Life Stressors and Posttraumatic Stress Disorder in a Seriously Mentally Ill Jail Population,

Inmates represent a vulnerable population with increased rates of trauma and posttraumatic stress disorder (PTSD). However, little is known about the rates of trauma and PTSD among male inmates with acute psychiatric illness. This prospective, randomized study was conducted to assess the current rates of trauma and PTSD in this population. The sample consisted of 48 patients admitted to a hospital jail psychiatry service in New York City. Subjects were administered the Life Stressor Checklist‐Revised and the Structured Clinical Interview for DSM‐IV‐TR Disorders, PTSD Module (SCID‐I). The rate of PTSD diagnosis via SCID‐I was 46.2% as compared to 2.1% diagnosis via clinical interview. All participants reported a history of at least one stressful and/or traumatic event, and many of these events occurred during incarceration. These results demonstrate that a great deal of trauma and PTSD goes unrecognized and untreated in this population, indicating the need for more effective treatment interventions.     

The problem of co-occurring disorders among jail detainees

This paper documents the degree and pattern of overlap of antisocial disorder. alcoholism. drug use disorders, and major depression among 688 randomly selected male jail detainees. Diagnostic assessments were made using the NIMH Diagnostic Interview Schedule. Data indicate that multiple disorders are a serious problem among male detainees. Detainees were more likely to have two or three disorders than to have a single disorder. Of detainees, 44% had a lifetime prevalence of two or more of these syndromes. Few subjects with multiple disorders were found to have primary, or initial onset of, substance abuse disorders or primary depression. Rather, antisocial disorder predominated as the primary syndrome in diagnostic profiles. The preponderance of antisocial disorder among codisordered detainees is disturbing because it is a poor prognostic indicator. Implications for substance abuse intervention, treatment of depression, and intervention with antisocial personality disorder among detainees are discussed.     

公安监所“80后”在押人员感化教育问题研究

感化教育在押人员是公安监所工作的一项主要任务,是确保监所安全和从事公安监所管理工作的监管民警必须掌握和运用的基础工作。研究＂80后＂在押人员感化教育问题,是做好转型时期监管工作的基础,是提高监管工作质量和深挖犯罪工作科学化的有效途径。     

Using the Referral Decision Scale to Screen Mentally Ill Jail Detainees: Validity and Implementation Issues

The prevalence of serious mental illnesses in jail populations is significantly greater than in the general population. Identifying individuals who warrant psychiatric evaluations is important and benefits correctional staff as well as detainees. One widely used screening instrument intended for this task is the Referral Decision Scale (RDS). This paper reviews the development and validation of the RDS. Using data from a multisite study which assessed postrelease outcomes for detainees with mental illness, various types of validity are addressed. The results confirm that the RDS has some inherent characteristics that seriously limit its practical application as a screening instrument for use by correctional staff.     

Co-occurring psychiatric and substance use disorders among male detainees in Italy

This paper presents data on the prevalence of co-occurring substance use and psychiatric disorders among newly imprisoned males in Italy. Interviewers conducted semi-structured clinical interviews with n = 302 male detainees seven days after their admission to the prison of Perugia from August 2005 through July 2006. Over half of male detainees (54.3%) had either a substance use disorder or another psychiatric disorder. One of every five detainees (20.9%) had comorbid substance use and psychiatric disorders. Compared to detainees with psychiatric disorder only, substance use disorder only, or no disorder, detainees with comorbid substance use and psychiatric disorders were significantly more likely to have severe impairment in the areas of employment, substance abuse, family and social functioning, and psychiatric symptoms. Findings underscore the need for careful diagnostic screening at intake, access to treatment during detention, and an effective transition to services at the time of release.     

Suicidal ideation in a United States jail: demographic and psychiatric correlates

Suicidal behavior is a significant problem in United States jails. Suicidal ideation (SI) is an established precursor to suicidal behavior in incarcerated populations. No studies to date have examined the prevalence of SI or its correlates in a mixed-gender U.S. jail sample. The purpose of the present study was to document rates of SI in a mixed-gender jail sample and examine socio-demographic and psychiatric correlates. This study of 511 jail inmates found that approximately 16% of participants reported clinically significant SI upon incarceration. White participants, suicide attempters, and those with a psychiatric diagnosis history endorsed greater SI. Reported SI did not differ by sex and was not correlated with age. Clinically, results indicate that screening for SI in jail samples is necessary to identify high-risk individuals for intervention to prevent suicidal behavior.     

Psychiatric disorder,IQ, and emotional intelligence among adolescent detainees: A comparative study

Objectives. To document criminality, psychiatric difficulty, IQ, EQ, and EI amongst Irish, male juvenile detainees (Detainee Group). To compare their IQ, EQ, and EI to non‐offending boys attending a child psychiatry clinic (Psychiatric Group) and boys without offending or psychiatric problems (Community Group). To compare psychiatric morbidity between the detainee and psychiatric groups. Method. Criminality levels of 30 detainees were evaluated using official court charge sheets. Psychiatric status was assessed through structured clinical interview (DISC‐IV); IQ through an individually administered IQ‐scale (WASI); EQ using the BarOn EQi:Youth Version (EQi:YV); and EI using the MSCEIT: Youth Version – Research Edition (MSCEIT:YV‐RE). IQ, EQ, and EI levels in the psychiatric and community groups were compared. Psychiatric morbidity between detainee and psychiatric groups were compared. Results. A total of 335 crimes led to the detention of detainees. Eighty‐three percent of detainees had a psychiatric disorder compared to 60% of young people in the psychiatric group. Detainees had 3.1 disorders each compared to 1.4 disorders in the psychiatric group. A total of 63.3% of detainees had an externalizing problem, 37.9% an internalizing problem, and 66.7% a substance dependency or use problem. A total of 21.4% of detainees had an IQ score below 70. The detainee and psychiatric groups had similar deficits in EI and significantly lower EI than the community groups. Conclusions. Serious levels of criminality and psychiatric disorder exist amongst Irish detainees. They have significantly lower IQ than young people attending a psychiatry clinic and both share deficits in the ability to accurately identify emotions, use emotions to guide thought processes and to prioritize thinking and to effectively regulate emotions.     

Evolution of the psycho-legal studies program

This article describes Saleem Shah's role as a mentor and consultant to the author. The author focuses on his influence in the development of the author's research program, examining issues in the police arrest of mentally ill offenders and the need for mental health services for jail detainees.     

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.     

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.     

Screening for severe mental disorder in jails

Despite the demonstrated prevalence of severe mental disorder among jail detainees and the legal mandate to provide mental health services, most jails do not have the resources to incorporate traditional, time-consuming psychological assessment techniques into their routine intake process. As a result, a number of mentally ill jail detainees remain undetected and untreated. This study outlines the development of the Referral Decision Scale (RDS), which detects persons who have a high probability of having a severe mental disorder so that they can be given a complete diagnostic evaluation. The 14-item RDS was statistically derived using discriminant analysis from data collected via the NIMH Diagnostic Interview Schedule on 728 randomly selected male jail detainees and then validated on 1,149 prison inmates. The final validated version of the RDS had an overall sensitivity of 0.791, specificity of 0.987, and positive and negative predictive value of 0.791 and 0.013, respectively. Since these statistics far exceed current detection rates, the RDS is likely to facilitate the diversion of mentally ill detainees in situations where it is impractical to administer psychological examinations to all incoming inmates. Training requirements for the RDS and directions for future research are discussed.This research was supported in part by National Institute of Mental Health under grant No. R01MH37988. We would like to thank Karl Kilgore, Stuart Michaels, John Lyons, Karen Abram, Richard White, and Christine Davidson for their statistical insights and helpful comments. James Collins is due special thanks for making his North Carolina prison data available. We are also grateful to Philip Hardiman, Thomas Monahan, and Ronald Simmons for their cooperation with the data-collection process.     

Relationship Abuse and Victims’ Posttraumatic Stress Disorder Symptoms: Associations with Child Behavior Problems

This study examined associations among male-to-female physical and psychological relationship aggression, female partners’ PTSD symptoms, and behavior problems among the children (n = 62) of men enrolled in a treatment program for relationship abuse perpetration. Psychological aggression was a stronger predictor of child behavior problems than physical assault. Restrictive engulfment and hostile withdrawal behaviors evidenced the strongest bivariate associations with child behavior problems, and were the strongest predictors of this outcome when considering four distinct forms of psychological aggression together. Victim PTSD symptoms largely mediated the effects of psychological aggression on child behavior. Findings suggest that male-to-female psychological aggression and victim PTSD symptoms play an important role in understanding behavior problems among children living with male relationship abuse perpetrators. Portions of this work were presented at the annual convention of the Association for the Advancement of Behavior Therapy, New Orleans, Louisiana, November, 2004.     

The Issue of Control in Jail: The Effects of Professionalism,Detainee Control,and Administrative Support on Job Stress,Job Satisfaction,and Organizational Commitment among Jail Staff

Jails are important, yet understudied, components of the American criminal justice system. While most research on correctional personnel has focused on prisons, a growing body of work is beginning to emerge on jails. This is encouraging given the unique circumstances that occur within jail environments (e.g., diversity and mobility of offenders, health issues among detainees, overcrowding, lack of training among staff, etc.). Given these conditions, the staff members who run jails become the glue that holds them together. The following study contributes to this burgeoning area of empirical inquiry by examining a variety of antecedents of job stress, job satisfaction, and organizational commitment among jail personnel. Using survey data collected from a large county correctional system in Orlando, Florida, the findings indicate that staff perceptions of professionalism, detainee control, and administrative support all significantly impact degrees of job stress, job satisfaction, and organizational commitment.     

Exploring the consequences of prolonged pretrial incarceration: evidence from a local jurisdiction in the Philippines

Prolonged pretrial incarceration is a key issue facing the criminal justice systems of many developing countries. Detainees stay in jail for years while undergoing trial but are still unconvicted. However, little is known about the consequences of this troubling phenomenon. Informed by relevant prison and criminological theories, this paper analyses jail official data and qualitative interviews from detainees in a local jurisdiction in the Philippines to understand the magnitude and consequences of prolonged pretrial incarceration. Results suggest the emergence of a legally cynical view of the criminal justice system shared by the detainees. These sentiments likely serve as bases for popular opinions that justify use of violence and vigilante justice on offender populations. Implications on judicial and penal reforms in the Philippines are discussed.     

Unfitness for Detention Among Arrestees with Suspected Mental Disorders in Paris,France

In this retrospective study (11/2013–04/2014), we aimed to identify the factors associated with psychiatric hospitalization among detainees in police custody. We included 137 patients (M/F, 74%/26%; median age, 37 years), and 125 (91%) had a mental disorder. Seventy‐seven patients (56%) had involuntary hospitalization. Sixty patients (44%) were declared fit for detention, and 48 (80%) of these patients had a mental disorder. All patients who required urgent psychiatric care and could not provide valid consent for care were declared as requiring involuntary hospitalization. Forty‐nine of the 62 patients (79%) who required urgent psychiatric care and were suspected to have committed serious crimes were involuntarily admitted. In conclusion, we commonly found that some individuals with mental disorders were considered fit for detention in police cells.     

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.     

Alleged police ill-treatment of non-political detainees in the Basque Country (Spain). Prevalence and associated factors

Epidemiological studies of ill-treatment and torture are difficult to carry out and are usually based on people arrested for political motives. The object of this prospective study was to document the prevalence of allegations of ill-treatment/torture in a sample of detainees who were arrested for non-political motives in the Basque Country (Spain). The influence of demographic and criminological variables was evaluated. A total of 837 interviews and medical-forensic examinations of 578 detainees were analyzed with a modified version of the protocol established by the Rehabilitation and Research Centre for Torture Victims (IRCT/RCT). Alleged ill-treatment occurred with a frequency of 13.3% in 99 subjects, with few cases being considered as torture in the strict sense. The most frequent methods included: coercion (6.8%), deprivation (6.0%) and physical ill-treatment (4.3%). The variables significantly associated with ill-treatment were national/ethnic identity and the type of offence committed by the detainee. A higher frequency of ill-treatment, together with longer periods of detention were observed among foreign detainees. The results contrast with those reported in a study of political detainees in the same region, in which complex and intensive torture methods were reported to be more habitual. In conclusion, this study underlines the importance of further developing preventative methods in order to reduce the occurrence of violations of human rights during periods of detention.     

The social,relational and mental health characteristics of justice-involved men in the south-west England

The aim of this article is to describe the social, relational and mental health characteristics of a sample of offenders serving prison or community sentences in the south-west England. About 100 adult male offenders were screened for anxiety and depressive disorders, post-traumatic stress disorder (PTSD), drug and alcohol dependence, and likely personality disorder using validated instruments. Fifty-eight per cent of the sample reported at least one common mental health problem, of these only 26% reported receiving treatment. Participants exposed to traumatic events and/or participants with past mental health problems were more likely to score positive for current common mental health problems. Our study identified factors that may increase the risk of a first episode or recurrent anxiety and/or depression for offenders. Health and criminal justice services should create partnerships and develop interventions that address the risk factors which lead and/or contribute to offenders' mental health difficulties.     

Posttraumatic Stress Disorder: Protective and Risk Factors in 18 Survivors of a Plane Crash

The aim of this study is to identify protective and risk factors related to the development of posttraumatic stress disorder (PTSD) on a sample of survivors from a single plane crash. Eighteen survivors were examined 6 months following the event. The subjects all underwent psychiatric interviews, Clinician‐Administered PTSD Scale structured interviews, personality and cognitive tests. Only 38.9% of them presented with all of the symptoms of PTSD; 22.2% showed no symptoms for PTSD; remaining survivors exhibited emotional/affective symptoms related to the event. In addition to the severity of the traumatic event itself, other risk factors identified were the loss of a relative, the manifestation of depressive symptoms, and the severity of physical injuries sustained. Low levels of hostility and high levels of self‐efficacy represented protective factors against developing PTSD.