Date on Master's Thesis/Doctoral Dissertation

5-2015

Document Type

Doctoral Dissertation

Degree Name

Ph. D.

Department

Social Work

Degree Program

Social Work, PhD

Committee Chair

Golder, Seana

Committee Co-Chair (if applicable)

Sar, Bibhuit

Committee Member

Higgins, George

Committee Member

Otis, Melanie

Committee Member

Hall, Martin

Subject

Posttraumatic Stress Disorder--Social aspects; Women ex-convicts--Psychology; Abused women--Psychology

Abstract

Women are the fastest growing segment of the criminal justice population in the United States (Minton, 2013; Pew Center on the States, 2009). Research is needed to understand Posttraumatic Stress Disorder (PTSD) among women involved with the criminal justice system to inform prevention and rehabilitation efforts. Despite findings suggesting that a mental health diagnosis of post-traumatic stress disorder (PTSD) is common among women in this population (Lynch, DeHart, Belknap, & Green, 2012; Salina, Lesondak, Razzano, & Weilbaecher, 2007), little research has examined the presence of this disorder among women involved with the criminal justice system with experiences of childhood victimization. Extant research indicates that women take different pathways toward involvement with the criminal justice system than men (Daly, 1992). This approach, the gendered pathways perspective (Salisbury & Van Voorhis, 2009), recognizes that women who become involved with the criminal justice system often have lives characterized by impoverished backgrounds, multiple victimization experiences, psychological distress and mental illness with self-medication as a means of coping. This research examined the structure of PTSD among 406 women on probation and parole with a history of victimization using the Post-traumatic Diagnostic Scale (PDS). Structural equation modeling was used to verify the structure of the PDS through five models: a one-factor model, numbing model, dysphoria model, dysphoric arousal model and DSM-5 model. Findings indicated that the dysphoric arousal model provided good fit to the data (X2 (109) =302.26, p < .001; CFI = .93; TLI = .91; RMSEA = .07; SRMR = .04). Next, multiple indicators multiple causes (MIMC) analyses were conducted to examine differences in factor structure based upon exposure to childhood victimization (childhood physical or sexual victimization and childhood sexual victimization) controlling for sociodemographic variables. Findings from the first MIMIC analysis (X2 (181) =503.67, p < .001; CFI = .91; TLI = .89; RMSEA = .07; SRMR = .06) provided adequate fit to the data, but indicated that symptom structure and severity was not significantly different for women based upon exposure to childhood physical and/or sexual victimization verses adult only victimization (B= .25, β = .08, SE= .17, p =.13). Results of the second MIMIC analysis (X2 (147) =439.71, p < .001; CFI = .90; TLI = .89; RMSEA = .07; SRMR = .07) provided good fit to the data and indicated that exposure to childhood sexual victimization versus other types of victimization significantly predicted differences in PTSD symptom structure and greater severity (B= .29, β = .10, SE= .14, p =.04). However, childhood victimization accounted for only 1% of the variance in PTSD symptomology. Implications for assessment and treatment of this highly-victimized and traumatized population are discussed including the usefulness of addressing the symptoms of dysphoric arousal including sleep disturbance, irritability, and difficulty concentrating. Suggestions for public policy include increasing economic insecurity and revisiting current legal climate linking substance use with criminal justice involvement.

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