Walker Inman Jr. was taken in by Duke, his father's half-sister, when he was 13. His father, an alcoholic, died when he was 2; his mother died when he was 6.
But Duke, known for her sexual escapades, was a half-hearted guardian and stripped Inman of executor powers, giving them to her butler. She gave almost all of her fortune to charity, leaving her disgruntled nephew only $7 million.
But Walker Jr.'s children also inherited money through their grandmother, who was Doris Duke's mother, and his father, Duke's half-brother.
Judy Kuriansky, a psychologist at Columbia University's Teachers College, didn't treat the Inman twins, but suggests dysfunction begets dysfunction.
"This is a generational problem escalated over time," said Kuriansky. "Their father is really passing on his own abuse from a generation before and so these kids, in a sense, have very little chance."
"When you think about this family, it seems almost like the problems with Michael Jackson's kids," she said. "They were so sequestered and treated so strangely and brought up so separate from society. … This family is the Michael Jackson situation times a hundred."
The twins were recently suspended from a private school in Utah for about $25,000 in unpaid tuition and late fees, according to Forbes magazine. Their mother is involved in a legal battle with Citibank and JP Morgan over the handling of the children's trust funds.
Court filings, according to Forbes, show outlandish requests for cash: $6,000 for a Halloween party, $1,000 per month for her children to eat out, especially at Starbucks. The monthly allotment for the twins is $16,000, which Daisha Inman claims is far less than the $180,000 a month their father spent before he died.
The twins told Rolling Stone that when they were 12, their father's fifth wife, Daralee, crashed into a tree, drunk at 7:30 a.m. when she was driving them to school. They were shaken, but uninjured.
At the same time, isolated from society, the teens said in the interview that they had never heard of the game musical chairs and still believed in Santa Claus.
"Dear Santa, I know I haven't been good, but if you do come all I want is to say hi to you in person," Patterson recently wrote, according to Rolling Stone.
According to Forbes, when the children were returned to Daisha Inman in 2010, they began "intensive" counseling to "rekindle their relationship" with their mother.
Psychologist Howard, who has not treated the Inman twins, said that the magazine interview may have been a first step for the twins in an attempt to rebuild their lives in therapy.
"This kind of longstanding and chronic and severe trauma and abuse and neglect definitely disrupts a typical child's development," she said.
"Typical tasks are harder to achieve," said Howard. "One of the first is the infant or toddler's secure attachment to the caregiver, relying on someone to meet their needs. That's how we develop the capacity to trust each other."
She said it is plausible that 15-year-olds could still believe in Santa because of disruptions in cognitive development, as well as isolation.
"Magical thinking can persist in a kid who has experienced long-term abuse," said Howard. "They are living in their imagination as an escape."
The twins may have been lucky, at least, to have each other. "It may have been the social support," she said. "Going through this alone is harder than with someone else.… A child alone [blames himself and] thinks he is really bad. A child with someone else thinks, 'Dad didn't want us.' It's less personal."
It's never too late to address the traumatic effects of abuse and there are good treatments to increase the capacity to trust, ease anxieties and to regulate emotions, according to Howard.
"Telling their story is one of the parts of trauma treatment," said Howard.
She said the Rolling Stone interview is a strong reminder to people to "do the right thing and make a phone call if kids are living in horrible conditions."
"My hope is that they come out of this," said Howard. "It could be a step in therapy, and hope they are protected and have the privacy to develop the appropriate narrative for themselves."