MMPI-2-RF Scales Have Limited Utility in Predicting Competency Restoration

MMPI-2-RF Scales Have Limited Utility in Predicting Competency Restoration

The present study evaluated whether specific aspects of psychopathological constructs assessed by the Minnesota Multiphasic Personality Inventory-2 Restructured Form (MMPI-2-RF) and specific cognitive abilities assessed by the Wechsler Abbreviated Scale of Intelligence (WASI/WASI-II), were associated with length of competency restoration of a sample of male pretrial defendants in a maximum security forensic psychiatric hospital. No MMPI-2-RF or WASI/WASI-II scales predicted restoration status at 180 days when controlling for age. Overall, the results suggested that externalizing behaviors are among factors that may play a role in predicting restoration status at certain time points. This is the bottom line of a recently published article in the International Journal of Forensic Mental Health. Below is a summary of the research and findings as well as a translation of this research into practice.

Featured Article | The International Journal of Forensic Mental Health | 2018, Vol. 17, No. 2, 167-180

Personality, Psychiatric, and Cognitive Predictors of Length of Time for Competency to Stand Trial Restoration

Authors

Laura M. Grossi, MA, Fairleigh Dickinson University
Debbie Green, PhD, Fairleigh Dickinson University
Melanie Schneider, MA, Fairleigh Dickinson University
Brian Belfi, PsyD, Kirby Forensic Psychiatric Center
Shanah Segal, PsyD, Kirby Forensic Psychiatric Center

Abstract

Certain defendant characteristics, including psychiatric diagnosis, externalizing problems, and cognitive deficits, are associated with longer periods of restoration of competency to stand trial and general lack of treatment success. Prior research has called for a more detailed examination of symptom-level differences between defendants rapidly restored to competency and those who require lengthier treatment for competency restoration. The present study evaluated whether specific aspects of psychopathological constructs assessed by the Minnesota Multiphasic Personality Inventory-2 Restructured Form (MMPI-2-RF), and specific cognitive abilities assessed by the Wechsler Abbreviated Scale of Intelligence (WASI/WASI-II), were associated with length of competency restoration among 344 male pretrial defendants hospitalized at a maximum security forensic psychiatric hospital. Higher Juvenile Conduct Problems (JCP) scores were associated with restoration within 90 days, and Antisocial Behavior (RC4) predicted restoration status at 90 days; no MMPI-2-RF or WASI/WASI-II scales predicted restoration status at 180 days when controlling for age. Overall, results suggested that externalizing behaviors are among factors that may play a role in predicting restoration status at select time points.

Keywords

Competency to stand trial, competency restoration, symptoms, MMPI-2-RF, WASI-II

Summary of the Research

“The psychological treatment of incompetent (IST) defendants as preparation for adjudication, termed, competency restoration, is largely educational and aimed at helping defendants gain a factual and rational understanding of the legal system. In addition, symptom and behavior management of those deemed IST plays an important role in various aspects of the restoration process…Although there is no standard competency restoration treatment protocol, treatment typically involves psychotropic medication, group therapy focused on psychoeducation, and when resources are available, individual therapy…Approximately two-thirds of IST defendants are deemed CST within 6 months of competency restoration treatment and more than 80% are restored to competency within one year…” (p.167-168).

“A relatively small literature has identified factors that are predictive of restoration/restorability, or length of time for competency restoration more generally…Even so, several demographic, historical, and clinical factors appear associated with restoration of competency or restorability…diagnoses of non-psychotic disorders, a criminal history, younger age, and/or female gender are typically associated with a determination that a defendant is restorable. In contrast, diagnoses of psychotic disorders and irremediable/organic cognitive disorders, greater number of days previously hospitalized, lack of prior convictions, current violent charge, older age, and male gender are frequently associated with a determination that a defendant is IST and/or unrestorable…The present study examined the extent to which specific psychological measures assessing personality, psychopathology, and intelligence may assist forensic evaluators in estimating the requisite length of treatment for competency restoration, in a sample of male IST pretrial defendants. Specifically, we examined the utility of the Minnesota Multiphasic Personality Inventory-2 Restructured Form…and Wechsler Abbreviated Scale of Intelligence…for informing predictions of competency restoration” (p.168).

“We hypothesized that scores on the MMPI-2-RF scales assessing problems in thinking and externalizing problems would be positively associated with length of time for competency restoration, with the length of restoration variable defined (1) continuously, reflecting the number of days from hospital admission until a passed formal CST evaluation, and (2) dichotomously, representing restoration status at 90 days and 180 days. This was predicted as the constructs assessed by these MMPI-2-RF scales are negatively associated with treatment adherence and completion in other settings. Further, this hypothesis was developed with the assumption that traits assessed by the MMPI-2-RF scales may not be necessarily reflected in a defendant’s behavioral history…” (p. 170).

“We additionally hypothesized that composite scores (FSIQ-2) and subtest scores (Vocabulary and Matrix Reasoning) of the WASI/WASI-II would be negatively associated with length of time for restoration of competency to stand trial. Based on the limited literature described above, we anticipated that the strongest associations with length of competency restoration would include FSIQ-2 and Vocabulary, and that Matrix reasoning would be less strongly related. Overall, we expected that pathological traits and impaired abilities, assessed by MMPI-2-RF scales and WASI/WASI-II subtests, would contribute to impairment of examinee’s competency-related abilities (i.e., defendants’ factual understanding, rational understanding, and ability to consult with a defense attorney) and thus prolonged hospitalization for competency restoration. Finally, the present study explored whether reasons for MMPI-2-RF profile un-interpretability were predictive of time to achieve competency restoration” (p.170).

“As standard practice, all defendants were evaluated for diagnostic clarification and treatment planning within a few weeks of admission to the hospital. As part of that assessment, the Wide Range Achievement Test – 4th Edition (WRAT-4), MMPI-2-RF, and WASI/WASI-II were administered. For the purposes of the present study, the results of these measures, along with defendants’ demographic and legal information, were obtained from defendants’ hospital records…Analyses examining whether IST and CST defendants could be differentiated at 90 days based on MMPI-2-RF and WASI/WASI-II scores indicated that only JCP [Juvenile Conduct Problems] scores significantly differentiated those who were restored and those who were not, although RC4 [Antisocial Behavior] also approached significance. However, both the results of JCP and RC4 analyses were contrary to prediction, with those defendants who remained IST endorsing fewer conduct-related problems in childhood and adolescence, and fewer antisocial beliefs, than those who were CST at 90 days” (p.176).

“None of the MMPI-2-RF or WASI/WASI-II scores differentiated between IST and CST groups at 180 days, although Vocabulary approached significance. The scales in combination were predictive of restoration status at 180 days; however, age, which was entered as a covariate, was the only variable that uniquely contributed to the model. Thus, the hypothesis that MMPI-2-RF and WASI/WASI-II scales would be predictive of restoration status at 180 days was not supported. Instead, older age appeared to be a stronger indicator of continued incompetency at 180 days, consistent with the literature” (p.177).

Translating Research into Practice

“It is imperative for clinicians to be able to identify those defendants who are likely to require hospitalizations for restoration of competency to stand trial early in their treatment for several reasons. Such defendants might have treatment needs that are distinct from those of defendants who are on a more typical restoration trajectory. For example, such defendants may benefit from intensive or specialized treatment (e.g., cognitive remediation or individual therapy), among other resources that will help them move more rapidly through the restoration process…Further, identifying such individuals and intervening appropriately may pre-empt a potential standstill in the legal process, and help to ensure that defendants’ legal rights and liberty are protected. In particular, treatment providers and defendants may benefit from reliable early identification of those defendants who are not restorable, so that Jackson relief can be applied for appropriately and in a timely fashion” (p.176).

“As measures of behavioral instability and oppositionality…the JCP and RC4 scales likely have implications for management in the forensic psychiatric hospital, in terms of reflecting chronic behavior problems and lack of cooperation. We had presumed that the characteristics assessed by these scales, including antagonism, antisociality, and lack of responsibility, might persistently impair a defendant’s ability to work with a lawyer. Instead, the ability of JCP to differentiate IST and CST defendants at a time point as early as 90 days may indicate that forensic psychiatric hospitals are well-equipped to work with defendants with antisocial characteristics and to ensure that legal and hospital resources are allocated appropriately” (p.177).

“Furthermore, these scales may be indicators of familiarity with the legal system, and thus better response to educational aspects of competency restoration. Alternatively, these scales may serve to differentiate patients whose traits are more criminogenic, and less psychiatric in nature, and thus require a lesser degree of pharmacological intervention than their peers. Regardless, JCP (and potentially RC4) may be clinically useful for the early identification of those defendants who will be successfully restored to competence with treatment as usual…Overall, exploratory findings suggest that estimated general intelligence and level of education may be more robust predictors of requisite time for competency restoration, such that low intelligence is associated with greater time until competency is restored. Further, these findings are applicable to the entire sample of defendants…These findings raise important implications for clinicians, who can quickly assess estimated general intelligence, gaining information regarding a defendant’s relative time for competency restoration, without the administration of more extensive cognitive tests or other additional measures” (p.176-177).

“Ensuring that defendants who have the potential to gain competency do so as quickly as possible is also important for economic reasons…the minority of IST defendants hospitalized for competency restoration for more than six months received a disproportionate amount of state mental health resources, when compared with those restored within six months…institutional and political pressures (e.g., to make room for new admissions, and to prosecute a violent offender, respectively) may influence determinations of competency status, particularly in cases of long-term hospitalization for competency restoration. As biases deriving from such pressures may impact decision-making about competency status and restorability, it is particularly important for evaluators to pay attention to relevant historical and empirical test data in forming empirically supported opinions” (p. 176).

Other Interesting Tidbits for Researchers and Clinicians

“These findings were somewhat consistent with prior research indicating that a lengthy criminal history is associated with restoration. However, findings are inconsistent with literature indicating that elevated RC4 and JCP scores (i.e., scores above the manual-recommended T-score cut-off) predict treatment failure in non-forensic contexts. The achievement of competency is not necessarily comparable to treatment success in other therapeutic contexts, and this finding may be interpreted in a straightforward manner, to mean that different personality characteristics have different predictive utility in different contexts. Notable tendencies toward antisocial or criminogenic behaviors (i.e., captured by psychological testing data including RC4 and JCP) may lead evaluators to believe that a defendant in this context (i.e., a maximum security forensic hospital) is more likely to possess competency-related abilities (e.g., due to familiarity with the legal system and prior experiences successfully completing the trial process) which would not be typically perceived as beneficial in non-forensic clinical contexts (e.g., civil hospital)” (p.176).

“Given the exclusion rate, future research might examine the ability of tests of personality and intelligence to predict time until competency restoration using a much larger sample. Larger samples might include female participants, as the present findings are not necessarily generalizable to the broader population of incompetent pretrial defendants. With a much larger sample, future research might examine whether elevations on specific scales (i.e., scores above the manual-recommended cut score) are predictive of time for competency restoration, as opposed to relatively high or low scores. Such an approach would be more informative for clinicians, who could then interpret scores above or below a particular threshold as indicative of alternative treatment…” (p.178).

“Further research might also examine the ability of self-report personality inventory scores to predict restoration status or restorability using less conservative exclusion criteria, as well as with alternative measures of personality and psychopathology (e.g., the Personality Assessment Inventory). Given the rate of exclusion and limited significant results related to personality and psychopathology in the present study, the MMPI-2-RF scales demonstrated little clinical usefulness in predicting length of competency restoration. This is important, as the administration of measures such as the MMPI-2-RF can take precious time and resources that could otherwise be allocated. It may be more efficient to obtain information relevant to behavioral instability and antisociality through brief clinical interviews and archival review of RAP sheets or hospital records” (p.178).

Authored by Amber Lin

Amber Lin is a volunteer in Dr. Zapf’s research lab at John Jay College of Criminal Justice. She graduated from New York University in 2013 with a B.A. (honors) and hopes to obtain her PhD in forensic clinical psychology. Her research interests include forensic assessment, competency to stand trial, and the refinement of instruments used to assess the psychological states of criminal defendants.

Attorneys’ perspectives on their clients’ abilities to plead guilty

Attorneys’ perspectives on their clients’ abilities to plead guilty

A substantial minority of attorneys may have faced a professional quandary in terms of doubting a client’s competence to plead but choosing not to raise the issue—a conflict for which little professional guidance exists. This is the bottom line of a recently published article in Psychology, Public Policy and Law. Below is a summary of the research and findings as well as a translation of this research into practice.

Featured Article | Psychology, Public Policy and Law | 2018, Vol. 24, No. 2, 171-179

Attorney Perspectives on Juvenile and Adult Clients’ Competence to Plead Guilty

Authors

Amanda NeMoyer, Drexel University
Sharon Kelley, Drexel University
Heather Zelle, University of Virginia
Naomi E. S. Goldstein, Drexel University

Abstract

An overwhelming majority of juvenile and criminal cases result in admission or guilty plea. Standards of competence apply at this stage of the proceedings, so the issue can be raised if someone—usually a defense attorney— believes the defendant lacks competence to plead. It is unclear how often defense attorneys question their clients’ competence to plead guilty and what factors lead to such decisions. This study surveyed defense attorneys about their experiences raising this issue in juvenile and criminal court and investigated factors that made them raise this issue and made them decide against formally questioning competence, despite suspecting their clients lacked requisite abilities. Most of the 199 responding attorneys reported having raised a competence issue at this stage, with more attorneys indicating they had done so at least once for an adult client than for a juvenile client. However, when asked about the number of times they raised this issue, attorneys reported doing so more frequently for juvenile clients than for adult clients. Client cognitive deficits, inadequate ability to assist counsel, and mental illness were reported to drive decisions to question competency in both courts. Attorneys endorsed choosing not to raise this issue because of concern about the low legal threshold for competence and that consequences would negatively affect their clients. Results of this study suggest a professional quandary for defense attorneys—who receive little guidance in this area—and add weight to the pressing need for meaningful examination of how the plea process works in principle and in practice.

Keywords

guilty pleas, admissions, competence, attorney perspectives, competence to plead

Summary of the Research

“The Supreme Court has historically adopted a laissez-faire approach to plea bargains, lauding them for their conservation of judicial resources and declining to scrutinize the practices that have developed around them. In addition, the Supreme Court has handed down few holdings specific to plea bargains because they are commonly believed to occur within the “shadow of the trial,” such that defendants engage in a rational decision making process and accept plea deals based on the strength of existing evidence. Thus, the Supreme Court has often rotely applied the Dusky standard of adjudicative competence (i.e., factual and rational understanding and ability to assist counsel) as the appropriate standard for questions surrounding adult competence to plead guilty. No national standard for juvenile adjudicative competence exists: some jurisdictions apply the Dusky standard used in criminal court, other jurisdictions apply a modified version of the Dusky standard, and one state (Oklahoma) has declined to apply any competence standards to defendants in juvenile court. Competence to plead guilty is therefore generally considered to include factual understanding, rational understanding, and ability to assist counsel” (p. 171-172).

“Defendants who plead guilty waive a multitude of rights—a total of 40 according to Redlich and Bonventre (2015). As a result, the waiver of rights standard (i.e., that a waiver be knowing, intelligent, and voluntary) also applies when a defendant seeks to plead guilty. As Justice Thomas articulated in Godinez: The focus of a competence inquiry is the defendant’s mental capacity; the question is whether he has the ability to understand the proceedings. The purpose of the “knowing and voluntary” inquiry, by contrast, is to determine whether the defendant actually does understand the significance and consequences of a particular decision and whether the defendant is uncoerced.

In sum, then, there are several requisites for a valid guilty plea, each of which could be a point of concern for a defense attorney. The process for bringing a potential case of incompetence to the court’s attention mirrors the process for other competencies—both in theory and in practical application. Because of the importance of proceeding only with competent defendants, any of the three actors (prosecutor, defense attorney, judge) may serve as gatekeeper and raise questions about competence to plead guilty. Nevertheless, this role typically falls to the defense attorney, who has relatively more interaction with the defendant and is duty bound to discuss pleas with his or her clients. Given the weight of responsibility associated with this gatekeeper role, it is critical to understand defense attorneys’ experiences related to questioning clients’ competence to plead guilty. Nevertheless, little is known about which considerations are of greatest concern to attorneys, whether attorneys view certain client characteristics as likely related to deficits of certain requisites, or other perspectives attorneys might have regarding application of the standards to their clients” (p. 172).

“Despite evidence suggesting that a considerable number of juvenile and adult clients demonstrate deficits that implicate the ability to plead guilty, no empirical studies have examined defense attorneys’ perspectives on their clients’ abilities to plead guilty. The few existing inquiries into defense attorneys’ experiences with competence to plead guilty have typically been speculative in nature, with conclusions drawn from a small number of individual defense attorney interviews rather than a systematic survey. Further, no researchers have examined the proportion of lawyers who have faced this issue, nor have researchers examined the underlying reasons for why attorneys have or have not raised the issue. To fill these gaps and add more quantitative data to literature in this area, the current study surveyed defense attorneys about their experiences questioning clients’ competence to plead guilty— both for juvenile clients in juvenile court and for adult clients in criminal court” (p. 173).

“Results indicate that a considerable majority of attorneys have raised questions about their juvenile and adult clients’ competence at the pleading stage. It is interesting to note that although a greater proportion of attorneys endorsed [factors that had] ‘ever’ [contributed to] having raised this issue for their adult clients, attorneys who had raised this issue before tended to report having done so more frequently for juvenile clients than for adult clients. It may be that, in general, attorneys are more inclined to raise this issue for adult clients given the increased severity of direct and collateral consequences for pleading guilty in criminal court as compared with juvenile court (e.g., prison sentence vs. juvenile probation). However, once attorneys decide that they will raise this issue for juvenile clients, they might raise it more often because of the frequency with which cognitive deficits and other challenges related to developmental immaturity contribute to questions related to the ability to competently proceed at the plea stage. Of course, the fact that attorneys with criminal court experience reported representing more adult clients (as compared with the number of juvenile clients represented by attorneys with juvenile court experience) may have contributed to the difference in whether they had ‘ever’ raised this issue for their adult clients; however, the fact that attorneys reported raising this issue more frequently for juvenile clients despite representing fewer juvenile clients overall seems to strengthen the suggestion that this issue is particularly relevant for clients in juvenile court.” (p. 177).

“Further, the focus on the ability to assist prong of the competence standard—of all the available components of the competence and waiver standards—may be the product of practical necessity. That is to say, attorneys in the preplea context are likely to find themselves more reliant on their clients than in later stages because they have not yet had the opportunity to review materials or develop a defense strategy. This reliance could be further increased in “closed-file” jurisdictions, where prosecutors are not required to provide as much preplea discovery. Thus, of all the prongs, the ability to assist prong is more pressing at this stage than the need for a client to understand the consequences of a plea bargain (which the attorney will likely address as plea bargaining progresses) or the need for a waiver to be knowing (which will be addressed later by the court via a plea colloquy)” (p. 177).

“Finally, our hypothesis that attorneys would report not raising the issue to avoid negative consequences for their clients was arguably supported—length of detention/incarceration and obtaining a better plea were among the most often cited reasons; however, concern about timely resolution of a case and maintaining relationships in the court (which might have an indirect negative effect on a client) were not frequently reported. It is worth highlighting that the clear ‘lead’ reason for not raising the issue in the case of both adult and juvenile clients was attorneys’ belief that, despite their perceptions of clients’ deficits, their clients would not be found to fall below the low threshold of the competence standard. Further suggesting the salience of this issue, 18% of participants who voluntarily responded to a final, open-ended request for additional information reported a belief that the competence threshold is far too low as currently defined” (p. 177-178).

Translating Research into Practice

“It appears that attorneys are raising this issue for juvenile clients based on a wider variety of reasons than they are for adult clients, for whom mental illness appears to be the major motivating factor. This trend might suggest that attorneys working with juvenile clients, in particular, could benefit from additional training focused on identifying the appropriate reasons to raise this issue and how to do so in a successful manner” (p. 177).

“It is generally accepted that the decision to plead guilty is in the purview of the client, which would seem to require, by extension, that an attorney raise the issue of competence when in doubt—a decision to plead guilty can hardly be the meaningful client choice countenanced by legal ethics and guidelines if it is made by a client who is incapable of making informed decisions. Yet, defense attorneys are also aware of the many external forces at play in the justice system and the paradoxical negative outcomes that might flow from their attempts to prevent a client from making this decision while incompetent. This diametric tension seems to defy resolution, leading even the recently revised ABA (2016) Criminal Justice Standards on Mental Health to simply leave the problem at the feet of defense attorneys: “If the defense attorney has a good faith doubt concerning the defendant’s competence to make decisions within the defendant’s sphere of control . . . , the defense attorney may make a motion to determine the defendant’s competence” (Standard 7–5.2, emphasis added). This dilemma underscores the need for additional guidance for defense attorneys as well as system-wide changes that reduce the tension in the first place” (p. 178).

“The sheer volume of cases that are processed via plea bargaining should already be enough to spur meaningful scrutiny of how the plea process works, and data regarding the proportion of defense attorneys who have faced internal questions about their clients’ competence without raising the issue add to that pressure. These findings—and the results of future research in this area—ought to prompt serious dialogue about and examination of the extent to which justice systems are (not) effecting due process via their uncritical reliance on an expedient, but largely unregulated, procedure” (p. 178).

Other Interesting Tidbits for Researchers and Clinicians

“The current study was merely an early step in identifying potential issues related to attorneys’ decisions to raise—or not raise—questions about their clients’ competence to plead guilty and was limited in several ways. First, the data were gathered by a self-report survey and, therefore, were likely affected by issues such as participant self-selection and cognitive bias. For example, few attorneys endorsed maintaining relationships with the court as a reason for not raising competence to plead guilty; it may be that this reporting reflects reality, but it also may be that social desirability effects deterred participants from endorsing some of these reasons. In addition, the item options were not randomly ordered, which may mean that the frequency with which they were endorsed was affected by where they were located within each option list. As noted in the Methods section, we chose not to inquire about how many times attorneys doubted clients’ competence but did not raise the issue. An estimate of how frequently this professional quandary arises would further strengthen the call for clearer guidelines and potential system reform, but we felt the current survey design was not the best approach for obtaining accurate information on that point. Finally, because the study focused solely on juvenile clients in juvenile court and adult clients in criminal court, we did not examine juvenile clients who are tried in criminal court. Because this group can face more severe sanctions than defendants in juvenile court while still demonstrating cognitive and developmental immaturity, questions of competence to plead guilty may arise more frequently for these clients. Future research should address this omission” (p. 178).

“Future studies should also examine judges’ perspectives on the issue, with attention to both standards that apply at the pleading stage (i.e., competence to plead, rights waiver validity). Attorneys might also be asked more explicitly about both standards, as well, given that the current study included rights waiver standard prongs as item options but phrased all questions in terms of competence to plead guilty. It would be informative to know whether attorneys and/or judges see the two standards as complementary or effectively the same—or perhaps they may even view one or the other as rather ineffectual or redundant. To build upon the current study, future research should also collect more qualitative data that will allow for a more nuanced understanding of the reasoning and tensions at play when defense attorneys are faced with clients who may be incompetent to plead guilty” (p. 178).

Authored by Amanda Beltrani

Amanda Beltrani is a current doctoral student at Fairleigh Dickinson University. Her professional interests include forensic assessments, professional decision making, and cognitive biases.

Living with the War Inside: How Posttraumatic Stress Symptoms and Substance Use are Related to Violent and Nonviolent Charges among Veterans

Living with the War Inside: How Posttraumatic Stress Symptoms and Substance Use are Related to Violent and Nonviolent Charges among Veterans

Posttraumatic stress symptoms, particularly intrusion symptoms, are associated with violent charges, while cocaine use is associated with nonviolent charges among veterans who use substances. This is the bottom line of a recently published article in Law and Human Behavior. Below is a summary of the research and findings as well as a translation of this research into practice.

Featured Article | Law and Human Behavior | 2018, Vol. 42, No. 2, 135–144

Associations Between Posttraumatic Stress and Legal Charges Among Substance Using Veterans

Authors

Diana C. Bennett, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan, and University of Michigan
David H. Morris, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan, and University of Michigan
Minden B. Sexton, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan, and University of Michigan
Erin E. Bonar, University of Michigan
Stephen T. Chermack, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan, and University of Michigan

Abstract

Substance misuse is prevalent among veterans entering the criminal justice system, and is related to recidivism. Research demonstrates that trauma exposure and posttraumatic stress (PTS) symptoms, which commonly co-occur with substance misuse, also increase the risk of legal involvement and recidivism. However, it is unclear whether the associations between trauma, PTS symptoms and violent and nonviolent crime may be conflated by substance use. The aim of the present study was to understand the association between PTS symptoms and criminal justice involvement (both violent and nonviolent crime) among substance-using veterans seeking Veterans Affairs (VA) specialty mental health care after accounting for substance use frequency and demographics including age, gender, and ethnicity. Further, this study examined whether specific clusters of PTS were associated with violent and nonviolent veteran offending. Participants included 697 veterans (52 women) aged 21 to 75 (M=47.49, SD=13.51) with a history of trauma exposure. Veterans self-reported past-month PTS symptoms, substance use, and lifetime legal charges. Logistic regression results indicated total PTS symptoms were associated with violent, but not nonviolent charges, above and beyond age, sex, race, cocaine use, and heavy alcohol use. Intrusion symptoms, in particular, were associated with violent charges. Results highlight the utility of examining PTS as a multifaceted construct and have implications for the assessment and treatment needs of justice-involved veterans. For example, the findings suggest that treatment needs appear to differ for those reporting violent or nonviolent offending, with a greater need for assessing and treating PTS for those involved with violent crime.

Keywords

posttraumatic stress, legal involvement, violence, veterans

Summary of the Research

“Criminal behavior in veterans is a growing concern as estimates suggest as many as 181,500 veterans are incarcerated annually, more than half for violent offenses. Substance use disorders (SUDs) are particularly prevalent among individuals entering the criminal justice system compared with the general population, especially among military veterans. […] Strong evidence suggests substance use, particularly alcohol and cocaine use, is inextricably linked to higher risk of physical aggression and increased violent offending. However, other mental health and psychosocial problems (e.g., trauma exposure, PTS) also increase risk of perpetrating violence and criminal involvement among both military and veteran samples and civilians. Given that these other problems often co-occur with substance use problems, it is important to understand the impact they have on criminal offending in veterans who use substances.” (p. 135–136)

“Trauma exposure has been found to correspond with greater incidences of violence perpetration among veterans and civilians which may, in turn, contribute to criminal offending. [The] association between trauma exposure and violence perpetration also has been reported among those with SUDs. [The] acts of violence may result in criminal charges, followed by conviction and incarceration. Indeed, some studies have reported that a vast majority of criminal justice-involved adults report a history of trauma exposure.” (p. 136)

“However, other research has failed to find direct associations between trauma exposure and the perpetration of violence or criminal involvement. These discrepant findings have led some to propose that there are other intermediate mechanisms that account for the effect trauma exposure has on violence and criminal involvement. […] Trauma exposure indirectly increases the risk of antisocial behavior through the development of posttraumatic negative affect, including among veterans. While most individuals recover in the first few months following a trauma, a substantial number retain their PTS symptoms and develop posttraumatic stress disorder. PTS symptoms are divided into four clusters—intrusive recollections, avoidance, negative alterations in cognitions/mood, and arousal—and include features such as emotion dysregulation, anger/irritability, and difficulty sleeping. It is these symptoms, and not merely trauma exposure, that are believed to increase the likelihood of antisocial behavior (e.g., aggressive actions, impulsive/dysregulated behavior) and criminal involvement.” (p. 136)

“Substantial evidence supports the link PTS symptoms have with violence perpetration and criminal involvement and its mediating role in trauma’s effect on criminal offending. […] To date, no study has examined the association PTS symptoms have with criminal offending among substance-using veterans. PTSD and substance use problems commonly co-occur at high rates in the veteran population, resulting in more functional problems among veterans compared with each condition alone. It is possible that PTS symptoms have an additive effect on criminal offending in veterans with a history of trauma and recent substance use problems.” (p. 136)

“The present study aimed to fill a gap in the literature by examining how PTS symptoms correspond with higher occurrences of criminal offending in a sample of substance-using veterans with a history of trauma, military or nonmilitary related. We focused on violent (e.g., assault, rape) and nonviolent (e.g., forgery, theft) offenses separately as they have different interpersonal, societal, and legal implications. […] We hypothesized that given the correlation between PTSD and aggression, veterans reporting greater PTS symptoms would be more likely to have a violent legal charge.” (p. 136)

“An ancillary aim of the present study was to examine whether different PTS symptom clusters demonstrate unique associations with violent and nonviolent crimes. […] We anticipated that only the PTS symptom cluster of hyperarousal [such as anger and irritability, p. 136] would be associated with violent criminal offenses. No other a priori predictions were made about the differential associations PTS symptom clusters would have with criminal offending.” (p. 136–137)

“Data for the present study were collected as part of the screening process for a randomized controlled trial (RCT) of an intervention for substance use and violence prevention. Participants were recruited from a Midwestern Veterans Healthcare System (VHS) hospital and an associated VHS community-based outpatient clinic using posters, presentations, and clinician referrals.” (p. 137)

“Eight hundred thirty-nine veterans completed self-report measures during the screening process. Only those reporting any lifetime history of military (e.g., friendly or hostile incoming fire, military sexual trauma, prisoner of war) or nonmilitary (e.g., nonmilitary sexual trauma, vehicle accident, natural disaster) trauma exposure at screening (N = 719) were included in the present analyses. An additional 22 participants who had missing data for variables of interest were excluded, resulting in a final sample of 697 participants (7.5% women). The age range for this sample was 21 to 75 years old (M = 47.49, SD = 13.51), and the majority identified as White (73.0%), with 20.1% Black/African American, 3.4% Other/Multiracial, 2.2% Hispanic/Latino, 1.0% American Indian/Alaskan Native, and less than one percent Asian/Pacific Islander.” (p. 137)

The measures utilized in the study included: For violent and nonviolent legal charges—adapted items from the legal section of the Addiction Severity Index; For heavy drinking and cocaine use—modified open-ended items from the Substance Abuse Outcome Module; For combat exposure—single item drawn from the Traumatic Life Events Questionnaire; For PTS symptoms—the 17-item PTSD Checklist for Civilians.

“The current study is among the first to empirically investigate the differential relations of PTS symptoms with violent and nonviolent legal charges among veterans with substance use. We found greater PTS symptoms were associated with higher likelihood of violent legal charges even after adjusting for variance accounted for by other known risk factors for violence (e.g., age, race, substance use), and results were not attributable to combat exposure. As hypothesized, this pattern was specific to violent criminal offenses and did not generalize to charges for nonviolent offenses, marking a contribution to the field as the extant research to date has examined violent but not nonviolent crimes.” (p. 139)

“Among the symptoms clusters for PTSD, only the intrusion cluster was significantly associated with violent legal charges in multivariate analyses, and specifically, for each one unit increase in severity of intrusion symptoms reported, an individual’s likelihood of being charged with a violent crime increases by 7%. None of the symptom clusters were related to nonviolent legal charges. […] Our finding involving intrusion symptoms is contrary to our hypotheses based on prior research linking hyperarousal symptoms, in particular, to aggression and violence. […] Our current findings emphasizing intrusion appear to relate to general strain theory by identifying a link between the emotional distress and dysregulation present in PTS symptoms with antisocial behavior, but further research is needed to clarify how, over time, symptom clusters may operate together. […] Our results suggest that perhaps veterans with more severe intrusion symptoms are at greater risk of being charged with a violent criminal offense, or violent offending may be associated with increased frequency or intensity of intrusion symptoms.” (p. 139–140)

“The present study expands previous efforts attempting to disentangle the combined effects of PTS symptoms and substance use on violent behavior and legal involvement. Our findings suggest substance use, specifically cocaine use, is uniquely associated with the risk for nonviolent legal involvement, whereas PTS symptoms are uniquely related to violent charges. […] The lack of a significant relation between heavy drinking and legal charges in the current sample is surprising, given that this association is well-documented in previous literature. The null finding may be attributable to the restriction of range in our use of a substance-using sample, sample differences, or our use of a single item to measure past month heavy drinking. Additionally, it may be that the interaction of alcohol and other substances, such as cocaine, contribute to greater risk for legal charges. We also found that men were more likely to receive a violent charge, and ethnic minorities were more likely to receive any legal charge, consistent with previous research.” (p. 140)

“The current study included a large clinical sample that is highly generalizable to specialty treatment-seeking veterans with substance use issues and PTS symptoms, a common clinical presentation (although exclusion criteria, described above, does limit this generalizability). Results extend previous literature and aid our understanding of the intersection between substance use, PTS symptoms, and legal involvement among veterans. Further, examination of different types of legal charges and distinct clusters of PTS symptoms provide more detailed information than has been identified in the literature to date about the role of PTS symptoms above and beyond substance use in the association with violent legal charges.” (p. 141)

Translating Research into Practice

“One contribution of the current study is the identification of differential relations between PTS symptoms and violent and nonviolent legal charges. […] The current study offers one possible connection in observing that, among individuals with a history of trauma exposure, PTS symptoms may be related to engagement in violent legal offenses, in particular. This result, if replicated, would serve to help bridge the well-established findings of high rates of trauma exposure and PTS symptoms among incarcerated individuals to expand our understanding of how these factors are associated with offending. In our sample, participants reporting having served in a war zone were actually less likely to have legal charges, indicating that among veterans, combat exposure alone does not increase likelihood of legal charges, and rather, other variables such as PTS may be more important.” (p. 140)

“Our findings suggest substance use, specifically cocaine use, is associated with the risk for nonviolent legal involvement, whereas PTS symptoms are uniquely related to violent charges. Veterans with dual diagnoses of substance abuse disorders and PTSD, in particular, may be at escalated risk for legal involvement. […] Assessment of PTS symptoms among substance-using veterans is critical, and provision of evidence-based trauma-focused or substance use treatment for veterans with substance use problems may be invaluable in decreasing the likelihood of legal involvement, particularly violent crime. […] Trauma-informed treatment may be especially important for reducing violence and aggression among justice-involved veterans with PTS symptoms, and a one-size-fits-all approach to rehabilitation may not be appropriate.” (p. 140–141)

“The present findings yield potentially important implications for evaluating mental health problems among veterans involved in the criminal justice system. For instance, the Department of Veterans Affairs developed the Veterans Justice Outreach (VJO) program to advocate for justice-involved veterans with mental health care needs to be given the option to pursue clinically indicated treatment as an alternative to lengthy incarceration or other sanctions. VJO coordinators are currently available at all VA medical hospitals and facilitate case management services, psychiatric assessments, outreach, and liaison to mental health services for treatment planning and intervention. Through VJO programming, veterans are able to utilize treatment for SUD, PTSD, and other mental health concerns as part of their adjudication. Recent meta-analyses suggest concurrent trauma-focused treatment for PTSD with SUD treatment is effective in reducing PTS symptoms compared with treatment as usual. However, treatment initiation and retention among those with PTSD and SUD can be challenging. Results from the current study suggest that screening VJO-involved veterans for PTSD in addition to substance use, and offering evidence-based trauma-focused treatment, may be integral for successful diversion from further legal involvement.” (p. 141)

Other Interesting Tidbits for Researchers and Clinicians

“Exclusion criteria included inability to read/speak English, inability to consent due to cognitive problems, current suicidal ideation, active psychosis, acute substance-induced cognitive impairment, current involvement in another intervention study, or residency outside the study catchment area. Those with legal guardians also were excluded.” (p. 137)

“Duration of the screening process was approximately 45–60 min, and participants were compensated for their time with gift cards totaling $10.” (p. 137)

“Although this study identified a connection between PTS and violent legal charges, it is important to note that most individuals with PTSD have not engaged in violent crime, and a diagnosis of PTSD alone is not indicative of elevated risk for violence. Rather, it is important for other risk and protective factors, such as substance use and engagement in violent crime, to be considered.” (p. 140)

“The findings should be considered in light of some study limitations. These data are cross-sectional in nature, and thus temporal associations and causality cannot be determined. We are limited in our interpretation of the data, given that we cannot determine the order of whether legal charges predate or follow military service and the development of PTS symptoms, and thus the direction of effects is unclear. […] In addition, the focus of the present study was to ascertain relationships specific to overall symptom severity and specific symptom clusters. As such, we did not utilize PCL-C cutoff scores indicative of probable PTSD. Therefore, our results may differ for veterans who meet full diagnostic criteria for PTSD. We also were limited in our measures of heavy drinking and cocaine use such that each were single-item only, which may help explain the weak or relative lack of findings involved with the SUD variables. […] Additionally, results may not generalize to all veterans, as the study was limited to those with recent substance use seeking specialty mental health care at the VA and without current suicidal ideation, psychosis or significant cognitive issues. […] Study data, including legal charges, were self-reported. […] Additional treatment studies are also needed to examine how clinical intervention can work to reduce recidivism among substance-using veterans, including case management, brief interventions targeting SUD, or trauma-focused treatment, and additional work is needed to determine the factors related to engagement and retention among this population.” (p. 141)

Authored by Kseniya Katsman

Kseniya Katsman is a Master’s student in Forensic Psychology program at John Jay College of Criminal Justice. Her interests include forensic application of dialectical behavior therapy, cultural competence in forensic assessment, and risk assessment, specifically suicide risk. She plans to continue her education and pursue a doctoral degree in clinical psychology.

Social Influence and Antisocial Predisposition in Early Childhood Increase the Potential for Gun Carrying in Adolescence

Social Influence and Antisocial Predisposition in Early Childhood Increase the Potential for Gun Carrying in Adolescence

Social influence and antisocial predisposition in early childhood increase the potential for gun carrying in adolescence. This is the bottom line of a recently published article in Law and Human Behavior. Below is a summary of the research and findings as well as a translation of this research into practice.

Featured Article | Law and Human Behavior | 2018, Vol. 42, No. 2, 110 – 118

Childhood Risk Factors Associated With Adolescent Gun Carrying Among Black and White Males: An Examination of Self Protection, Social Influence, and Antisocial Propensity Explanations

Authors

Beardslee Jordan, Arizona State University
Docherty Meagan, Arizona State University
Mulvey Edward, University of Pittsburgh
Schubert Carol, University of Pittsburgh
Pardini Dustin, Arizona State University

Abstract

Adolescent gun violence is a serious public health issue that disproportionately affects young Black males. Although it has been postulated that differential exposure to childhood risk factors might account for racial differences in adolescent gun carrying, no longitudinal studies have directly examined this issue. We examined whether childhood risk factors indexing neighborhood crime, peer delinquency, and conduct problems predicted the initiation of adolescent gun carrying among a community sample of Black and White boys. Analyses then examined whether racial differences in risk factors accounted for racial differences in gun carrying. Data came from a sample of 485 Black and White boys who were repeatedly assessed from 2nd grade until age 18. Multi-informant data collected across the first 3 years of the study were used to assess neighborhood crime, peer delinquency, and conduct problems. Illegal gun carrying was assessed annually from 5th grade through age 18. Growth curve analyses indicated that children with higher initial levels of conduct problems and delinquent peer involvement, as well as those who increased in conduct problems across childhood, were more likely to carry a gun prior to age 18. Black boys were also more likely to carry guns than Whites. Racial differences were greatly reduced, but not eliminated, after controlling for initial levels of conduct problems and delinquent peer involvement. Findings suggest that early prevention programs designed to reduce adolescent gun violence (including racial disparities in gun violence) should target boys with severe conduct problems and those who affiliate with delinquent peers during elementary school.

Keywords

Adolescent gun carrying, racial disparities, self-protection, social influence, antisocial predisposition

Summary of the Research

“Studies examining risk factors for adolescent gun carrying have focused on self-protection, social influence, and antisocial predisposition explanations” (p. 110).

“The current study addresses these issues by examining (a) the extent to which childhood risk factors associated with self-protection (i.e., neighborhood crime), social influence (i.e., peer delinquency), and antisocial predisposition (i.e., conduct problems) models prospectively predict the initiation of adolescent gun carrying and (b) whether race differences in these childhood risk factors accounts for differences in adolescent gun carrying among a community sample of Black and White males” (p. 111).

Measures:
“At each assessment from fifth grade to age 17, boys self-reported whether they had carried a gun since the previous time-point using the Self-Reported Delinquency Scale” (p. 113).

“We used a subscale from the Neighborhood Impressions Questionnaire as an indicator of neighbor- hood crime” (p. 113).

“Peer delinquency was assessed via youth self-report at each assessment from Time 1 to Time 6 using the Peer Delinquency Scale” (p. 113).

“Early conduct problems were assessed using parent and teacher ratings on eight items from the Child Behavior Checklist and Teacher Report Form (respectively) from Time 1 to Time 6” (p. 113).

Results:
“Approximately 28% of Black boys reported carrying a gun prior to age 18 and 10% of White boys reported carrying a gun prior to age 18” (p. 114).

“This model indicated that there was significant between individual variability in the initial level of neighborhood crime, and the average level of neighborhood crime tended to decrease only slightly over time” (p. 114).

“On average, there was a slight decrease in boys’ self-reported peer delinquency from Time 1–6, whereas conduct problems showed a slight increase across the same time period. The variance of the intercept and slope values for both conduct problems and peer delinquency were statistically significant.” (p. 114).

“All growth factors indexing child risk factors were associated with higher odds of gun carrying when each growth factor was examined separately, except for the slope of peer delinquency, which was not significant” (p. 115).

“When adolescent gun carrying was regressed on all latent growth factors together, results demonstrated that individuals who started higher on peer delinquency and conduct problems (intercepts) had significantly higher odds of carrying a gun in adolescence” (p. 115).

“Additionally, boys who experienced greater increases in conduct problems throughout childhood also demonstrated higher odds of carrying a gun in adolescence. In contrast, the association between initial levels of neighborhood crime and adolescent gun carrying was nonsignificant” (p. 115).

“Analyses indicated that Black youth were significantly more likely to carry a gun in adolescence than White youth without adjusting for covariates. Consistent with the differential exposure hypothesis, Black youth also had significantly higher intercepts on all three risk factors (i.e., neighborhood crime, peer delinquency, conduct problems) and a more rapid increase in conduct problems across time compared to Whites ” (p. 115).

“Indirect effects analysis indicated that approximately 36% of the race effect on gun carrying was attributable to differences in initial levels of peer delinquency, and approximately 24% of the race effect on carrying was attributable to differences in initial levels of conduct problems. Together, these two indirect paths accounted for approximately 60% of the effect of race” (p. 115).

“To help illustrate the patterns of change over time in the risk factors and the associations between the growth factors and adolescent gun carrying, we conducted LCGMs [Latent Class Growth Models] for each of the risk factors and examined the associations between the LCGM groups and adolescent gun carrying. Results indicated that four-group solutions were best for neighborhood crime and conduct problems but a three-group solution was best for peer delinquency” (p. 115).

“For neighborhood crime and peer delinquency, the two highest groups were significantly more likely to carry a gun in adolescence than the lowest groups” (p. 115).

“For conduct problems, the high-increasing group was significantly more likely to carry a gun than all other groups. Additionally, the high-decreasing group and the low-increasing group were significantly more likely to carry a gun than the consistently low group” (p. 115).

Translating Research into Practice

“Lending some support to the social influence and antisocial predisposition pathways, results demonstrated that boys who consistently affiliated with delinquent peers and exhibited high or increasing conduct problems during elementary school years were at highest risk for carrying a gun during adolescence” (p. 116).

“Early affiliation with delinquent peer groups might entrench young boys in delinquent social networks where gun carrying and other serious violence is modeled and reinforced. This suggests that affiliation with delinquent peers throughout childhood might have long lasting consequences in terms of young boys’ beliefs and values about delinquency which can lead to gun carrying. It also suggests that gun carrying might emerge simply because of opportunity and exposure” (p. 116).

“The significant associations between initial level and change in childhood conduct problems with adolescent gun carrying also provide support for the antisocial predisposition hypothesis. This suggests that gun carrying represents an adolescent behavioral manifestation of an early emerging predisposition toward deviant behavior that is observable in early childhood” (p. 116).

“Consistent with prior research, gun carrying in adolescence is much more common among Black boys than White boys” (p. 116).

“It is important to note that the higher rates of conduct problems and delinquent peer involvement among Black boys is likely the result of a cascading array of early environmental risks that impact families living in impoverished minority communities. The present study provided some evidence in support of this, given that parents of Black boys reported significantly more neighborhood crime in early childhood than parents of White boys. Taken together, results suggest that the foundation for racial disparities in firearm violence starts in early childhood” (p. 117).

Other Interesting Tidbits for Researchers and Clinicians

“It was interesting that there was very little within-individual change in peer delinquency, although there were significant differences in where individuals started, which were maintained over the subsequent 3-year period” (p. 116).

“Consistent with the antisocial predisposition hypothesis, gun carrying might be the culmination of a gradual escalation of conduct problems, with gun carrying merely serving as a means to achieve broader antisocial goals in adolescence, such as intimidating or controlling victims” (p. 116).

Moreover, for the result that “gun carrying in adolescence is much more common among Black boys and White boys”(p.116), “One hypothesis assumes that racial differences emerge because minorities are more likely to experience certain risk factors than Whites (i.e., differential exposure models). The other hypothesis assumes that racial differences emerge because certain risk factors risk factors that minorities and Whites are equally exposed to have stronger influences on gun carrying for minorities than Whites (i.e., differential sensitivity models)” (p.117).

“Contrary to differential sensitivity models, there was no evidence that the associations between the risk factors and gun carrying differed between Black and White boys, which was consistent with a prior study examining racial differences in juvenile arrests” (p. 117).

“[F]uture studies should test both hypotheses when looking for potential explanations for racial disparities” (p. 117)

In addition, “[f]uture research should incorporate measures of youth-reported personally experienced crime and victimization to determine whether personally experienced victimization is more strongly associated with later gun carrying. Furthermore, the present study only examined the predictors of gun carrying, not firearm violence. Future research should examine the risk factors that distinguish youth who actually use a firearm to cause harm to another person” (p. 117).

Authored by Ahyun Go

Ahyun Go graduated from John Jay College of Criminal Justice with a BA in Forensic Psychology. She was also minoring in Police Studies. She plans to continue her studies in forensic psychology MA program in the near future. Her main research interests include cognitive biases and crime investigation.

Female Inmates Less Likely to Report Sexual Abuse if it is Perpetrated Repeatedly

Female Inmates Less Likely to Report Sexual Abuse if it is Perpetrated Repeatedly

Bivariate and multivariable mixed effects logistic regression analyses were used to examine individual, assault, and context-level predictors of reporting on 397 incidents of staff sexual misconduct. The final model revealed that 6 predictors (age at time of assault, physical injury, multiple incidents, perpetrator with multiple victims, the year the abuse began, and the number of years women have left on their sentence) account for 58% of the variance in reporting. Disclosure to inmate peers and/or family and friends was significant in the bivariate results. This is the bottom line of a recently published article in Law and Human Behavior. Below is a summary of the research and findings as well as a translation of this research into practice.

Featured Article | Law and Human Behavior | 2017, Vol. 41, No. 4, 361-374

Sexual Misconduct in Prison: What Factors Affect Whether Incarcerated Women Will Report Abuses Committed by Prison Staff?

Authors

Sheryl P. Kubiak, Michigan State University
Hannah J. Brenner, California Western School of Law
Deborah Bybee, Michigan State University
Rebecca Campbell, Michigan State University
Cristy E. Cummings, Michigan State University
Kathleen M. Darcy, University of Chicago
Gina Fedock, University of Chicago

Abstract

More than 80,000 prisoners each year are sexually victimized during incarceration, but only about 8% report victimization to correctional authorities. Complicating reporting is the fact that half of the perpetrators are staff members. Given the restrictive and highly regulated prison environment, studies that examine reporting behaviors are difficult to conduct and to date information available relied on those who have reported or hypothetical victimization studies. This study uses an ecological framework and archival data from a class action lawsuit of sexual misconduct to determine predictors of reporting. Relying on a subsample of 179 women, chosen because they have all experienced at least 1 penetration offense, we use bivariate and multivariable mixed effects logistic regression analyses to examine individual, assault, and context-level predictors of reporting on 397 incidents of staff sexual misconduct. The final model revealed that that 6 predictors (age at time of assault, physical injury, multiple incidents, perpetrator with multiple victims, the year the abuse began, and the number of years women have left on their sentence) account for 58% of the variance in reporting. Disclosure to inmate peers and/or family and friends was significant in the bivariate results. These findings indicate the need for stronger and more systematic implementation of Prison Rape Elimination Act guidelines and remedies that create and enforce sanctions, including termination, for staff violating policy and state law.

Keywords

incarcerated women, Prison Rape Elimination Act, reporting, staff sexual misconduct

Summary of the Research

“Given the growing national attention to the issue of sexual assault within prison settings and the national implementation of federal guidelines for the prevention and reduction of such assaults mandated by the Prison Rape Elimination Act (PREA), it is important to understand what factors influence the reporting of sexual assault during incarceration…Therefore, the purpose of this study is to explore what factors predict whether women who were sexually assaulted by staff while in prison report the abuse in an effort to inform and enhance the implementation of PREA” (p.362).

“The current literature suggests that individual, assault, and contextual factors affect victims’ decisions to report a sexual assault to authorities in noninstitutional environments. Some research suggests that similar factors may shape reporting decisions for incarcerated and nonincarcerated victims,,.however additional research is needed to explore factors unique to the prison experience and to enhance our understanding of the dynamics that affect prison reporting. The salience of studying these dynamics is particularly poignant when the primary authority figures that prisoners report to are staff members, in this case, also the same group that is perpetrating the victimization” (p.364).

“Logistically, reporting sexual victimization in prison requires the victim to notify an officer or other departmental staff. Per PREA standards, any notification of sexual victimization to departmental staff – whether verbal or written – sets in motion policies and procedures for staff reporting the incident to others in authority…For this study, records from a specific class action lawsuit, filed on behalf of victimized incarcerated women within one state, were used…the cases in this class action lawsuit constitute a sample with a naturally occurring comparison group: incarcerated women who experienced sexual assaults but did not report the abuse to prison authorities and those who experienced assaults and did report the abuse” (p.364).

“The aim of this study is to explore what differentiates the two groups of women by asking these specific research questions: (a) What individual, assault and contextual factors predict reporting sexual victimization within prison? (b) What combination of predictors produces the strongest model for predicting reporting by incarcerated women?…within this sample, we saw much higher frequencies of reporting. In fact, 112, of the 179 (62%) women reported at least one incident of sexual misconduct by a male staff member, a rate much higher than would be anticipated given the national data and previous research” (p.364-370).

“Of the individual level factors, only victim age was significant. In contrast to community studies, where older women are more likely to report than younger women, we found that age was negatively associated with reporting among these incarcerated women…Unlike the community based studies there were no differences found in reporting by race. These results indicate that there is not a distinct profile of incarcerated women who are more likely to report staff sexual misconduct. Assault-level characteristics showed multiple significant relationships while reporting. One key finding, mirroring community-based research, is that assaults that involved physical injury were more likely to be reported…Similarly, assaults that occurred multiple times by the same officer were less likely to be reported, and – as the bivariate analysis suggests – assaults involving an aspect of resource dependency for women were also less likely to be reported…Thus, addressing staff sexual misconduct may require considering safety for women in prison and reevaluation of the levels of and types of deprivation within correctional settings” (p.370-371).

“Pertaining to the contextual variables, the bivariate analysis demonstrated that women were more likely to report with the passage of time and after particular historical events, especially after the initial lawsuit was filed. However, once the linear time trend was controlled for, there were no additional effects of the individual policy changes…women were more likely to report in later years as compared with earlier…In addition, one variable at the victim-in-context level, years left to serve, was found to predict reporting in the final model. In particular, having to serve 12 or more additional years in prison lowered the likelihood of reporting…Disclosure of victimization,” to either peers within prison or friends/family outside of prison, “was associated with reporting” (p.371).

Translating Research into Practice

“Future research may focus the role of time and the range of abuse incarcerated women experience before reporting; in other words, time could be given special attention in terms of pinpointing crucial incidents that contribute to reporting decisions…Future research may consider life history calendars with women in prison in order to understand the timing of women’s experiences of staff sexual misconduct, including forms of retaliation over time. Similar to this study, mixed methods research may particularly provide insight into not only reporting decisions but also a richer depiction of women’s experiences of staff sexual misconduct” (p.370).

“Likewise, given abuse involving a sense of consent or dependency may go underreported and may occur several times over a woman’s stay in prison, interventions are needed that disrupt and ultimately prevent recurring sexual abuse by staff. Although prisons commonly forbid even overfamiliarity between officers and prisoners, improved policy implementation and monitoring may help detect staff perpetration tactics that rely on presenting abuse as ‘consensual’ and those tactics exploiting women’s lack of access to material goods…In addition, best practices for correctional institutions are needed for identifying and removing any correctional staff perpetrating multiple incidents over time. Thus, future research may examine successful institutional efforts to eradicate, prevent, and effectively respond to staff sexual misconduct. Interventions focused on staff, such as bystander interventions for correctional staff, may particularly help unravel, uncover, and disrupt the dynamics that allow correctional staff to perpetrate assaults against multiple prisoners” (p.371).

“Thus, for practice and policy procedures, peer support intervention models both within correctional settings and for support networks for incarcerated women may help improve formal reporting rates. These types of interventions could target both peers within correctional settings as well as family and friends of those who are incarcerated, and incorporate types of responses to provide to disclosures, education on formal reporting pathways, ways of advocating for correctional responses, report retaliation, and other types of activities to promote, facilitate, and protect the process of formal reporting” (p.371).

Other Interesting Tidbits for Researchers and Clinicians

“Taken together, these findings point to disturbing aspects of underreported staff sexual misconduct, yet also highlight key directions for improving reporting of this abuse. As a concerning dynamic, staff sexual misconduct that happens repeatedly to an incarcerated woman and abuse by officers perpetrating assault across multiple prisoners are less likely to be formally reported. Likewise, this abuse is likely to be insidious or occurring without causing additional physical violence. However, this type of abuse contributes to the epidemic nature of sexual victimization in prisons that prompted and propels PREA. Coordinated systematic efforts are needed to understand ongoing staff sexual misconduct and to improve formal reporting for this type of abuse” (p.371-372).

Authored by Amber Lin

Amber Lin is a volunteer in Dr. Zapf’s research lab at John Jay College of Criminal Justice. She graduated from New York University in 2013 with a B.A. (honors) and hopes to obtain her PhD in forensic clinical psychology. Her research interests include forensic assessment, competency to stand trial, and the refinement of instruments used to assess the psychological states of criminal defendants.