Patterns of substance involvement and criminal behavior: a gender-based cluster analysis of Pennsylvania arrestees

Increased propensity for violence among female jail detainees with PTSD, panic disorder and alcohol use disorder

Purpose

The female jail population is steadily growing in rural jails across the country. Detainees have high rates of mental health and substance use disorders, some of which are linked to violent offenses. These conditions include post-traumatic stress disorder (PTSD), panic disorder (PD) and alcohol use disorder (AUD). This study aims to examine the associations between these disorders among females charged with violent offenses.

Design/methodology/approach

The sample consists of 167 female detainees from local rural jails in the USA. To assess participants’ behavioral health, the Comprehensive Addictions and Psychological Evaluation – 5 (CAAPE-5) was administered. The associations between PTSD, PD, AUD and violent offenses were investigated using bivariate statistics and multivariate logistic regression.

Findings

Over half of the female detainees in the sample met criteria individually for PTSD, PD or AUD, substantiating previous work on prevalence rate. Of the sample, only 10% were charged with violent offenses, from which the predominant condition reported was PTSD. Among detainees arrested for violent offenses, 69% also met criteria for PTSD, 56% for AUD and 44% for PD. Multivariate results indicate AUD was the only significant predictor for violent offenses.

Research limitations/implications

Female detainees experience trauma and mental health conditions at high rates. Research-informed mental health care may result in increased treatment efficacy. Provided the links between PTSD, PD and AUD, special considerations for this population should address interpersonal factors in treatment that may relate to violent offenses.

Originality/value

Little research exists examining female jail detainees and the implications of AUD, PTSD and PD on violent offending. To the authors' knowledge, this is the first study to examine the relationship between AUD, PTSD and PD in female jail detainees with violent offenses.

Substance Use Risk Indicators and Offending Patterns Among Local Jail Inmates

This study examined clinical indicators of adult jail inmates' substance use severity and offending patterns. Clinical assessment and booking data were gathered from a random sample of 283 adult inmates using the Comprehensive Addiction and Psychological Evaluation-5, which is consistent with diagnostic criteria in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Greater substance use risk was associated with increased likelihood of detention for property-related offenses, nonviolent offenses, and multiple jail admissions. Inmates with greater substance use risk were also significantly less likely to be detained for violent offenses. The assessment and coordination of care for jail inmates in local detention centers is paramount to reducing jail bookings, especially for nonviolent offenses.

Breaking the addictive cycle of the system: improving US criminal justice practices to address substance use disorders

PURPOSE

Recent political commentary in the USA has suggested that there is great potential for current criminal justice practices designed for drug-involved offenders to be significantly overhauled in the near future. It is imperative to plan for these changes by assessing how well current programs serve drug-involved criminal justice populations. The paper aims to discuss these issues.

DESIGN/METHODOLOGY/APPROACH

This critical assessment begins with an overview of the most recent research on the prevalence and impact that substance use disorders have within the criminal justice system. Although the evidence demonstrates that relying on incarceration as a crime control method for drug-involved offenders has many shortcomings, there are innovative new programs being adopted across the country. Two of these promising programs are discussed, as well as the potential results that could be realized from integrating medication assisted treatment into appropriate criminal justice programs designed for drug-involved offenders.

FINDINGS

Incarceration is a failed practice for attending to the underlying reasons why many drug-involved offenders become involved in criminal activities. There are encouraging new programs emerging in different parts of the USA, but the inclusion of supplemental treatment options could further promote positive outcomes.

ORIGINALITY/VALUE

The impending expansion of criminal justice programs for drug-involved offenders must consider how innovative new programs can be fused with supplemental treatment options to achieve the best results.

The Connections Between Substance Dependence, Offense Type, and Offense Severity

The link between drug use and crime has been broadly described, but little detail is known about the contributions of alcohol and drug dependence to different types of offending. Data were drawn from the 2010 Arrestee Drug Abuse Monitoring II (ADAM II) program to examine the relationships between dependence, offense type, and severity among recent male arrestees ( N = 3,006). A substantial proportion (ranging from 15% to 39%) of arrestees across all offense types and severity levels endorsed drug-dependent items. Smaller proportions (between 5% and 16%) of arrestees endorsed alcohol-dependent items. Drug dependence was associated with higher odds of receiving felony charges and higher probability of being charged with a substance-related offense. Alcohol dependence was associated with lower odds of felony charges, but greater probability of being charged with a violent offense. Assessment and treatment provisions need to be systematically implemented to reduce these types of offenses.

An evaluation of a short-term drug treatment for jail inmates

A total of 70 jail inmates who participated in an intensive, short-term drug treatment program were compared with a matched group of 70 jail inmates who did not participate in the program. Survival analysis was used to estimate the hazard of recidivism during 14 months following release from jail. The hazard ratio was significantly lower for the treatment than control group, and an analysis using propensity scores confirmed these results. Only 27% of the treatment participants were returned to jail or prison for more than 30 days, compared with 46% of the matched control group. According to qualitative responses from the participants, the program helped inmates recognize the consequences of their behavior and change their perspective. The results indicate that an intensive, short-term drug treatment program can be implemented within jails and might be a useful tool to help offenders prepare for reentry and reduce their risk of recidivism.

Drug-abusing offenders with comorbid mental disorders: problem severity, treatment participation, and recidivism

This study examined problem severity, treatment participation, and recidivism among 1,016 offenders with co-occurring mental disorders who participated in California's Proposition 36. Participants were assessed using the Addiction Severity Index (ASI) at baseline, and their records on mental health diagnoses, drug treatment participation, and arrests were also obtained. Participants' co-occurring disorder (COD) severity was classified as mild or severe based on specific mental health diagnoses. Predictors of recidivism were examined among mild-COD and severe-COD participants separately using ordinal logistic regression. Results indicate that although previous arrests, education, and treatment retention length are predictors of recidivism generally, gender, age, primary drug, ASI drug severity score, and treatment modality are differentially important depending on COD status. These results underscore the need for COD-focused intervention strategies among offenders, taking into consideration the severity of their COD status.

Testing for HIV, sexually transmitted infections, and viral hepatitis in jails: still a missed opportunity for public health and HIV prevention

Jails provide an underutilized public health opportunity for screening for HIV, sexually transmitted infections (STIs), and viral hepatitis, and for such other infectious diseases as tuberculosis. Incarcerated individuals are more likely to be men, poor, persons of color, and at high risk for HIV. The vast majority of jails in the United States do not screen routinely for HIV or STIs, thereby missing an opportunity for HIV and STI diagnosis, treatment, and prevention. Nesting HIV testing within STI testing and treatment in conjunction with testing and treatment for other infectious diseases, as appropriate based on community prevalence, provides a public health opportunity and will enhance HIV prevention. HIV testing and linkage to care, both within corrections and in the community, comprise an important component of the "seek and treat" strategy to further prevent HIV infection. Jail-based screening of infectious diseases, especially for HIV and STIs, in conjunction with treatment and linkage to community care has thus far been a neglected component of HIV prevention among high-risk communities.

Profiles of disability among adults with bipolar spectrum disorders

BACKGROUND

Heterogeneous groups of patients with a spectrum of service needs are commonplace in mental health settings. Although comprehensive assessments are available to measure variations in service needs, numerous challenges still exist when confronting this heterogeneity and many assessments used in clinic settings are lengthy and have not been demonstrated to be consistent over time.

OBJECTIVE

The purpose of this study was to identify subgroups of persons with bipolar spectrum disorders, who have similar disability profiles, and to the extent to which the subgrouping is stable over time.

METHODS

Participants were recruited from the Continuous Improvement for Veterans in Care-Mood Disorders. Eligible patients (N = 435) were those who received inpatient or outpatient treatment for bipolar disorder at a large urban VA mental health facility in Western Pennsylvania from July 2004 through July 2006. This was a naturalistic cohort study of patients with bipolar spectrum disorders. Baseline and 1-year follow-up data were collected using face-to-face interviews and recorded abstraction. The World Health Organization Disability Assessment Scale was the primary measure used to identify subgroups within this sample.

RESULTS

Using a classification strategy called latent profile analysis, this study identified three unique subgroups that showed significant differences in various clinical measures at baseline and follow-up. The largest and most consistent subgroup differences were observed in the current bipolar symptomatology.

CONCLUSION

The classification of functional status in the present study can aid clinicians in the identification of bipolar patients, with specific impairment profiles, who may need additional intervention. Future research is needed to understand whether specific interventions targeted at these subgroups can improve the quality of care for this high-need and at-risk population.

Gender differences in 16-year trends in assault- and police-related problems due to drinking

This study examined the frequency and predictors of physical assault and having trouble with the police due to drinking over 16 years among women and men who, at baseline, were untreated for their alcohol use disorder. Predictors examined were the personal characteristics of impulsivity, self-efficacy, and problem-solving and emotional-discharge coping, as well as outpatient treatment and Alcoholics Anonymous (AA) participation. Women and men were similar on rates of perpetrating assault due to drinking, but men were more likely to have had trouble with the police due to drinking. Respondents who, at baseline, were more impulsive and relied more on emotional discharge coping, and less on problem-solving coping, assaulted others more frequently during the first year of follow-up. Similarly, less problem-solving coping at baseline was related to having had trouble with the police more often at one and 16 years due to drinking. The association between impulsivity and more frequent assault was stronger for women, whereas associations of self-efficacy and problem-solving coping with less frequent assault and police trouble were stronger for men. Participation in AA was also associated with a lower likelihood of having trouble with the police at one year, especially for men. Interventions aimed at decreasing impulsivity and emotional discharge coping, and bolstering self-efficacy and problem-solving coping, during substance abuse treatment, and encouragement to become involved in AA, may be helpful in reducing assaultive and other illegal behaviors.