Cleveland Women Face Trauma, Like Prisoners of War

PHOTO: Amanda Berry, right, hugs her sister Beth Serrano after being reunited in a Cleveland hospital, May 6, 2013.
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While little is known about the conditions in the home where three Cleveland women were allegedly enslaved for a decade, the trio likely suffered from the same kind of deprivation as prisoners of war, according to at least one psychological expert who trained in hostage situations with the FBI.

"Certainly diagnostically, we are looking at post-traumatic stress disorder in its severest form," said Herbert Nieberg, associate professor of law and justice at Mitchell College in New London, Conn. "Not only were they held in captivity, but nobody picked up on it and that makes people feel hopeless."

WATCH: Families of Allegedly Abducted Women: An Emotional Rollercoaster

Gina DeJesus, 23, Amanda Berry, 27, and Michele Knight, 32, vanished near their homes in Cleveland in separate incidents in 2002, 2003 and 2004, but were found Monday night only miles away from where they had disappeared in a home owned by 52-year-old former school bus driver Ariel Castro.

Berry broke through the door of the home with the help of neighbor Charles Ramsey, and called police, who rescued the two other women. They also found Berry's 6-year-old daughter, who was allegedly conceived in captivity.

LISTEN: Amanda Berry's 911 Call

WATCH: Cleveland Hero Charles Ramsey: 'Something Is Wrong Here' http://abcnews.go.com/US/video/cleveland-hero-charles-ramsey-says-something-is-wrong-here-19125172

Police said Castro and his two brothers, Pedro Castro, 54, and Onil Castro, 50, were arrested in connection with the crime.

Their alleged kidnapping dredges up haunting stories of other women who had been held captive, some under conditions of torture and sexual assault.

Jaycee Dugard spent 18 years as a prisoner of Phillip and Nancy Garrido who kidnapped her in 1991 at the age of 11 on her way to school in Tahoe, Calif. She was held in a backyard compound where she was subjected to rape, manipulation and verbal abuse.

Dugard, now 32, gave birth to two daughters fathered by her abductor. She lived in virtual solitary confinement until her first daughter was born three years into captivity and wasn't allowed to spend time outdoors until after her second daughter was born, more than six years after her abduction.

Elizabeth Smart was abducted from her Salt Lake City home in 2002 when she was only 14. She was found nine months later with a middle-aged couple, Brian David Mitchell and Wanda Ileen Barzee, who were later convicted of the crime.

WATCH: Elizabeth Smart Lauds Happy Endings

Smart, now 25, told GMA today that the women should not let the suspect Castro "ruin another second of their lives. He's stolen so much from them already.

"They don't need to relive everything that's happened because their rescue is proof that there are good people out there, more good people than not, who want the best for them, who want them to be happy, want good things to happen."

The Cleveland women are said to have told police they always knew they would be rescued.

"If I had to guess, they are grateful to have been liberated, but what I expect to see is difficulty trusting people," said Nieberg.

The women were allegedly kidnapped in their mid-teens, a time when they are more vulnerable, according to youth psychologist Chuck Williams, founding director of the Center for the Prevention of School-Aged Violence at Drexel University in Philadelphia.

"These young women were kidnapped as teens at a time when they were impressionable, their every move was controlled and dictated to them, and they were most likely told that they would be found and killed if they tried to leave," he said. "They are no longer thinking for themselves. In a sense, the captor has taken over their mind."

John Walsh, host of "America's Most Wanted" and whose son Adam was abducted and murdered in 1981, said the women should "get psychological help and therapy."

"Get ready. Get prepared," he told ABC News. Of Berry's daughter, he added, "Here is a little girl in this mix that looks like she may have been created by a sexual assault of the kidnapper."

But Alan Kazdin,, professor of child psychiatry at Yale University and director of the Yale Parenting Center, said media should be careful not to speculate about the effects of even the most severe form of trauma on the victims.

"Post-traumatic stress disorder as we know is a measure of psychiatric impairment in a continuum," he said. "We look for impairment of daily function. … Our job is to talk about right now … we don't have to work out the past, and it can even make it worse."

"I am not saying they are unscathed … but we can't make any assumptions unless we have a strong basis for that," he said. "They have been exposed to something really bad and it's horrible and could change anyone. But how did it change you?"

He said there were "really good" treatments for both anxiety and depression.

"Let's give them the help they need and not say they are scathed and ruined."

But in some of the longest and most horrific cases of forced captivity, child victims have not survived unscathed -- either physically or emotionally.

In the most notorious case in the United States in the 1950s and 1960s, a girl only known as "Genie" spent her life from infancy tethered to a potty seat or tied up in a sleeping bag in a mesh-sided crib under a metal cover in a dimly lit room in suburban California. She had contact only with her abusive father during nearly 12 years of confinement.

In 1957, believing she was mentally retarded, Clark Wiley locked his daughter Genie away, separating her from her nearly blind mother and 6-year-old brother, under the guise of protecting her. He spoon-fed her only Pablum and milk, and spoke to her mostly in barks and growls. He beat her with a wooden paddle every time she uttered a sound.

In 1970, Genie's 50-year-old mother, Irene, escaped with Genie, then 13, but she was never able to walk properly or even successfully master language, even as part of a scientific study at UCLA funded by the National Institute of Mental Health. The psychological effects were lifelong.

In another case that garnered world headlines in 2008, Austrian Josef Fritzl was convicted of keeping his daughter and three of the seven children he fathered with her in a basement dungeon for 24 years. The developmental growth of the children was stunted from the years of captivity: when released they spoke only in simple grunts and gestures.

READ: The Story of 'Wild Child' Genie

Austrian psychiatrists described Fritzl's daughter Elizabeth like "the walking dead," after her release and her father's imprisonment. At 42, her teeth were horrifically decayed and, like her children, she had vitamin D deficiency, anemia and deformed posture.

She had been raped by her father from the age of 11 and was often left tied to a pole in the family basement while her mother and other siblings enjoyed a normal life upstairs.

READ: Elizabeth Fritzl Like the 'Walking Dead'

"This case is so unique, we can only look for approximations," Dr. Stuart Goldman, a psychiatrist at Harvard University's Children's Hospital in Boston, told ABCNEWS.com at the time. "This would include long-term prisoners subject to extreme mental anguish and parents who have witnessed horrendous acts in some of the genocidal conflicts around the world."

Today, Goldman said that with so few details, it's hard to know the impact of trauma on the Cleveland women and Berry's daughter.

"Whether it's 12 years, 10 years of 24 years, clearly the trauma is extensive," he said. The degree depends on their background, resilience and personal resources not only going into this, but coming out. It's variable. But there is no way that something as horrendous as this is not going to cause some variation of traumatic disorder. Either being imprisoned or being tortured, either way, it will have a long-term impact."

If nothing else, said Goldman, "the pain and sorrow of losing all those years of their lives."

"Most prisoners are wary of people, but if they are able to conjure up an image of a better life, they do better," he said. "People who don't see light at the end of the tunnel, are at greater risk."

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