Mental Health Among Incarcerated Women: An Examination of Factors Impacting Depression and PTSD Symptomology

Female offenders experience mental health symptoms at a higher rate than male offenders and females in the community. The current study investigated individual characteristics and experiences that may impact symptoms of depressive disorders and posttraumatic stress disorder (PTSD) among a sample of female inmates in a large Southern prison system. Results showed high rates of reported childhood and adult victimization experiences among the sample. Factors such as seeking mental health treatment prior to incarceration significantly impacted the reporting of depressive and PTSD symptoms, as did victimization histories. Findings suggest that women would benefit from screening to identify mental health needs at the onset of incarceration as well as gender responsive needs assessment and programming to address histories of victimization and current mental health symptomatology.     

Victimization, posttraumatic stress disorder symptomatology, and later nonsuicidal self-harm in a birth cohort

This longitudinal population-based study examined pathways to nonsuicidal self-harm (NSSH) in relation to childhood sexual abuse (CSA), assault victimization in early adulthood, posttraumatic stress disorder symptomatology (PTSD), and other mental disorders. At age 21, 476 men and 455 women completed interviews on assault victimization, PTSD, and other mental disorders. At age 26, they completed independent interviews on self-harm and childhood sexual abuse (CSA). Multivariate logistic regression analyses were conducted to determine predictors for NSSH at age 26. For men, anxiety and depressive disorders at age 21 were the only significant predictors of NSSH at age 26. For women, victimization, PTSD, and other anxiety disorders at age 21 all significantly predicted NSSH. CSA predicted later NSSH only indirectly, by increasing the risk of anxiety disorders among men and of assault victimization among women. In conclusion, pathways to nonsuicidal self-harm differed by sex. For women there were direct links with assault victimization and PTSD in early adulthood, whereas for men only internalizing disorders predicted future NSSH.     

Current psychopathology in previously assaulted older adults

Older adult women age 55+ years (N = 549) were interviewed as part of a population-based epidemiological research study of lifetime experiences with physical and sexual assault and current mental health problems. Although overall rates of psychopathology were low, producing very small cells for comparison, women who reported experiencing physical assault an average of 28 years previously were more likely to present with past year substance abuse, depression, and avoidance and reexperiencing symptoms of posttraumatic stress disorder (PTSD) than those with no previous physical or sexual assault. Women who reported experiencing sexual assault an average of 50 years previously were more likely to present with autonomic arousal and avoidance symptoms of PTSD than those with no prior sexual assault. The aforementioned findings should be considered with caution, however, as sample cell sizes were minimal for all but the PTSD symptom subtypes. Mental health service implications for older adults are discussed.     

Developmental Impacts of Child Abuse and Neglect Related to Adult Mental Health, Substance Use, and Physical Health

This study examined the association between officially recorded child abuse and neglect and adult mental health, substance use, and physical health outcomes. Data are from a longitudinal study of more than 30 years in which individuals were interviewed most recently in their mid—30s. Analyses consisted of group comparisons using chi-square tests for categorical variables and independent samples t-tests for continuous measures. Logistic and linear regressions controlled for gender and childhood SES, adult age, marital status, and education. Adults maltreated in childhood reported more symptoms of adult depression, anxiety, and more impairment due to mental and physical health problems. A higher percentage of those with maltreatment histories reported lifetime alcohol problems and appear at greater risk for substance abuse. Most findings of these bivariate analyses remained significant after accounting for gender and childhood socioeconomic status. Somewhat fewer significant results were observed after controlling for adult age, marital status, and education.     

Self-injurious behaviors, PTSD arousal, and general health complaints within a treatment-seeking sample of sexually abused women

Eighty-nine adult female survivors of childhood sexual abuse, presenting for psychological treatment, were assessed for self-reported rates of self-injurious behaviors (SIB), health complaints, and posttraumatic stress disorder (PTSD) symptoms of physiological arousal. A composite measure of current SIB was significantly and positively associated with health complaints, PTSD arousal, and three measures of sexual abuse severity: age of onset for sexual abuse, injury experienced during the sexual abuse, and perceived life threat. Tests of mediation revealed that symptoms of PTSD arousal mediated the relationship between earlier age of onset for sexual abuse and SIB. PTSD arousal moderated the relationship between sexual-abuse-related injury and SIB. SIB was a unique predictor of health complaints, even after controlling for sexual abuse severity and PTSD arousal.     

Social Connection to Neighbors,Multiple Victimization,and Current Health Among Women Residing in High Crime Neighborhoods

This study assessed current health [physical health, bodily pain, global distress, posttraumatic stress-related disorder (PTSD) symptoms, and illicit substance use] among 160 minority women residing in high crime areas with varying numbers of different types of victimization histories and varying levels of social connections (SCs) to neighbors. Multivariate analyses of covariance indicated a main effect for number of different types of victimization and for SC to neighbors, after considering ethnicity, immigration, and marital status. Women with two or three+ different types of victimization reported higher global distress, PTSD symptoms, and illicit substance use than women with zero or one type of victimization. Likewise, women with low levels of SC to neighbors reported higher bodily pain than women with high levels of SCs to neighbors.     

Emotion Regulation Mediates the Relationship between a History of Child Abuse and Current PTSD/Depression Severity in Adolescent Females

Although experiencing child abuse (i.e., physical abuse, sexual abuse, exposure to violence) is associated with a variety of mental health difficulties, simple exposure to abuse does not produce symptoms in every individual. The current study explored emotion regulation as a mediator in the relationship between a history of child abuse and symptoms of posttraumatic stress and depression. Adolescent females (ages 11–17 years) were asked to retrospectively report on their exposure to child abuse, current symptoms of PTSD/depression, and emotion regulation abilities. Caregiver report of adolescent emotional difficulties was also obtained. Analyses revealed that child abuse-exposed females, when compared to females without a trauma history, had worse emotion regulation abilities and increased mental health difficulties. Moreover, emotion regulation significantly mediated the relationship between child abuse and all assessed mental health symptoms. These findings extend previous work from adult samples, underscoring the importance of assessing emotion regulation abilities in abuse-exposed youth.     

Victimization and perpetration among perinatal substance abusers

This study examined associations between demographic, psychiatric, substance abuse, and childhood abuse variables and past 30-day victimization and perpetration among 77 perinatal substance abusers. Victimization rates were 70% emotional, 34% physical, 29% sexual, and 42% personal freedom violations. For perpetration, incidence was 71% emotional, 25% physical, 5% sexual, and 9% personal freedom violations. Through univariate regression, Addiction Severity Index (ASI) psychiatric and drug composite scores, childhood physical abuse, borderline personality disorder (BPD) and post-traumatic stress disorder (PTSD) were found to significantly predict victimization. In contrast, ASI psychiatric and drug composite scores, BPD, PTSD, and aggressive-sadistic and antisocial personality disorders were found to significantly predict perpetration. In multiple regression models, ASI drug and psychiatric composite scores accounted for the majority of the variance for both victimization and perpetration, suggesting that women with high ASI scores should be queried about their involvement in abusive acts at time of admission to drug treatment.     

The Relationships Between Childhood Sexual Abuse,Social Anxiety,and Symptoms of Posttraumatic Stress Disorder in Women

The relationships between childhood sexual abuse, social anxiety, and symptoms of posttraumatic stress disorder were examined in a sample of 313 undergraduate women. Thirty-one percent of the women reported some form of sexual abuse in childhood. Women with a history of sexual abuse reported more symptoms of anxiety, distress in social situations, and posttraumatic stress disorder than other women. Women who experienced attempted or actual intercourse reported more avoidance than women with no history of abuse and women with exposure only, and more PTSD symptoms than all other groups of women. Women who experienced fondling reported more PTSD symptoms than women with no history of abuse. Pressure, age of onset of abuse, abuse by a family friend, and abuse by other perpetrators were all significant abuse characteristics in predicting adult social anxiety. Implications of these results for research and interventions are discussed.     

Factors Associated with Domestic Violence and Sexual Assault Victimization

This study explored factors associated with a lifetime history of domestic violence and sexual assault in a sample of welfare recipients in Illinois. Results indicate that childhood exposure to domestic violence is a risk factor for both sexual assault and domestic violence victimization, but that childhood physical abuse is only a risk factor for domestic violence. Increased education and employment skills and having more children were also risk factors for domestic violence victimization. Domestic violence was significantly associated with depression, while sexual assault was associated with low social support and a greater perceived need for mental health services. Frequent alcohol and drug use were not associated with either type of victimization. Research implications are discussed.     

Revictimization and self-harm in females who experienced childhood sexual abuse: results from a prospective study

Lifetime trauma histories were ascertained for females with confirmed histories of childhood sexual abuse and comparison females participating in a longitudinal, prospective study. Abused participants reported twice as many subsequent rapes or sexual assaults (p = .07), 1.6 times as many physical affronts including domestic violence (p = .01), almost four times as many incidences of self-inflicted harm (p = .002), and more than 20% more subsequent, significant lifetime traumas (p = .04) than did comparison participants. Sexual revictimization was positively correlated with posttraumatic stress disorder symptoms (PTSD), peritraumatic dissociation, and sexual preoccupation. Physical revictimization was positively correlated with PTSD symptoms, pathological dissociation, and sexually permissive attitudes. Self-harm was positively correlated with both peritraumatic and pathological dissociation. Competing theoretical explanations for revictimization and self-harm are discussed and evaluated.     

Revictimized Adult Women: Perceptions of Mental Health Functioning and Associated Services

In this study, using a sample of adult women (N = 418) from various environments, mental health outcomes and perceptions about different types of support following childhood and adulthood sexual and physical violence were assessed. The respondents were from three locations: general community, state prison, and sexual assault and domestic violence service providers. A cluster analysis based on victimization experiences was conducted; subsequent analyses showed that women who endured more types of abuse had more self-reported mental health difficulties. Somewhat paradoxically, women who utilized more therapeutic services held more negative perceptions of their mental health functioning, while use of tangible services had no significant association. Those who found therapeutic services helpful had significantly higher self-reported concurrent mental health functioning.     

The mental health needs of incarcerated youth in British Columbia, Canada

The purpose of the study was to identify the current prevalence of mental disorders and mental health needs among incarcerated male and female youths in Canada, and to present these data in the context of rates found in other jurisdictions. One hundred forty male and 65 female incarcerated young offenders in British Columbia were screened with the Massachusetts Youth Screening Instrument Version 2 (MAYSI-2); provisional psychiatric diagnoses were assessed with the Diagnostic Interview Schedule for Children Version IV (DISC-IV); abuse history and aggressive symptoms of Conduct Disorder (CD) were coded from file information. Nearly all youths (91.9% of males and 100% of females) met the criteria for at least one mental disorder. Substance abuse and dependence disorders were highly prevalent (85.5% of males and 100% of females). Aggressive forms of CD were common (72.9% of males and 84.3% of females), as were exposure to physical abuse (60.8% of males and 54.3% of females) and sexual abuse (21.2% of males and 42.4% of females). Female youths had significantly higher odds of presenting with: (1) substance abuse/dependence disorders; (2) current suicide ideation; (3) sexual abuse; (4) PTSD; (5) symptoms of depression and anxiety; (6) Oppositional Defiant Disorder; and (7) multiple mental disorder diagnoses. Male youths had significantly higher odds of presenting with aggressive symptoms of CD. Overall, rates of mental disorder among this sample of serious and violent young offenders were higher than rates previously reported for incarcerated youths — both in Canada and in other jurisdictions.     

Self-report rates of physical and sexual violence among Spanish inmates by mental illness and gender

High rates of mental illnesses and victimization have been reported for prison populations. This study estimates physical and sexual victimization rates (inmate-on-inmate and staff-on-inmate) for people with and without mental illnesses residing in Spanish prisons. A random sample of 2484 male and 225 female inmates was drawn from eight prisons in Spain. Self-report data were collected on victimization, mental illness and sociodemographic characteristics. Prevalence rates of physical and sexual victimization during the past six months in prison among men with mental illnesses were higher than for men without reported mental illnesses (39.1% vs. 16.4% and 8.6% vs. 3.3%, respectively). Similar comparative results were found for women with and without mental illnesses (29.7% vs. 17.5% and 13.3% vs. 10.3%, respectively). A positive association was found between mental illnesses and victimization. This evidence suggests the need for integrated trauma treatment and proactive steps to protect incarcerated persons from violence during incarceration.     

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.     

The developmental epidemiology of childhood victimization

This article examines developmental trends in the rates of different kinds of victimization across the span of childhood. The Developmental Victimization Survey was a national telephone survey of the victimization experiences of 2,030 children from ages 2 to 17. The overall mean number of victimizations during a single year increased with age, as did the percentage of children with polyvictimizations (4 or more different kinds of victimization). However, some specific types of victimization, physical bullying and sibling assaults, were highest prior to adolescence and then declined. Other types had different developmental patterns by gender. Peer assaults increased in adolescence for boys but not for girls. Child maltreatment and sexual victimization increased in adolescence for girls but not for boys. The complex and diverse patterns of developmental vulnerability to different kinds of victimization at different ages need more exploration and explanation in order to better target prevention and intervention policies.     

The relationship between childhood sexual abuse and adult mental health among undergraduates: victim gender doesn't matter

A large body of research has documented the harmful effects of childhood sexual abuse (CSA) on adult mental health among females, but less work has examined this issue among males. This study examined whether gender moderated the relationship between CSA and adult mental health among a mixed-gender sample of 406 undergraduates. A Pearson chi-square test indicated that a significantly greater proportion of females (41.6%) than males (30.7%) reported a history of CSA. ANCOVAs tested whether gender, CSA status, and their interaction were related to adult mental health symptomatology as measured by Brief Symptom Inventory gender-normed t scores. Participants with a history of CSA reported significantly higher levels of global mental health problems, hostility, paranoid ideation, and psychoticism. The gender by CSA status interaction was not significant for any scale, indicating that the harmful effects of CSA on adult mental health did not vary by gender.     

Gender Differences in Child Abuse and Intergenerational Transmission of Crime and Substance Abuse among Israeli Inmates

The aim of this study was to examine the gender differences in various types of childhood abuse and family history of crime, substance abuse, and mental health problems. Our study was conducted among 110 Israeli female and male inmates (50 female and 60 male inmates). The findings indicated a higher rate of multiple types of childhood abuse among the female inmates compared with the male inmates. The findings also revealed that female inmates reported more prevalence of parents’ substance abuse, crime, and family’s mental health problems than the male inmates did. Moreover, the female inmates reported higher rates of emotional, physical, and sexual abuse associated with family history variables compared with the male inmates. Furthermore, the findings indicated that female inmates whose siblings were involved in substance abuse and crime reported higher rates of sexual and emotional abuse compared with the male inmates. We discussed the implications of these findings.     

Onset of conduct disorder, use of delinquent subsistence strategies, and street victimization among homeless and runaway adolescents in the Midwest

This study examines the effects of childhood-onset conduct disorder on later antisocial behavior and street victimization among a group of homeless and runaway adolescents. Four hundred twenty-eight homeless and runaway youth were interviewed directly on the streets and in shelters from four Midwestern states. Key findings include the following. First, compared with those who exhibit adolescent-onset conduct disorder, youth with childhood onset are more likely to engage in a series of antisocial behaviors such as use of sexual and nonsexual survival strategies. Second, youth with childhood-onset conduct disorder are more likely to experience violent victimization; this association, however, is mostly through an intervening process such as engagement in deviant survival strategies.     

Social Factors Associated with History of Sexual Assault Among Ethnically Diverse Adolescents

We examine the association of adolescents’ self-reported sexual assault victimization with their living arrangements, parent’s education, and plans for college. Participants included 1,634 ethnically-diverse and economically-disadvantaged high school students in southeast Texas. Lifetime history of forced sexual assault was reported by 8.3% of girls and 9% of boys. No association with gender, age, or parent’s education was detected. However, adolescents in non-traditional households (living with one parent, grandparents, or other) were more likely to report rape than youth living with both parents. Adolescents who were one race/ethnicity were less likely to report being raped than those in the multiple race category. Sexual assault intervention programs should account for a teenager’s living situation; and prevention efforts may benefit from targeting individuals in non-traditional households. The lack of an association with either gender or socio-educational status indicates that all children are at risk and that school-based programs should be broadly targeted.