Author's School

Brown School

Language

English (en)

Date of Award

Summer 8-15-2022

Degree Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Chair and Committee

Brett Drake

Committee Members

Darrell Hudson, Melissa Jonson-Reid, Carrie Pettus-Davis, Geoff Ward

Abstract

The U.S. incarcerates more people than any other country in the world, with 2.2 million people currently behind bars, 60% of whom are people of color. At the same time, there is an unprecedented political consensus to develop strategies for reducing the incarcerated population and safely returning the majority of incarcerated individuals to society. While there has been a substantial research focus on the potential of this population to commit acts of violence post-release, this tells only half the story. This dissertation hopes to provide a more complete picture of the role of violence in the lives of individuals released from prison – not only as perpetrators of violence, but also as victims of violence throughout their lives. Research indicates that this population experiences unusually high levels of exposure to trauma across the life course and that effective post-release intervention will require trauma-informed service systems and trauma-specific interventions. Lifetime prevalence of PTSD is estimated to be 20-60% for incarcerated men, compared to 3.6% in community samples. Few studies exist, however, documenting the types of trauma exposures and the developmental timing of the trauma exposures experienced by incarcerated individuals, especially men, as most trauma research to date has focused on incarcerated women. In order to develop appropriate interventions that increase the likelihood that incarcerated individuals will be capable of functioning in society after release, it is essential that knowledge about the specific nature of trauma for this population be further developed. Data for this dissertation was taken from a parent study performing a randomized controlled trial (RCT) on a reentry intervention. The study sample consisted of 1544 individuals (90% male, 10% female) transitioning out of prisons in four states. Using latent class analysis, this dissertation identified three distinct classes or subgroups, each comprising about a third of the sample, based on type and timing of trauma exposures. While one class was defined by low levels of exposures over the life course, the other two were characterized by high levels of either interpersonal polyvictimization or environmental exposures. Covariates such as gender, race/ethnicity, and mental health diagnosis were used to determine likelihood of membership within each subgroup based on individual characteristics. Additionally, relationships between class membership and adverse reentry outcomes were analyzed. Findings indicated that those with low exposures in childhood continued to have low exposures in adulthood and into the reentry period. Those with high trauma exposures in childhood continued to have high exposures in adulthood and into the reentry period. This is consistent with other trauma research, in particular polyvictimization research, which has found that trauma exposure acts as a risk factor for later trauma exposure. Moreover, each of the two high exposure classes was associated with risk for a different adverse reentry outcome, supporting a tailored approach to intervention design. This dissertation concludes by proposing an original conceptual framework, the Mass Incarceration Trauma (MIT) framework. The MIT framework is guided by an ecological systems perspective, a foundational theoretical approach in social work and public health, and recognizes that effective assessment and intervention requires an understanding of the complex contexts in which individuals live. The MIT framework presents the cumulative trauma exposures commonly faced by this population, before, during, and after incarceration, at the individual, social, environmental, and historical levels. Because traumatic stress undermines health and daily functioning, it is essential that interventions for this population address both the ongoing risk for trauma exposure and the consequences of multiple, repeated past exposures across ecological levels. It is hoped that the findings from this study will contribute to a necessary knowledge base aimed at advancing effective interventions and reducing trauma in the lives of incarcerated individuals and the communities they return to.

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