Incarceration and adversity histories: Modeling life course pathways affecting behavioral health

An Interpretive Description of Drug Withdrawal Among Pregnant Women in Jail

OBJECTIVE

To explore the experience of drug withdrawal among pregnant women in jail.

DESIGN

A qualitative interpretive descriptive approach.

SETTING/PROBLEM

The care of incarcerated pregnant women constitutes a complex and significant public health problem. Many have substance use disorder (SUD) and cycle in and out of jails in their community, resulting in repeated experiences of drug withdrawal. Most jails do not provide medication-assisted therapy for management of withdrawal, a situation that violates standards of care set by leading health organizations. The experience of drug withdrawal among pregnant women in jail has not been qualitatively explored in the literature.

PARTICIPANTS

Five women completed interviews for the study.

INTERVENTION

In-depth, qualitative interviews.

RESULTS

Five themes with subthemes emerged from the interviews: Framing the Story Through Life History: I Need You to Know Where I Come From, Patterns of Thinking About Substance Use, The Manifestations of Withdrawal: Body and Mind, Perceived Punishment for Drug Use During Pregnancy, and Mixed Perceptions of Withdrawal Treatment.

CONCLUSION

Participants told a story beyond that of the physical withdrawal symptoms, revealing new insights into their maternal distress and the need for compassionate, nonstigmatized care to address physical and mental symptoms, as well as advocacy for the provision of an evidence-based standard of care. Nurses who care for pregnant women with SUD in the jail setting could benefit from collaborative relationships with other health care professionals in the community to reduce disparate health outcomes for this vulnerable population.

Relationships between sleep duration and health among U.S. adults with a history of household incarceration during childhood

The rate of incarceration in the United States has increased at an alarming rate in the past 30 years and thus so has the number of children having a household member incarcerated (referred to as household incarceration). Associations between experiencing household incarceration in childhood and later negative health and developmental outcomes are well-documented; however, the underlying mechanisms linking this childhood stressor and adult outcomes have been less well studied. Using state Behavioral Risk Factor Surveillance System survey data (N = 145,102), this study examines how experiencing household incarceration during childhood is associated with mental and physical health in adulthood and mediational pathways through suboptimal sleep (short or long sleep). Results indicate there were significant indirect effects of household incarceration to physical and mental distress through short sleep (≤ 6 hr per 24 hr) and long sleep (≥ 10 hr per 24 hr), and a significant indirect effect of household incarceration to body mass index through short sleep. Findings from the present study highlight indirect pathways through which household incarceration in childhood is linked with sleep health in adulthood and, in turn, to negative mental and physical health. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Reaching young people living with HIV & AIDS and young people in detention with comprehensive sexuality education (CSE): a preparatory formative study in Ghana

As an interface between health and education, comprehensive sexuality education (CSE) offers a potent tool among other interventions to accelerate healthy transition of adolescents into adulthood. With increasing interest in in-school CSE provision/delivery, young people in out-of-school contexts may be left behind. This study forms part of implementation research to understand if the activities used to train and support the facilitators are feasible, appropriate, acceptable, and effective in enabling them to engage a defined group of young people, deliver CSE to them in the out-of-school context, and assist them in obtaining relevant services. This paper presents findings of mapping of out-of-school CSE interventions in Ghana, ongoing or completed between 2015 and 2020, and then discusses a needs assessment of two purposively selected groups of vulnerable out-of-school youth: young people living with HIV and AIDS (YPLHIV) and those living in detention (YPiD). We conducted 10 interviews with YPLHIV and three focus group discussions with YPiD in November 2020. Qualitative data were analysed thematically using both deductive and inductive approaches. The mapping yielded 29 interventions (18/62% were ongoing) focused extensively on the delivery of CSE-related knowledge and information; none were aimed at building facilitators' capacity and most targeted the northern regions. Among YPLHIV, living positively after diagnosis, disclosure skills and use of HIV/AIDS health services were critical. YpID sought clarification on personal hygiene, consent in sexual relationships, medium/channel to deliver CSE, and issues around same-sex sexual intercourse. Both groups sought skills in dealing with stigmatisation and discrimination. Implications of the findings for our own and other interventions are highlighted.

Adverse Childhood Experiences and Criminal Justice Contact in Adulthood

OBJECTIVE

To assess the relationship between adverse childhood experiences (ACEs) and formal criminal justice system processing during young adulthood and middle adulthood.

METHODS

Data are from the National Longitudinal Study of Adolescent to Adult Health (N = 8531). Logistic regression, multinomial logistic regression, and Poisson regression models were used to assess the relationship between accumulating ACEs (0, 1, 2, 3, or 4 or more) and criminal justice system processing during young adulthood (24-32) and middle adulthood (33-43).

RESULTS

Accumulating ACEs -especially 4 or more ACEs- was significantly associated with various forms of criminal justice contact during young and middle adulthood, including having been arrested, experiencing a greater number of arrests, having been incarcerated in adulthood, having been incarcerated multiple times, and having spent longer periods of time incarcerated.

CONCLUSIONS

This study documents that the association between ACEs and formal criminal justice extends into young and middle adulthood. Considering the consequences of both ACEs and criminal justice system contact for a variety of life domains, the findings suggest the need for developing and employing early interventions to disrupt pathways to criminal justice system involvement.

Adverse Childhood Experiences and Perceived Unfair Police Treatment: Differences by Race and Ethnicity

PURPOSE

The purpose of the study was to examine racial/ethnic heterogeneity in the relationship between adverse childhood experiences (ACEs) and perceived unfair police treatment in the United States.

METHODS

Data are from the National Longitudinal Study of Adolescent to Adult Health (n = 8,876). Logistic regression models were used to assess the relationship between accumulating ACEs and perceived unfair police treatment. Moderation analyses were conducted to assess interactions between ACEs, race, and ethnicity.

RESULTS

Those with four or more ACEs were 3.4 times as likely to report perceived unfair police treatment by adulthood, relative to individuals with zero ACEs (odds ratio = 3.411, 95% confidence interval = 2.634, 4.418). Still, Black individuals have the highest probability of experiencing unfair police contact, and this pattern remains relatively stable irrespective of the number of ACEs. The probability of perceived unfair police treatment significantly increases alongside accumulating ACEs for all other racial and ethnic groups.

DISCUSSION

Exposure to accumulating ACEs substantially elevates the likelihood of perceived unfair police treatment. However, perceived unfair police treatment is so common in the lives of Black Americans; it occurs at considerably high rates irrespective of ACE exposure.

Maternal incarceration: Impact on parent-child relationships

Female incarceration is rising steeply in Australia and other high-income countries. The majority of incarcerated women are mothers. Their children represent a particularly vulnerable group, often subject to adverse experiences due to their family's disadvantaged circumstances involving inadequate housing, food insecurity, poverty, poor health, a lack of personal safety due to violence and resulting trauma. This qualitative study explores parenting experiences of incarcerated mothers separated from their children. Interviews involved 65 mothers in three Australian prisons and 19 stakeholders providing correctional services and support for incarcerated women. Data were analysed using interpretive description. Mothers' accounts highlighted frustrations resulting from trying to maintain relationships with their children, often exacerbating their separation and compounding parenting difficulties. Two major themes emerged from the data: 'protecting their children' and 'at the mercy of the system'. Mothers described how they tried to protect their children from the consequences of their incarceration, yet many of the correctional system processes and procedures made it even harder to maintain connection. Incarcerated mothers need support in their parenting role. Ideally, this support should commence during incarceration. Further, changes within prison routines could enhance mothers' efforts to keep in contact with their children, through visits and phone calls.

Adverse Childhood Experiences and Justice System Contact: A Systematic Review

CONTEXT

Given the wide-ranging health impacts of justice system involvement, we examined evidence for the association between adverse childhood experiences (ACEs) and justice system contact in the United States.

OBJECTIVE

To synthesize epidemiological evidence for the association between ACEs and justice system contact.

DATA SOURCES

We searched 5 databases for studies conducted through January 2020. The search term used for each database was as follows: ("aces" OR "childhood adversities") AND ("delinquency" OR "crime" OR "juvenile" OR criminal* OR offend*).

STUDY SELECTION

We included all observational studies assessing the association between ACEs and justice system contact conducted in the United States.

DATA EXTRACTION

Data extracted from each eligible study included information about the study design, study population, sample size, exposure and outcome measures, and key findings. Study quality was assessed by using the Newcastle-Ottawa Scale for nonrandomized trials.

RESULTS

In total, 10 of 11 studies reviewed were conducted in juvenile population groups. Elevated ACE scores were associated with increased risk of juvenile justice system contact. Estimates of the adjusted odds ratio of justice system contact per 1-point increase in ACE score ranged from 0.91 to 1.68. Results were consistent across multiple types of justice system contact and across geographic regions.

LIMITATIONS

Most studies reviewed were conducted in juvenile justice-involved populations with follow-up limited to adolescence or early adulthood.

CONCLUSIONS

ACEs are positively associated with juvenile justice system contact in a dose-response fashion. ACE prevention programs may help reduce juvenile justice system contacts and improve child and adolescent health.