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Trauma and Mental Health among Women in the Criminal Legal...
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Trauma and Mental Health among Women in the Criminal Legal System: Causes, Consequences, and Solutions

A special issue of Social Sciences (ISSN 2076-0760). This special issue belongs to the section "Crime and Justice".

Deadline for manuscript submissions: closed (1 November 2024) | Viewed by 6488

Special Issue Editors

Dr. Marie Karlsson

E-Mail Website
Guest Editor
Center for Studies in Sexology and Sexuality, Malmö University, 205 06 Malmö, Sweden
Interests: interpersonal violence; sexual victimization; trauma seqelae; trauma-focused treatment; sexual health
Dr. Melissa J. Zielinski

E-Mail Website
Guest Editor
Department of Psychiatry, University of Arkansas for Medical Sciences, 4301 W Markham St, Little Rock, AR 72205, USA
Interests: traumatic stress; drug addiction; incarceration; implementation science; justice-involved women

Special Issue Information

Dear Colleagues,

Welcome to the submission page of this Special Issue on Trauma and Mental Health among Women in the Criminal Legal System: Causes, Consequences, and Solutions.

Justice-involved women are a vulnerable population with high rates of mental illness and exposure to chronic and severe trauma (Harner et al., 2015). A recent literature review (Karlsson & Zielinski, 2020) found that 56–82% of incarcerated women have experienced sexual victimization, many of them since childhood. Unsurprisingly, the most prevalent mental health concerns in this population are diagnoses often associated with traumatic stress including PTSD, depressive disorders, and substance-use disorders. Indeed, interpersonal violence victimization has long been conceptualized as a pathway to prison for women, oftentimes through the development of mental health issues (e.g., Lynch et al., 2017). However, research that goes beyond simply documenting the presence of these issues is limited, and there is a need for greater emphasis on the causes, consequences, and solutions for improving justice-involved women’s health and wellbeing.

This Special Issue aims to build on the well-established connection between traumatic stress and women’s incarceration by soliciting empirical, review, and theoretical articles that can be used to inform efforts to improve the health and well-being of justice-involved women, their families, and their communities. The examples of relevant studies focused on the needs of this population could include intervention and implementation research targeting traumatic stress sequelae; research on the acceptability of interventions, programs, or policies; and/or studies on efforts to address the intergenerational transmission of violence. Studies could also focus on the criminal legal system as it relates to women’s health (e.g., the impact of procedures or policies) or on societal and community-related issues relevant for this population such as SES and poverty, access to care (healthcare and childcare), and/or other human right concerns. Notably, we wish to elicit the high-quality international and interdisciplinary research relevant to this Special Issue and submissions that are focused on women currently or previously involved with the legal system will be accepted to capture the broad potential impact of justice-involvement amongst this population.

In addition to above, another purpose of this Special Issue is to present research from “SHARE: An exposure therapy group for sexual violence survivors”. Please submit your proposals and any questions to special issue guest editors by 15 May 2024. Notification of acceptance will be provided by 1 May 2024. Final papers are due on 1 November 2024 for peer review.

References

  • Harner, H. M., Riley, S., Budescu, M., Gillihan, S. J., & Foa, E. B. (2015). Posttraumatic stress disorder in incarcerated women: A call for evidence-based treatment. Psychological Trauma: Theory, Research, Practice, and Policy, 7(1), 58-66–66. https://doi.org/10.1037/a0032508.
  • Karlsson, M. E., & Zielinski, M. J. (2020). Sexual Victimization and Mental Illness Prevalence Rates Among Incarcerated Women: A Literature Review. Trauma, Violence & Abuse, 21(2), 326–349.
  • Lynch, S. M., Wong, M. M., DeHart, D. D., Belknap, J., Green, B. L., Dass-Brailsford, P., & Johnson, K. M. (2017). An Examination of the Associations Among Victimization, Mental Health, and Offending in Women. Criminal Justice and Behavior, 44(6), 796-814–814. https://doi.org/10.1177/0093854817704452.

Dr. Marie Karlsson
Dr. Melissa J. Zielinski
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a double-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Social Sciences is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1800 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Publisher's Notice

As stated above, the central purpose of this Special Issue is to present research from “SHARE: An exposure therapy group for sexual violence survivors”. Given this purpose, the Guest Editors’ contribution to this Special Issue may be greater than standard Special Issues published by MDPI. Further details on MDPI's Special Issue guidelines can be found here: https://www.mdpi.com/special_issues_guidelines. The Editorial Office and Editor-in-Chief of Social Sciences has approved this and MDPI’s standard manuscript editorial processing procedure (https://www.mdpi.com/editorial_process) will be applied to all submissions. As per our standard procedure, Guest Editors are excluded from participating in the editorial process for their submission and/or for submissions from persons with whom a potential conflict of interest may exist. More details on MDPI’s Conflict of Interest policy for reviewers and editors can be found here: https://www.mdpi.com/ethics#_bookmark22.

Keywords

  • trauma sequelae
  • traumatic stress
  • interpersonal violence
  • sexual victimization
  • incarcerated women
  • evidence-based treatment
  • evidence-based practice
  • mental health
  • prison
  • jail
  • reentry
  • court
  • criminal legal system
  • women
  • implementation
  • intervention

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Published Papers (7 papers)

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Research

15 pages, 523 KiB  
Article
Childhood Physical Victimization and Relationship Dysfunction in Justice-Involved Women: A Path Analysis
by Megan Foster and Emily Salisbury
Soc. Sci. 2025, 14(4), 196; https://doi.org/10.3390/socsci14040196 - 24 Mar 2025
Viewed by 290
Abstract
(1) Background: The pathways perspective considers how different biological, psychological, and social experiences affect women compared to men and how these experiences can lead to initial justice-involvement and recidivism. The relational model provides context for understanding women’s pathways to the criminal justice system. [...] Read more.
(1) Background: The pathways perspective considers how different biological, psychological, and social experiences affect women compared to men and how these experiences can lead to initial justice-involvement and recidivism. The relational model provides context for understanding women’s pathways to the criminal justice system. Interpersonal relationships have strong effects on women’s likelihood to offend. The relationship between risk factors like childhood victimization, adult relationship dysfunction, self-esteem, and self-efficacy are less clear. (2) Methods: Using a sample of justice-involved women, the current study uses a path analysis to investigate the impact of childhood physical abuse on adult relationship dysfunction and if this relationship is mediated by self-esteem and/or self-efficacy. (3) Results: Childhood physical abuse was found to have a significant negative effect on self-esteem and self-efficacy as well as a significant positive effect on adult relationship dysfunction. Indirect relationships were not significant. (4) Conclusions: The current study verifies previous pathways analysis but does not support self-esteem and self-efficacy as mediators of adult relationship dysfunction. Full article
(This article belongs to the Special Issue Trauma and Mental Health among Women in the Criminal Legal System: Causes, Consequences, and Solutions)
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23 pages, 274 KiB  
Article
Trauma in Female Forensic Psychiatric Patients: A Mixed-Method Study into the Clinical Practice of Trauma-Focused Treatment
by Vivienne de Vogel, Juul Depla and Marije Keulen-de Vos
Soc. Sci. 2025, 14(3), 124; https://doi.org/10.3390/socsci14030124 - 20 Feb 2025
Cited by 1 | Viewed by 732
Abstract
Research shows that victimization rates in forensic mental health care are high for both female and male patients. However, gender differences have been found in types and patterns of victimization (more sexual abuse and more complex trauma for women), cognitive appraisal, and response [...] Read more.
Research shows that victimization rates in forensic mental health care are high for both female and male patients. However, gender differences have been found in types and patterns of victimization (more sexual abuse and more complex trauma for women), cognitive appraisal, and response to traumatic events. Gender-responsive treatments focusing on trauma have been designed to adhere to these gender differences; however, despite promising research results, these interventions are yet to be introduced in many settings. This study examined how trauma is addressed in current clinical practice in Dutch forensic mental health care, whether professionals are knowledgeable of gender differences in trauma, and how gender-responsive factors such as self-esteem, self-efficacy, social relations, and coping skills are considered in treatment for female patients. We used a mixed-method design consisting of an online survey and 33 semi-structured interviews with professionals and patients. The results suggested that Dutch forensic mental health care could address trauma more structurally, and professionals could be more aware of gender differences and gender-responsive factors. Early start of trauma treatment was deemed important but was not current practice according to patients. Based on this study, guidelines were developed for gender-responsive, trauma-informed work in forensic mental health care. Full article
(This article belongs to the Special Issue Trauma and Mental Health among Women in the Criminal Legal System: Causes, Consequences, and Solutions)
15 pages, 506 KiB  
Article
The COVID Shift: Comparing Hybrid Telehealth to In-Person Group Therapy for Incarcerated Women Survivors of Sexual Violence Victimization
by Ana J. Bridges, Marley F. Fradley, Ayla R. Mapes, Roselee J. Ledesma, Emily L. Allen, Marie E. Karlsson and Melissa J. Zielinski
Soc. Sci. 2025, 14(2), 108; https://doi.org/10.3390/socsci14020108 - 13 Feb 2025
Viewed by 695
Abstract
Incarcerated women report extremely high rates of lifetime sexual violence victimization. Survivors Healing from Abuse: Recovery through Exposure (SHARE) is an exposure-based group therapy specifically designed for incarcerated women survivors of sexual violence. SHARE has been continuously delivered in a women’s prison for [...] Read more.
Incarcerated women report extremely high rates of lifetime sexual violence victimization. Survivors Healing from Abuse: Recovery through Exposure (SHARE) is an exposure-based group therapy specifically designed for incarcerated women survivors of sexual violence. SHARE has been continuously delivered in a women’s prison for more than 12 years. However, like many prisons during the COVID-19 pandemic, the prison ceased all in-person programming between March 2020 and July 2021. In response, the SHARE treatment team pivoted to a hybrid telehealth delivery model (i.e., group participants gathering in a facility group room and therapists joining via video, displayed on a computer screen within the group room). Given the lack of evidence for hybrid telehealth in carceral settings, and specifically for group therapy for sexual trauma, the current study compared ratings on internalizing symptoms (Brief Symptom Inventory-18 or BSI-18), posttraumatic stress symptoms (Posttraumatic Checklist-5 or PCL-5), and group cohesion ratings (Inclusion of Self in Other scale, or IOS) for participants who received SHARE in person (n = 21) or through hybrid telehealth (n = 19). The results demonstrated that participants of in-person and hybrid telehealth SHARE groups reported similar significant reductions in BSI-18 (15.21 in person vs. 16.00 in hybrid telehealth) and PCL-5 (30.78 in person vs. 26.40 in hybrid telehealth) scores pre- to post-treatment and comparable IOS ratings (5.06 in person vs. 5.31 in hybrid telehealth). The findings suggest hybrid telehealth is an effective and feasible treatment modality for meeting the need for trauma-focused therapy in prisons. Future studies examining the effectiveness and implementation of trauma-focused hybrid telehealth groups in prisons are warranted. Full article
(This article belongs to the Special Issue Trauma and Mental Health among Women in the Criminal Legal System: Causes, Consequences, and Solutions)
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32 pages, 1163 KiB  
Article
A Novel Exploration of Women’s Pathways Through Prison and the Roles of Trauma, Addiction, and Mental Health
by Rain Carei, Mollee K. Steely Smith, Matthew Landon, Haley Church, Courtney Bagdon-Cox, Chee Kay Cheong and Melissa J. Zielinski
Soc. Sci. 2025, 14(2), 105; https://doi.org/10.3390/socsci14020105 - 12 Feb 2025
Viewed by 975
Abstract
Trauma, mental illnesses, and substance use disorders (SUD) are well-documented contributors leading to women’s incarceration; however, less is known about how these factors also influence women’s pathways through prison once incarcerated. To address this gap, we examined (1) women’s pathways to and through [...] Read more.
Trauma, mental illnesses, and substance use disorders (SUD) are well-documented contributors leading to women’s incarceration; however, less is known about how these factors also influence women’s pathways through prison once incarcerated. To address this gap, we examined (1) women’s pathways to and through prison-based mental health services, (2) summarized their sociodemographic and diagnostic profiles, and (3) examined how mental health and addiction relate to indicators of within-prison functioning, intervention receipt, and recidivism. Data derived from routine administrative and treatment records of women incarcerated between January 2015 and December 2023 in the Washington Corrections Center for Women (WCCW). The full sample comprised 5775 women who entered WCCW during the study period. The majority (53.2%) of women admitted to prison in the study period had at least one mental health diagnosis requiring at least moderate mental health intervention. Substance use (62.73%), trauma-related (61.11%), and mood (47.71%) disorders were most common. Individuals with at least a diagnosis of psychosis, neurocognitive disorders, and personality disorders had greater rates of close observation stays, crisis events, and non-suicidal self-injury risk assessments. Psychosis was associated with the highest rate of crisis events, while personality disorders were associated with the highest rate of non-suicidal self-injury risk assessments. Three-year recidivism rates were highest amongst those with a diagnosis of psychosis or ADHD. Trauma-focused and substance use treatments were associated with lower rates of crisis interventions and other critical incidents in their post-treatment period, but no relationship was observed for reductions in post-release recidivism. Overwhelmingly, women enter prison with significant mental health care needs and require a high-level of care that is largely reflective of the nearly ubiquitous nature of trauma, psychological distress, and addiction. The level of care needed, in response to the varied and complicated diagnostic profile of incarcerated women (e.g., ADHD, psychosis, trauma), as well as the number of critical incidents stemming from symptoms, reflects the need for more clinical staff to expand reach along with training in a wide range of modalities. Full article
(This article belongs to the Special Issue Trauma and Mental Health among Women in the Criminal Legal System: Causes, Consequences, and Solutions)
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13 pages, 434 KiB  
Article
Examining Trauma-Related Shame and Trauma Coping Self-Efficacy as Predictors of PTSD in Women in Jail
by Shannon M. Lynch and Stephanie Kaplan
Soc. Sci. 2025, 14(1), 49; https://doi.org/10.3390/socsci14010049 - 17 Jan 2025
Viewed by 1142
Abstract
Women in jail experience high rates of exposure to interpersonal violence and PTSD. However, programming to address women’s trauma-related treatment needs in corrections facilities is limited and this population remains underserved. Research identifying treatment targets to reduce PTSD symptoms and to support recovery [...] Read more.
Women in jail experience high rates of exposure to interpersonal violence and PTSD. However, programming to address women’s trauma-related treatment needs in corrections facilities is limited and this population remains underserved. Research identifying treatment targets to reduce PTSD symptoms and to support recovery is needed. Prior research suggests trauma-related shame and coping self-efficacy are associated with PTSD symptoms in the general population. The present study aimed to expand upon the current literature by using structural equation modeling to evaluate the associations among cumulative interpersonal violence exposures, trauma coping self-efficacy (TCSE), trauma-related shame, and current PTSD symptoms in a sample of randomly selected women in jail (n = 150). Over half the sample (55%) reported clinically significant PTSD symptoms. Shame (β = 0.372, p = 0.001) and TCSE (β = −0.375, p < 0 000) significantly predicted PTSD symptoms, explaining 50% of the variance in PTSD. These findings provide preliminary direction for identification and implementation of evidence-based treatments addressing trauma-related shame and TCSE to reduce PTSD symptoms in incarcerated women. Full article
(This article belongs to the Special Issue Trauma and Mental Health among Women in the Criminal Legal System: Causes, Consequences, and Solutions)
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17 pages, 255 KiB  
Article
Implementation of Peer-Led Seeking Safety for Women in Jail
by Kathryn M. M. Nowotny, Danielle Lee Estes, Krystle Nicole Culbertson and Ladies Empowerment and Action Program
Soc. Sci. 2025, 14(1), 38; https://doi.org/10.3390/socsci14010038 - 14 Jan 2025
Viewed by 881
Abstract
Women are the fastest-growing segment of the incarcerated population and experience high rates of cumulative trauma exposure, mental illness, and PTSD. The aim of this study is to assess the implementation of a peer-led Seeking Safety (an evidence-based intervention for addressing trauma and [...] Read more.
Women are the fastest-growing segment of the incarcerated population and experience high rates of cumulative trauma exposure, mental illness, and PTSD. The aim of this study is to assess the implementation of a peer-led Seeking Safety (an evidence-based intervention for addressing trauma and addiction) pilot program for women in jail. Guided by principles from community-based participatory research and cooperative inquiry, participant surveys were analyzed (secondary data) using descriptive methods (n = 60), and qualitative interviews with program facilitators were conducted and analyzed using a general inductive approach (n = 7). Peer-led Seeking Safety is feasible, acceptable, and appropriate for women in jail, with high levels of participant satisfaction. We describe several “lessons learned” related to the jail context, including structure and security processes and vicarious and retraumatization experiences among facilitators. Preventing facilitator burnout is necessary for the sustainability of the program. Future implementations of Seeking Safety in jails should consider the lessons learned in this study. Full article
(This article belongs to the Special Issue Trauma and Mental Health among Women in the Criminal Legal System: Causes, Consequences, and Solutions)
15 pages, 686 KiB  
Article
Is Sharing One’s Personal Story of Victimization Preferred? Incarcerated Women’s Perspectives on Group Treatment for Sexual Trauma
by Marie E. Karlsson, Melissa J. Zielinski and Ana J. Bridges
Soc. Sci. 2024, 13(11), 570; https://doi.org/10.3390/socsci13110570 - 24 Oct 2024
Cited by 1 | Viewed by 935
Abstract
Treatment preferences are an important part of evidence-based practice and have been shown to affect treatment outcomes. In this two-part study, incarcerated women were asked about their preferences for two versions of a trauma-focused group treatment: one that requires sharing their personal memory [...] Read more.
Treatment preferences are an important part of evidence-based practice and have been shown to affect treatment outcomes. In this two-part study, incarcerated women were asked about their preferences for two versions of a trauma-focused group treatment: one that requires sharing their personal memory of sexual victimization (Sharing Required) and one that does not (Sharing Not Required). Study 1 enrolled 88 non-treatment seeking women who evaluated the treatments based on descriptions of the groups. Study 2 was a partially randomized patient preference trial with 85 treatment-seeking women who either agreed to be randomly assigned to one of the two therapy groups or declined randomization and instead were directly assigned to their preferred therapy. Participants in Study 1 evaluated the Sharing Not Required condition more favorably (p < 0.001, Cohen’s d = 0.39). However, the results were affected by PTSD symptom severity as those above the clinical cutoff for probable PTSD evaluated both group treatments more favorably than those below the cutoff (ps < 0.05, Cohen’s ds ≥ 0.46). Study 2 found no significant difference between the proportion of participants who chose Sharing Required, Sharing Not Required, or had no personal preference, and the results did not differ by PTSD symptom severity (ps ≥ 0.70). Outcomes suggest that a variety of forms of trauma-focused therapy may be acceptable to incarcerated women, including those that involve personal narration of trauma memories and those that do not. Full article
(This article belongs to the Special Issue Trauma and Mental Health among Women in the Criminal Legal System: Causes, Consequences, and Solutions)
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