Correlates of Presence and Remission of Post-trauma Stress Disorder in Incarcerated Women: A Case-Control Study Design.

Shaoling Zhong,Graham Mellsop,Xiaomin Zhu,Xiaoping Wang,Jiansong Zhou

doi:10.3389/fpsyt.2021.748518

Abstract

Women in prison are vulnerable to post-trauma stress disorder (PTSD). However, little is known about the presence of PTSD in imprisoned women or of the natural course of that disorder. The purpose of this study was to assess the risk factors for PTSD in incarcerated women and document correlations of remission. We conducted a retrospective case-control study in the Female Prison of Hunan Province, China. Participants were screened for PTSD and depression using the Chinese version of the MINI International Neuropsychiatric Interview (MINI) 5.0. Of the 2,322 women screened, 220 met the criterion for PTSD on admission. Remission (N = 142) and non-remission PTSD (N = 78) were then separated depending on current PTSD status. History of drug use (OR = 0.43, 95% CI: 0.28–0.66, p < 0.001) and violent offense (OR = 1.56, 95% CI: 1.17–2.09, p < 0.001) were associated with the presence of PTSD. Positive associations with remission were found for longer length of sentence (61–120 vs. 13–60 months) (OR = 4.20, 95% CI: 1.50–11.75, p = 0.006), violent offense (OR = 2.50, 95% CI: 1.12–5.60, p = 0.03), and comorbid depression (OR = 29.69, 95% CI: 3.50–251.78, p = 0.002); while a negative correlate was identified for past depression (OR = 0.24, 95% CI: 0.11–0.53, p < 0.001). Although some incarcerated women with PTSD can spontaneously remit, this study suggested certain criminological and clinical risk factors are associated with the presence of PTSD and others with remission over time. Timely screening and effective intervention should be tailored for individuals with PTSD in prisons.

Highlights

There are over 100,000 women imprisoned in China, with an increase rate of 39% in the last decade [1, 2]
Compared to non-post-trauma stress disorder (PTSD), incarcerated women with PTSD were more likely to be living in rural areas (39.1 vs. 31.3%, p = 0.02), employed prior to the prison (65.0 vs. 56.0%, p = 0.01), have been violent offenders (44.1 vs. 30.0%. p < 0.01), non-smokers (18.2 vs. 27.7%, p < 0.01), no history of drug use (81.8 vs. 72.3%, p < 0.01), and have a past history of depression (34.5 vs. 29.0%, p < 0.01)
Among the 220 incarcerated women who suffered from PTSD at imprisonment, 142 spontaneously remitted during their imprisonment, giving a remission rate of 64.5%

Summary

Introduction

There are over 100,000 women imprisoned in China, with an increase rate of 39% in the last decade [1, 2]. 211,870 women were incarcerated in the United States, as compared to 112,797 in 2010 [3]. 7% of prisoners are women but their rate of increase is 9 times greater than for men across the world [4]. High incidence of mental health problems and serious mental illness in the prison population have been identified. Incarcerated women have been shown to be vulnerable to post-traumatic stress disorder (PTSD) [5, 6].

Objectives

Methods

Results