Editorial

Citation

MacDonald, M., Greifinger, R. and Kane, D. (2015), "Editorial", International Journal of Prisoner Health, Vol. 11 No. 2. https://doi.org/10.1108/IJPH-03-2015-0008

Editorial

Article Type: Editorial From: International Journal of Prisoner Health, Volume 11, Issue 2.

Welcome to Issue 11 (2) of the International Journal of Prisoner Health. As always, we are pleased to present papers that address a broad range of prisoner health issues, drawn from various countries around the world. This issue features studies that explore diverse topics including peer mentoring initiatives in prison, post-release issues and the development of suicide ideation.

In our opening paper, Robyn L. Gobin, Madhavi K. Reddy, Caron Zlotnick and Jennifer E. Johnson report on a study that explores the association of specific types of interpersonal trauma and Post Traumatic Stress Disorder (PTSD) symptom severity with Antisocial Personality Disorder (ASPD) and psychopathy in a sample of incarcerated women and men. The authors note that high rates of personality disturbance, especially ASPD, have been documented in incarcerated populations. Psychopathy is a clinical construct that substantially overlaps with, but is distinct from, ASPD with both sharing certain features and, despite considerable overlap between the two constructs, the unique features and differential prevalence rates of ASPD and psychopathy highlight the importance of examining the relationship between trauma and the two disorders separately. In all, 88 incarcerated men and women were assessed for ASPD diagnosis, psychopathy severity, PTSD symptom severity and history of physical, sexual, and crime-related trauma. Sample findings indicated, after accounting for gender, that ASPD was associated with physical and crime-related trauma victimisation (but not sexual victimisation), while psychopathy was only associated with physical trauma victimisation (but not crime-related victimisation). The authors also noted a trend for positive association between psychopathy and sexual trauma victimisation. It was also evident that, after accounting for trauma experiences, current PTSD symptoms were not predictive of ASPD or psychopathy in any of the models. Findings also provide further evidence for the link between lifetime trauma victimisation and antisocial personality disturbance, but suggest that current symptoms of PTSD do not play a role in this association. While noting study limitations, the authors conclude that findings suggest an association between lifetime physical trauma victimisation and both ASPD and psychopathy among incarcerated women and men with major depressive disorder. A significant association between ASPD symptom severity and exposure to crime-related trauma was also apparent. Associations were not explained by PTSD symptoms. Findings contribute to an understanding of the nature of the relationship between ASPD/psychopathy and trauma exposure, namely, that the association between personality disturbance and trauma is not explained by PTSD symptom severity. They also suggest that interventions with incarcerated men and women with ASPD and psychopathic traits may benefit from sensitivity to histories of physical and crime-related trauma.

Dorothy Newbury-Birch, Katherine Jackson, Tony Hodgson, Eilish Gilvarry, Paul Cassidy, Simon Coulton, Vicky Ryan, Graeme Wilson, Ruth McGovern, and Eileen Kaner report on a study that aimed to examine the prevalence of alcohol use disorders amongst young people in the criminal justice system. The primary purpose of the research was to compare the ability of the Alcohol Use Disorders Identification Test (AUDIT) to the Youth Justice Board ASSET tool in identifying alcohol-related need in Youth Offending Team (YOT) clients. The study sample was drawn from three YOTs and two secure establishments (one Secure Training Estate and one Youth Offending Institution) in the northeast of England. Staff administered an anonymous questionnaire which consisted of the ten items of AUDIT and ASSET section 6, which relates to substance misuse. A total of 429 questionnaires were completed with the majority (81 per cent) of the young offenders identified as experiencing alcohol-related health risk or harm and 77 per cent scoring within a possible alcohol-dependent range. Totally, 77, 30 per cent of young people completing both assessments were identified as having an AUD by AUDIT but not identified as needing alcohol-related treatment using ASSET. While noting the limitations of the study, the authors conclude that the addition of a single question from AUDIT (question 3) to the ASSET might significantly increase the ability of youth justice professionals to identify alcohol-related risk or harm in young offenders. The authors conclude that prevalence of AUDs in young offenders is much higher than in the general population and that current methods of identifying young people with alcohol-related problems in the criminal justice system may significantly underestimate the need for alcohol-related intervention. They note there is also a need for alcohol treatment services which are specifically geared towards adolescents. Further research is recommended to identify the best alcohol screening and assessment tool for use with different age groups of young offenders who drink. In addition, more training for professionals in the youth justice system in alcohol-related issues is recommended to assist in the identification of risk of AUDs and to raise awareness of the link between alcohol and crime.

In our third paper James Woodall, Jane South, Rachael Dixey, Nick de Viggiani and William Penson report on an investigation into the potential positive and negative impact of peer interventions in prison. The term “peer intervention” covers a multitude of approaches, ranging from peer education, mentoring, peer support, peer counselling and peer training. The authors point to the lack of quantitative evidence to suggest that such programmes are clinically effective, while acknowledging empirical evidence does exist that demonstrates positive impacts of peer-based programmes on certain health outcomes. They also note some emerging themes, which suggests that peers are able to offer a greater sense of empathy than trained staff and can be viewed by other prisoners as credible sources of information. Potential negative impacts of peer-based interventions can include abuse of positions of trust, distribution of contraband and “burnout” and mental exhaustion experienced by peer delivers as a result of the demands placed on their time by other prisoners. The reported study aimed to address the current shortage of evidence relating to peer-based approaches by reporting qualitative findings from an expert symposium, which was part of a wider systematic review to determine the effectiveness and cost-effectiveness of peer interventions in prison. Experts from a range of organisations were selected to participate in the symposium, which utilised a format of keynote presentations and separate discussion groups. Findings from the symposium indicated a belief that peer interventions in the prison setting created both positive and negative impacts at an individual and organisational level. It was clear from the evidence gathered from the expert symposium that peer interventions in prison settings can impact positively on health outcomes, but these effects were perceived to be more well defined for peer deliverers than recipients. A further emerging issue was the adverse effects that peer interventions cause to the security of the prison. However, despite the reported organisational risks, the positive impact on institutional culture and ethos as a result of peer interventions was recognised. The authors conclude that while peer-based interventions may be particularly effective at maintaining or improving the health and wellbeing in the prison population, particularly for peer deliverers, further research is required to validate the claims from the participants in this study.

Sonia Shagufta, Daniel Boduszek, Katie Dhingra and Derrol Kola-Palmer report on a study that aimed to elicit greater understanding of factors that might protect from the development of suicide ideation in prison. The main purpose was to investigate whether Criminal Social Identity (CSI) might play a potentially protective role against the development of suicide ideation (a cognitive occurrence separate from, but predictive of, suicidal behaviour) in prison using a sample of juvenile Pakistani prisoners. The authors posit that understanding suicide risk in prison requires a greater understanding of the factors that contribute to, and prevent, the development of suicidal thoughts. Consequently, the main purpose of the reported study was to specify and test a structural model examining the relationships between the three factors of CSI and suicidal thoughts, while controlling for age, offender type (violent or non-violent), period of confinement and substance dependence. Research participants were 415 male prisoners incarcerated in prisons in Khyber Pakhtunkhwa (KPK) Pakistan. The respondents ranged in age from 11 to 18 years. Data were gathered from participants via an anonymous, self-administered paper questionnaire. Data analysis revealed that only in-group ties were significantly related with suicide ideation. This suggests that it is the psychological perception of resemblance and emotional connection with a criminal group (in-group ties) that confers a protective effect against the experience of suicide ideation. In other words, the in-group ties with other prisoners may provide a sense of belongingness that prevents the development of negative emotional and interpersonal states, including elevations in negative affect, pessimism, fear of negative evaluation and shyness, as well as lower levels of social support, agreeableness and sociability, which have been found to be linked to both suicidality and loneliness. Whilst noting the limitations of their study, including potential for bias as a result of stigma and sensitivity surrounding suicide in Pakistan, and the self-report nature of the data, the authors conclude that results from their study suggest there might be scope for the wellbeing and mental functioning of prisoners to be enhanced through interventions that aim to maintain or increase individuals’ sense of shared social identity. In addition, the research contributes important information on suicide ideation in Pakistan, a country in which data collection pose considerable challenges, and provides a strong basis for further investigation of suicidal thoughts and behaviour.

In our final paper, Khadra Abdi Jama-Alol, Eva Malacova, Anna Ferrante, Janine Alan, Louise Stewart and David Preen examine the influence of offence type, prior imprisonment and various sociodemographic characteristics on mortality at 28 and 365 days following prison release. The authors predicate their study on the lack of clarity concerning the effect of offence type on post-release mortality rates. In addition, they contend that little is known about the impact of recidivism on post-release mortality. To examine these variables, the authors used linked data of Western Australian (WA) ex-prisoners to examine mortality rates within four weeks and within one year of their release from prison. The examination focused on the influence of offence type and prior imprisonment on post-release mortality among WA adult ex-prisoners from 1994 to 2003, while controlling for age, gender, Indigenous status and social disadvantage. The study hypothesis was that the severity of offence types similar to recidivism will have an effect on post-release mortality. The study population comprised all individuals released from WA prisons as adults in the period from 1 January 1994 to 31 December 2003. Mortality at 28 and 365 days was examined due to the high mortality rates among ex-prisoners in the early period following release reported nationally and internationally, and in particular, during the first two to four weeks following return to the community. Data analysis indicated that offender mortality at 28 days following release from prison is significantly influenced by offence type and prior imprisonment. Offenders imprisoned for drug-related offences had a significantly increased risk of death compared with other imprisoned offenders. The number of prior prison terms was also an important risk factor for mortality among ex-prisoners during the first 28 days of release. Those with a longer history of imprisonment had a substantially increased risk of death. Age was not significantly associated with 28-day post-release mortality. However, older ex-prisoners aged 35-44 years had almost half the adjusted risk of death at 365 days following release compared with ex-prisoners aged 18-24 years. The authors conclude that the study highlights the vulnerability of particular ex-prisoners and are consistent with other studies of mortality among ex-prisoners after release indicating that certain groups of offenders are at particular risk of death upon release into the community. They also recommend that variables, such as psychological and victimisation histories should be considered when designing post-release programmes for both male and female offenders.

Morag MacDonald, Robert Greifinger and David Kane