Date on Master's Thesis/Doctoral Dissertation


Document Type

Doctoral Dissertation

Degree Name

Ph. D.


Social Work

Degree Program

Social Work, PhD

Committee Chair

Golder, Seana

Committee Co-Chair (if applicable)

Hall, Martin

Committee Member

Otis, Melanie

Committee Member

Sterret, Emma

Committee Member

Yankeelov, Pamela


Female offenders--Psychology; Abused children--Psychology


This study aims to begin to identify and describe the pathways through which childhood victimization negatively affects adult physical health. In particular, the proposed research will examine the relationship among childhood victimization, health risk behaviors and adult physical health in a population of criminal justice involved women. Previous research has depicted a relationship between childhood victimization, and physical health outcomes, but there is scant research that examines why this relationship exist. Among the most frequent health risk behaviors are alcoholism, smoking, illicit drug use and sexual risk behaviors. Health risk behaviors are highly intertwined with the bio-psycho-social factors that result from childhood victimization and directly contribute and complicate adult health outcomes. In general, research has shown that early adversities, including victimization, poverty, parental substance abuse and poor family functioning, have long-term impacts on one’s health and well-being in adulthood (Springer, Sheridan, Kuo, & Carnes, 2003). Researchers and theorists agree that the leading causes of morbidity and mortality have been directly linked to health behavior and lifestyle factors, with current research showing that victimization and other childhood experiences contribute to the development of these health risk behaviors. Specifically, women involved in the criminal justice system demonstrate higher rates of and more extensive childhood victimization histories when compared to women in the general population (Brier & Jordan, 2004; Brown, Miller, & Maguin, 1999; Covington, 2003; McDaniels-Wilson & Belknap, 2008; Tripodi & Pettus-Davis, 2013). Histories of early trauma among women offenders has been shown to increase the likelihood of future violence, chronic addiction, criminal activity, homelessness and health problems, both physical and mental health (Anderson, Rosay, & Saum, 2002; Bloom, Owen, & Covington, 2004; Grella, Stein, & Greenwell, 2005; Haller & Miles, 2004; Messina et al., 2003; Messina & Grella, 2006). The present sample consisted of 406 women on probation and parole with a history of childhood victimization in Jefferson County, Kentucky. Structural equation modeling was utilized to examine the relationship between the constructs. Results of the final model (χ2= 26.459, p=.090; TLI= .976; CFI= .985; RMSEA= .038; SRMR=.0505) provided good fit to the data. The findings of the model indicate that there is a direct effect of childhood victimization on perception of physical health, with every one unit of increase in childhood victimization resulting in .014 increase in worse health perception, when controlling for health risk behaviors. Additionally, childhood victimization had an effect on health risk behaviors, there was a .10 increase in health risk behaviors for every one unit of increase in childhood victimization. In terms of the relationship between the health risk behavioral pathway and perception of physical health, for every unit of increase for health risk behaviors there was a .02 increase in negative health perception when controlling for childhood victimization. Lastly, the findings indicate partial mediation, with health risk behaviors accounting for 12.5% of the variance in the relationship between childhood victimization and health perception. Implications for policy and treatment practice in the public health and healthcare arenas are discussed, including increased access to services, screening procedures, interdisciplinary service teams and integration of drug and mental health treatment in the criminal justice system.

Included in

Social Work Commons