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Fovet T, Wathelet M, Amad A, Horn M, Belet B, Benradia I, Roelandt JL, Thomas P, Vaiva G, D'Hondt F. Trauma exposure and PTSD among men entering jail: A comparative study with the general population. J Psychiatr Res 2021; 145:205-212. [PMID: 34929470 DOI: 10.1016/j.jpsychires.2021.12.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 11/27/2021] [Accepted: 12/10/2021] [Indexed: 12/17/2022]
Abstract
Research has consistently shown high levels of post-traumatic stress disorder (PTSD) in correctional settings. We aimed to compare the prevalences of trauma exposure, subthreshold PTSD, and full PTSD in incarcerated people with those observed in the general population. We used the Mini-International Neuropsychiatric Interview to screen for psychiatric disorders among men upon admission to jail (N = 630) and non-incarcerated men living in the same geographic area (the northern district of France; N = 5793). We utilized a multinomial regression model to assess the association between admission to jail and the prevalences of trauma exposure, subthreshold PTSD, and full PTSD. We employed logistic regression models to verify the interaction between admission to jail and PTSD status on the presence of psychiatric comorbidities. Full PTSD was overrepresented among men in jail after adjustment for all covariates (OR [95% CI] = 3.49 [1.55-7.85], p = 0.002). The association between PTSD status and the presence of at least one psychiatric comorbidity was also more important upon admission to jail than in the general population. Admission to jail was not associated with a higher prevalence of trauma exposure (OR [95% CI] = 1.12 [0.85-1.46], p = 0.419) or subthreshold PTSD (OR [95% CI] = 1.17 [0.81-1.68], p = 0.413). These results suggest higher prevalence rates of full PTSD and psychiatric comorbidities associated with PTSD symptoms in incarcerated people than in the general population. The provision of trauma-focused interventions tailored to these clinical specificities should be considered for the jail population.
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Affiliation(s)
- Thomas Fovet
- Univ. Lille, Inserm, CHU Lille, U1172 - Lille Neuroscience & Cognition, F-59000 Lille, France; Centre national de ressources et de résilience Lille-Paris (CN2R), F-59000 Lille, France.
| | - Marielle Wathelet
- Univ. Lille, Inserm, CHU Lille, U1172 - Lille Neuroscience & Cognition, F-59000 Lille, France; Centre national de ressources et de résilience Lille-Paris (CN2R), F-59000 Lille, France; Fédération régionale de recherche en psychiatrie et santé mentale, Hauts-de, France
| | - Ali Amad
- Univ. Lille, Inserm, CHU Lille, U1172 - Lille Neuroscience & Cognition, F-59000 Lille, France; Fédération régionale de recherche en psychiatrie et santé mentale, Hauts-de, France
| | - Mathilde Horn
- Univ. Lille, Inserm, CHU Lille, U1172 - Lille Neuroscience & Cognition, F-59000 Lille, France
| | - Bettina Belet
- Univ. Lille, Inserm, CHU Lille, U1172 - Lille Neuroscience & Cognition, F-59000 Lille, France; Centre national de ressources et de résilience Lille-Paris (CN2R), F-59000 Lille, France
| | - Imane Benradia
- EPSM Lille Métropole, Centre Collaborateur de l'Organisation Mondiale de la Santé pour la recherche et la formation en santé mentale, Lille, France
| | - Jean-Luc Roelandt
- EPSM Lille Métropole, Centre Collaborateur de l'Organisation Mondiale de la Santé pour la recherche et la formation en santé mentale, Lille, France; ECEVE, UMRS 1123, Université Paris Diderot, Sorbonne Paris Cité, INSERM, Paris, France
| | - Pierre Thomas
- Univ. Lille, Inserm, CHU Lille, U1172 - Lille Neuroscience & Cognition, F-59000 Lille, France; Fédération régionale de recherche en psychiatrie et santé mentale, Hauts-de, France
| | - Guillaume Vaiva
- Univ. Lille, Inserm, CHU Lille, U1172 - Lille Neuroscience & Cognition, F-59000 Lille, France; Centre national de ressources et de résilience Lille-Paris (CN2R), F-59000 Lille, France
| | - Fabien D'Hondt
- Univ. Lille, Inserm, CHU Lille, U1172 - Lille Neuroscience & Cognition, F-59000 Lille, France; Centre national de ressources et de résilience Lille-Paris (CN2R), F-59000 Lille, France
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Facer-Irwin E, Blackwood NJ, Bird A, Dickson H, McGlade D, Alves-Costa F, MacManus D. PTSD in prison settings: A systematic review and meta-analysis of comorbid mental disorders and problematic behaviours. PLoS One 2019; 14:e0222407. [PMID: 31557173 PMCID: PMC6762063 DOI: 10.1371/journal.pone.0222407] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Accepted: 08/28/2019] [Indexed: 11/21/2022] Open
Abstract
Purpose Prevalence rates of PTSD are higher in the prison population than in the community. We sought to systematically review the extent to which this disorder is associated with other mental health disorders and problematic suicidal or aggressive behaviours in the prison population. Methods Studies reporting a relationship between PTSD and comorbid mental disorders and/or problematic behaviours in imprisoned adolescent and adult populations were identified from four bibliographic indexes. Primary studies involving clinical interviews, validated instruments leading to DSM or ICD diagnoses, or validated self-report questionnaires such as the PTSD checklist were included. Random-effects meta-analysis was conducted where possible. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Results This review identified 36 studies, with a combined sample of 9594 participants, (6478 male and 2847 female prisoners) from 11 countries. Thirty-four of the identified studies employed a cross-sectional design. We identified significant associations between PTSD and comorbid mental disorders including depression (OR = 3.4, 95% confidence interval (CI): 2.3–4.9), anxiety (OR = 2.9, 95% confidence interval (CI): 1.8–4.7) and substance use (OR = 1.9, 95% confidence interval (CI): 1.5–2.4). We also identified significant associations between PTSD and suicidality (OR = 3, 95% confidence interval (CI): 2.4–3.8) and aggressive behaviours (this latter finding was not subject to meta-analysis). Significant methodological heterogeneity was identified between studies. Conclusions High rates of psychiatric comorbidity among prisoners with PTSD, and links to suicidal behaviour, self-harm and aggressive behaviour, provide further support for the need for trauma-informed treatment approaches in prisons. However, significant gaps in the current evidence were apparent. In particular, a lack of large, longitudinal studies meant that the temporal relationships between PTSD and relevant outcomes cannot currently be determined.
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Affiliation(s)
- Emma Facer-Irwin
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, United Kingdom
- * E-mail:
| | - Nigel J. Blackwood
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, United Kingdom
| | - Annie Bird
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, United Kingdom
| | - Hannah Dickson
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, United Kingdom
| | - Daniel McGlade
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, United Kingdom
| | - Filipa Alves-Costa
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, United Kingdom
| | - Deirdre MacManus
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, United Kingdom
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Zuñiga RAA, Reyes GG, Murrieta JIS, Villoria RAMG. Posttraumatic stress symptoms in people exposed to the 2017 earthquakes in Mexico. Psychiatry Res 2019; 275:326-331. [PMID: 30954842 DOI: 10.1016/j.psychres.2019.04.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Revised: 04/01/2019] [Accepted: 04/01/2019] [Indexed: 11/17/2022]
Abstract
This is the first study to produce a reliable valid measure of the symptoms of Posttraumatic Stress Disorders (PTSD) in Mexico, which has a high incidence of disasters, and has not had a measurement of PTSD frequency in the population. The objective was to analyze the prevalence of PTSD symptoms in persons who experienced the 2017 earthquakes in Mexico. A probabilistic sample of 1539 participants from Mexico City, the State of Mexico, Chiapas, Puebla, Morelos and Oaxaca during November and December of 2017 was screened using the Davidson Trauma Scale (DTS) for symptoms of post-traumatic stress. The prevalence of PTSD symptoms was 34.6%, with greater effects on the inhabitants of Oaxaca, Morelos and Puebla, women, indigenous people and people who experienced damage to their homes (p = 0.001). The DTS had a moderate negative correlation with the RS-14 and a Cronbach's alpha coefficient of 0.957. The confirmatory factor analysis generated four factors that explain 50% of the variance, compatible with a Dysphoria model. We can conclude that one in three people exposed to earthquakes had symptoms of post-traumatic stress.
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Baranyi G, Cassidy M, Fazel S, Priebe S, Mundt AP. Prevalence of Posttraumatic Stress Disorder in Prisoners. Epidemiol Rev 2018; 40:134-145. [PMID: 29596582 PMCID: PMC5982805 DOI: 10.1093/epirev/mxx015] [Citation(s) in RCA: 80] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2017] [Accepted: 10/25/2017] [Indexed: 12/13/2022] Open
Abstract
People involved with criminal justice frequently are exposed to violence and traumatic experiences. This may lead to posttraumatic stress disorder (PTSD); however, no review, to our knowledge, has synthetized findings in this setting. We conducted a systematic review and meta-analysis to estimate prevalence rates of PTSD in prison populations. Original studies in which prevalence rates of PTSD in unselected samples of incarcerated people were reported were systematically searched between 1980 and June 2017. Data were pooled using random-effects meta-analysis, and sources of heterogeneity for prespecified characteristics were assessed by meta-regression. We identified 56 samples comprising 21,099 imprisoned men and women from 20 countries. Point prevalence of PTSD ranged from 0.1% to 27% for male, and from 12% to 38% for female prisoner populations. The random-effects pooled point prevalence was 6.2% (95% confidence interval: 3.9, 9.0) in male prisoners and 21.1% (95% confidence interval: 16.9, 25.6) in female prisoners. The heterogeneity between the included studies was very high. Higher prevalence was reported in samples of female prisoners, smaller studies (n < 100), and for investigations based in high-income countries. Existing evidence shows high levels of PTSD among imprisoned people, especially women. Psychosocial interventions to prevent violence, especially against children and women, and to mitigate its consequences in marginalized communities must be improved. Trauma-informed approaches for correctional programs and scalable PTSD treatments in prisons require further consideration.
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Affiliation(s)
- Gergõ Baranyi
- Center for Research on Environment Society and Health, School of GeoSciences, The University of Edinburgh, Edinburgh, United Kingdom
| | - Megan Cassidy
- Unit for Social and Community Psychiatry, WHO Collaborating Center for Mental Health Services Development, Queen Mary University of London, London, United Kingdom
| | - Seena Fazel
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - Stefan Priebe
- Unit for Social and Community Psychiatry, WHO Collaborating Center for Mental Health Services Development, Queen Mary University of London, London, United Kingdom
| | - Adrian P Mundt
- Medical Faculty, Universidad Diego Portales, Santiago, Chile.,Medical School, Universidad San Sebastián, Puerto Montt, Chile
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Pérez-Pedrogo C, Martínez-Taboas A, González RA, Caraballo JN, Albizu-García CE. Sex differences in traumatic events and psychiatric morbidity associated to probable posttraumatic stress disorder among Latino prisoners. Psychiatry Res 2018; 265:208-214. [PMID: 29738944 PMCID: PMC6016368 DOI: 10.1016/j.psychres.2018.04.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Revised: 03/01/2018] [Accepted: 04/05/2018] [Indexed: 10/17/2022]
Abstract
Latinos comprised 17.1% of the U.S. population and 33.1% of US prisoners, yet they are underrepresented in the psychopathology literature. Despite higher rates of trauma among incarcerated individuals than in the general population, most of the previous research in this area focused primarily on women samples, and very few studies examined sex differences in PTSD and traumatic experiences. In addition, there is a need for research assessing traumatic experiences and probable PTSD in men and women Latino inmates to inform culturally competent care and sex sensitive care for this vulnerable and underserved population. Our study examined whether men and women Latino inmates with probable Posttraumatic Stress Disorder (PTSD), based on the cut off 40 or more symptoms on the Davidson Trauma Scale (DTS), differed significantly by the number of event types experienced, the type of potentially traumatizing event, and in co-occurring psychiatric conditions. A multi-stage sample design was used to select a probabilistic sample of 1,331 inmates from 26 penal institutions in PR of which 1179 participated in the study. Bivariate associations were calculated for each type of traumatic event and probable PTSD. Mean number of types of potentially traumatizing event experienced was comparable for both sexes (F = 3.83, M = 3.74) yet sex differences were found in the nature of the event. Women with probable PTSD had higher rates of experiencing rape and sexual abuse. Men had higher rates of experiencing combat in war, a life-threatening accident, of witnessing violence, and being threatened with a weapon. Men with significant ADHD symptoms in childhood and with Generalized Anxiety Disorder (GAD) during adulthood were almost 5 and 7 times as likely to score above threshold on the DTS whereas women were >3 times as likely in the presence of ADHD symptoms in childhood or depression during adulthood. This study underscores the need to improve understanding of the clinical manifestations of trauma and co-occurring psychiatric conditions for appropriate sex sensitive interventions targeting Latinos living in prisons.
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Affiliation(s)
- Coralee Pérez-Pedrogo
- University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico; Carlos Albizu University, San Juan Campus, San Juan, Puerto Rico.
| | | | - Rafael A González
- East London NHS Foundation Trust, Child and Adolescent Mental Health Service (CAMHS), London, UK; Centre for Mental Health, Division of Brain Sciences, Department of Medicine, Imperial College, London, UK
| | - José N Caraballo
- University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico
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Ibañez GE, Agudo M, Martin SS, O'Connell DJ, Auf R, Sheehan DM. Offending Behavior, Drug Use, and Mental Health Among Foreign-Born versus U.S. Born Latino Criminal Justice Clients. J Immigr Minor Health 2018; 19:674-685. [PMID: 28035647 DOI: 10.1007/s10903-016-0542-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Little is known about the offending behavior and recidivism factors of Latinos by nativity (U.S. born, foreign-born). The present study focused on Latinos in community corrections (n = 201) in Miami, Florida, and examined differences in criminal activity, drug use, and mental health by nativity. Data were collected utilizing convenience sampling between June 2014 and December 2015. The research question was: what are the offending, drug use, and mental health histories of Latinos involved in community corrections? Participants were mostly male (n = 120; 59.7%), White (n = 105; 52.2%), and Cuban (n = 97; 48.3%). U.S. born community corrections clients (n = 141) were more likely to report more lifetime and recent criminal activity; and more likely to report lifetime and recent drug use behavior than foreign-born Latinos (n = 60). No differences were found in recent mental health. Correctional healthcare should tailor services such as substance abuse treatment differently toward U.S. born and foreign-born Latinos.
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Affiliation(s)
- Gladys E Ibañez
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, 33199, USA.
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, AHC-5, Room 478, Miami, FL, 33199, USA.
| | - Michelle Agudo
- Center for Drug and Health Studies, University of Delaware, Newark, DE, USA
| | - Steve S Martin
- Center for Drug and Health Studies, University of Delaware, Newark, DE, USA
| | - Daniel J O'Connell
- Center for Drug and Health Studies, University of Delaware, Newark, DE, USA
| | - Rehab Auf
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, 33199, USA
| | - Diana M Sheehan
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, 33199, USA
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Dixon LE, Ahles E, Marques L. Treating Posttraumatic Stress Disorder in Diverse Settings: Recent Advances and Challenges for the Future. Curr Psychiatry Rep 2016; 18:108. [PMID: 27771824 PMCID: PMC5533577 DOI: 10.1007/s11920-016-0748-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Racial and ethnic minorities are at high risk for developing posttraumatic stress disorder (PTSD) after experiencing a traumatic event and are less likely to receive evidence-based treatment for their symptoms. There is a growing body of literature showing that culturally appropriate interventions result in greater uptake, symptom reduction, and sustained treatment gains. This article review explores new findings in the cultural understanding of PTSD among racial and ethnic minorities. We first review recent advances in the understanding of PTSD symptomotology. Next, we provide overview of trials demonstrating efficacy and effectiveness of cognitive processing therapy (CPT), prolonged exposure (PE), and trauma-focused cognitive-behavioral therapy (TF-CBT) in diverse communities. Then, we discuss specific implementation strategies common across intervention trials used to increase feasibility, acceptability, adoption, and sustainability. Last, we discuss areas for future research and dissemination efforts.
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Affiliation(s)
- Louise E. Dixon
- Department of Psychology, University of California Los Angeles, 1285 Franz Hall, Box 951563, Los Angeles, CA 90095-1563, USA
| | - Emily Ahles
- Department of Psychiatry, Massachusetts General Hospital, 70 Everett Ave., Suite 516, Chelsea, MA 02150, USA
| | - Luana Marques
- Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, 70 Everett Ave., Suite 516, Chelsea, MA, 02150, USA.
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Waters SF, Hagan MJ, Rivera L, Lieberman AF. Improvements in the Child-Rearing Attitudes of Latina Mothers Exposed to Interpersonal Trauma Predict Greater Maternal Sensitivity Toward Their 6-Month-Old Infants. J Trauma Stress 2015; 28:426-33. [PMID: 26418308 DOI: 10.1002/jts.22043] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The current study investigated maternal sensitivity in a treatment-seeking sample of predominately Latina, low-income pregnant women with histories of interpersonal trauma exposure. Pregnant women (N = 52; M = 27.08 years, SD = 5.66) who enrolled in a study of a perinatal adaptation of child-parent psychotherapy reported on their posttraumatic stress symptoms and child-rearing attitudes at baseline and again at 6-months postpartum. Maternal sensitivity was measured via observational coding of a free-play episode at 6-months postpartum. Two thirds of mothers exhibited healthy levels of maternal sensitivity, M > 4.0 (range = 2.5-7.0). The results of multiple linear regression predicting maternal sensitivity, R(2) = .26, indicated that greater improvements in child-rearing attitudes over the course of treatment predicted higher levels of maternal sensitivity, β = .33, whereas improvements in posttraumatic stress symptoms over the course of treatment did not, β = -.10. Mothers' attitudes regarding parenting during the perinatal period may be a mechanism by which intervention fosters healthy mother-infant relationship dynamics. Thus, parenting attitudes are a worthy target of intervention in vulnerable families.
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Affiliation(s)
- Sara F Waters
- Department of Human Development, Washington State University, Vancouver, Vancouver, Washington, USA.,Department of Psychiatry, Child Trauma Research Program, University of California, San Francisco, San Francisco, California, USA
| | - Melissa J Hagan
- Department of Psychiatry, Child Trauma Research Program, University of California, San Francisco, San Francisco, California, USA.,Department of Psychology, San Francisco State University, San Francisco, California, USA
| | - Luisa Rivera
- Department of Psychiatry, Child Trauma Research Program, University of California, San Francisco, San Francisco, California, USA
| | - Alicia F Lieberman
- Department of Psychiatry, Child Trauma Research Program, University of California, San Francisco, San Francisco, California, USA
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