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.     

Official incidents of inmate-on-inmate misconduct at a women’s prison: using importation and deprivation theories to compare perpetrators to victims

Importation and deprivation theories have long been used to explain prison misconduct and victimization among male inmates. However, the key variables from these theories have rarely been tested on female inmates. In addition, many of these existing studies use combined samples of males and females, while ignoring female-only samples of prisoners. Using data from official misconduct reports collected from 2007 to 2012 from a large women’s prison in Ohio, the current study sought to compare the characteristics of perpetrators of inmate-on-inmate misconduct to their victims. Findings reveal that variables from both importation (age, race, and current violent offender status) and deprivation (mental health status and prior violent disciplinary reports) theories were significant in predicting perpetrator vs. victim likelihood. Policy implications and suggestions for future research are discussed.     

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.     

Child maltreatment histories among female inmates reporting inmate on inmate sexual victimization in prison: the mediating role of emotion dysregulation

Despite data indicating that child maltreatment (CM) in various forms is associated with adult sexual victimization among community women, few studies have explicitly explored how types of CM might relate to prison sexual victimization. Because little is known about how CM might give rise to prison sexual victimization, the present study also examined emotion dysregulation emanating from early abuse experiences as a potential mediator in the link between early CM and inmate-on-inmate prison sexual victimization. Approximately 168 incarcerated women completed self-report inventories assessing various types of childhood maltreatment, emotion dysregulation, and coerced or forced sexual experiences in prison. Nearly 77% of the sample endorsed experiencing at least one form of CM, with 64% of inmates reporting that they experienced two or more forms of CM. Approximately 9% of inmates reported sexual coercion and 22% reported a forced sexual experience in prison. Each form of CM was associated with prison sexual coercion; however, fewer associations emerged between CM and forced prison sexual experiences. Emotion dysregulation was found to mediate links between CM, particularly co-occurring CM, and sexual coercion in prison, but it was unrelated to forced prison sexual experiences. Implications are discussed.     

Examining the characteristics of male sexual assault targets in a Southern maximum-security prison

Studies concerning inmate-on-inmate sexual assaults within male correctional facilities are sparse in the sociological and correctional literatures. Only a few studies have specifically examined the characteristics of male inmate sexual assault targets. The current research sought to address this gap by providing an examination of factors related to victimization likelihood. Using data gathered in March 2000 from 142 inmates (18% return rate) in one Southern maximum-security prison, the authors examined demographic and behavioral characteristics of male inmate sexual targets. Based on inmates' self-reports of sexual victimization--threatened and/or forced sexual assault encounters--correlates of victimization were identified. Approximately 18% of the inmates reported inmate-on-inmate sexual threats, and 8.5% reported that they had been sexually assaulted by another inmate while incarcerated.     

The effects of treatment exposure on prison misconduct for female prisoners with substance use,mental health,and co-occurring disorders

Inmates with mental health and co-occurring mental health and substance use disorders present difficult challenges for correctional institutions and treatment providers. The complex nature of co-occurring disorders further exacerbates these difficulties and is associated with poor treatment compliance and increased likelihood of engaging in institutional misconduct. The current study examines whether exposure to prison-based treatment reduces involvement in prison misconduct among a sample of female prison inmates controlling for disorder types (i.e. mental health disorder only, substance use disorder only, and co-occurring mental and substance use disorders). Findings revealed that with exposure of more than 181?days of treatment, the odds of misconduct involvement among females with co-occurring disorders more than doubled compared to receiving no treatment. This finding is at odds with treatment retention literature that suggests that a minimum period of time in treatment is needed to affect post-treatment success. Possible explanations for these findings and policy implications are discussed.     

Childhood gender atypicality, victimization, and PTSD among lesbian, gay, and bisexual youth

This study examined childhood gender atypicality, lifetime victimization based on sexual orientation, and current mental health, including trauma symptoms and posttraumatic stress disorder (PTSD), among 528 lesbian, gay, and bisexual youth. Nearly 80% reported verbal victimization, 11% physical, and 9% sexual, with males reporting significantly more victimization. Victimization began, on average, at age 13. Verbal attacks occurred as early as age 6, physical attacks at 8, and sexual attacks at 9. Youth who were considered gender atypical in childhood reported more victimization and more current mental health symptoms. PTSD was found in 9% of youth and was associated with past physical victimization.     

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.     

Prevalence of mental disorders and deliberate self-harm in Greek male prisoners

The aim of this survey was to determine the prevalence of current and lifetime mental disorder and deliberate self-harm among male prisoners in Greece. The subjects were 80 randomly selected remanded and sentenced prisoners in a Greek prison. They were assessed for mental disorder including suicidality and substance misuse using the Mini International Neuropsychiatric Interview (MINI). We also collected information regarding contact with psychiatric services, previous deliberate self-harm as well as physical health and conducted a brief assessment of their intellectual functioning. Mental disorder was diagnosed in 63 (78.7%) prisoners. The main diagnoses were: anxiety disorder, 30 (37.5%); major depression, 22 (27.5%); antisocial personality disorder, 30 (37.5%); alcohol dependence, 21 (26.3%) and opiate dependence 22 (27.5%) and schizophrenic or bipolar disorder 9 (11.2%). Deliberate self-harm prior to and during imprisonment was reported by 15% and 2.5% of prisoners, respectively, and 12 prisoners (15%) had IQ below 75. This survey identified a significant level of need for specialist mental health services in prison. Further studies are required to assess the specific needs of those patients who are too unwell to remain in prison, the need for specific treatments for substance misuse and improved assessment/treatment of common psychiatric disorders.     

Measuring victimization inside prisons: questioning the questions

Violence and victimization inside the prison setting are accepted as facts, although the facts about their prevalence remain uncertain. Variation in the methods used to estimate rates of sexual and physical victimization contribute to the wide range in estimates appearing in the prison literature. This article focuses on the questions used in the prison victimization literature to elicit information on victimization from inmates, compared to questions used in the general victimization literature. The questions used in the National Violence Against Women and Men Surveys are used to estimate sexual and physical victimization rates for an entire prison system. Rates of victimization were found to vary significantly by specificity of the question, definition of perpetrator, and clustering of behaviors. Facts about victimization inside prison will become more certain when the methodology becomes more standardized and consistent with definitions of victimization.     

Substance Use and Intimate Violence Among Incarcerated Males

The purpose of this study was to examine substance use patterns among a sample of incarcerated males who report engaging in levels of intimate violence, as well as identifying similarities and differences in demographic, economic status, mental health, criminal justice involvement, relationships, and treatment factors for three groups of incarcerated males - those who report perpetrating low intimate violence, those who report perpetrating moderate intimate violence, and those who report perpetrating extreme intimate violence the year preceding their current incarceration. Findings indicated that low intimate violence group's perpetration consisted almost exclusively of emotional abuse. Moderately intimate violent males and extremely intimate violent males, however, report not only high rates of emotional abuse but physical abuse as well. The distinction between moderate and extremely violent groups was substantial. Findings also indicated that perpetrators at different levels of violence in this study did not vary significantly in age, employment history, marital status, or race. However, the three groups showed significant differences in three main areas: (1) cocaine and alcohol use patterns, (2) stranger violence perpetration and victimization experiences, and (3) emotional discomfort. Implications for substance abuse and mental health treatment interventions and for future research are discussed.     

Risk of harm: inmates who harm themselves while in prison psychiatric treatment

In this study, 242 randomly selected male offenders who were receiving psychiatric treatment in prison were administered psychological and neuropsychological evaluations and were followed during their treatment in a prison psychiatric hospital. Offenders who harmed themselves in treatment were compared to those who did not harm themselves. Eighteen percent of offenders harmed themselves, the severity of which required medical intervention. Young age, drug abuse, absence of Axis I mental disorder but presence of Axis II borderline personality disorder identified offenders who harmed themselves. Psychopathy checklist-revised (PCL-R) total rating > or = 30 and PCL-R Factor 2 (antisocial lifestyle) rating also identified offenders who harmed themselves. Additionally, offenders who harmed themselves also were 8.36 times more likely than their cohorts to harm treatment staff. Theoretical understanding of offenders who harm themselves, the importance of considering the environmental context in identifying risk factors for self-harm, and implications for treatment are suggested.     

Examining Predictors of Depression Among Older Incarcerated Women

For older women in prison, adjustments to prison life are often affected by a variety of mental and physical health symptoms. Many come to prison with specific histories of traumatic life experiences that place them at risk for high levels of depression. Using data gathered from 327 older women (mean age = 56.5), we examined the relationship between a variety of preprison conditions and prison deprivation factors as possible predictors of depression. Stepwise regression results indicated that depression was greater for those with prior abuse histories, functional health problems along with poorer perceptions of mental and physical health, safety and other prison environment concerns. Although race was not a significant predictor in the regression model, a t-test did find that whites were more depressed than African Americans in our sample. Other correlates of depression are also identified that lend insights into the high rates of depression found among elderly women in prison. With such high rates of psychiatric disorders among women offenders, more treatment interventions are needed to adequately serve this population.     

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.     

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.     

Doing time: A qualitative study of long-term incarceration and the impact of mental illness

Once convicted, the perpetrator of serious crime embarks upon a new journey: the challenge of adjusting to long-term imprisonment. Prisoners' views of incarceration and the meaning of this experience may affect their later adjustment to life in the community. On the basis of brief narrative responses collected during an epidemiological survey of the psychological health of prisoners in France, this study examined the impact of incarceration on psychological state in a group of 59 inmates serving long sentences. Qualitative content analysis and computer-assisted linguistic analysis (using ALCESTE software) were performed on the textual data of open responses to three standard questions. Using a combination of these two approaches, seven categories of the subjective experience of prisoners in the sample were identified: the Outside World, Others, Punishment, Time, Affects and Impulses, Self-Concept, and Speech. Further qualitative analyses were then performed to compare the responses of Severely Mentally Ill (SMI) subjects and subjects with no psychiatric disorder. These analyses revealed contrasting attitudes towards incarceration. SMI subjects spoke in more hostile and persecutory terms about their experience in prison, attributing suffering to external circumstances, while subjects with no psychiatric disorder evoked similar themes, but with an introspective attitude. The themes evoked by mentally ill individuals in our sample suggest that their reactions to the prison environment arise in part from aspects of their psychiatric symptoms, and this may have relevance to future mental health policy and practices in criminal corrections.     

Brief mental health screening of prison entrants: psychiatric history versus symptom screening for the prediction of in-prison outcomes

While prisoners are known to suffer very high rates of mental illness, evidence is often lacking to inform the development of effective approaches to prison mental health service provision, including the approach to mental health screening. In addition, research to date has been dominated by prevalence studies and little is known about the mental health needs of prisoners over time. A random sample of prison entrants was recruited from a large remand and reception prison in New South Wales, Australia (n = 707) for the completion of a brief health survey. A second survey was completed during the subsequent six months (n = 317) in order to examine the effect of timing of assessment on mental health status. Those followed up within three months (n = 182) were further included in an analysis of predictive validity comparing the performance at baseline of self-reported history of previous diagnosis versus current symptom screening for psychological distress, in predicting subsequent mental illness. When assessed over six months from prison entry, mental health status was found to vary by timing of assessment. At prison entry, self-reported history of previous diagnosis of a mental health disorder was found to be a better predictor of mental illness over three months than screening for psychological distress.     

MENTAL DISORDER AND VIOLENT VICTIMIZATION: THE MEDIATING ROLE OF INVOLVEMENT IN CONFLICTED SOCIAL RELATIONSHIPS*

This study examines whether the relationship between mental disorder and violent victimization is attributable to the disproportionate involvement of mentally disordered people in conflicted social relationships. The data consist of a sample of discharged psychiatric patients (N= 270) and a sample of nonpatients (N= 477) drawn from the same neighborhoods. Results show that mentally disordered patients were more likely to be victimized by violence and to be involved in conflicted social relationships. Moreover, involvement in conflicted social relationships mediated the effect of mental disorder on violent victimization, a result that held when illegal drug use by the patients was taken into account. Implications for research and theory are discussed.     

Assault in prison and assault in prison psychiatric treatment

Studies have described measures associated with assault in the community, but few have identified measures associated with assault in prison or prison psychiatric treatment. In this study, prison assault histories and assaults while in prison psychiatric treatment for 222 randomly selected male inmates were evaluated. Using record reviews, interviews, neuropsychological, Rorschach, and psychopathy measures, risk factors for assault in prison and in prison psychiatric treatment were identified. Youth Authority placement, inhalant use, antisocial lifestyle, neurological injury, neuropsychological impairment, and higher PCL-R Factor II ratings were associated with assault in prison. Absence of major mental disorder, neurological impairment, or psychotic thinking, but presence of psychopathy was associated with assault in prison psychiatric treatment. In identifying risk for violence, the importance of (1) the context in which violence occurs; (2) the need for clear admission criteria for prison psychiatric treatment; and (3) the need to develop risk assessments that are specific to prison environments are emphasized.     

Prison misconduct among female inmates with mental disorders,substance abuse/dependence,and co-occurring disorders in Taiwan

This survey study attempted to address two research questions: (1) whether female inmates with either singular mental illness or singular substance abuse/dependence disorders were more likely to break institutional rules in prison than their disorder-free counterparts; and (2) whether female inmates with both mental illness and substance abuse/dependence disorders (CODs) were more likely to engage in misbehaviour than either disorder-free or singularly disordered women during the course of their confinement. The current study employed a sample of 643 female inmates and the data for analyses contained information on inmates’ CODs, mental and substance abuse/dependence disorders, and pre-prison and prison experiences. The results showed that female inmates with CODs committed the most misconduct in prisons, but no significant effect was found on prison misconduct among inmates with singular disorders and disorder-free female inmates. Possible explanations for these results were suggested, and public policy implications were discussed in the concluding section.