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THE PRESCOTT REPORT
PART I
National Science and Public Health Policy Issues
In NIH VIOLENCE RESEARCH: HISTORICAL PERSPECTIVES AND FUTURE DIRECTIONS
James W. Prescott, Ph.D.
Health Scientist Administrator, Developmental Behavioral Biology Program
National Institute of Child Health and Human Development
National Institutes of Health (1966-1980)Submitted To:
PANEL: NIH RESEARCH ON ANTI-SOCIAL, AGGRESSIVE AND VIOLENCE-RELATED BEHAVIORS AND THEIR CONSEQUENCES OF THE CENTER FOR SCIENCE POLICY STUDIES
Sandy Chamblee, J.D.
Acting Director
Office of the Director
National Institutes of Health
21 June 1993
Submitted by:
BioBehavioral Systems
5175 Luigi Terrace #35
San Diego, CA 92122
619: 455-0692
SUMMARY PERSPECTIVES
This report begins with a brief introduction to certain historical events that bear directly on the mission objectives of the "Panel on NIH Research on Anti-Social, Aggressive and Violence-Related Behaviors and Their Consequences". The historical perspectives on this subject matter provided by former PHS Surgeon General C. Everett Koop, M.D. could not be more relevant today than when he addressed these issues in 1982; and selected portions of Dr. Koop's address are provided, herein, for the benefit of the Panel members and their advisors.
Another historical document on these issues has been provided by the National Institute of Child Health and Human Development (NICHD) publication: Perspectives on Human Deprivation, Biological, Psychological and Sociological that was published in 1968 and which represented the best thinking and recommendations of scholars in response to the NICHD's request for a "state -of- the art" statement on the scientific and health policy issues and priorities that the NICHD should adopt to guide the mission of the NICHD on this subject matter. Many of the scientific and policy issues identified in that document are also as relevant today, as they were in 1968. The Panel should give careful attention and review to these documents in the preparation of their recommendations for the NIH Violence Research Program.
A brief summary of some of the significant scientific issues and findings concerning the "Origins of Violence" –from the perspective of the BioBehavioral Sciences– is given with an enumeration of certain unfinished tasks that require attention and completion by the NIH.
Statements of concern address certain misinterpretations and misapplications of scientific findings by the "Federal Violence Initiative" that are used to support a questionable national science and health policy for violence research and prevention initiatives. A case example will illustrate these issues and the serious ethical problems and violations of human rights that are inherent in certain proposed violence prevention initiatives, particularly, as they involve children.
Finally, as Part II, an annotated history of scientific and health policy issues and events involving the NICHD's prior history of activity in violence research is given, as background and context for the recommendations that the Panel will be making with respect to the future role of the NIH in violence research. This section constitutes Part II of "The Prescott Report".
I. National Science and Public Health Policy Issues
A. Address: Violence and Public Health by C. Everett Koop, M.D., PHS Surgeon General and Deputy Assistant Secretary For Health. Delivered to the American Academy of Pediatrics, New York October 26, 1982.
In the above address Dr. Koop stated, in part:
...I appreciate this opportunity to speak to you this morning on a subject that is uncomfortable to raise: violence as a public health concern. It is uncomfortable because, when we do raise that issue, we are really admitting that mankind still has quite a distance to travel in its long march toward civilized living.I'm not limiting my remarks just to child abuse this morning, rather, this is a call to action on your part–individually and collectively–to address this issue of violence by discussion, study, and research.
We've got to do this because violence has grown to become one of the major public health problems in American society today. It is not new, of course.
...Let me propose as a starting-point the proposition that physicians need to become more familiar with the symptoms of violent personality in child and parent alike.
...A family environment that is cruel and uncaring will send cruel and uncaring children into the world as aggressive, violent adults.
...I recognize that not all physicians would agree with that assessment of their role. They would object to it as being yet another example of the "medicalization of social problems." And I fully appreciate the uneasiness felt by many physicians and other Health Professionals with society's habit of casually turning to medicine to solve what may simply not be a health or medical problem. But with violence, I think there is a difference.
This point was also made at a workshop held last summer by the Institute of Medicine. The subject was the prevention of violence. On this matter of the "Medicalization of Violence," the participants made several good points, which I will summarize:
there seems to be no other institutional focus for research into the causes of violence that takes into account the multiple biological, psychological, social, and societal dimensions of crime, its victims, and its prevention. The institutions closet to being able to provide a multidisciplinary approach to research in the prevention of family violence, for example, would be the National Institute of Mental Health and the National Institute of Child Health and Human Development.
SECOND, the National Institute of Law Enforcement and Criminal Justice, the research arm of the Justice Department, sees "prevention" as a way of stopping a recurrence of a criminal act. In effect, the justice department does not have what would be in our discipline of medicine a "primary prevention" strategy. And on reflection, one would have to admit that such a strategy under the criminal justice system could very well come in conflict with traditional civil liberties.
And THIRD, the workshop participants agreed that the morbidity and mortality from violence are extremely costly to society not only in productive years lost but in the hard dollar terms of the impact on the health care system. This is particularly true in the cases of abused children, who frequently have chronic disabilities even after treatment.
...We might not want this very complicated issue to gravitate toward medicine for answers, but I believe we need to accept the fact that we may have a contribution to make. I believe that we do and we are obligated to make that contribution.
...When that time arrives, then we may indeed be close to understanding and controlling violence, which is one of the most extensive and chronic epidemics in the Public Health of this country.
There is little to add to these excerpts from this excellent statement by Dr. Koop. They speak from the past and they speak to the future for those who care to listen and to act–"individually and collectively–to address this issue of violence by discussion, study, and research."; particularly, for the "National Institute of Mental Health and the National Institute of Child Health and Human Development."
From the PREFACE that was written by Gerald D. LaVeck, M.D., Director, NICHD, the following excerpts are relevant:
It was in response to its mandate and to the compelling nature of the problems of our times that the National Institute of Child Health and Human Development undertook a broad- based assessment of psychosocial deprivation, in order to ascertain the state-of-the-art, to identify gaps in knowledge and understanding, and to determine the implications of the findings for research policy and for social action programs. The Institute is uniquely equipped to examine the area of psychosocial deprivation due to: (1) its concern for child health–in the broadest sense–and human development across the life span, and (2) its multidisciplinary approach to multidimensional problems that bridge the biomedical- behavioral domain.From Chapter V: "Toward A Research Policy For Psychosocial Deprivation" that was written by Sigmund Dragastin, Ph.D., the following recommendations with respect to "Biological Substrates" and its "Research Needs" are particularly relevant to the "Panel on NIH Research on Anti-Social, Aggressive and Violence-Related Behaviors and Their Consequences". Specifically:...As the work began, it soon became apparent that there is neither a broadly shared conceptual perspective on the meaning and nature of psychosocial deprivation, nor a well- established and comprehensive base of empirical knowledge concerning its consequences. However, psychosocial deprivation appears to involve a complex set of physiological genetic, cognitive-learning, social-emotional, and social-structural causes and consequences.
...For help in the assessment of psychosocial deprivation, the NICHD turned to the scientific community. In March 1968, four interdisciplinary task forces were established to undertake documented review of four component areas of psychosocial deprivation. Fifty scientists contributed papers on various aspects of the phenomenon and these have been synthesized into four chapters.
...As evident from the titles–"Psychosocial Deprivation and Personality Development"; "Influences of Biological, Psychological, and Social Deprivation upon Learning and Performance"; "Biological Substrates of Development and Behavior"; and "Socialization and Social Structure"–each of the chapters deals with the sate of knowledge within a component area, but remains cognizant of the interactive and overlapping nature of all four, artificially determined, component areas. ...The fifth chapter "Towards a Research Policy for Psychosocial Deprivation," represents a summary of that conference.
...As a result of their reviews, the authors of the four chapters are unanimous in urging that high priority and massive support be given to expansion of research in psychosocial deprivation. They stress the necessity for achieving more thorough understanding of the intricate interrelationships of biomedical and social problems in order that national social action programs can be effective and relevant to the populations concerned. (emphases added).
Another aspect of the sensory deprivation problem relates to the issue of maternal social deprivation where animal isolation studies have shown the development of behavioral pathologies, for example, hyperexcitability, hyperactivity and increased violent- aggressive behavior as a consequence of these early isolation experiences. Preliminary data suggest that there are organic deficits in the brain and nervous system associated with early maternal-social deprivation and thus suggests a biological basis and predisposition to violent-aggressive behavior. The available data, however, are sparse and a highly focused research program is required to identify the nature and quality of the biological aspects of this problem area.
(p.294)The above NICHD publication provides both a scientific foundation and a health policy rationale for research on how psychosocial deprivation affects the biological systems of the brain that results in aggression; anti-social behaviors and violence; and I would add here, as I have done elsewhere–subsequent to this 1968 publication– the drug and alcohol abuse and addiction that necessarily flows from psychosocial deprivation. The specific transfer functions of these relationships– which are commonly expressed in depression and violence and their "self-medication" with alcohol and drugs– have been detailed elsewhere. I will address these issues more fully later in this statement.
From Chapter IV: "Biological Substrates Of Development and Behavior", under the section: "Early Social Deprivation", the following excerpts are particularly relevant to the mission of the NIH Panel, as it provides both an historical background and context for the continuation of interrupted research programs of the NICHD on the role of psychosocial deprivation to the development of aggressive, anti-social and violent behaviors. Specifically:
Social isolation, viewed as a qualitatively defined example of sensory deprivation, results in behavioral inadequacies and motor stereotypes that have been well described but not so well explained. Physiological correlates have been studied exclusively from the endocrinological point of entry, and need to be investigated in terms of neural correlates. Harlow et al. (1963), Mason and Sponholz (1963), Mason (1967), Mason et al. (1968), Menzel, Davenport, and Rogers (1963), all describe for higher nonhuman primates the stereotypes, the emotional peculiarities, and the maladaptive social behaviors of the early social isolates.This last statement is indeed a bridge–not only between the social and biological disciplines– but between the past and future where future violence research initiatives cannot but help build upon this conceptual foundation and the remarkable scientific progress and breakthroughs that resulted from the limited implementation of the NICHD mandate "that high priority and massive support be given to expansion of research in psychosocial deprivation".Recent work by Mason (1967), which compared infants reared with moving mother surrogates against those reared only on nonmoving surrogates, provides dramatic support for kinesthetic and somesthetic afference as a factor in preventing the development of movement stereotypes and impaired socialization, as assessed at 10 months of age.
Although Harlow (1964) has maintained a clear distinction between social and sensory deprivation, where he states: "The most extreme deprivation condition we have studied is total social isolation (not sensory isolation, only social isolation)" (p.154). Prescott (1967), in a review of the animal maternal-social deprivation literature, concluded that maternal-social deprivation constitutes a special case of sensory deprivation, specifically somatosensory deprivation which includes somesthetic and kinesthetic components. Further, Prescott (1967) proposed that the behavioral pathologies associated with maternal-social deprivation, which include hyperexcitability, increased violence and aggression, impaired socialization and heterosexual function, movement stereotypes and apathy with autistic forms of behavior can be attributed specifically to neurostructural, neurochemical, and neuroelectrical deficits in the somato-sensory system and allied central nervous system structures associated with the mediation and regulation of affective-motor processes. The cerebellum, limbic system, frontal cortex, and reticular activating system were specifically implicated as neurofunctional systems to account for the behavioral pathologies associated with early somato-sensory deprivation.
The maternal-social deprivation problem was not originally conceptualized as a psychobiological problem involving a specific form of sensory deprivation, and furthermore, biological studies of the quality and quantity associated with visual sensory deprivation have not been conducted with respect to the somato-sensory system.
Essman (1968), however, has obtained the first neurochemical data on the cerebellum and limbic system in isolation-reared and group-reared mice where neural deficits for isolation were confirmed.
..The above formulations and supporting data provide a bridge between the social and biological disciplines through the phenomena of sensory experience and its deprivation during ontogenetic development. The possibility of identifying specific neural structures in the specification of a biological predisposition to violent-aggressive behavior and impaired socialization, as a consequence of lack of early sensory-social experience, remains to be validated by further research and suggests another exciting frontier in the behavioral biological sciences which has long range and substantive implications for human development and society.
(pp. 255-256, emphasis added)
Proposed Research Agenda For NIH Violence Research Initiatives: The Developmental PsychoBiological or BioBehavioral Perspective
A. Developmental Brain-Behavioral Perspectives
As the preceding material has already communicated, there is an explicit theoretical frame-of-reference that has guided this developmental neuropsychologist's study of the developmental origins of violent behaviors. First, it is developmental; and secondly, it is a brain-based theory of behavior; and thirdly, it must be recognized that these two are intrinsically inseparable from one another.
There is no question that the brain is the organ of behavior: of our feelings-emotions; thoughts; reasoning, social-moral values and actions. Without the brain none of these behaviors can exist; and without understanding the brain structures and processes mediating these behaviors, a meaningful comprehension and understanding of these behaviors cannot be realized. And such comprehension and understanding cannot be realized without knowing and understanding how the developing brain is encoded and programmed through life experiences, i.e through the six sensory systems of the body.
The role of genetics in the encoding and programming of the developing brain from the sensory environment for the understanding of complex behaviors is of clearly secondary importance– if not of relative non-importance for the understanding and prediction of these complex behaviors. The additive model of variance commonly used in behavioral genetics is profoundly erroroneus and has misdirected research programs in behavioral genetics for decades. Simply stated, no genotype is expressed in a vacuum and is always expressed in some environment where that environment often plays a crucial role in modulating genetic expression. All allegedly "genotypical behaviors" must be referenced to the specific environmental conditions within which that genotype has been expressed, if any statements about "genotypical behaviors" are to have any scientific validity. In short, behavioral-genetic phenomena always and everywhere involve an interaction between genes and environment and that is why an additive model of variance lacks scientific validity; and why statements that ascribe behavioral functions to only genotype", i.e. without reference to the specific environment within which that genotype has been expressed are without validity.
The contemporary interest and approach in pursuing the "bad gene" theory of violent behavior is without scientific merit and has disastrous social implications and consequences which I will elaborate upon later. I will also suggest a positive-constructive research program in the behavioral genetics of violent behavior that will avoid the "bad gene" theory of violent behavior which imputes racial and ethnic factors and, thus, discrimination; provide for a substantive clarification of the limitations and dangers of research on the genetic bases of violent behaviors; and will also provide for a research paradigm that, hopefully, will end the nature-nurture controversy on the origins and processes of pathological violence in homo sapiens.
As previously mentioned, It is well documented that the rearing of infant mammals, particularly the primate infant, under conditions called social isolation or maternal-infant deprivation, results in the development of depression, socially withdrawn behaviors, self-mutilation; movement stereotypes; impaired social-sexual functioning and uncontrolled pathological violent behaviors. These primate isolation rearing studies were pioneered by the Harlows at the Wisconsin Regional Primate Center, University of Wisconsin and have provided the best experimental animal model for the study of pathological human primate violence. Dr. Harlow emphasized the over-riding significance of "tactile comfort", as a social construct, in explaining his experimental results.
The most significant subsequent contribution to understanding the specific environmental factors that produce the maternal-social deprivation syndrome in these isolation reared primates were from the studies by Dr. William Mason, an NICHD supported grantee, first when he was at Yerkes Primate Center, then at the Primate Center, University of Davis. Dr. Mason and his associates documented that rearing infant monkeys on a mobile surrogate mother vs. a stationary surrogate mother resulted in the prevention of most of the abnormal social emotional behaviors associated with isolation rearing including self-mutilation and other violent behaviors. Dr. Mason emphasized the importance of dynamic social interaction between mother and infant to explain his experimental results. At the time (1968), Dr. Mason did not recognize the significance of the vestibular sensory system, as a neurobiological system, in the mediation of his experimental results.
Recapitulating, it was the reconceptualization of the isolation rearing studies and the maternal-social deprivation syndrome by Dr. Prescott, as an issue in developmental neurobiology, i.e. Somatosensory Affectional Deprivation (SAD) that lead to the recognition of the profound importance of the Mason and Berkson study and its underlying neurobiology, i.e. the role of the vestibular-cerebellar system in the regulation of social-emotional behaviors which must translate into the regulation of limbic-frontal lobe activity. (These dramatic behavioral effects can be seen in the Time Life documentary film; "Rock A Bye Baby", 1970).
It was for these reasons that neurobiological studies of brain structure and function were initiated as part of the implementation of the NICHD mandate to study the consequences of psychosocial deprivation, specifically, to evaluate the effects of maternal-infant separation and isolation rearing upon the primate brain. The following brief summaries of some of those studies are provided below:
1. Brain implant studies on pathologically adult violent rhesus monkeys who were reared in social isolation documented electrophysiological abnormalities in the cerebellum and limbic system structures of these animals. Specifically, abnormal neuronal "spiking" was found in those brain structures of isolation reared monkeys by Dr. Robert G. Heath, Tulane University Medical School under an NICHD contract (1968) where Dr. Bernard Saltzberg (now deceased) was principal investigator. These findings and the extensive interneuronal connections between the cerebellum and limbic system –which this neuropsychologist predicted according to his SAD (Somatosensory Affectional Deprivation) theory of depression and violence–has been extensively reported in the scientific literature by Dr. Heath and in an NICHD sponsored conference whose proceedings were published. [R.G. Heath (1975). Maternal-Social Deprivation and Abnormal Brain Development: Disorders of Emotional and Social Behavior. In: Brain Function and Malnutrition: Neuropsychological Methods of Assessment, (Prescott, J.W., Read, M.S. and Coursin, D.B., Eds). John Wiley, New York].
As a part of the NICHD contract research program, signal analyses algorithms were developed by Professor Saltzberg that were able to detect the occurrence of these sub-cortical spike discharges from scalp EEG recordings that were clinically normal. It was proposed to determine whether this neurodiagnostic technology could successfully discriminate violent from non-violent prison inmates where the Federal Bureau of Prisons expressed a strong interest in exploring a collaborative research project with the NICHD to evaluate this possibility. These interagency interests and collaborations were blocked by Dr. Kretchmer, then Director, NICHD and represents one of the unfinished research tasks that needs to be completed by the NIH. The identification of known pathological violent offenders that are characterized by abnormal brain function– which is known to be related to explosive uncontrolled violent behaviors– would translate into maintaining such individuals in protective custody for treatment and would preclude the releasing of such individuals to the community where they would commit additional acts of violence, e.g. rape and homicide which occurs all too frequently. In short, this neurodiagnostic technology could be a life-saving technology.
2. Professor Austin Riesen, University of California, Riverside and his associates have documented abnormal dendrites and spines in somatosensory and motor cortex in isolation reared monkeys but not in visual cortex.
3. Professor William Greenough and his associates, University of Illinois found abnormal dendrites and spines in cerebellum and neocortex in isolation reared rodents and primates.
4. A.J. Berman, M.D. and Doreen Berman, Ph.D. with Dr. Prescott published the effects of cerebellar decortication in pathologically violent isolation reared monkeys. Paleocerebellar but not neocerebellar decortication eliminated the pathological violence and transformed the violent monkey into an extremely friendly and inquisitive, exploratory animal. Film documentation of these studies are available for presentation to the Panel, if desired. These studies were undertaken to test Dr. Prescott's theory that isolation rearing results in the development of abnormal brain cells, particularly, in the cerebellum and that removal of such presumed abnormal brain cells should result in reduction or modification of the abnormal social-emotional behaviors, specifically violent behaviors. These studies were very successful and were not conducted to provide a justification for brain surgery of violent offenders. Similar positive effects were obtained in significantly reducing the autistic-like behaviors; chronic movement stereotypes; and tactile avoidance in isolation reared infant monkeys. The implications of these brain surgery studies are too complex to elaborate upon in this report.
5. Studies on platelet serotonin levels in isolation reared monkeys was initiated by Dr. Prescott with Dr. Mary Coleman, Children's Hospital and Dr. Johnson, Animal Resources Branch, NIH. Dr. Coleman published these studies in 1971 that documented significantly reduced platelet serotonin levels in isolation reared monkeys compared to normally reared monkeys.
The above primate studies (there are not many others) only touch the tip of the iceberg in documenting the brain and other abnormalities consequent to isolation rearing or maternal-social deprivation. Neuroendocrine abnormalities have been found in children with psychosocial dwarfism, an example of abuse and neglect, by Dr. John Money and others. The broad range of potential brain and other biological abnormalities consequent to child abuse and neglect have hardly been explored and represents one of the great unfinished research tasks of the NICHD and other federal agencies concerned with these issues, particularly where child abuse and neglect is predictive of later anti-social and violent behaviors.
It is emphasized that "abuse" was never a component in the primate isolation rearing studies. Only "neglect", i.e., somatosensory affectional deprivation that is inherent in maternal-social deprivation was involved in these studies. Proper nutrition and physical health care were always maintained in these isolation reared animals. The implications of these findings and insights for human child rearing practices cannot be overemphasized since it is the deprivation of physical affectional bonding that is the dominant characteristic of contemporary child rearing practices in our society and is the "hidden" and most damaging variable in the "abuse" component of the child abuse and neglect syndrome. Individuals and cultures that abuse or inflict physical pain upon infants and children are rarely characterized as being physically affectionate which is essential for "bonding" to occur (Prescott, 1975, 1977, 1979, 1990).
The Kaspar Hauser Syndrome by Dr. John Money. Without question, one of the most significant research programs involving child abuse and neglect that have been supported by the NICHD were those at The Johns Hopkins University School of Medicine. The NICHD supported research of Dr. John Money, Office of Psychohormonal Research and those of Drs. Powell and Blizzard, Dept of Pediatrics made possible the scientific breakthrough of identifying the "failure to thrive" syndrome as due to child abuse and neglect. Dr. Money renamed this disorder "Psychosocial Dwarfism" and has recently published a book on this syndrome: The Kaspar Hauser Syndrome of "Psychosocial Dwarfism" (1992, Prometheus Press, see additional details in VI: Epilogue and Appendix A).
The effects of somatosensory affectional deprivation (SAD)upon the human brain have yet to be evaluated. And it is quite possible that we are rearing generations of children to become brain dysfunctional and who will define the brain dysfunctional generations of today and of the future. The implications of this prospect for the future of our society and human civilization itself is staggering. We appear to be rearing generations of psychopaths, as more and more children are becoming violent and homicidal at an increasing earlier age; and suicidal (Salk, et. al, 1985).
C. Relationship of Perinatal Trauma To Later Violent Behaviors
The Salk, et al. (1985) study has particular relevance for the proposed NIH Violence Research Program. These investigators studied 51 adolescent suicides and two matched non-suicide control groups to assess the possible role of perinatal medical-neuropsychological factors to suicide. They found three perinatal risk factors in 81% of the suicide cases. These were: 1) respiratory distress for more than one hour at birth; 2) no antenatal care before 20 weeks of pregnancy; and 3) chronic disease of the mother during pregnancy.
These investigators could only speculate on the possible mechanisms mediating this relationship which Prescott (1986) suggested involved damaged neuronal mechanisms of affectional bonding which prevented affectional bonding to occur even in an environment where sources of physical affectional bonding might be present. This proposed mechanism is analogous to the inability of the diarrheic infant to absorb nutrients which are available from the environment. Unfortunately, information was not available on the degree of physical affectional "bonding" present in the suicide and control groups. This represents one of the many areas of needed research that should properly be supported by the NICHD.
It is perhaps helpful and informative to describe in more detail some of the recent experimental findings that link early perinatal trauma to adult violent behaviors. One of these more dramatic studies, as a follow-up of the Salk, et al (1985) study was reported by Jacobson, et. al (1987). The summary of this study is provided by the abstract which is reproduced below:
The study was undertaken to test whether obstetric procedures are of importance for eventual adult behavior of the newborn, as ecological data from the United States seem to indicate. Birth record data were gathered for 412 forensic victims comprising suicides, alcoholics and drug addicts born in Stockholm after 1940, and who died there in 1978-1984. The births of the victims were unevenly distributed among six hospitals. Comparison with 2,901 controls, and mutual comparison of categories, showed that suicides involving asphyxiation were closely associated with asphyxia at birth, suicides by violent mechanical means were associated with mechanical birth trauma and drug addiction was associated with opiate and/or barbiturate administration to mothers during labor. Irrespective of the mechanism transferring the birth trauma to adulthood–which might be analogous to imprinting–the results show that obstetric procedures should be carefully evaluated and possibly modified to prevent eventual self-destructive behavior.Specifically, the authors reported that perinatal asphyxia carried a risk factor for suicides from hanging, strangulation, drowning and gas poisoning that was five times greater than for controls; for perinatal mechanical trauma, e.g. breech presentations, forceps delivery and multiple nuchal loops, the risk factor for suicides from hanging and other mechanical injuries was twice as great as controls; for perinatal opiate/barbituate use the risk factor for drug addiction was approximately three times greater than the controls.
In a subsequent study, Jacobson, et al (1988) evaluated the role of obstetric pain medication in adult amphetamine addiction in the offspring. In this study of 200 amphetamine addicts and 195 non-addicted sibling controls he reported that there was a 5.6 times greater incidence of amphetamine addiction when nitrous oxide was given for 4.5 hours or longer vs. 0.25 hours or less. Based upon their statistical data, the authors also concluded:
To the extent that the cases in this study are representative for the addict population in Stockholm, the number of amphetamine addicts in Stockholm can be estimated to have been less than 60% of the present level if nitrous oxide had not been administered in the past (apparent from data for various exposure levels, Fig. 3.).In this writer's re-analysis of the data in Fig. 3, according to the percentage of amphetamine addicts and non-addicted siblings for the five conditions of duration of nitrous oxide analgesia, the risk factor for amphetamine addiction was 7.2 times greater when nitrous oxide was given for 4.5 hours or longer vs. 0.25 hours or less.
In this re-analysis, it should be noted that of the 141 amphetamine addicts there was a lower percentage (17.0%) in the category of nitrous oxide duration of less than 0.25 hours than of the 154 non-addicted siblings where 27.9% fell into this category. In short, for this short duration of nitrous oxide inhalation there were 64% fewer amphetamine addicts when compared to the controls. Thus, this short term duration of nitrous oxide inhalation appeared to confer some prophylactic benefit for the prevention of amphetamine addiction when compared to the non-addicted siblings.
For the most extreme group of nitrous oxide inhalation which was 4.5 hours or greater, there was an 18.4 percent of amphetamine addicts in this group compared to 7.1 percent for the non-addicted siblings. In short, there was a 159% greater incidence of amphetamine addicts in this group compared to the incidence of non-addicted siblings.
When these two groups are compared, viz the 64% reduction of amphetamine addicts in the short duration of nitrous oxide inhalation of less than 0.25 hours to the 159% increase of amphetamine addicts in the longest duration of nitrous oxide inhalation of 4.5 hours or greater (when compared to the controls), the increased risk for amphetamine addiction is 7.2 times greater for the longest nitrous oxide inhalation group when compared to the shortest duration of nitrous oxide inhalation of 0.25 hours or less.
The interesting unanswered question is why a mild exposure to nitrous oxide inhalation would confer a "protective" function of reduced risk (64%) to amphetamine addiction when compared to controls?.
In a third study by Jacobson, et al (1990) the risk for opiate addiction in adult offspring was evaluated as a consequence of the administration of opiates, barbiturates and nitrous oxide for greater than one hour in all subjects during labor within 10 hours before birth. There were 139 opiate addicts compared to 230 non-addicted siblings in this study.
It was found that in subjects who had subsequently become addicts there was a significantly increased percentage of mothers (25%) who had received opiates or barbiturates, or both, when compared to unmatched non-addicted siblings (16%); and these mothers also received nitrous oxide for longer periods and more frequently. In short, there was a 56% increase in opiate addiction, as a consequence of opiate, barbituate and nitrous oxide administration during labor. After controlling for a number of other variables it was found that the risk for adult opiate addiction increased to 4.7 times for the three drug administrations when compared to matched sibling controls.
David Levy (1945) in a study on the "Psychic Trauma of Operations In Children" reported on three cases of male circumcision at ages 12 months (2 cases) and at 6-1/2 years. Psychological trauma included the development of night terrors, temper tantrums and rage. In the 6-1/2 year old suicidal impulses developed. Levy reports:
"...a circumcision at the age of 6 years 7 months, was preceded by a struggle of the patient with his father and the anesthetist before they overpowered him. Immediately after the anesthesia wore off, he said over and over, "They cut my penis. I wish I were dead." The rest of the day the patient never left his mother's side. Thereafter his previous temper tantrums developed into destructive rages. During the treatment he played numerous killing games, in which his father was the principal victim. The operation represented a castration by his father."
(p.10)Questions must be raised as to the extent to which adult rage and suicidal behaviors are facilitated by the assaults of circumcision during the newborn period which inflicts excruciating pain upon the newborn. (There are approximately a third more suicides than homicides in the U.S.). Does this excruciating pain experienced during the newborn period damage the neuronal mechanisms that mediate pleasure where it is known that activating pleasure/reward systems of the brain inhibits rage and violent behaviors? (Heath, 1964). And to what extent does the "saturation" of those brain systems designed to experience pleasure with pain establish the beginning neurobiological foundations for sado-masochistic behaviors?
Also, is there a link between circumcision when combined with other factors known to be linked to violent behaviors and the willingness to kill oneself or others for one's religious or ethnic/national beliefs? The willingness of many fundamentalist monotheistic men to die or kill for their religious beliefs is well known, as is their enormity for mutilative behaviors, even against women and children. These potential relationships are more than worthy of study.
D. Consequences of Failure to Provide Effective Pain Relief During Neonatal Surgical Procedures Upon Physiology, Behavior and Health Status.
There is now incontrovertible evidence that the failure to provide effective pain relief during surgical procedures in neonates results in such stress to the neonate that the psychophysiological integrity of the neonate is so severely compromised that it results in enhanced morbidity and mortality in such neonates. It is now informed medical opinion that "the response of newborns to the stress of cardiac (Anand, Hansen and Hickey, 1990) and noncardiac (Anand, Sippell & Aynsley-Green, 1987; Anand, Sippell, Schonfield & Aynsley-Green, 1988) operations is substantially greater than that of adults" (Anand and Hickey, 1992). Specifically, Anand and Hickey (1987) have previously proposed a physiologic basis "for the use of deep levels of anesthesia and postoperative analgesia to attenuate the extreme responses of newborns to perioperative pain and stress" (Anand & Hickey, 1992).The findings of Anand & Hickey (1992) upon variations in the effectiveness of anesthesia and postoperative analgesia in neonatal cardiac surgery are so dramatic and relevant to the study proposed herein that direct quotations from their Results and Conclusions are particularly warranted:
Results. The neonates who received deep anesthesia (with sufentanil) had significantly reduced responses of beta-endorphin, norepinephrine, epinephrine, glucagon, aldosterone, cortisol, and other steroid hormones; their insulin responses and ratios of insulin to glucagon were greater during the operation. The neonates who received lighter anesthesia (with halothane plus morphine) had more severe hyperglycemia and lactic acidemia during more severe hyperglycemia and lactic acidemia during surgery and higher lactate and acetoacetate concentrations postoperatively (P<0.025). The group that received deep anesthesia had a decreased incidence of sepsis (P=0.03), metabolic acidosis (P<0.01), and disseminated intravascular coagulation (P=0 .03) and fewer postoperative deaths (none of 30 given sufentanil vs. 4 of 15 given halothane plus morphine, P<0.01).Conclusions. In neonates undergoing cardiac surgery, the physiologic responses to stress are attenuated by deep anesthesia and postoperative analgesia with high doses of opioids. Deep anesthesia continued postoperatively may reduce the vulnerability of these neonates to complications and may reduce mortality. (N Engl J Med 1992; 326: 1-9).
In the above study, the authors were particular to note and describe the mechanisms of increased stress and its relationship to sepsis:
The increased incidence of sepsis in the halothane group may have been related to postoperative changes in immune function; such changes have been correlated with hormonal stress responses in adult patients. Beta-endorphins, glucocorticoids, catecholamines, and prolactin are important regulators of immune responses; such interactions may be integrated by the hypothalamus (p.7).The consequences of significantly increased release of stress hormones upon the developing brain and later behaviors have yet to be fully appreciated. The finding of extended periods of non-rapid-eye-movement sleep in neonates undergoing circumcision without anesthesia by Emde, et al (1971) is a case in point. The findings of Porter, Miller and Marshall (1966) demonstrated that spectrographic analyses of neonatal pain cries could distinguish between cries to circumcision and other stressors and that these neonatal cries could also be distinguished by listening adults.
It takes no leap of faith or evidence to recognize that such pain states will interfere with the maternal-infant bonding process which is known to have its own adverse consequences upon brain structure, function and behavior (supra; and Marshal, et. al, 1982). And isolation rearing is known to alter brain neurochemistry; dendrites/spines; and loss of opiate receptors (Essman, 1971, 1989; Bonnet,1976; Prescott, 1980), supra). The implications of perinatal and postnatal trauma that alters brain chemistry and structure that predisposes the organism to addictive behaviors requires major systematic evaluations.
Although, it is beyond the scope of this statement to systematically cite numerous animal studies on the effects of maternal stress upon fetal and neonatal brain development, function and behavior, the study of Peters (1990) is illustrative of these kind of studies. Peters (1990) reviewed earlier findings that maternal stress modifies 5-hydroxytryptamine (5-HT) receptor binding in several brain regions of the adult offspring and alters the intensity of behavioral responses to 5-HT receptor agonists. In a further study of the same maternal stressor (crowding combined with daily saline injections during the final week of pregnancy), an elevated maternal plasma free tryptophan level without significantly affecting total tryptophan was reported. The increased maternal plasma tryptophan was associated with significantly increased fetal brain levels of tryptophan, 5-HT and 5-hydroxyindoleacetic acid (5-HIAA, a metabolite of 5-HT). These increases were found to be maintained at 10 days postnatal life.
Since 5-HT is recognized to have a role in the control of neuron development during the perinatal period, it was suggested that the stress-induced increase in fetal brain 5-HT synthesis may play a part in the mechanisms by which prenatal stress influences adult behavior. 5-HT has also been implicated in uncontrolled adult violent homicidal and suicidal behaviors (Asperberg, Traskman and Thoren, 1976; Brown, et. al., 1979,1982; Linnoila, Virkkunen and Scheinn, 1983).
Similar arguments can be made for the flooding of the neonatal brain with adrenal corticosteroids and other stress hormones from the hypothalamic-pituitary-adrenal system consequent to circumcision stress which have unknown long-term consequences for "encoding" and influencing the developing brain with a possible permanent induction of a psychobiological substrate or pattern of psychophysiological stress ("brain engrams") that interacts with, influences and confounds all subsequent experiences of pain and pleasure.
This is to say that such profound neonatal pain involving the unique sensory-brain systems that are designed to mediate pleasure may be contributory to the establishment of "sado-masochistic" processes at a most fundamental neurobiolgical level that is beyond the normative range of conscious awareness. Additionally, the possible enhancement of "androgenization" of the developing brain due to excessive output of adrenal androgens consequent to perinatal and postnatal stress, e.g. circumcision, is a possible contributory mechanism to such later behaviors.
There are other considerations. What extent, if any, are the mechanisms that convert androgens to estrogens within the brain affected or impaired by perinatal and postnatal trauma? And what are the long term behavioral implications of such a possibility? (Baum, 1979; Phoenix, Goy and Resko, 1968; Diamond, Liacuna & Wong, 1973). What are the long-term consequences of a "hyperandrogenization" of the developing brain associated with perinatal and postnatal trauma for enhanced aggression and violence; quality of male-female relationships; and the capacity for intimacy in sexual relationships? These and related questions have been more fully addressed by Money (1986,1987,1970) and Money, Wolff and Annecill (1972) and cannot be elaborated upon herein.
Clearly, any program on "NIH Research on Anti-Social, Aggressive and Violence-Related Behaviors and Their Consequences" must give high priority to the above issues where some of these issues were emphasized in the NICHD report on Perspectives On Human Deprivation" . Systematic research is needed in clarifying the role of perinatal and postnatal trauma and stress with adult violent behaviors and the role of neurotransmitter substances such as 5-HT. This is an area of research leadership that the NICHD had rightly assumed under the Developmental Behavioral Biology Program but was abandoned when the NICHD discontinued its agency responsibility to support this kind of research in the late 1970s.
It is emphasized that the postnatal trauma of circumcision which inflicts excruciating pain on the newborn is an act of violence and child abuse which the NICHD should rightfully address, particularly its potential long term consequences for contributing to the development of sexually violent behaviors (Prescott, 1989) and other disorders of emotional, social and sexual development including addiction cited above (Levy, 1945; Marshall, 1980, 1982).
Can early identification of neuroendocrine and brain abnormalities in abused and neglected children serve as early indicators for immediate therapy that should necessarily involve Somatosensory Affectional Therapy (SAT). Major research programs are needed to evaluate the therapeutic effectiveness of SAT in contrast to drug therapies. There are strong scientific reasons to support the effectiveness of Somatosensory Affectional Therapy (SAT) since it is Somatosensory Affectional Deprivation (SAD) that produces depressed, alienated, anti-social, aggressive and violent behaviors.
The effectiveness of somatosensory stimulation as a therapeutic stimulus have been well documented by a number of investigators (Cairns, 1966; Field and Schanberg, 1986; Geber, 1958; Kennell, et. al, 1974; Kilbride, et al., 1970; Leiderman, et. al, 1973; Lynch,1970,1977; Neal,1967; Prescott, 1975, 1977,1979; Schaffer and Emerson, 1964ab; Sackett, 1970; Siegel,1973; Suomi, Harlow and McKinney, 1972; Suomi and Harlow,1972; Tassinari,1968; Warren, 1972; Woodcock, 1969 and many others).
Clearly, prevention and not therapy is the solution since there are not enough therapists with the right therapies to undo the magnitude of damage that is being inflicted upon the infants and children of this nation. However, research attention must be given to the evaluation of the effectiveness of the "somatosensory therapies", e.g., acupressure, acupuncture, the various Oriental, European and American schools of massage and "body work": Rolfing; Trager Psychophysiological Integration, etc.
The hypothesis that genes control or regulate violent or peaceful behaviors is necessarily an evolutionary argument. It has been proposed that the human primate, through the process of evolution, has acquired genes that accounts for its pathological violent behaviors and, conversely, its peaceful behaviors. It must be recognized that the evolutionary gene hypothesis must work both ways–for peace or violence and questions must be raised why there has been no serious scientific suggestion or effort to find the "peaceful" gene. If the "bad" gene theory of human violence is to be pursued, then equal attention must be given to the pursuit of finding the "good" gene of peaceful behaviors. Why does this scientific bias exist in the "objective" scientific pursuit of genetic-behavior relationships involving violent and peaceful behaviors?
Given the evolutionary nature of the human genotype, it would seem to make sense to examine the genotype and behavior of homo sapiens with its closest genetic relative, Pan paniscus (Pygmy or Bonobo Chimpanzee). Comparative analyses of genomes would directly address the proposed genetic linkage to violent and/or peaceful behaviors in the human primate for the following reasons.
In a study reported by Baldini, A. et al: "A chimpanzee-derived chromosome-specific alpha satellite DNS sequence conserved between chimpanzee and human" (Chromosoma, 1991, March 100(3): 156-61) the following is reported:
Partial sequence analysis showed that Pan-3 and a previously described human chromosome 17-specific clone have up to 91% sequence identity. To our knowledge this is the highest similarity reported between alphoid subsets from human and any other primate.These and related studies should encourage a genome mapping of Pan paniscus to compare it with the on-going genome mapping of homo sapiens. Genome differences between these two primate species would be identified where the genome characteristics specific only to the human primate would be evaluated with respect to their relationship, if any, to peaceful or violent behaviors and/or any other behaviors.
The additional unique advantage of Pan paniscus is that this primate species is perhaps the most peaceful and non-violent of the primates; and exhibits none of the pathological violent characteristics of homo sapiens. If a genome for pathological violent behavior in homo sapiens exists then it must be represented in that genome variance unique only to homo sapiens and not represented in Pan paniscus. What is that genome variance that is unique to homo sapiens and can it be demonstrated that that unique genome variance is specifically linked to the complex social behaviors that are characterized as pathological violent behaviors? Apart from the obvious somatic differences between Pan paniscus and homo sapiens what other differences, e.g. language, cognitive functions and capacity, etc could be represented by genome characteristics that are unique to homo sapiens?
Clearly, in any program of study that searches for the "violent geneome" and "peaceful genome" equal attention must be given to the complex social organization and behaviors involving male-female and adult-offspring behaviors that could provide information as to the behavioral characteristics that are predictive of their peaceful behaviors and, thus, probably predictive of peaceful behaviors in homo sapiens. An examination of the social organizations of relatively peaceful and relatively violent primate species (infrahuman and human) would clearly have merit and should be a high priority for any NIH Violence Research Initiative.
The proposed evolutionary behavioral genetic studies involving the Bonobo poses no ethical problems in attempting to establish an evolutionary-genetic link to violent or peaceful behaviors and would produce a wealth of basic scientific knowledge whose potential value can only be estimated as substantial.
A converse study of Pan paniscus would evaluate the alternate environmental hypothesis on the genesis of violent behaviors, i.e. maternal-social deprivation or isolation rearing. If Pan paniscus was reared in social isolation in the same manner that the rhesus monkey and other primates have been reared would Pan paniscus develop the same pathological depressive, autistic-like and violent behaviors that have been so well documented in rhesus and other primate species? If they do not, why not? Would such a result suggest that Pan paniscus has some "good" genes that protects them from the injurious results of isolation rearing that have been documented in virtually all mammals so reared? This outcome, however, is highly improbable.
These two research paradigms involving Pan paniscus should lead to the resolution of the nature-nurture controversy concerning the genesis of violent behaviors in homo sapiens.
III. Cross-Cultural Studies On Violent and Peaceful Cultures
As powerful as the laboratory animal isolation rearing studies are for elucidating the specific sensory systems and brain structures involved in child rearing and their ultimate consequence for violent or peaceful behaviors, it is necessary to confirm these insights and findings at the human level. It is for these reasons, that I embarked on a series of cross-cultural and other studies to confirm that the specific sensory systems of body touch and body movement are crucial for the development of affectional bonding between mother and infant; and that these variables are powerfully predictive of whether an individual or culture that are reared with or without "affectional bonding", will develop either peaceful or violent adult behaviors.
Thus, I searched the Human Relations Area Files, the repository of data on "primitive" or pre-industrial cultures, to evaluate this hypothesis. R.B. Textor, in his "Cross-Cultural Summary", provided a statistical data bank on 400 primitive cultures where all available information on these 400 primitive cultures were intercorrelated to determine the nature and strength of their interrelationships. My SAD theory predicted that those primitive cultures characterized by a high degree of maternal-infant body contact, specifically, carrying the infant on the body of the mother or caretaker throughout the day, would result in those cultures being very peaceful; conversely, those cultures that were characterized by minimal maternal-infant body contact would be very violent cultures.
I selected all those "primitive" cultures that had information on those specific child rearing practices; measures of their violence; and whether premarital sex was permitted or punished. The cultural anthropologists that evaluated these different behaviors were all different and were not knowledgeable of how these cultures were rated on the other variables. Barry, Bacon and Child evaluated the degree of maternal-infant body contact; Philip E. Slater evaluated the degree of violence which was the most extreme measure of violence in the HRAF, namely, "torture, mutilation and killing of enemy captured in warfare"; and Ford and Beach; and John T. Westbrook evaluated pre-marital sexual behaviors.
There were 49 primitive cultures in which information was available on all three of these variables and they constituted the sample for my study. The infant physical affectional variable– by itself– accurately predicted the violence and non-violence in 36 of the 49 cultures which is a 73% correct classification. Subsequent information from cultural anthropologists provided corrective information on three cultures that were erroneously classified and their re-classification resulted in 39 of the 49 or 80% of the primitive cultures being correctly classified with respect to their violence and non-violence. Thus, the predictive power of the infant physical affectional variable, alone, was established at 80%.
The remaining 10 cultures were correctly classified with information on their sexual behaviors. Specifically, four of the ten cultures were characterized by high infant physical affection and high adult physical violence when it should have been low. All four of these cultures punished premarital sexuality which accounted for their violence. Six of the ten cultures were characterized by low infant physical affection and low adult physical violence when it should have been high. All six of these cultures permitted premarital sexuality which accounted for their peaceful behaviors. In short, the deprivation of early infant physical affection can be compensated for later in life by permitted sexual pleasure in adolescence. Conversely, the advantages of early infant physical affection can be negated later in life through the denial of sexual pleasure during adolescence.
In short, my SAD theory that utilized two measures of physical affectional pleasure during the formative periods of brain development, 1) maternal-infant relationship; and 2) adolescent sexual development, could accurately predict with 100% accuracy the violence and non-violence of these 49 primitive cultures that are distributed throughout the world. There were 29 (59%) peaceful cultures and 20 (41%) violent cultures in this study.
There is no other theory or data base that I am aware of that can make this kind of behavioral prediction and which can specify the sensory processes and brain mechanisms that mediate these behaviors. It is emphasized that without the knowledge gained from the controlled animal primate laboratory studies of maternal-social deprivation (isolation rearing) this cross-cultural study and my subsequent cross-cultural studies would not have been possible.
IV. Selected Ethical Considerations In Violence Research
A. Errors of Extrapolation From "Monkey to Man" and From "Jungle" to "Jungle".
Perhaps the most egregious of comments and errors made in recent memory concerning the extrapolation of monkey behavior to human behavior was made by Dr. Frederick Goodwin, Director, National Institute of Mental Health in his address before the National Mental Health Advisory Council of February 11, 1992 where he stated, in part:
...Somebody gave me some data recently that puts this in a perspective and I say this with the realization that it might be easily misunderstood, and that is, if you look at other primates in nature–male primates in nature–you find that even with our violent society we are doing very well.If you look, for example, at the male monkeys, especially in the wild, roughly half of them survive to adulthood. The other half die by violence. That is the natural way of it for males, to knock each other off and, in fact, there are some interesting evolutionary implications of that because the same hyperaggressive monkeys who kill each other are also hypersexual, so they copulate more and therefore they reproduce more to offset the fact that half of them are dying.
Now, one could say that if some of the loss of social structure in this society, and particularly within the high impact inner city area, has removed some of the civilizing evolutionary things that we have built up and that maybe it isn't just the careless use of the word when people call certain areas of certain cities jungles, that we may have gone back to what might be more natural, without all of the social controls that we have imposed upon ourselves as a civilization over thousands of years in our own evolution.
Indeed, Dr. Goodwin's remarks were "misunderstood"–to the point of a firestorm being raised with his comparison of hypersexed and violent monkeys in the jungle with that of the hypersexed and violent humans living in the "jungles" of the inner cities who are, of course, predominantly black and other minorities.
There are so many extraordinary errors of fact; misunderstanding of infrahuman primate behavior; and misconception of evolutionary and statistical-social inferences to the human primate from one, unnamed species of monkey, that it is difficult to know where to begin to set the record straight.
First, if Dr. Goodwin wishes to make statements of evolutionary-genetic relevance between infrahuman primates and homo sapiens he should, at least, begin with the closest genetic relative to homo sapiens, i.e. Pan paniscus (Bonobo, Pygmy Chimpanzee) and not some genetically remote monkey species that was arbitrarily selected from some 180 monkey species that exist. If Dr. Goodwin had done this, he would have had a pleasant or perhaps an unpleasant surprise when he would have discovered that the Bonobo is probably the most peaceful and non-violent of the infrahuman primates and the most hypersexual where the females freely mate with most other males in the troop and there is no fighting among the males–they just wait their turn. And their mating is not confined to just the period of estrus, as it is in virtually all monkey species. The male violence of the Bonobo against the female is infrequent and is rarely with serious injury; and male violence against the offspring is virtually non-existent. If only the human primate behaved like the Bonobo–and why doesn't it?!
It is difficult to understand Dr. Goodwin's comment's that half of the male monkeys die by violence and "That is the natural way of it for males, to knock each other off". The opposite is generally true where males will fight over females and territory and will rarely fight to the death. Natural signals have been developed that acknowledge the victor and the fight is over, e.g. the defeated wolf that lies on its back and bares its neck to its victor does not result in the victor going in for the "kill".
Dr. Goodwin's allegations that the hypersexuality of copulation in the violent monkeys exists so that "they reproduce more to effect the fact that half of them are dying" is simply bizarre on its face. I am not aware of any evidence that male fighting influences the rather regular and fixed estrus cycle of the female such that it would be shortened to permit more pregnancies in a shorter period of time. If anything, stress has just the opposite effect upon estrus cycles which would inhibit estrus and, thus, copulation, pregnancy and birth of offspring in these animals. Further, what evidence does Dr. Goodwin have that the proposed increased births due to all this copulation by violent monkeys will be predominantly males and not females–to compensate for all those males killed in battle? And what is the copulatory rate of violent monkeys compared to non-violent monkeys and in which species? Isn't Dr. Goodwin aware that in harem organized troops the alpha male sequesters the females to himself and prevents other males from having sexual access to them? Given this fact, what males(s) are doing all this copulating among the violent monkeys? And what difference does it make to the female who can only be impregnated once no matter how many copulations there are; and, thus, only one birth. It would be more reasonable to state that the monkeys are violent because they are being deprived of copulation (pleasure) by the alpha male. Dr. Goodwin would undoubtedly benefit from knowing the social organization and behaviors of the rhesus monkey colony on Cayo Santiago Island and other primate groups.
What kind of science and scientific thinking is this that purports to provide a model to understand human violence and a guide for national science policy for research on human violence by one of the nation's leading government scientists? I would like to see– and so should the NIH Panel– the original study of these violent monkeys referenced by Dr. Goodwin. A critique of Dr. Goodwin on these matters by the NIH Panel is certainly in order and should be conducted to restore public confidence in science and its ability to properly analyze social problems and to generate reasonable solutions based upon those analyses.
My cross-cultural anthropological data on human "primitive" cultures supports the relationships found in the Bonobo, i.e. freedom of sexual expression, particularly of the female, is highly associated with peaceful, egalitarian and non-violent cultures. Sexual control and repression are associated with just the opposite behaviors: human inequality with high crime and violence (Prescott, 1979, 1990). And these relationships between sexual repression and violence are not new, as the clinical psychological, psychiatric and psychoanalytic experiences have long acknowledged.
Secondly, any extrapolation between infrahuman primates and homo sapiens, as involving only or primarily genetic-evolutionary factors, is simply fallacious and incomprehensible on its face. This becomes particularly egregious when the comparisons are made with a particular racial-ethnic group of homo sapiens. Such exercises represent not only bad science but unacceptable ethical behavior that inflicts psychological harm and social injustice upon those minority groups that are being compared with specific species of monkeys.
Although, Dr. Goodwin acknowledged the importance of social structure in understanding violence: "the loss of structure in society is probably why we are dealing with this issue and why we are seeing the doubling incidence of violence among the young over the last 20 years", he does not develop this all important fact with respect to his emphases on individual differences of genetics and biology to identify the "vulnerable", "at risk" individual who is likely to become violent and who is then targeted for "treatment" rather than treating the real culprit–the social structure.
The social structure of a community and family are indeed very important with respect to understanding peaceful and violent behaviors and this is why the social structure and organization of peaceful and violent human cultures require formal evaluation –in their own right–and for comparison to the social structure and organization of the closest genetic relative of homo sapiens, the Bonobo, (Pygmy Chimpanzee). Pan paniscus is, in my view, the primate of choice to compare with homo sapiens concerning social and sexual behaviors, particularly as they involve violent and peaceful behaviors.
The above commentaries of Dr. Goodwin, as a government psychiatrist and scientist, are particularly disturbing, but as a leading federal official that sets national science and health research policy, they are alarming and disastrous. These issues are so serious that they should be addressed by the "Panel on NIH Research on Anti-Social, Aggressive and Violence -Related Behaviors and Their Consequences".
B. The Dangers of The "Medicalization of Social Problems"
In the beginning of this report, I quoted Dr. Koop's general concern about the danger and inappropriateness of "medicalizing social problems", although, he strongly supported the role of physicians, as primary health care providers, to become involved in the prevention and treatment of violence. This involvement is particularly relevant and necessary for pediatricians who are confronted with the health issues surrounding child abuse and neglect.However, there is a different kind of "medicalization of social problems" that involves the identification of young children "at risk" for later violent or criminal behavior and then targeting these children for psychiatric interventions, i.e. drug therapies that are purported to be beneficial in controlling violent and aggressive behaviors. This has to be one of the most alarming and dangerous proposals being advanced by "The Federal Violence Initiative" that is being strongly promoted by Dr. Frederick Goodwin and other members of the psychiatric mental health establishment. In short, problem children with early manifestation of "aggression" will be identified who are presumed to have brain biochemical imbalances (based upon studies of adult violent offenders who have a long history of violence and who been shown to have significantly reduced levels of brain serotonin); and then targeted for drug therapies to presumably correct their presumed brain serotonin (or other biochemical) deficits that will presumably translate into preventing these children from becoming violent or criminal.
There are not only profound ethical and moral problems associated with this proposal but the scientific foundation is simply lacking to support such massive screening of children to identify children "at risk" for later violent and criminal behavior; and then target these children for psychopharmacological and other unspecified treatment interventions. The "scientific foundation" for the Federal Violence Initiative has been provided by the National Research Council (NRC), National Academy of Sciences' report: "Understanding and Preventing Violence (1992) which has recommended:
Recommendation 4: The panel calls for a new multicommunity program of developmental studies of aggressive, violent, and antisocial behaviors, intended to improve both causal understanding and preventive interventions at the biological, individual and social levels.(p. 341)
and
As described in more detail in Chapter 3, this multicommunity study would include initial assessments, follow-ups, and randomized experiments for two cohorts in each communityThe justification for establishing study cohorts at birth and at age eight to identify those "at risk" for later violent or criminal behavior is based upon the NRC statement:–a birth cohort and a cohort of 8-year olds (pp.341-342)
The Predictors and correlates of childhood aggression and adult violence are so well known and well replicated that they are not reviewed in detail here (p. 358).This is unfortunate since it is precisely this scientific data base that must be examined in detail–not to question that such significant correlations exist but rather to examine the magnitude of those correlations and the purposes to which that data are being marshalled to serve. An example will be given that will suffice to illustrate the points under question.
The NRC report rightly acknowledges the important studies of a number of studies that have documented the significant correlations between measures of aggression in childhood and measures of criminal conduct in adulthood. For example,
The classic and pioneering study of Huesmann, Eron, Lefkowitz and Walder (1984) found that of 335 eight year old males that were evaluated on aggression only 19 of the 82 children who were rated as "highly aggressive" were later convicted of a crime by age 30 years. Thus, only 23% of children rated as highly aggressive at age 8 years were convicted for a crime by 30 years of age. And this data does not distinguish between crimes of violence and non-violence. The incidence for adult violent behaviors is undoubtedly even lower.
In brief, based upon this data, 77% of children rated as highly aggressive at age eight would be wrongfully selected for drug treatments since these children were not convicted of a crime by age 30 years.
This error rate of classification is totally unacceptable to support giving "therapeutic" drugs to children. There are other equally significant problems with the proposed national health policy of psychopharmacological interventions that is being proposed by the NIMH-Federal Violence Initiative.
Specifically, the basic knowledge on brain biochemistry and violence is not sufficiently established to support such a psychopharmacological treatment program in children. One of the biochemical hypothesis is that serotonin deficits are linked to violent behaviors. This has been reported in both animal and adult human studies. There are no studies that I am aware of that have documented that such serotonin deficits exist in children rated as highly aggressive at age eight, as evaluated by Huesmann, et. al.(1984) or that such serotonin deficits exist in those convicted of a crime by age 30 years in their sample. Such facts would have to be established before any consideration can be given to any psychopharmacological treatments that are designed to change presumably abnormal brain or body chemistry in these individuals. Even if serotonin deficits were found in these children, what are the harmful effects of the chronic administration of such drugs on young children? And, there are better solutions for the "treatment" of aggressive children!
These questions and related issues have been addressed by Peter R. Breggin, M.D. in his extraordinary book: Toxic Psychiatry (1991) which should be required reading for the members and advisors to the "Panel on NIH Research on Anti-Social, Aggressive and Violence-Related Behaviors and Their Consequences", and as an antidote for those who advocate drugs as the solution to human problems, particularly the use of drugs on children. There are other solutions – PREVENTION–, as Dr. Breggin has so eloquently described in his book Beyond Conflict (1992) which also merits reading by the NIH Panel and its various advisors.
There are other reasons why the proposed psychopharmacological therapies proposed for aggressive eight year old children are unwarranted and unjustified. For example, it has yet to be demonstrated that drug therapies in adult violent offenders with known serotonin deficits have been effective in reducing serotonin deficits and violence in these adult offenders. More importantly, it has not been answered as to what specific factors in the environment are responsible for the reduction in brain serotonin in violent adults–let alone in children rated as aggressive at age 8 years. The claim that reduced brain serotonin is due to genetic factors is presumptive given that isolation rearing is known to reduce serotonin and alter other brain neurotransmitters in animals (Coleman, 1971; Essman, 1979, 1980; Valzelli and Morgese, 1980; Prescott, 1980 and many other references).
Additionally, the normative baseline data have yet to be established in children and other subjects on the putative neurotransmitters proposed to be mediating violent or criminal behaviors. These questions must be answered before any attempt is made to apply any such drug therapies to children. And even with these answers, drugging children is not the solution–it not only obscures the problem through suppression of symptoms without addressing etiology but also creates new problems which are detrimental to the normative and healthy development of the child.
The above issues are are illustrative of some of the problems that are associated with the NRC Report to justify psychopharmacological and other medical interventions in children to alter their presumed abnormal brain and body chemistry to restore "normal" behavioral functioning. And it is again emphasized that 77% of the highly aggressive children in the above study did not develop criminal behaviors by age 30, as measured in that study. It is imperative that every study of this kind that was reviewed by the NRC to justify psychopharmacological "treatment" of children be statistically re-evaluated to identify the error rate of classification of subjects in the statistical relationships reported. A statistically significant modest correlation is adequate to support scientific theory building and to point to directions for further study and even interventions that pose little or no risk to the subject but such limited statistical relationships, although "significant", cannot be used to support "interventions" that pose risks to children or other subjects.
A major unfinished research task for the Huesmann, et al (1984) study is to evaluate the life circumstances of the 77% highly aggressive children who were not convicted of a crime by age 30; and similarly for the 23% highly aggressive children who were convicted of a crime by age 30. An identification of these life experiences and factors would do more for the prevention of crime/violence than all the drugs in the psychopharmacopeia. As I discussed this study with Dr. Walder, one of the co-authors of the study, I predicted that assessments of the degree of maternal-infant bonding; paternal-child bonding; and the overall degree of meaningful social and physical affectional relationships during childhood and adolescence would account for most of the variance in measures of adult crime and violence. These studies have yet to be conducted.
The above issues are also directly related to the many studies that have documented the significant influence of violent TV upon the expression of aggression in children. The children most likely to be influenced by violent TV are those most deficient in physical affectional bonded relationships. My SAD theory predicts that children who have a high degree of physical affection will be relatively "immune" to the effects of violent TV, i.e. they will not be influenced to express aggressive-violent behaviors. Similarly for alcohol-induced violence. SAD deprived individuals become violent under alcohol; physical affectionately bonded individuals do not become violent under alcohol. These relationships require systematic evaluations.
Returning to the children whose aggressive-violent behaviors are facilitated by violent TV, the solution to this problem is to reduce or eliminate violent TV from their environment–not targeting these children for drug therapy to reduce their aggression. In this vein, no objections can be raised to the many sound recommendations of intervention in the NRC Report, e.g. increased prenatal care of the pregnant woman and postnatal care of her newborn and herself; nutrition and family support; elimination of physical assaults, as "discipline" in the home, etc.
The above examples are sufficient illustrations of the wrongful "Medicalization of Social Problems" that poses serious health risks to individuals, particularly children, who are targeted for such medical-psychiatric treatments; and the many serious ethical problems that are raised when infants and children are wrongfully labelled and targeted for such studies with later intervention "treatments".
In summary, our scientific knowledge and data base are not sufficient to support the medical-psychiatric interventions on children, as proposed and advocated by the Federal Violence Initiative and the NRC Report: Understanding and Preventing Violence that is endorsed by the NIMH psychiatric mental-health establishment.
In conclusion, I have the following recommendations for the "Panel on NIH Research on Anti-social, Aggressive and Violence-Related Behaviors and Their Consequences" for their consideration and action:
1. Affirm Dr. Koop's statement that:
there seems to be no other institutional focus for research into the causes of violence that takes into account the multiple biological, psychological, social, and societal dimensions of crime, its victims, and its prevention. The institutions closest to being able to provide a multidisciplinary approach to research in the prevention of family violence, for example, would be the National Institute of Mental Health and he National Institute of Child Health and Human Development.2. Address the history of NICHD's support of research on the effects of psychosocial deprivation which includes maternal-social deprivation, child abuse and neglect and the developmental origins of violence; and the relevance of that history to the current mandate of the NIH to: "assess the adequacy of NIH funded violence-related research to meet the public need and to assure that the research is conducted in a socially responsible manner;
3. Examine why the NICHD suddenly and inexplicably:
a) abandoned its agency responsibility to support research in those programmatic areas identified above under "psychosocial deprivation", particularly, child abuse and neglect, given its Congressional mandate to support "research and training relating to maternal health, child health, and human development, including research and training in the special health problems and requirement of mothers and children" (PL 87-838, Sec 441);
b) discontinued its research priority of "child abuse and the unwanted child" that were stipulated in the 1 July 1970 edition of the Division of Research Grants (DRG) Manual of Referral Guidelines (p. H-18);
c) refused to comply with the directive to the NICHD by DHEW Secretary Caspar Weinberger of June 22, 1973 for the NICHD to accelerate its support of research on child abuse and neglect; and
d) withdrew the funds allocated to publish the proceedings of the NICHD Conference on "Child Abuse and Neglect: Issues in Developmental Research" (by Dr. Kretchmer); where such publication would have been of material benefit to the NIH Panel in executing its current mandate on these issues;
4. Recognize the preeminent importance of the failure of maternal-infant bonding, as it is reflected in the terms of psychosocial deprivation, maternal-social deprivation; child abuse and neglect, as a major cause in the development of depression, alienation, anti- social and violent behaviors; and to give this subject matter the highest priority for future NIH initiatives on Violence Research;
5. Recommend that the NICHD be re-directed to resume its Congressional mandate and historical obligations to conduct "research and training in the special health problems and requirement of mothers and children" that includes the consequences of the failure of maternal-infant bonding that is inherent in psychosocial deprivation; maternal-social deprivation; and child abuse and neglect; and which leads to depression, anti-social and violent behaviors.
6. Resume studies on the effects of the failure of maternal-infant bonding inherent in psychosocial deprivation; maternal-social deprivation and child abuse and neglect upon brain structure and function and other biological systems of the body. Special attention is to be given to quantitative electrophysiological studies of brain function with special emphases on quantifying sub-cortical spiking activity in known pathological violent personality disorders who have a history of failure of maternal-infant bonding associated with psychosocial deprivation, maternal-social deprivation and child abuse and neglect.
7. Evaluate the proposals and recommendations in the NIMH "Federal Violence Initiative" and the NRC Report: Understanding and Preventing Violence with respect to:
a) their scientific and social soundness;
b) ability to advance the understanding and prevention of violent behaviors;
c) the relationship of the above initiatives and programs with respect to the NIH mission on Anti-Social, Aggressive and Violence-Related Behaviors and Their Consequences;
d) the ethical and moral issues and problems that are raised concerning the implementation of the NIMH/NRC proposals and recommendations; and
e) the risks of harm and injury inflicted upon children in their proposals and
8. Evaluate the effects of the perinatal and postnatal trauma of genital mutilation of children upon brain development, function and behavior, particularly as it may relate to the development of rage, sexual violence and sado-masochistic behaviors.
9. Evaluate the relationship between the failure of affectional bonding in the maternal-infant and parent-child relationship upon the development of alcohol/drug abuse and addiction. The theories and findings of Barry (1976, 1982,1989) and Prescott (1980, 1989) provide a firm theoretical and conceptual bases to pursue such studies and to evaluate why certain cultures accept and tolerate the use of certain drugs and not other drugs. The known effects of marijuana as an anti-aggression and anti-violence drug are particularly worthy of continued study (Marijuana and Health, 1971; Prescott, 1980, 1989 and others).
A. "Maternal-Social Deprivation" Redefined as Somatosensory Affectional Deprivation.
The first significant scientific breakthrough in NICHD supported research on child abuse and neglect was provided by the reconceptualization and redefinition of the "maternal-social deprivation" phenomena from a social theory of pathology to a sensory deprivation theory of neuropsychological and neurobiological pathology by Dr. James W. Prescott. This new reconceptualization identified Somatosensory Affectional Deprivation (SAD) that involved the somesthetic (skin) and vestibular-cerebellar (body movement) sensory systems as the principal sensory systems involved in the development of the emotional-social pathologies consequent to maternal-social deprivation (the "neglect" component of child abuse and neglect).
This reconceptualization led to a variety of brain studies in the isolation reared primate that documented abnormal structural (neuronal dendrites and spines) and functional (electrophysiological) abnormalities in various brain structures (cerebellum, limbic system and somatosensory and motor neocortex) of these maternal- socially deprived animals by various NICHD supported neuroscientists. How these brain abnormalities are directly related to the depression and uncontrolled violence of these isolation reared monkeys have yet to be determined. Included in this theoretical breakthrough was the recognition and discovery that the cerebellum has a central role in the mediation of the maternal-social deprivation syndrome and that the cerebellum is the master integrating and regulating system of the brain for sensory-emotional-social behaviors, as well as its known classic role in the regulation of motor behaviors.
The insights learned from the controlled experimental animal studies of maternal-social deprivation (maternal infant separation or isolation rearing of infants) that identified the somesthetic and vestibular sensory systems as primarily responsible for the maternal-social deprivation syndrome led to the testing of these insights on 49 primitive cultures distributed throughout the world where SAD theory predicted the violence and non-violence in these 49 primitive cultures with 100% accuracy by Dr. Prescott. The primary maternal-infant physical affectional variable was whether the infant was carried or not carried on the body of the mother or caretaker (vestibular-cerebellar stimulation) throughout the day. The secondary predictive variable was whether premarital sex was permitted or punished within these cultures. There is no other theory or data base that has made this kind of prediction of peaceful or violent behaviors.
C. The Kaspar Hauser Syndrome of "Psychosocial Dwarfism"
The publication of The Kaspar Hauser Syndrome of "Psychosocial Dwarfism by Dr. John Money is an historical milestone in the published scientific, medical and psychological literature that has, once again, chronicled man's greatest crime against humanity–the abuse, violence and neglect of children. What was once perceived as primarily a "medical" problem– a child's failure to thrive–is now known to be otherwise. Once again, the medical profession, health professionals , and the social engineers of society must confront the source of human disorders as not residing in our "genes" or other internalized defects of destiny of the individual but rather in human society itself.
Children fail to thrive–physically, psychologically and spiritually–because parents and society have failed to understand the real meaning of affection, nurturance, love. Treatment of the injured child and the disordered adult, as if the problem was only theirs, will not solve or prevent the crimes of future generations of child abuse and neglect, as Dr. Money has so eloquently emphasized. Dr. Money could not have made a better case for the scientific documentation that restoration of affection, nurturance and love is the therapy of choice for both treatment and prevention of child abuse and neglect. Clearly, the proposed "medicalization" of the injured child, as a consequence of this social disorder, through drug therapies can no longer be countenanced. This all important lesson cannot permitted to be lost upon the architects and social engineers of health care reform.
There was good reason to open this report with the counsel of George Santayana: "Those who cannot remember the past are condemned to repeat it." And Dr. Money has given even more meaning and substance to this sage council when he queried about an imagined reincarnation of Kaspar Hauser and the question was asked: "...what has been discovered regarding the profound developmental sequelae of childhood abuse and neglect in the Kaspar Hauser syndrome." Dr. Money replies:
Perhaps they would be amazed that it took so long, over a century and a half, to discover what is still incomplete. Perhaps also they would be even more amazed at how little effort has been expended on discovering the cause and prevention of parental abuse and neglect of children. They would have recognized, in this respect, that nothing much has changed since 1828.
(p.262)
It is within this context that the abandonment of abused and neglected children by the National Institute of Child Health and Human Development, National Institutes of Health over these past thirteen years must be evaluated and judged. Indeed, it is more than being "amazed" "at how little effort has been expended on discovering the cause and prevention of parental abuse and neglect of children." It is a matter of criminal negligence and indifference by the institutional authorities of our society that must be addressed and corrected.
Not those who die, but those
who die before they must
and want to die, those who
die in agony and pain
are the great indictments
against civilization.Eros and Civilization (1962)
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Warren, H. (1972). African infant precocity. Psychological Bulletin. 78:353-367.
Yarrow, L. (1961). Maternal deprivation: Toward an empirical and conceptual re-evaluation. Psychological Bulletin. 13:673-685.
Zigler, E. (1979). Controlling Child Abuse in America: An Effort Doomed to Failure.
In: Child Abuse and Violence (Gil, D., Ed). AMS Press: New York.
1. HD 00325 Dr. John Money The Johns Hopkins University School of Medicine
2. HD 07111 Dr. John Money The Johns Hopkins University School of Medicine
3. HD 01852 Drs. Powell & Blizzard The Johns Hopkins University School of Medicine
4. HD 01104 Dr. Krieger Children's Hospital of Michigan
5. HD 04335 Dr. Mitchell University of California, Davis
6. PH 43-68-1412 Dr. Saltzberg Tulane University Medical School (Contract)
7. HD ??? Dr. William Mason Yerkes and Davis Primate Research Centers
There were many more NICHD grants than those listed above which are the only ones that remain identified in the limited notes that I have on this history. It is emphasized that it was the NICHD grant supported research of Dr. Money and Drs. Powell & Blizzard at Johns Hopkins University Medical School that led to the scientific breakthrough that identified the "failure to thrive syndrome" as due to child abuse and neglect, i.e. "Abuse Dwarfism" which Dr. Money first introduced at the NICHD sponsored Conference: "NICHD Conference On Child Abuse and Neglect: Issues In Developmental Research" June 17-18, 1974.
Dr. Money, in his book: The Kaspar Hauser Syndrome of "Psychosocial Dwarfism" states in his "Acknowledgments" the following:
The United States Public Health Service's National Institute of Child Health and Human Development has, for all twenty-nine years of its existence, continuously supported the Psychohormonal Research Unit (PRU) at the Johns Hopkins University and Hospital, thus may claim kudos for this book as well as for the PRU research publications cited in it.
(Prometheus Press, Buffalo, New York, 1992)
In the light of the foregoing history how is it possible that the NICHD/NIH/DHHS officials are still claiming that:
That should have been corrected out of that report, because at no time in the Institute history since or prior to that report have we been engaged in a program of child abuse"(p.175, transcript). (Norman Kretchmer, M.D., Director, National Institute of Child Health and Human Development, 21 July 1980); and
"The NICHD has never supported a program of research on child abuse and neglect" (Betty H. Pickett, Ph.D., Acting Director, NICHD, in a letter to Senator Alan Cranston of 19 February 1980).
"The NICHD has never supported a program of research on child abuse and neglect" (DHHS Secretary Richard S. Schweiker in a letter to Senator McC. Mathias, Jr. of 11 May 1981); and
The National Institute of Child Health and Human Development (NICHD) has not supported a program of research on the causes of child abuse and neglect.
(Duane Alexander, M.D., Director, National Institute of Child Health and Human Development, 19 December 1991 in a letter to Dr. Prescott).
WHAT IS BEING SERVED BY THE WRONGFUL DENIAL OF NICHD'S HISTORY OF RESEARCH SUPPORT ON CHILD ABUSE AND NEGLECT AND DEVELOPMENTAL ORIGINS OF VIOLENCE–
AND THE ABANDONEMENT OF ABUSED AND NEGLECTED CHILDREN BY THE
NATIONAL INSTITUTE OF CHILD HEALTH AND HUMAN DEVELOPMENT, NIH?
This continuing indifference, apathy and neglect of DHEW/DHHS agencies toward child abuse and neglect has a long history. In the NICHD Memo of 14 May 1976 to Jehu C.Hunter, Acting Associate Director, OPPE, NICHD from Joseph M. Bobbitt, Ph.D., Assistant Director for Behavioral Science, OPPE, NICHD, Subject: "Intradepartmental Committee on Child Abuse and Neglect Meeting, May 8,1975, he noted the following:
Mr. Ferro (Acting Associate Chief, Children's Bureau) was also concerned because he saw no evidence of the interest of DHEW agencies in child abuse and neglect for FY 1976. He finally said that perhaps the Secretary would have to remind the agencies and set fiscal obligations as he did for FY74.
Several of us indicated that this approach would be unwise.
This acknowledged indifference and apathy toward child abuse and neglect by DHEW agencies was shared by the US Congress who remained unresponsive to my testimony before the Appropriations Subcommittee's in both the US House of Representatives (May 10, 1983) and US Senate (April 27, 1983) concerning the significant increase in child abuse-neglect and homicides of children; and the unlawful termination of the NICHD agency's responsibility to support research on child abuse and neglect and developmental origins of violence by Dr. Kretchmer, Director, NICHD.
Child abuse and neglect; homicides, suicides, rapes and other forms of human violence have continued to escalate over this past thirteen years with no end in sight to the increasing violence in our society. And the beginnings of this violence is with child abuse and neglect which the NICHD has unconscionably and unlawfully abandoned.
This history must be taken into account and corrected, if the NIH Research Initiatives on Violence are to have any significance in coping with the uncontrolled violence of this nation.
1. 16 SEPT 1970 NIH RECORD: Photo story of Dr. Prescott accepting a gift of 22 isolation reared infant monkeys from Hazelton Laboratories on behalf of NICHD and its research programs on the effects of psychosocial deprivation upon abnormal brain development-function and aberrant behaviors.
2. 4 JAN 1972 NIH RECORD: Photo story of Dr. Prescott accepting the "CINE Golden
Eagle Award" for his scientific and advisory contributions to the Time Life Documentary Film: "Rock-a-Bye Baby" that told the story of the Developmental Behavioral Biology Program of research on how maternal-infant separation or isolation rearing results in brain abnormalities, depression and violence in the deprived infant and adult.
3. 4 OCT 1973 NICHD Memo to Dr. Prescott from Dr. Bobbitt regarding proposed NICHD research on "battering in Monkey and Man" and acknowledgment of DHEW Secretary Caspar Weinberger's Directive of 22 June 1973 to the NICHD to increase its activities in child abuse and neglect.
4. 17-18 JUNE 74 OPENING REMARKS: Gilbert L. Woodside, Ph.D., Acting Director, NICHD to the "NICHD Conference On Child Abuse and Neglect: Issues In Develop- mental Research" that acknowledged Secretary Caspar Weinberger's (DHHS) instruction to the NICHD to increase its activities in child abuse and neglect with Conference Program.
5. 15 April 1975 NICHD Memo to John Burckhardt, Office of Assistant Secretary for Health from Dr. Bobbitt, Assistant Director for Behavioral Science, OPPE, NICHD that informed him that the NICHD would not publish the proceedings of its conference on child abuse and neglect.
6. 22 May 1975. NICHD Memo to Acting Chief, Children's Bureau, OCD from Acting Associate Director for Program Planning and Evaluation, NICHD, NIH that stated: "The Director, NICHD (Dr. Kretchmer), 'has decided not to commit the funds necessary to publish the proceedings of the above indicated research conference."
7. 14 May 1975 NICHD Memo to Dr. Bobbitt, OPPE, NICHD from Jehu C. Hunter, OPPE, NICHD that acknowledged lack of DHEW agencies interest in child abuse and neglect that would require corrective action from DHEW Secretary.
8. 16 May 1975 NICHD Memo to Acting Associate Chief, Children's' Bureau, OCD from Acting Associate Director, Office of Program Planning and Evaluation, NICHD, NIH that acknowledges NICHD's FY 75 & 76 budget commitment to child abuse and neglect research.
9. 1 JUNE 1977 NIH RECORD: Photo story of Dr. Prescott's receiving the "Maryland Psychological Association's Outstanding Contributions to Psychology Award" for his "original theoretical and research contributions to a developmental neurobiological model of socialization."
10. 10 DEC 1979 Letter to Dr. Kretchmer, Director, NICHD from Dr. John Money, The Johns Hopkins University School of Medicine that describes his NICHD supported research on "Psychosocial Dwarfism", a consequence of child abuse and neglect.
11. 1992 "Acknowledgment" from the book: The Kaspar Hauser Syndrome of "Psychosocial Dwarfism" by Dr. Money that honors the 29 year history of NICHD support of his research that lead to his discoveries that child abuse and neglect was the cause of "Psychosocial Dwarfism" and which also made possible the publication of this book. (Prometheus Press, Buffalo).
12. 11 APR 1980 NICHD termination notice of Dr. Prescott's 17 year career as a federal scientist administrator for the misuse of his government position and resources to support his personal and private activities of supporting research on child abuse and neglect and developmental origins of violence for the some 15 years when he was Health Scientist Administrator, Developmental Behavioral Biology Program, NICHD, NIH
13. 15 March 1980 The Federal Employee. "NIH Hatchet-Job on Distinguished Scientist"
14. 23 FEB 1981 Letter to DHHS Secretary Richard S. Schweiker from Senator Charles McC. Mathias, Jr.
15. 19 FEB 1990 NICHD Letter to Senator Alan Cranston from Dr. Betty H. Pickett that stated: "The NICHD has never supported a program of research on child abuse and neglect".
16. 11 July 1980 Letter to Senator Alan Cranston from Dr. Money, re. Pickett letter.
17. 31 July 1980 Memo to Mr. Doheny, Hearing Examiner, Merit System Protection Board from Dr. Money regarding his NICHD supported research on child abuse and neglect.
18. 11 MAY 1981 Letter to Senator Charles McC. Mathias, Jr. from DHHS Secretary Richard S. Schweiker that stated: "The NICHD has never supported a program of research on child abuse and neglect."
19. 19 DEC 1991 Letter to Dr. Prescott from Dr. Duane Alexander, Director, NICHD that states: "The National Institute of Child Health and Human Development (NICHD) has not supported a program of research on the causes of child abuse and neglect".
20. 25 FEB 1992 NIH Letter to Dr. Prescott from Dr. Healy, Director, NIH affirming Dr. Alexander's letter of 19 Dec 91 to Dr. Prescott.
21. DEC 1979 Alienation of Affection, Psychology Today by James W. Prescott
Reverse side: Table of 49 primitive culture study
22. MAR/APR 89 Sixteen Principles For Personal, Family and Global Peace by
James W. Prescott, The Truth Seeker.
Reverse side: Tables of cross-cultural studies on relationship of infant pain and affection to adult social behaviors and cultural organization
Text republished with kind permission of James W. Prescott. HTML by Erik Möller. Please tell me about any errors you find. Translations are welcome.