among women with a history of childhood abuse without current major depression (8 of 14), women with a history of childhood abuse with current major depression (9 of 13), and nonabused women with current major depression (8 of 10). Only 5 of 14 abused women without current depression met DSM-IV criteria for PTSD, whereas 11 of 13 abused women with current depression fulfilled a DSM-IV diagnosis of PTSD (chi2 1 = 6.68, P = .01).

For the induction of stress, we used a standardized psychosocial stress protocol that has been shown to reliably induce activation of the hypothalamic-pituitary-adrenal axis and the autonomic nervous system.42 The test mainly consists of a 10-minute anticipation and preparation phase and a subsequent 10-minute public speaking and mental arithmetic task in front of an audience. In 6 independent validation studies, this protocol was shown to induce endocrine and autonomic changes reminiscent of stress, which significantly differ from placebo conditions.42 The magnitude of endocrine and autonomic responses is generally interpreted as reflecting biological stress reactivity.42

The psychosocial stress test was performed between 1:30 and 4:00 PM as described elsewhere.42 Blood samples from indwelling catheters and heart rate measurements were obtained in 15-minute intervals before (15 and 0 minutes), during (15 minutes), and after (30, 45, 60, 75, and 90 minutes) the stress exposure. Blood was collected in EDTA tubes, placed immediately on ice, and centrifuged at 4°C for 10 minutes at 3000 rpm. Plasma was separated, coded, stored at -80°C, and assayed for ACTH and cortisol concentrations by members of the research team blinded to group assignment and sample sequence using commercial radioimmunoassays (ACTH: Nichols, San Juan Capistrano, Calif; cortisol: DiaSorin, Stillwater, Minn).

Data Analysis

Hormone and heart rate data were analyzed using 2-way analysis of covariance (ANCOVA) with repeated measurement (first factor was group, second repeated factor was time, and covariate was ethnicity). In the case of significant effects, between-subjects comparisons were performed for single time points followed by a priori defined contrasts to compare individual group means. In addition, maximum levels of hormone concentrations and heart rates were computed and compared among groups using ANCOVA (factor was group and covariate was ethnicity) followed by a priori defined contrasts. Homogeneity of variance was tested using the Levene test.43 In the case of unequal variance, raw data were logarithm transformed, and all analyses were repeated. All analyses were 2-tailed, with the level of significance set at P<.05.


Results obtained by 2-way ANCOVA with repeated measures indicated that the stress test induced significant increases in mean ACTH (main effect for the time factor [T]: F7 = 26.56, P<.001), cortisol (T: F7 = 54.92, P<.001), and heart rate levels (T: F7 = 26.62, P<.001) across all groups. With respect to ACTH concentrations, there was a significant main effect for the group factor (G) (F3 = 3.81, P = .02) and a significant group by time interaction effect (G T) (F21 = 3.81, P<.001). Ethnicity (categories: African American, white; determined by self-report) had a significant effect on plasma ACTH concentrations (F1 = 6.68, P = .01). Between-subjects comparisons showed that mean ACTH levels of the 4 groups significantly differed at 15 minutes (G: F3 = 3.40, P = .03; regression [ethnicity]: F1 = 5.88, P = .02) and 30 minutes (G: F3 = 5.85, P = .002) after the start of stress induction. Abused women with and without current major depression exhibited increased ACTH concentrations compared with controls and nonabused depressed women (Figure 1, A). Comparison groups also differed with respect to maximum ACTH concentrations (Table 1). Maximum ACTH responses minus baseline were more than 6-fold higher in abused women with depression (net peak, 9.0 pmol/L [41.0 pg/mL]; 95% CI, 4.7-13.3 pmol/L [21.6-60.4 pg/mL]) than in controls (net peak, 1.4 pmol/L [6.19 pg/mL]; 95% CI, 0.2-2.5 pmol/L [1.0-11.4 pg/mL]; difference, 8.6 pmol/L [38.9 pg/mL]; 95% CI, 4.6-12.6 pmol/L [20.8-57.1 pg/mL]; P<.001). Because of heterogeneity of variance of mean ACTH concentrations (Levene test41 P<.01), logarithm-transformed ACTH values were additionally computed, and all statistical effects for ACTH were confirmed (data not shown).

Comparison groups also differed with respect to profiles of cortisol responses (G T: F21 = 5.64, P<.001; regression (ethnicity): F1 = 1.01, P = .32). Between-subjects comparisons revealed that the comparison groups differed at 30 (G: F3 = 7.06, P = .001), 45 (G: F3 = 5.24, P = .004), and 60 (G: F3 = 3.47, P = .02) minutes after the start of stress induction, with abused women with current depression exhibiting higher cortisol responses than all other groups (Figure 1, B). The 4 comparison groups also differed with regard to maximum cortisol concentrations. Abused women with current depression demonstrated increased maximum levels vs all other groups (Table 1).

There was a trend of a group effect with respect to the mean heart rates (F3 = 2.24, P = .09; regression (ethnicity): F1 = .00, P = .95) across all time points. Significant differences between subjects were found at 15 minutes (G: F3 = 2.94, P = .04) after the start of stress induction. Abused women with current major depression exhibited significantly higher heart rate responses at this time compared with controls (Figure 1, C). Comparison groups also differed with respect to maximum heart rate levels. Abused women with depression demonstrated higher mean maximum heart rates than did controls (Table 1).


Severe stress early in life is associated with persistent sensitization of the pituitary-adrenal and autonomic stress response, which, in turn, is likely related to an increased risk for adulthood psychopathological conditions. This is the first human study to report persistent changes in stress reactivity in adult survivors of early trauma. The findings are remarkably consistent with findings from laboratory animal studies.32, 33

Increased pituitary reactivity to stress in some women with a history of early-life stress without psychiatric disorder may reflect a biological vulnerability for the development of stress-related psychiatric disorders. In these women, there appears to exist a counterregulatory adaptation of the adrenal cortex as reflected by increased ACTH concentrations but normal cortisol responses, which also has been observed in some animal models of severe early stress.34, 44 The manifestation of affective or anxiety disorders in adulthood may depend on additive factors, including genetic vulnerability and recent life stress. These factors, taken together, may result in relatively high CRF neuronal activity whenever these women are exposed to stress, ultimately resulting in symptoms of depression and anxiety.

Depressed subjects without early stress experiences showed normal stress reactivity, suggesting differential pathophysiology in subtypes of depression. Increased stress sensitivity may be related to a mixed state of depression and anxiety, including PTSD symptoms, which develops after early trauma. Recently, our group has shown that in rats many of the neurobiological consequences of maternal separation, including CRF hypersecretion, are reversed by treatment with antidepressants, including paroxetine and reboxetine (P.M. Plotsky, PhD; C.O. Ladd, BS; R.L. Huot, BS; et al, unpublished data, 2000).

Future studies in survivors of childhood abuse should separate the effects of different kinds of abuse at different developmental stages and should explore potential reversibility of this biological stress vulnerability after psychotherapeutic and psychopharmacological intervention. Such findings may have important implications for the prevention and treatment of mood and anxiety disorders in survivors of early trauma. Much effort has recently been directed toward the development of CRF receptor antagonists for the treatment of depression and anxiety.45 The utility of CRF receptor antagonists in depression is currently being evaluated in an open-label clinical trial.46 Our findings suggest potential utility of such compounds for the prevention and treatment of psychopathological conditions related to early-life stress.

Author/Article Information

Author Affiliations: Center for Psychobiological and Psychosomatic Research, University of Trier, Trier, Germany (Dr Heim); and Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Ga (Drs Newport, Heit, Graham, Bonsall, Miller, and Nemeroff, and Ms Wilcox).

Corresponding Author and Reprints: Charles B. Nemeroff, MD, PhD, Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 1639 Pierce Dr, WMRB, Suite 4000, Atlanta, GA 30322 (e-mail:

Funding/Support: This work was supported in part by PHS grant M01-RR00039 from the General Clinical Research Centers Program, NIH, NCRR, and the Conte Center for the Neurobiology of Mental Disorders.

Acknowledgment: We thank M. J. Owens, PhD, B. Pearce, PhD, D. Knight, BS, A. Borthayre, BS, and S. Plott, BS, for comprising the stress test committee and S. Böhm, BS, and S. Welter, BS, for their contributions.


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Pamela Pritchard wrote the following letter, introducing the letter of apology written by the PCUSA (Presbyterian Church) to the victims of Bill Pruitt and their families.

Dear friends,

This is the letter of apology (to us) adopted by the 216th General Assembly (in essence the "whole church"). I don't know how you feel about this, but I feel very honored, validated, joyful, and tearful. You are very, very courageous women and I was priviledged to have been your representative during this process.

Pamela Pritchard

1. We, the 216th General Assembly (2004) of the Presbyterian Church (U.S.A.) acknowledge that our children, adolescents, and adults have suffered sexualabuse, molestation, and exploitation as committed by members and leaders of our congregations, governing bodies, and agencies, including those specific incidents that occurred in the Congo and continued in the U.S. church during the period of 1946- 1985, as identified in the Final Report of the Independent Committee of Inquiry, Presbyterian Church (U.S.A.) (September, 2002).

2. We apologize that we as a church did not take adequate steps to prevent the specific incidences as confirmed in the Final Report, that our church did not understand the significance of, or believe, the earliest reports of incidents of sexual abuse when survivors turned to people in positions of authority and responsibility, that our church did not do more at the time of their reporting to intervene and stop the perpetrators of sexual abuse, and that our church did not do more after discovering the truth of the victims’ allegations to reach out to others who might have been victimized.

3. We apologize that some of us in our church chose to doubt and discredit the survivors who came forward with the truth, that some dismissed the reports, and that some demonized them, all of which added a layer of pain and anguish to the original abuse.

4. We apologize that our church’s inactions over the years allowed hurt and harm to extend to the survivors’ families, children, friends, and faith. We recognize that we as a church have suffered losses in the nature and quality of our relationships as a community of faith.

5. We apologize that some of us in our church were complicit as our sisters and brothers in the body of Jesus Christ suffered the loss of their innocence, had childhoods stolen, lost opportunities to enjoy more of the fullness of life that God offers all in Jesus Christ (John 10:10b), and lost a child’s ability to trust the people of the church.

6. We acknowledge that survivors who have come forward have demonstrated a primary motivation to work through the church to improve our faith community, tell the truth, prevent further victimization, seek healing, and make our church safe for all.

7. We express our thankfulness to God for the courage of the survivors whose witness has held us accountable to be true to our calling as the followers of Jesus Christ. We express our gratitude to those among us who have listened to victims, supported their efforts, and worked for justice.

8. We welcome the many other women and men in our church who have been abused as they come forward, and we pledge to work with them so that they may be restored to God’s fullness of life.

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from Benz
Saturday, July 23, 2005 - 21:56



I am most interested generally in the content of your posts. There has been a wide collection of articles on such topics as politics, depression, cults and abusers etc. Some of your articles have interested me more re-reading them, largely for their informative value, but I think more than anything it is the subject matter which seems relevant to the questions and problems Im trying to deal with myself on similar issues.

The article posted where you ask whether academics were FFed by TF is one example of a topic I found of particular relevance to exposing TFs methods (if this can be proved), but also other articles (ie: Jehovahs Witnesses tactics, CAN, How it started., etc). What I want to know is if your choice of articles is entirely based on what grabs your attention at a given time or whether you have a particular area of interest, or are perhaps studying in a particular field.

I ask this because I am trying to do some research in the following areas which you may have come across information on:

- links between religion and fantasy (Phantasy) and mythology

- links between fantasy (Phantasy) and politics

- overall information on Group fantasy and Group psychology (I notice there is a reference in your article to group identity)

- information regarding learned helplessness, Pavlovs dogs and conditioning - and how this may be linked to phantasy/ politics.

If you have come across any information on the above topics Id be most interested.

(reply to this comment)

From moon beam
Tuesday, October 04, 2005, 06:37


Obedience to authority. New York: Harper & Row. Myer, G. (2003, May 30). A young man radicalized by his months in jail. York Times, pp. A1, A14. Orwell, G. (1981). 1984. New York: Signet. Prentice-Dunn, S., & Rogers, R. W. (1983).

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Deindividuation: The absence of self-awareness and self-regulation in group members. In P. B. Paulus (Ed.), The psychology of group influence. Hillsdale, NJ: Erlbaum. Festinger, L. (1957).

A theory of cognitive dissonance. Stanford, CA: Stanford University Press. Fraser, S. C. (1974).

Deindividuation: Effects of anonymity on aggression in children, Unpublished report. Los Angeles: University of Southern California. 22 Haritos-Fatouros, M. (2002).

Adorno, T. W., Frenkel-Brunswick, E., Levenson, D. J., & Sanford, R. N. (1950). The authoritarian personality. New York: Harper & Row. Atran, S. (2003, May 5).

Disinhibition of aggression through diffusion of responsibility and dehumanization of victims. Journal of Personality and Social Psychology, 9, 253-269. Bandura, A. (1988).

Mechanisms of moral disengagement. In W. Reich (Ed.), Origins of terrorism: Psychologies, ideologies, theologies, states of mind (pp. 161-191). New York: Cambridge University. Barstow, A. L. (1994).

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Evil: Inside human cruelty and violence. New York: Freeman. Bennet, J. (2003, May 30).

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The new order (The Third Reich). Alexandria, VA: Time Life Books. Browning, C. R. (1992).

Ordinary men: Reserve police battalion 101 and the final solution in Poland. New York: Harper Perennial. Chang, I. (1997).

The rape of Nanking: The forgotten holocaust of World War II. New York: Basic Books. Cialdini, R. B. (2001). Influence: Science and practice (4th ed.). Boston: Allyn and Bacon. Darley, J. M. (1992). Social organization for the production of evil. Psychological Inquiry 3, 199-218. Darley, J. M., & Batson, D. (1973).

The Psychological Origins of Institutionalized Torture. London: Routledge. Hoffman, B. (2003, June).

The logic of suicide terrorism. The Atlantic Monthly, 40-47. Huggins, M., Haritos-Fatouros, M., & Zimbardo, P. G. (2002).

Violence workers: Police torturers and murderers reconstruct Brazilian atrocities. Berkeley, CA: University of California Press. Keen, S. (1986).

Faces of the enemy: Reflections on the hostile imagination. New York: Harper Collins. Kramer, H., & Sprenger, J. (1971; original 1486).

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Shy murderers. Psychology Today, 11, 69 ff. Merari, A. (1990). The readiness to kill and die: Suicidal terrorism in the Middle East. In W. Reich (Ed.), Origins of terrorism: Psychologies theologies, states of mind. New York: Cambridge University Press. Merari, A. (October 4 & 5, 2002).

Deindividuation and aggression. In R. G. Geen & E. I. Donnerstein (Eds.), Aggression: Theoretical and empirical reviews: Issues in research (Vol. 2, pp. 155-171). New York: Academic Press. Ross, L. (1977).

The intuitive psychologist and his shortcomings. In L. Berkowitz (Ed.), Advances in experimental social psychology (Vol. 10, pp. 173-220). New York: Academic Press. Staub, E. (1989).

The roots of evil: The origins of genocide and other group violence. New York: Cambridge University Press. Triandis, H. C. (1994).

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Becoming evil: How ordinary people commit genocide and mass killing. New York: Oxford University Press. Watson, J., R. I. (1973).

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The human choice: Individuation, reason, and order versus deindividuation, impulse, and chaos. In W. J. Arnold & D. Levine (Eds.), 1969 Nebraska Symposium on Motivation (pp. 237-307). Lincoln, Nebraska: University of Nebraska Press. Zimbardo, P. G. (1975).

On transforming experimental research into advocacy for social change. In M. Deutsch & H. Hornstein (Eds.), Applying social psychology: Implications for research, practice, and training (pp. 33-66). Hillsdale, NJ: Erlbaum. Zimbardo, P. G. (1976).

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Zimbardo, P. G. (2003b, May/ June). Phantom menace: Is Washington terrorizing us more than Al Qaeda?. Psychology Today, 36, pp.34-36. Zimbardo, P. G., Haney, C., Banks, C., & Jaffe, D. (1973, April 8).

The mind is a formidable jailer: A Pirandellian prison. The New York Times Magazine, pp. 38 ff. (reply to this comment
From moon beam
Saturday, July 30, 2005, 11:21

Thank you Benz, I am going away for summer break but will get back to you on some of the subjects you highlighted, when I get back. For now I'll leave you with these (below) as well as an article I posted a few days ago called "Evil chapter"

The critically acclaimed BBC documentary The Power of Nightmares,is now available for free download from The Internet Archive.

The series examines the culture of fear and documents how it was created by modern-day politicians.
The series is in three parts, so be sure to download all three.
Download it here-it is well worth seeing.

I also highly recomend "The century of self" also directed, written and produced by Adam Curtis. 2004 United Kingdon. DV.. Running time: 240 minutes. Curtis manages to find the most amazing archival BBC footage of famous people going about their lives which manages to transport you to whatever time and place he's discusing.
His sense of music and pacing is impeccable, and his concepts show you historical events in a whole new light.

It is one of the few films to discuss Edward Bernays,(Frauds nephew) which ponders the impact Freud's theories had on 20th century culture, particularly the way psychological ideas muddied the distinctions between consumerism,politics, democracy and advertising.

Boasting wonderful archival clips and an extraordinary interview roster that includes strategists Dick Morris,Philip Gould, actress Celeste Holm (who shared Marilyn Monroe's psychiatrist), est founder Werner Erhardt, Mario Cuomo, surviving relatives of Freud and Bernaise, and many others.


We live today in a society dominated by the self and its feelings! To be oneself' is no longer considered selfish but healthy and virtuous.
THE CENTURY OF THE SELF shows how this revolution in how we see ourselves happened over the past 100 years. It asks if this has really been a liberation of the self or if it has just made us more vulnerable to being manipulated and controlled by those in power? To many in both politics and business this triumph of the self is the ultimate expression of democracy power has finally moved to the people. This series examines the validity of that idea while recounting the extraordinary and purvasive role members of the Freud family have played in fostering and encouraging this irresistible rise of the self, from Sigmund to Matthew.

(reply to this comment
From ESJ
Monday, October 31, 2005, 16:29

Moonbeam, the bibliography of study references you've listed above is awesome! How can one access all these reading materials? Are most or some of them available on the Net?(reply to this comment
From moon beam
Friday, November 04, 2005, 07:53

Hi Eva

Either a good library and failing that there are online libraries where you have to join and pay a subscription fee. Or if you are a student, including open university, you can gain access to fantastic sets of libraries and resourse materials on the net.

Also if you type in 'google for the publication and title (reference) it should lead you to the paper/book or journal, or at least where and how you can get a hold of it.

Here is the website for one of the references
I hope this helps.

I just saw 60 mins and I thought you did great. (reply to this comment
from Question
Thursday, July 21, 2005 - 07:41

The apology letter at the end of this article is very interesting. Should it be in a separate article, or is it somehow related to the study?
(reply to this comment)
From moon beam
Thursday, July 21, 2005, 08:31

Yes, I was writing two but lost one unfortunatley, due to my cat, who often wonders across my desk. The other one was commenting on and collating different articles from the website for surviver's of "missionary kids". (at the end of article)

The site declares:

"Who are we?

We are a group of former missionary kids (MKs) who were abused as children - emotionally, physically, spiritually, sexually and/or through abusive neglect - while our parents served overseas with evangelical mission agencies. This abuse occurred in various settings - at boarding schools, on mission compounds, in missionary homes, etc.

Our mission is to call evangelical mission agencies and their supporting churches back to the Biblical mandate to establish justice and healing - especially in those cases where the church has wounded its own missionary children.

MK Safety Net desires to reach out to other victims who need support and healing. We are willing to help other victims break their silence and to provide support, healing and hope. We offer help to other MK victims by:

* Networking with other MK survivors
* Providing professional referrals to: Clergy specialists & Other support groups

It has many articles which are interresting like:

Issues a Missionary Community’s Comprehensive Child Abuse Policy Should Address

A section of letters and poems etc...

"Dear Rich and All:

I want to address the question of parental silence. I'm sure you know by
virtue of Ann's involvement as well as my own that we have some very
personal knowledge of what is involved in breaking the parental silence! But
I want you to imagine for a moment that you have spent your entire life with
a theology that is based on "go ye into all the world...." and have devoted
your life to that. Now you learn what that cost your children but because of
your efforts (within that theological framework) there are now thousands of
Christians. How do you deal with that conflict? I'm thinking of our own
senior missionaries, where her father was such a force in the
above-mentioned missionary enterprise. How does she deal with that? That is
to say nothing of how they spent their entire lives out there trying to
establish a solid Christian church in the tribe they were assigned to. And
how about the missionaries to a tribe who spent their years among them who
now claim some 6-8,000 Christians? How do you deal with what you have done
viz. sacrificing your children for Church? It can't happen, in my judgment.
Were I in their place, I would be in severe mental and psychological
turmoil; terrible inner conflict. And, indeed, I suspect they are. They
would be in a position of saying they were wrong and that all their work was
basically in vain because they performed the unacceptable practice of
sending their kids into that hellhole, Mamou. I know that the above is a bit
simplistic but I think you get what I am trying to say. The silence is
understandable, whatever the judgment of it may be!!

As for me, the children are a-priori number one. And while I sympathize with
all the others, there is basically NO excuse and we are guilty of abandoning
our kids and committing them to the hands of seriously mentally and
emotionally defective teachers and "parents" at Mamou. And, what is equally
disturbing is that this is undoubtedly going on as I write!! What a

Howard Beardslee
Parent of Mamou alumni

Dear Ann,

A couple of thoughts. In "enmeshed" systems and in incestuous systems,
individuals lose their sense of identity and get swallowed up in 'group
think' and group identity. When "group" and group identity obliterates the
individual, the individual's power base is eroded and it is very difficult
for individuals to speak out against the system. There seems to be a major
contradiction built into a missionary subculture whose whole reason for
existence is to go around the world and "shout from the rooftops" that
non-Christians are sinners and need to confess and repent. Yet when "sin
is found within the camp", the response so often is dead silence. As one MK
victim stated it so well, "my parent's mission board was dedicated to two
things: the Great Commission and the Great Cover-up!"

Ann, your perspective as a parent is extremely helpful and eye-opening.
What you are pointing out here is that silence on the part of the parents
allows mission board leaders to "get off the hook", allowing the leaders to
remain silent. Mission board leaders' silence in turn reinforces the
silence of parents and other missionaries, MKs, etc. Somehow, somewhere,
this vicious circle of silence needs to be broken. Silence is the great
enemy. In the meantime, we continue to hear reports from around the world
that MK's are trying to report MK abuse but get stuck in dysfunctional,
broken systems in which their parents have difficulty finding their own

The highly authoritarian subculture of missionary work adds to the whole
problem. From my experience, it seems to me as though many, if not most,
missionary parents need to actually be given permission to break the
silence before they will ever speak up. This is tragic. Why is it that the
very same courageous missionaries who can look a so-called "pagan" in the
eye and pronounce them sinners wilt when faced with confronting a fellow or
sister missionary's sin?

The contradictions between how missionaries relate to "outsiders" and how
they relate to "insiders" abound.

This is why we on the Mamou Steering Committee pled with the C&MA leadership
(both the President and Vice-President of the Division of Overseas
Ministries) to write letters giving both the parents and MK's
themselves permission to start talking about the abuse that occurred at
Mamou Alliance Academy in Guinea, W. Africa. I think it helped when they
followed through, but just think of what that says about the state of the
missions subculture!

The missions subculture itself really needs to take a good look at its
highly authoritarian structure, its enmeshment, its "group think" mentality
that punishes individuals who do speak up, its incestuous patterns of
behavior. Headquarters staffs and supporting local churches need to become
aware of the problems, need to own up to the problems, and start to see how
they in turn contribute to these very problems by not fostering open
communication and by not requiring feedback loops and accountability
throughout the whole system.

Thanks for your input as a parent, Ann.

Rich Darr
Survivor of Mamou Alliance Academy"

It's quite an easy site to browse around. (reply to this comment
From moon beam
Thursday, July 21, 2005, 08:38

Dear Ann:

What you wrote about the silence of parents tapped into many things for me.
First, the silence of parents (and the church) is a continuation of what we
experienced as children. Almost everyone who hears my story of Mamou always
asks "why didn't you tell your parents?". I hate the question because there
is an implicit message that it was our fault as children that we had to
endure the misery for so long. If only we had told our parents, everything
would have been alright. There are many answers to the question of why we
didn't tell our parents (I thought the ICI addressed it well in their
report), but one of the most salient is that the response of parents and
the church would have been no different when we were children than what it
has been today. Children at Mamou who did tell their parents were either
silenced or blatantly disbelieved. That is how many parents and certainly
the church have treated us today as we have told our stories.

I agree with Howard that parents have a very difficult time addressing the
issue of their kid's abuse because it means examining the call of God on
their lives, etc. I think that therein lies a large part of the problem.
Missionaries place themselves apart from rules the rest of the population
function under by declaring their careers God-given. Rather than
understanding that their paid work is really a career/job they have chosen,
just as the rest of the world's population have careers/jobs, they place
themselves in a special category. This has many repercussions, e.g. how
many missionaries are fired because they simply are not performing well?
It is very hard to fire someone who is in their job because God told them to
do it.

Another repercussion of course is that missionaries are willing to
institutionalize very young children for the sake of their career. Can you
imagine this happening in your average Canadian/American family in a North
American setting? They would be severely censured by the church for
placing career above family. But within the missionary community, this is
not only tolerated but is sanctioned. It is justified because God called
them to do the career/work they are involved in.

I remember talking to an Alliance missionary couple in the mid-1980's. They
had sent 5 kids to Dalat school. They said that they would do it all over
again, regardless of what their kids had experienced there, because it was
the will of God, and God was responsible. An extreme example, but that is
the underlying principle Missionaries justify their decisions with. (I have
not met any of their children, but I understand most of them do not want
anything to do with Christianity.)

I think it is very ironic that our parents did not protect us as children,
but that now many parents want their children to protect them from having
to face the terrible mistakes they made. I remember a few years ago one
Mamou alumni saying he could not talk about Mamou until his father died
because it would have caused his father so much pain to have to look at how his
decisions impacted his family. And there is indeed excruciating pain for
parents to have to look at their life choices and how it impacted their
children (and how those choices impacted themselves as parents, as well).
But we as adult children should not have to sacrifice our own healing in
order to protect our parents.

The irony is that when parents are willing to look at what happened with
their adult children, and why it happened, everyone's pain is ultimately
eased and healing can happen. I am very grateful that my parents were
willing to take the risk of looking at what happened as a result of their
career choices. I suspect one of the most difficult plane rides they took
was to fly up to Toronto in the late 1980's to ask me why I was so angry at
them. It was the beginning of a difficult journey towards healing as a
family, and one that I will forever be grateful for. The process is very
painful, but it is possible to move through it to the other side. However,
parents are usually not willing to take the risks. Actually, it just
occurred to me that missionaries also were not willing to take the risk of
saying "I am choosing this career", so they placed the responsibility on God
by saying "God called me". Maybe many of these parents were never willing
to take responsibility for their own actions.


Bev Shellrude Thompson
Survivor of Mamou Alliance Academy
(reply to this comment
From EBW
Monday, October 31, 2005, 15:22


I would like to point out that the missionary group identified in the above article as C&MA, in which abuse of children was widespread and serious, is none other than The Christian and Missionary Alliance. David Berg's denomination before he founded the COG. (reply to this comment

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