Traumatic Event Exposure and Behavioral Health Disorders among Incarcerated Females Self-Referred to Treatment

At least half of the women inside prison have mental health problems, have experienced physical, sexual, or emotional abuse during their formative years and often in adulthood, and have addiction problems. Only a minority of these women receive treatment for their behavioral health problems associated with trauma while incarcerated, even though these problems are risk factors for returning to prison after release. This study focuses on the traumatic experiences and behavioral health problems of a group of female inmates who volunteered in August 2009, to be screened for admission into an integrated trauma-reentry program implemented at an adult female correctional facility. Of the 278 women who self-referred for screening, 196 preliminarily met the time eligibility criterion of residing at the prison for eight to 24 more months. Half of these women (n?=?97) were actually time-eligible for screening and agreed to be screened. Of this sample of treatment-seeking soon-to-be-released female prisoners, the vast majority (93%) reported significant and complex histories of traumatic event exposure and high rates of either posttraumatic stress disorder (PTSD) or sub-threshold PTSD, past alcohol and other substance abuse or dependence, other axis I psychiatric disorders, and subjective distress. Identifying trauma exposure histories and associated behavioral health problems within this population and providing effective interventions holds potential promise for preparing incarcerated women to manage their post-release lives in ways that will keep them safe, healthy, and in the community.     

An Analysis of Advertisements: A Lens for Viewing the Social Exclusion of Women in Police Imagery

This study examines whether there are differential relationships among trauma exposure, familial risk and protective factors, substance abuse, and posttraumatic stress disorder (PTSD) among incarcerated and non-incarcerated women. A case-control method was used to match 100 incarcerated women with 100 women in the general population. Incarcerated women had a significantly higher risk of trauma exposure as compared with controls, with odds ranging from 1.7 to 3.7. When group was controlled, exposure to sexual or physical trauma significantly increased the odds of PTSD (odds ratio = 5.0; p < .05), as did substance use in response to traumatic distress (odds ratio = 8.9; p < .001). Family-related characteristics did not appear to moderate this relationship. The findings suggest that incarcerated women are at high risk for PTSD given their high rates of trauma exposure and apparent lack of appropriate coping mechanisms; the results support the use of trauma-specific interventions for this population.     

Disorders of extreme stress (DESNOS) symptoms are associated with type and severity of interpersonal trauma exposure in a sample of healthy young women

Childhood abuse and other developmentally adverse interpersonal traumas may put young adults at risk not only for posttraumatic stress disorder (PTSD) but also for impairment in affective, cognitive, biological, and relational self-regulation ("disorders of extreme stress not otherwise specified"; DESNOS). Structured clinical interviews with 345 sophomore college women, most of whom (84%) had experienced at least one traumatic event, indicated that the DESNOS syndrome was rare (1% prevalence), but DESNOS symptoms were reported by a majority of respondents. Controlling for PTSD and other anxiety or affective disorders, DESNOS symptom severity was associated with a history of single-incident interpersonal trauma and with more severe interpersonal trauma in a dose-response manner. Noninterpersonal trauma was associated with elevated prevalence of PTSD and dissociation but not with DESNOS severity. Study findings indicate that persistent posttraumatic problems with self-regulation warrant attention, even in relatively healthy young adult populations.     

A Life Course Analysis of Homeless Shelter Use among the Formerly Incarcerated

Prior work finds that the formerly incarcerated are at an elevated risk of homelessness. However, studies disagree regarding how these individuals experience homelessness; quantitative research emphasizes homelessness as a temporary obstacle experienced shortly after release, yet ethnographic work suggests that formerly incarcerated individuals experience frequent and/or lengthy bouts and are at risk long after release. Drawing on the life course perspective and nearly eight years of administrative records post release, this study examines patterns and correlates of homeless shelter use in a cohort of individuals released from prison. The results suggest that both immediate and delayed shelter use exist. Although the risk is highest soon after release, approximately half of individuals who used shelters experienced their first spell more than two years after release. Moreover, shelter use spells were prolonged and repeated. Findings also highlight the influence of cumulative disadvantage in understanding who is most at risk for shelter use.     

Traumatic stress symptoms in women exposed to community and partner violence

Prior research documents increased trauma symptoms associated with exposure to violence, primarily by examining types of violence separately. This study extends prior research by examining traumatic stress symptoms associated with two types of violence exposure, community violence and partner violence. A sample of 90 low-income African American women from an urban area completed measures assessing exposure to community violence, partner violence, and trauma symptoms. Exposure to community violence and partner violence were associated with increased reporting of trauma symptoms. Participants who experienced high levels of exposure to both types of violence reported more trauma symptoms than women who were exposed to only one type of violence or neither type of violence. The results suggest that the accumulation of exposures to violence is linked with greater distress. Thus, interventions with women exposed to violence should assess violence exposure in multiple domains and attend to the implications of multiple exposures to violence.     

The Relationship between Homelessness and Behavior Problems among Youth in North Texas: a Brief Report

This study sought to examine the relationship between homelessness and behavior problems among a community-based sample of youth in North Texas. Data were obtained from a cross-sectional, probability sample of households and a targeted sample of homeless families in Dallas, Texas, with children older than 5 years old (N?=?5232). Parents were asked to report five behavior problems on behalf of their children including arrest or trouble with police, academic problems, behavior problems at school, suspension, and suicide attempts. Logistic and negative binomial regression procedures were used to examine the relationship between homelessness and behavior problems. Youth exposed to homelessness were 36% (OR?=?1.63; 95% CI 1.00–1.85) more likely to exhibit any kind of behavior problems than youth who had never experienced homelessness. Homeless youth had 5.51 times the odds of arrest (95% CI 2.60–11.68), 1.74 times the odds of academic problems (95% CI 1.24–2.43), and more than 3 times the odds of suicide attempts (95% CI 1.46, 7.61) than youth who had never been homeless. Homelessness was associated with higher rates of problem behavior, including arrests, academic problems, and suicide attempts. Because homeless youth are commonly enrolled in school and present at health care clinics and emergency departments, clinics and schools may aid in the identification of homeless youth, as well as referral to care. In this way, clinicians may help reduce the burden of behavioral problems that disproportionately affect homeless youth.     

Criminal Justice System Involvement Among Homeless Adults

This study characterized the specific offenses for which homeless individuals are arrested and incarcerated. Data were gathered from 581 homeless adults across 6 Oklahoma City shelters. Participants were asked to self-report incarceration history, nights spent in jails and prisons, and the offenses for which they were arrested. Overall, 76% of the sample had ever been arrested. Fifty-seven percent of the sample had been to jail more than 3 times in their lifetime and 13% had ever intentionally been arrested. The most prevalent type of arrest was drug possession (35%), followed by driving under the influence (31%) and disorderly conduct or public drunkenness (28%). Violent arrests, such as assault, robbery, domestic violence, murder, and rape, were the least prevalent type of arrest. In summary, offenses were largely drug and status offenses. These offenses may be prevented through increased substance use treatment accessibility and availability of housing. Policies to increase employment and housing for homeless adults regardless of criminal history should be expanded to reduce the occurrence of justice involvement.     

Multiple traumatic experiences and the development of posttraumatic stress disorder

This study assesses the differential and combined impacts of multiple lifetime stressors in the development and severity of posttraumatic stress disorder (PTSD) symptoms. One hundred and four clinical and 64 nonclinical participants were assessed for their exposure to four types of interpersonal trauma: physical and sexual abuse in childhood, lifetime community violence, and domestic violence in adulthood. PTSD symptomatology was assessed using the Los Angeles Symptom Checklist (LASC). Results indicated that exposure to lifetime multiple traumatic experiences was positively correlated with severity of PTSD symptoms. Clinical participants had experienced significantly more multiple traumas and had a higher rate of PTSD than the nonclinical participants. Results also suggested that adults who had experienced childhood sexual abuse were at higher risk for the development of PTSD related to interpersonal violence than adults who were not sexually abused as children.     

Probable posttraumatic stress disorder in a sample of urban jail detainees

This study examined the nature and extent of probable posttraumatic stress disorder (PTSD) among men in a substance abuse treatment program in a large urban jail. Specifically, it explored the prevalence of probable PTSD and other psychiatric problems among jail detainees, the types of trauma detainees experienced during different phases of their lives, and how those experiences might have contributed to the development of probable PTSD. Results showed that psychiatric problems were quite serious; nearly one-quarter of the sample reported previous psychiatric hospitalization, and nearly 10% were being currently treated with psychiatric medication. In addition, 21% of the sample met the criteria for probable PTSD, a rate five times greater than that in the general population. The current study suggests that the presence of probable PTSD among male detainees should be incorporated into the creation and implementation of jail-based behavioral healthcare services, including screening, assessment, and clinical interventions. Furthermore, in-custody drug treatment programs should adopt trauma-informed strategies for all program participants as the expected standard of care.     

Community violence and PTSD in selected South African townships

Given the high rates of crime in South Africa's townships, nonpolitical violence out-side the home and its psychological impact on women were investigated within two samples, the primary a help-seeking sample and the secondary a community sample. In the help-seeking sample, two thirds of the women reported having experienced several traumatic events outside the home. Those women displayed a median of 9 PTSD (post-traumatic stress disorder) symptoms, with nearly half meeting all criteria for PTSD. In the community sample, 40 women of color were interviewed at a community festival for women, and again two thirds reported having experienced several traumatic events outside the home during the previous year. These women displayed a median of 8.8 PTSD symptoms, with none meeting all criteria for PTSD. South Africa's distinctive culture of violence is discussed as context for understanding issues of community violence and PTSD among women in its minority townships.     

Electronic jail revisited

Our study examines the prevalence and consequences of criminal victimization in a quota sample of homeless adults. This already besieged population experienced considerably higher rates of victimization than the general population and those in poverty. A majority of homeless victims could not identify their offender and were the victims of a violent crime. Although we found clear differences between the homeless and the comparison populations in the victimization episode, our results also suggest significant differences between homeless victims and homeless nonvictims. Victims had higher incomes and a greater fear of the streets, were more depressed, had a history of mental hospitalization, and experienced more physical symptoms. Finally, victimization was not a significant predictor of homeless persons' depression and mastery in our sample, unlike the cases of other, more specific samples and the general population. We argue that homelessness may be such an overwhelming life circumstance that single life events and their effect on mental health are masked by this ultimate state of victimization.     

Offenders as victims: post-traumatic stress disorder and substance use disorder among male prisoners

Background: Comorbid substance use disorder(s) and post-traumatic stress disorder (SUD-PTSD) is common among prisoners and linked to an increased risk of criminal recidivism; however, little is known about the characteristics of prisoners with this comorbidity. Aim: This study provides a preliminary examination of the clinical and criminal profile of male inmates with symptoms of SUD-PTSD, and examines whether this profile differs according to whether a person has experienced a trauma while in prison. Methods: Thirty male inmates from two correctional centres in Sydney, Australia, were recruited and assessed using a structured interview. Results: The sample reported extensive criminal, substance use and trauma histories. A history of substance dependence was almost universal (90%) and 56.7% met diagnostic criteria for PTSD with the remainder experiencing sub-threshold symptoms. Forty-three per cent reported a traumatic event while in prison. Those who had experienced trauma in prison, compared to those who had not, were more likely to nominate heroin as their main drug of concern and to be receiving drug treatment in prison. There was also a trend toward inmates who had experienced a trauma in prison being more likely than inmates who had no prison trauma to have experienced a physical assault. Conclusion: Male prisoners with SUD-PTSD are a high-needs group yet treatment responses are poor. Further research examining treatment options for this comorbidity may improve prisoner well-being and reduce recidivism.     

Social support among releasing men prisoners with lifetime trauma experiences

High rates of lifetime trauma experiences exist among men incarcerated in US state and federal prisons. Because lifetime trauma experiences have been linked to problematic behavioral and psychiatric outcomes for incarcerated populations, trauma-informed interventions could improve post-release well-being of releasing men prisoners with trauma histories. Social support has consistently been found to have a positive impact on trauma-related outcomes in non-incarcerated populations. Therefore, it is reasonable to hypothesize that social support may be an important intervention component for releasing men prisoners with trauma experiences; yet, the relationship between trauma experiences, psychiatric and behavioral factors, and social support has received almost no attention in research with men prisoners. Using a probability sample of 165 soon-to-be-released men, the present study examined differences in certain demographic, criminal justice history, mental health, substance abuse, and social support (type, quality, amount, and source) variables between releasing men prisoners with and without lifetime trauma experiences. Results indicate that men with trauma histories had more negative social support experiences and fewer positive social support resources before prison than their counterparts. Men with trauma histories also had more lifetime experiences with mental health and substance use problems. On further investigation of the subsample of men with trauma histories, those who were older, had substance use disorders, and histories of mental health problems anticipated fewer post-release social support resources. Study findings underscore the nuances of social support for men prisoners with trauma experiences and point to implications for future directions in targeted trauma-informed intervention development for releasing men prisoners.     

Partner's stake in conformity and abused wives' psychological trauma

This study investigates the potential buffering effect of help-seeking in the association between intimate partner assault and women's psychological trauma, and how this, in turn, may depend on the partner's stake in conformity. The sample consists of 374 women reporting the experience of domestic violence from a current intimate partner, drawn from the larger survey Violence and Threats of Violence Against Women and Men in the United States, 1994-1996. Help-seeking did not appear to buffer the impact of assault severity, contrary to expectation. However, the partner's stake in conformity did condition the effect of his or her having been arrested. Victims had higher levels of posttraumatic stress disorder (PTSD) when police arrested partners of average or below-average stake in conformity. But victims of partners characterized by higher than average stake in conformity did not show elevated PTSD due to their partners having been arrested. On the other hand, PTSD was higher among women experiencing more emotional abuse from the partner.     

Self-Reports of Traumatic Events in a Random Sample of Incarcerated Women

Abstract

As the number of incarcerated women increases, in-depth knowledge about women's life experiences is needed to direct treatment, pre-release planning, and supervision. This study describes the nature, scope, and socioeconomic correlates of traumatic life events in a random sample of 403 women entering a state correctional facility. Ninety-nine percent of the sample reported having experienced at least one traumatic life event; 81% experienced five or more. Reports of several experiences differed by age, race, and marital status. The most compelling findings were related to the experience of homelessness. Women who had been without a place to live for at least seven days were between 2.19 and 5.62 times more likely to have experienced 14 of 21 traumatic events. Most of these events were defined by interpersonal violence. Implications for correctional policy are discussed, particularly the potential for incarceration to replicate or ameliorate symptoms of traumatic stress through the structure and routine of the prison environment.     

No home in their native land: Homeless canadians as marginal persons in the social order

This paper sets out to assess a problem which the author claims has not been given sufficient attention: homelessness. The author observes that the homeless are a disorganised and politically disenfranchised people. This paper analyses the composition of the homeless, and notes the increasing numbers of women, young men, teenagers, and children who are homeless. Effort is made to debunk many of the popular myths associated with homelessness. The real process by which people become homeless is explored and homelessness is shown to be the product of the capitalist system of distributing housing.     

Examining Dose–Response Relationships Between Childhood Victimization,Depression, Symptoms of Psychosis,and Substance Misuse for Incarcerated Women

The current study uses the dose–response model to examine the relationships between childhood victimization events and subsequent depression, symptoms of psychosis, and substance misuse in a sample of 230 randomly selected incarcerated women in the United States. Results on the frequency of victimization were mixed. In this sample, both frequency of physical abuse and frequency of sexual abuse significantly predicted current symptoms of psychosis, but only frequency of physical abuse significantly predicted substance misuse. Incarcerated women who experienced multivictimization were 5.7 times as likely to report depression, 4.2 times as likely to report current symptoms of psychosis, and 3.8 times as likely to meet criteria for a substance use disorder. Results indicate that adjusting prison-based interventions to address multivictimization may improve outcomes and reduce recidivism among this population.     

Psychological health in midlife among women who have ever lived with a violent partner or spouse

This study examines the psychological health correlates of domestic violence in a large random sample of mid-aged Australian women (N = 11,310, age 47 to 52 years). Logistic regressions were used to investigate the associations between domestic violence and depression, anxiety, and psychological wellbeing, after adjusting for demographic variables (marital status, income management, area). Results indicate increased odds of having experienced domestic violence for those who had: ever experienced a diagnosis of depression, anxiety, or an "other" psychiatric disorder; recent symptoms of depression and anxiety; used psychoactive medication for depression or anxiety in the 4 weeks prior to the survey; and who reported current depression. Current psychological well-being had an inverse association with a history of domestic violence: As psychological well-being decreased, the odds of having ever experienced domestic violence increased. The results indicate that a history of domestic violence is associated with decreased psychological well-being in mid-aged Australian women.     

Incidence and Correlates of Posttraumatic Stress Disorder in Australian Victims of Domestic Violence

In recent years, evidence has emerged of the significant incidence of posttraumatic stress disorder (PTSD) among victims of domestic violence. The present study examined incidence and correlates of PTSD in 100 female victims of domestic violence resident in women's shelters in Adelaide, South Australia. Forty-five women were found to meet all diagnostic criteria for PTSD. Women meeting PTSD diagnostic criteria reported having experienced higher levels of violence and were more likely to report having a spouse with an alcohol problem and having believed they would be killed by their spouse than women who did not meet criteria. Diagnosis of PTSD was also associated with higher levels of anxiety and depression.