Speaking unavoidable truths: understanding early childhood sexual and physical violence among women in prison

Past-year nonmedical use of prescription drugs among women on probation and parole: A cross-sectional study

BACKGROUND

Prescription drug-related overdose deaths have increased dramatically in recent years. Women in the justice system experience high rates of drug use, victimization, trauma symptoms, and other health problems and would appear to be at high risk for nonmedical use of prescription drugs (NMUPD). This study will be among the first to describe prevalence and correlates of NMUPD among this population.

METHODS

This cross-sectional study collected data from 406 victimized women on probation and parole between 2010 and 2012. In a multiple logistic regression model, we differentiated women who reported past-year NMUPD from those who did not using demographic, health, other drug use, substance use treatment, and trauma symptom severity variables.

RESULTS

Past-year NMUPD was reported by 26.8% (n = 109) of the overall sample. Women reporting NMUPD were significantly younger and more likely to be white. Past-year use of alcohol (adjusted odds ratio [AOR]: 3.3; 95% confidence interval [CI]: 1.8-6.1), marijuana (AOR: 3.6; 95% CI: 1.8-7.0), methamphetamines (AOR: 6.1; 95% CI: 1.7-21.3), and heroin (AOR: 8.4; 95% CI: 2.0-35.2) were significantly associated with NMUPD. Additionally, each unit increase in the measure assessing bodily pain was associated with a 40% increase (AOR: 1.4; 95% CI: 1.1-1.7) in the odds of NMUPD. Finally, meeting diagnostic criteria for posttraumatic stress disorder almost doubled (AOR: 1.9; 95% CI: 1.1-3.4) the odds of reporting past-year NMUPD.

CONCLUSIONS

Victimized women on probation and parole report high rates of NMUPD, and this behavior intersects with other complex social, behavioral, psychological, and physical needs. The authors recommend increased access to trauma-informed correctional care among women in the justice system.

Childhood Adversities and Substance Misuse Among the Incarcerated: Implications for Treatment and Practice in Correctional Settings

BACKGROUND

Incarcerated populations have high rates of childhood adversities and substance use problems. Moreover, childhood adversities are well-documented predictors of substance misuse.

OBJECTIVE

To investigate the impact of childhood sexual and physical abuse, caregiver abuse of drugs or alcohol, and time spent in foster care on several substance misuse outcomes.

METHODS

Data comes from a sample of 16,043 incarcerated men and women in the United States Survey of Inmates in State and Federal Facilities. Bivariate analyses revealed differences by sex in childhood adversities and socioeconomic characteristics. Logistic regression analyses assessed the data for a link between childhood adversities and substance misuse after adjusting for other variables. Analyses were stratified by sex to show differences in predictors of substance misuse between men and women.

RESULTS

Childhood adversities increased the risk of many substance misuse outcomes. The prevalence of physical abuse, sexual abuse, foster care, and caretaker abuse of drugs or alcohol were greatest for inmates who reported injecting and sharing drugs. Growing up with a caregiver that used drugs or alcohol was a consistent predictor of increased risk of substance misuse for men and women. However, childhood sexual abuse increased risk for only women.

CONCLUSIONS

Inmates who experience physical abuse, sexual abuse, foster care involvement and caretakers who use drugs and alcohol are at an increased risk of substance misuse, injecting drug use and syringe sharing. Implications suggest correctional HIV prevention and substance misuse programs must address unresolved trauma and important gender differences.

Waiting to be Caught: The Devolution of Health for Women Newly Released from Jail

Traditionally understood ideas about health and criminal behaviors are integrally linked within an individual's health, as well as a community's health. In a time when women are increasingly jailed, it is important to examine the life ways of women who are newly released. This study, using participatory action research and critical hermeneutic data analysis techniques, examined women's health and social experiences following their release from jail. Findings suggest that women experienced an onward and downward momentum of health indices, or devolution, with regard to economic status, physical and mental health status, intimate and family relationships, and general social functioning. It is argued that basic public health and community nursing interventions would provide a more seamless transition from jail back into community and would positively impact the individual and community health issues that are embedded within the criminal activity.

Parenting Programs for Incarcerated Parents

Increases in the number of incarcerated parents have led to the implementation of parent training programs in prisons. Although many programs exist, programs differ in their design and methods of self-assessment. This article examines the current state of research on parenting interventions, including the types of programs available, the outcomes measured in each study, and the overall effectiveness of parent training. Variables that may affect program effectiveness, such as sentence length, educational level, and parent gender, are considered. The importance of primary prevention through parent training is discussed, including implications for social welfare and further scientific inquiry.

Predictors of High Level of Hostility among Homeless Men on Parole

High levels of hostility present a formidable challenge among homeless ex-offenders. This cross-sectional study assessed correlates of high levels of hostility using baseline data collected on recently-released male parolees (N=472; age 18-60) participating in a randomized trial focused on prevention of illicit drug use and recidivism. Predictors of high levels of hostility included greater depressive symptomatology, lower self-esteem, having a mother who was treated for alcohol/drugs, belonging to a gang, more tangible support, having used methamphetamine and having a history of cognitive difficulties. These findings highlight the need to understand predictors of hostility among recently released homeless men and how these predictors may relate to recidivism. Research implications are discussed as these findings will shape future nurse-led harm reduction and community-based interventions.

A warm touch in a cold cell: inmates' views on conjugal visits in a maximum-security women's prison in Israel

Conjugal visits are believed to have positive effects during and after confinement. Yet, studies on the dynamics of such visits from women's point of view and their attitudes toward such visits are sparse. This study sought to identify and analyze female inmates' attitudes toward conjugal visits, describe the dynamics of conjugal visitations, and examine the meaning of conjugal visitation programs to the participants. The findings of this study reveal that (a) female inmates perceive conjugal visits as a significant and positive program in the prison, (b) these visits ease their pains of imprisonment and help to strengthen their relationships with their partners, and (c) nevertheless, the inmates express some criticism toward the poor condition of the visitation facilities and their unsatisfactory upkeep, claiming that such conditions limit their ability to feel and act freely during the meetings.

Nurse researchers in corrections: a qualitative study

The United States has more people, per capita, in prisons and jails than any other country in the world. Because the prison population is largely composed of people who have been economically and socially disadvantaged, a very high percentage enter correctional facilities in poor health. Because of the large concentrated numbers of women, men, and youth in prisons and jails, an exceptional opportunity exists for nurses and other researchers to conduct creative and innovative research to improve the health care of this hard-to-reach population. The purpose of this study was to explore the experiences of nurse researchers who have been successful in conducting studies in different correctional settings. A qualitative descriptive design was used, and telephone interviews with 16 participants were completed. The participants described how they established credibility, the challenges they faced, and the unexpected personal and professional rewards they received. Recommendations for potential researchers will hopefully lead to an increase in research with this invisible population.

Using a trauma-informed framework to care for incarcerated women

Available health and social services in women's correctional facilities often do not consider the interrelationship of gender, trauma, and mental illness. As a result, preexisting health issues are often exacerbated, leaving women to reenter their communities with more complex health needs. We propose that a trauma-informed framework can be used to guide clinical interactions with female inmates. A case study is presented as an example of proposed best clinical practice. Future trauma-related practice implications are provided.

The Extensive Sexual Violation and Sexual Abuse Histories of Incarcerated Women

A growing body of research reports on the lifetime prevalence of sexual victimization experiences among incarcerated women. However, none of this research provides a detailed account of the many types and levels of sexual violations and sexual abuses, the age of occurrence, and the victim–offender relationship. This study used the Sexual Abuse Checklist (designed by the first author) and a modified version of the Sexual Experiences Survey (SES) to obtain a detailed account of 391 incarcerated women's self-reported sexual violation and abuse histories. Seventy percent of the women reported at least one violation consistent with what qualifies as “rape” in most states in the United States today, and half of the women reported child sexual abuse victimization. The most prevalent victim–offender relationships were male strangers, male lovers or boyfriends, male dates, husbands, uncles, brothers, male cousins, and stepfathers.

Childhood maltreatment and cluster B personality pathology in female serious offenders

The authors examined early maltreatment among serious female offenders at a maximum-security correctional facility, contrasting the maltreatment histories of inmates with and without Cluster B personality pathology. Women were interviewed regarding the frequency of 13 indicators of psychological or physical abuse perpetrated by maternal or paternal caregivers and the frequency of 10 types of sexual abuse perpetrated by persons at least 5 years older. Reports were based on inmates' recollected worst years of maltreatment before age 16. Women in both diagnostic groups reported substantial early maltreatment. Cluster B inmates reported higher levels and a greater variety of maternal and paternal physical and psychological abuse but were not distinguished from non-Cluster B inmates on levels of childhood sexual abuse. Inmates reported more physical and psychological abuse from maternal than paternal caregivers. The results document the high levels of childhood maltreatment of female prisoners and the relevance of this history to personality pathology.

Perception of mutual violence in incarcerated women’s intimate partner relationships in Mexico City

The purpose of this article is to determine the degree of physical violence received and inflicted over the past two years by a sample of women in prison in their relationships with their partners (N=/213). Over half of the women report having suffered some form of violence at the hands of their partners at some time in their lives. As for physical violence experienced over the past two years, one out of every four women has experienced violence at the hands of her partner. The women in this study rated the act of physical violence they had experienced in the past two years as severe, a term they also used to describe the degree of disturbance, anger and fear they felt after the violent incident. As for the violence the women inflicted on their partners, one out of every four women has inflicted violence on her partner (26.8%) although they rate the most aggressive event during these past two years as slight. After the event, over half the women felt severely disturbed as well as slightly angry and scared.

Conceptualizing nursing research with offenders: another look at vulnerability

In this article, vulnerability is examined as it applies to the conduct of nursing research with offenders. As a group, offenders present with a multitude of acute and chronic physical and mental health care needs; they are subject to discrimination, stigmatization, and marginalization; and as such, they often experience dual, multiple, or overlapping vulnerabilities. As research participants, they are especially vulnerable to coercion, as a direct consequence of their dependency status within the correctional system. Embracing a research agenda that focuses on offenders as a vulnerable population is fraught with ambiguities not generally encountered in other settings. The ethical conduct of research with vulnerable populations reflects a contemporary research problem that requires ongoing discourse within the nursing community and the health care community at large.

Methodological issues associated with studying an illegal act: assisted dying

The experience of receiving patient requests for assistance in prematurely ending life can represent both an ethical and legal dilemma for nurses in the United States. Similarly, the study of nurses' involvement with such a sensitive topic also poses risks to the study participants, the researcher, and the nursing profession's covenant with society. The purpose of this article is to explore methodological issues and approaches associated with studying an ethically and legally sensitive issue, and to describe application of these approaches to a study of oncology nurses' experiences with receiving requests for assisted dying from terminally ill patients with cancer.

Nursing Care Partnerships with Women Leaving Jail

Crime is a significant and complex social issue with profound health consequences for individuals, families, and communities. Conceptualizing criminal behaviors as health behaviors reflects the potential for innovative interdisciplinary approaches and alliances to interrupt cycles of crime as a way to improve health. Incarcerated populations have extremely high rates of undiagnosed and undertreated infectious diseases and mental illnesses. Nursing is uniquely positioned to develop prevention, intervention, and treatment strategies for individuals involved in criminal activities before, during, and after incarceration.

The Relationship of Maladaptive Beliefs to Personality and Behavioral Adjustment Among Incarcerated Women

This study examined the relationship between schema domains (Young, 1999) and adjustment in a sample of female prison inmates (N= 116). Participants completed the Early Maladaptive Schema Questionnaire—Revised, the SCID-II Screen, the Brief Symptom Inventory, and the Prison Violence Inventory. Institutional records provided information concerning documented behavioral infractions. The Impaired Limits domain score, representing entitlement and poor self-control themes, was associated with screening scores for paranoid, antisocial, borderline, histrionic, and narcissistic personality disorders, as well as hostility symptoms, institutional misconduct, and self-reported violence perpetration and victimization. The Disconnection/ Rejection domain score was associated with a wide array of self-reported mental illness symptoms. A significant relationship between the Impaired Autonomy domain scale and dependent personality disorder (SCID-II Screen) was also observed. Results indicate that domains of belief are plausibly related to specific dysfunction in personality and behavioral adjustment. Results also suggest the potential benefit of using cognitive therapy with incarcerated women.