Female Prison Inmates Research Articles

Risk and vulnerability of key populations to HIV infection in Iran; knowledge, attitude and practises of female sex workers, prison inmates and people who inject drugs.

Background In this study data of three national surveys conducted among female sex workers (FSW), prison inmates and people who inject drugs (PWID) were presented and compared in relation to knowledge, attitude, and practises. The surveys were conducted in 2009 and 2010 and included 2546 PWID, 872 FSW and 5530 prison inmates. Knowledge, attitude and practises towards HIV were measured through similar questions for each category. Over 90% of all participants had ever heard of HIV/AIDS, although only approximately half of them perceived themselves at risk of contracting HIV. More than 80% were able to correctly identify the ways of preventing the sexual transmission of HIV; while more than two-thirds did not use condom in their last sexual contact. Approximately 20% of prisoners and FSW had a history of injecting drugs. Among all participants who have injected drugs, prisoners had the highest unsafe injecting behaviour at the last injection (61%), followed by FSW (11%) and PWID (3%). Despite major efforts to control the HIV epidemic in Iran, the level of risk and vulnerability among prisoners, FSW and PWID is still high. The level of comprehensive knowledge about HIV/AIDS is relatively good; however, their risk perception of contracting HIV is low and high-risk behaviours are prevalent. Therefore, HIV prevention programs should be redesigned in a more comprehensive way to identify the best venues to reach the largest number of people at a higher risk of contracting HIV and decrease their risk overlaps and vulnerability factors.

A Factor Mixture Model Approach to Elaborating on Offender Mental Health Classification With the MMPI–2–RF

A large proportion of prison inmates suffer from mental illnesses or severe personality disorders; therefore, offender classification is a worthwhile endeavor both for efficiently allocating mental health treatment resources and security risk classification. This study sought to elaborate on offender classification by using an advanced statistical technique, factor mixture modeling, which capitalizes on the strengths of both latent trait analysis and latent class analysis. A sample consisting of 616 male and 194 female prison inmates was used for this purpose. The MMPI–2–RF Restructured Clinical (RC) scales were used to elaborate on a variety of latent trait, latent class, and factor mixture models. A 3-factor, 5-class mixture model was deemed optimal in this sample. Remaining MMPI–2–RF scales as well as scores on external criterion measures relevant to externalizing psychopathology were used to further elaborate on the utility of the resulting latent classes. These analyses indicated that 3 of the 5 classes were predominantly different expressions of externalizing personality proclivities, whereas the remaining 2 indicated inmates with substantial internalizing or thought-disordered characteristics. Implications of these findings are discussed.

Alcohol Use Disorder Diagnoses in the Criminal Justice System

This study explored the compatibility between the current Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; DSM-IV-TR) diagnostic criteria for alcohol abuse and dependence with the initial (DSM-5.0) and most recent (DSM-5.1) proposed diagnostic criteria. Data drawn from a structured clinical interview used in the assessment of 6,871 male and 801 female state prison inmates were analyzed according to the existing and proposed diagnostic formulations. The greatest congruence was observed in cases that received no diagnosis according to the DSM-IV-TR because these also received no diagnosis in the DSM-5.1. Most cases with a current dependence diagnosis received a severe designation according to the proposed criteria. However, those with an abuse diagnosis were divided across various DSM-5.1 severity levels. Some diagnostic criteria were nearly universally endorsed among those classified with the highest severity levels, which indicated that some criteria may serve as cardinal indicators of a severe alcohol use disorder (SAUD). Additional diagnostic criteria not yet suggested for inclusion in the DSM (i.e., preoccupation with alcohol use and alcohol use to relieve emotional distress) were also evaluated. Evidence demonstrated these two criteria served as functional indicators of alcohol use disorder (AUD). This assessment approach can be used to establish appropriate treatment objectives based on the severity of diagnosed AUDs. Meeting these treatment objectives, especially in a correctional population, may have important implications for future offending. Recommendations are made for prospective research in this area.

An examination of the triarchic conceptualization of psychopathy in incarcerated and nonincarcerated samples.

The current study tested hypotheses associated with the triarchic conceptualization of psychopathy (Patrick, 2010b; Patrick, Fowles, & Krueger, 2009), which describes three distinctive, albeit related, phenotypic domains-boldness, meanness, and disinhibition. We used two samples consisting of 209 female prison inmates and 627 undergraduate students whom had been administered a range of psychopathy and psychopathy-relevant measures. Our results indicated that the triarchic domains explained variance in other psychopathy models to degrees consistent with conceptual expectations. We also examined associations between the triarchic domains and personality traits relevant to psychopathy in the female correctional sample. The results showed that boldness was preferentially associated with narcissism, thrill/adventure seeking, and low behavioral inhibition system functioning; meanness with machiavellianism, low empathy, and low behavioral inhibition system; and disinhibition with impulsivity and fun seeking.

Substance Use Disorder Prevalence among Female State Prison Inmates

Background: Substance use disorders (SUDs) are prevalent among female inmates. As the female state prison population continues to increase, describing the specific clinical and demographic characteristics of female prisoners remains of paramount importance to better define women’s needs in the state prison system. Objectives: To determine the prevalence and patterns of current DSM-IV SUDs and explore whether particular demographic characteristics are more strongly associated with specific SUD categories. Methods: Data were derived from routine clinical assessments of 801 female inmates incarcerated in the Minnesota Department of Corrections state prison system. The Substance Use Disorder Diagnostic Schedule-IV (Hoffmann NG, Harrison PA. SUDDS-IV: Substance Use Disorder Diagnostic Schedule-IV. Smithfield, RI: Evince Clinical Assessments, 1995) was administered to all inmates as a computer-prompted interview on admission to the prison. Results: Of the inmates, 70.0% were dependent on at least one substance, and 7.9% met criteria for substance abuse. Alcohol dependence (30.2%) and cocaine dependence (30.1%) were the two most prevalent SUDs. The remaining substance dependence diagnoses that predominated were as follows: stimulant dependence, 24.1%; marijuana dependence, 15.6%; and heroin dependence, 9.6%. Over half (56.9%) were dependent on a substance other than alcohol. Prevalence of cocaine dependence [odds ratio (OR) = 2.83, 95% confidence interval (CI) = 1.92–4.16] was significantly higher among African Americans, whereas prevalence of stimulant dependence (OR = 9.24, 95% CI = 5.40–15.80) was significantly higher among Caucasians. Prevalence of alcohol (OR = 2.12, 95% CI = 1.38–3.25) and heroin (OR = 2.67, 95% CI = 1.50–4.77) dependence was significantly higher among Native Americans. Conclusions and Scientific Significance: SUDs in general, and illicit drug use disorders in particular, are prevalent among female inmates entering a state prison system. Membership to a particular ethnic group may identify a set of inmates at elevated risk for the presence of substance-specific dependence diagnoses.

Prevalence of ADHD and Its Subtypes in Male and Female Adult Prison Inmates

There are few published studies of attention-deficit/hyperactivity disorder (ADHD) in adult inmates, and even fewer studies that have considered ADHD in adult inmates by gender. The present study examined the prevalence of ADHD, its subtypes, and associated psychological and neuropsychological comorbidity as a function of gender in a sample of 3,962 inmates (3,439 men and 523 women; mean age = 33.6 years, range 17-73) who had completed the 250-item, self-report, Diagnostic and Statistical Manual of Mental Disorders, 4th edition (Text Revision) (DSM-IV-TR)-aligned Coolidge Correctional Inventory (CCI). The overall ADHD prevalence rate found was 10.5%, which is substantially higher than the rate among adults in the general population (2-5%). The female inmate ADHD prevalence rate (15.1%) was higher than the male inmate ADHD rate (9.8%), consistent with some previous studies. The most prevalent ADHD subtype for both genders was the hyperactive-impulsive subtype. The combined and inattentive ADHD subtypes had higher levels of comorbid psychopathology than the hyperactive-impulsive ADHD subtype. As the presence of ADHD and associated gender differentials may impact the success of rehabilitation and educative programs with inmates, the assessment of ADHD and comorbid psychopathology should be a priority in initial inmate screening and evaluation.

Applicability of General Power-Control Theory to Prosocial and Antisocial Risk-Taking Behaviors Among Women in South Korea

Grasmick and colleagues expanded general power-control theory to include both pro-and antisocial risky behaviors more than 10 years ago; however, to date, there have been no empirical tests of their theoretical modifications. The current study tested the comprehensive model of general power-control theory using three different samples from South Korea: women who enter traditionally male-dominated occupations, female prison inmates, and women incarcerated for intimate partner killing. Results related to women’s patriarchal attitudes and preference for general risks supported our expectations and confirmed the tenets of general power-control theory that focus on both pro- and antisocial risky behaviors. In addition, the ones related to patriarchy of the family of origin supported Hagan’s original power-control theory focusing on only antisocial risky behaviors.

Thinking Styles and Emotional States of Male and Female Prison Inmates by Mental Disorder Status

This study explored criminal thinking styles and feelings of aggression and hopelessness among male and female inmates who reported mental disorders and those who did not. A total of 4,204 respondents (3,986 males and 218 females) who were expected to be released from prison within 24 months completed an hour-long audio computer-assisted self-interview survey that included the Beck Hopelessness Scale, Buss-Perry Aggression Questionnaire Short-Form, and Criminal Sentiments Scale-Modified. Weights were constructed to adjust the sampled population to the full population of the prison. A mental disorder was reported by 19.8% of male and 46.1% of female participants, with 6.6% of males and 19.4% of females reporting a serious mental disorder. The criminal thinking patterns of male and female inmates who reported mental disorders were consistent with those of inmates who reported no mental disorders; however, levels of criminal attitudes were significantly higher among males reporting serious mental disorders than males reporting other mental disorders or no disorders. Inmates reporting mental disorders scored significantly higher on measures of aggression and hopelessness. Results of this study suggest that inmates who report mental disorders have antisocial attitudes consistent with inmates who do not report mental disorders but have levels of aggression and hopelessness that are higher than their counterparts who do not report mental disorders. These findings are vital to the development of evidence-based interventions that respond accurately and holistically to the complex constellation of needs among persons with mental disorders who are involved in the justice system.

Trauma Exposure and Mental Health Characteristics of Incarcerated Females Self-Referred to Specialty PTSD Treatment

Objectives: This study examined the traumatic and stressful event exposure history and psychiatric health characteristics of soon-to-be released female inmates who self-referred to specialty posttraumatic stress disorder (PTSD) treatment. Methods: The final sample (N=209) included female prison inmates aged 18 or older who were assessed for trauma exposure and axis I disorders with standardized clinical instruments. Results: The rate of serious mental disorders was high. Presence of psychiatric disorders was significantly associated with a history of traumatic event exposure and full or subthreshold PTSD, and high rates of overall traumatic event exposure (88%) and childhood sexual or physical trauma (74%). Descriptive profiles of specific lifetime traumatic and stressful events were associated with psychiatric disorders. Conclusions: Findings suggest strong behavioral effects associated with lifetime traumatic and stressful event histories and indicate major psychiatric health care needs among female prison inmates that are likely unmet by existing services. (Psychiatric Services 62:954–958, 2011)

Trauma Exposure and Mental Health Characteristics of Incarcerated Females Self-Referred to Specialty PTSD Treatment

This study examined the traumatic and stressful event exposure history and psychiatric health characteristics of soon-to-be released female inmates who self-referred to specialty posttraumatic stress disorder (PTSD) treatment. The final sample (N=209) included female prison inmates aged 18 or older who were assessed for trauma exposure and axis I disorders with standardized clinical instruments. The rate of serious mental disorders was high. Presence of psychiatric disorders was significantly associated with a history of traumatic event exposure and full or subthreshold PTSD, and high rates of overall traumatic event exposure (88%) and childhood sexual or physical trauma (74%). Descriptive profiles of specific lifetime traumatic and stressful events were associated with psychiatric disorders. Findings suggest strong behavioral effects associated with lifetime traumatic and stressful event histories and indicate major psychiatric health care needs among female prison inmates that are likely unmet by existing services.

What is the latent structure of alcohol use disorders? A taxometric analysis of the Personality Assessment Inventory Alcohol Problems Scale in male and female prison inmates.

Three indicators derived from the Personality Assessment Inventory (PAI) Alcohol Problems scale (ALC)-tolerance/high consumption, loss of control, and negative social and psychological consequences-were subjected to taxometric analysis-mean above minus below a cut (MAMBAC), maximum covariance (MAXCOV), and latent mode factor analysis (L-Mode)-in 1,374 federal prison inmates (905 males, 469 females). Whereas the total sample yielded ambiguous results, the male subsample produced dimensional results, and the female subsample produced taxonic results. Interpreting these findings in light of previous taxometric research on alcohol abuse and dependence it is speculated that while alcohol use disorders may be taxonic in female offenders, they are probably both taxonic and dimensional in male offenders. Two models of male alcohol use disorder in males are considered, one in which the diagnostic features are categorical and the severity of symptomatology is dimensional, and one in which some diagnostic features (e.g., withdrawal) are taxonic and other features (e.g., social problems) are dimensional.

ADHD-related symptoms among adults in out-patient psychiatry and female prison inmates as compared with the general population

Objective. To compare the prevalence of symptoms consistent with attention deficit hyperactivity disorder (ADHD) and related problems in adults in the general population, out-patient psychiatry (where females are in majority), and female convicts. Method. A questionnaire based on the DSM-IV criteria of ADHD, reported childhood symptoms, reading and spelling problems, difficulties and suffering, and general assessment of functioning (GAF) was distributed to samples of the general population, open care psychiatry, and female prison inmates. Completed questionnaires were received from 517/1000, 349/400, and 50/65 of the three samples, respectively.Results. Symptoms consistent with ADHD were more than three times higher in out-patient psychiatry than in the general population (6.6% versus 2.1%), with a male-to-female ratio of 1.6–1.7. The severity of symptoms and frequencies of associated disabilities were similar in men and women. ADHD symptoms and related problems occurred in 50% of the female prisoners, which is similar to male prisoners according to the literature.Conclusion. The high prevalence of symptoms and disabilities of ADHD in women should lead to awareness of the disorder in both sexes and be addressed in terms of diagnostic work-up, treatment, and rehabilitation.

Attention deficit/hyperactivity disorder in female offenders: prevalence, psychiatric comorbidity and psychosocial implications

Attention deficit-/hyperactivity disorder (ADHD) is associated with social maladaptation and delinquency in later life. This study was conducted to determine the prevalence of ADHD and comorbid conditions in female prison inmates. One hundred and ten adult female prison inmates of a German prison for women were investigated. SCID-I and -II interviews and standardized German instruments for the assessment of ADHD in adults (HASE) were used. The lifetime prevalence of ADHD was 24.5 and 10% for persisting ADHD according to DSM-IV criteria. A decline of the prevalence of persisting ADHD with age from 17.9% (age <25 years) to 10% (age 26-45 years) and 0% (age >45 years) was observed. Female prisoners with ADHD were younger at their first conviction as compared with females without ADHD and they showed longer incarceration periods in relation to age. The prevalence of other axis I disorders was high in both the ADHD and the non-ADHD female population, but significantly higher in ADHD females. Mean number of axis I diagnoses was 3.6 in females with ADHD and 2.3 in females without ADHD. No differences were found between females with and without ADHD regarding the prevalence of psychotic, affective, anxiety, somatization and posttraumatic disorders. Substance use disorders and in particular the use of stimulants were more frequent in females with ADHD as well as borderline personality disorder and eating disorders. The results suggest a high prevalence of ADHD in female prisoners that exceeds the prevalence estimates from epidemiological studies in general female populations. Moreover, it appears that ADHD is particularly frequent in adolescent and young adult female offenders and increases the risk for further psychiatric morbidity. The results indicate the need of adequate psychiatric support of female prison inmates including therapeutic programs for ADHD.

A Survey of HIV and HCV among Female Prison Inmates in Portugal

HIV and hepatitis C virus (HCV) monitoring among prison inmates is instrumental in countries with concentrated HIV/AIDS epidemics. Knowledge on these dynamics in imprisoned women in Portugal is scarce. The HIV and HCV prevalence was estimated among inmates in the largest Portuguese prison for women, which holds 57% of all female inmates in Portugal, according to sociodemographic and behavioural variables and characterised attitudes towards HIV/AIDS according to serological status. Collected variables included age, education, country of birth, penal status, and accumulated time in prison. Drug injection and sharing of injection material were inquired, as well as age at first sexual intercourse. Inmates also characterised their attitudes towards HIV/AIDS. A venous blood sample was collected and tested for anti-HIV and anti-HCV antibodies. In this sample of 445 female inmates, 10% were HIV-positive, while 11% were HCV-positive. Longer imprisonment periods were associated with relatively higher HCV prevalence and women with later ages at first sexual intercourse were less frequently HIV-positive, regardless of drug injecting behaviour. HIV prevalence was 44% in women who had ever injected drugs and 6% in those who had never injected. HCV frequency was 69% among injecting drug users (IDUs) and 4% among non-IDUs. In women who injected drugs both HIV and HCV were more frequent when the number of injections was higher and when women reported sharing of injection material. Similar attitudes towards HIV/AIDS were found for HIV-positive and negative women, but those living with HIV had more tolerant positions. This study emphasizes the role of injecting drug use in the transmission of HIV and HCV in women in Portuguese prisons and reinforces the need for the systematic adoption of harm reduction measures.

Taxometric Analysis of the Levenson Self-Report Psychopathy Scale

Levenson's Self-Report Psychopathy scale (Levenson, Kiehl, & Fitzpatrick, 1995) was administered to 1,972 male and female federal prison inmates, the results of which were subjected to taxometric analysis. We employed 4 taxometric procedures in this study: mean above minus below a cut (Meehl & Yonce, 1994), maximum slope (Grove & Meehl, 1993), maximum eigenvalue (Waller & Meehl, 1998), and latent-mode factor analysis (Waller & Meehl, 1998). The results showed consistent support for a dimensional interpretation of the latent structure of psychopathy, corroborating previous research conducted on the Psychopathy Checklist (e.g., Psychopathy Checklist–Revised; Hare, 2003) and Psychopathic Personality Inventory (Lilienfeld & Andrews, 1996) and denoting that psychopathy is a dimensional construct (degree of psychopathic characteristics) rather than a qualitatively distinct category of behavior (psychopath).

Childhood Sexual Abuse by a Family Member, Salivary Cortisol, and Homicidal Behavior of Female Prison Inmates

Little is understood about neuropathophysiology and neuroendocrinology associated with childhood sexual abuse by a family member in females who commit homicide. To determine if females sexually abused by a family member as a child also experienced more childhood physical abuse, had more neurological histories including traumatic brain injuries (TBIs), displayed more homicidal behaviors, and had abnormal diurnal variation in the stress hormone cortisol compared with females not sexually abused by a family member. A cross-sectional study was conducted with 137 female inmates, including 9 murderers and 12 noncriminal females, with logistic regression statistical analysis comparing females who have (n = 60) and have not (n = 89) been sexually abused by a family member, as determined by Muenzenmaier's Childhood Abuse Scale. Final multivariate logistic regression model controlling for higher numbers of incarcerated adult family members (odds ratio [OR] = 1.63, p = .01) revealed that female victims of childhood sexual abuse by a family member experienced more childhood physical abuse (OR = 1.09, p = .05), experienced more TBIs (OR = 1.49, p = .01), and displayed increased violent behaviors including homicide (OR = 1.67, p = .05) compared with those not sexually abused by a family member. In univariate analysis, females sexually abused by a family member also experienced more sexual abuse by a non-family member (OR = 1.21, p = .036), more hospital visits for abuse injuries (OR = 1.27, p = .03), and more recent abuse (OR = .95, p = .008). Childhood sexual abuse by a family member was related significantly to decreased diurnal cortisol variation (OR = .087, p = .044) when controlling for number of years since last abuse, number of incarcerated adult family members, body mass index, depression, and TBIs. Risks associated with sexual abuse by a family member should be considered for individuals and policies to prevent potential homicide by those who experienced it. Further study is needed.

Neurological Function and HIV Risk Behaviors of Female Prison Inmates

The purpose of this study was to explain relationships between neurological dysfunction, HIV serological status, and HIV risk behaviors that have not been well understood. A secondary analysis was conducted on data from 117 female prison inmates. Another 18 female inmates from the same prison were further evaluated with more specific neurological, neuropsychological, and HIV risk behavior Risk Assessment Battery (RAB) measures. Neurological function, defined by valid, reliable quantitative measures of cognition, behavior/mood, cranial nerves, motor, reflexes, and sensation, was significantly correlated with HIV RAB scores (.743, p = .006), and RAB scale scores (.824, p = .001) in HIV-negative, but not HIV-positive, inmates. Specifically, the reflex deficits subscale correlated with RAB scores (.779, p = .003) and RAB scale scores (.682, p = .015) in the HIV-negative group. These findings combined with subjects' histories suggest cerebral dysfunction possibly contributes to HIV risk behaviors in certain high-risk female inmates predating HIV infection. These findings further suggest that HIV risk reduction should target neurologically impaired females as a high-risk group. Larger studies are needed to validate these findings.

Men and Women in the Same Prison

The purpose of this study was to investigate the gender differences in the state of interpersonal needs and psychological health of male and female prison inmates who live in the same prison. The authors conducted in-person interviews with 118 male and 70 female inmates. The results show that women present a better interpersonal state and psychological health than do men. For both genders, the consequences of fulfilling or not fulfilling interpersonal needs-specifically, social loneliness and sexual satisfaction-are associated with psychological health. These findings suggest the importance of the state of prison inmates' interpersonal needs in promoting psychological health in the context of the prison, where these needs are generally difficult to be met. Making contacts possible between male and female inmates who are in the same prison might help them to better fulfill some of their interpersonal needs, especially those related to their sexual lives.

Estudo de comportamento associado à infecção pelo HIV e HCV em detentas de um presídio de São Paulo, Brasil

An increase has been observed in AIDS and hepatitis C cases in women, including female prison inmates. This study focused on inmates' behavioral factors associated with risk of HIV and HCV transmission in a women's detention facility in São Paulo, Brazil. Behavioral questionnaires were applied and HIV and HCV serology were performed. The selected measure of association was odds ratio for both the bi and multivariate logistic regression analyses. 290 inmates participated in the study. HIV and HCV prevalence rates were 13.9% and 16.2%, respectively. Statistically significant associations were observed (p < 0.05) between HIV and the following variables: partner with AIDS OR = 6.9 (2.7-35.2); injection drug users (IDU) OR = 3.3 (1.6-14.7); regular partner OR = 3.7 (1.5-8.3), and between HCV and: IDU OR = 13.7 (4.4-42.7); IDU partner OR = 4.9 (1.9-12.2); previous arrest OR = 2.8 (1.2-6.5) adjusted for: partner with AIDS, IDU, IDU partner, drug user, and previous arrest. In conclusion, parenteral risk was associated with HIV and HCV infection and sexual risk with HIV. Appropriate and continuous preventive programs are recommended in the prison.

Opportunities for Addressing the STD Epidemic through Interventions Targeted to North Carolina’s Incarcerated Populations

among inmates of jails, prisons, and juvenile detention facilities is many times higher than among the general population. Surveillance projects at the Centers for Disease Control and Prevention (CDC) have found high rates of chlamydial infection, gonorrhea, and reactive syphilis serology among inmates entering both adult and juvenile correctional facilities (Table 1). The Bureau of Justice Statistics also reports that 1.8% of male prison inmates and 2.6% of female prison inmates in the US are infected with HIV. The association of STDs with incarcerated populations should not, however, imply that the infections were acquired in prison or jail. Although transmission can occur within such facilities, it is not common. Rather, correctional settings represent a unique opportunity to access populations that have a high risk for STD infections and offer screening, treatment, and education.