Unraveling the Relationship Between Trauma, Coping Resources, and Post Traumatic Stress Symptoms Among Older Adults in Prison

Background: America’s prison system is rapidly graying, and older adults in prison have serious physical and mental health problems (Maschi et al., 2012).  Recent evidence suggests that older adults have a high frequency of traumatic and stressful life events (T-SLE; Maschi et al., 2011).. Additionally, stress process theory (Pearlin, 2005) posits a protective role for coping resources on the relationship between T-SLE and mental well-being is known about the role of coping resources (cognitive, emotional, physical, spiritual, and social coping) act as a protective factor for later life mental well-being, yet it is unexplored using a sample of older prisoners. This study fills a gap in the literature by examining the relationships between cumulative traumatic and stressful life events, coping resources, and post traumatic stress symptoms among older adults in prison using structural equation modeling.

Methods: The study used a cross-sectional correlational design. Data were gathered from 674 prisoners (aged 50+) housed in the northeastern correctional system in 2010. An anonymous self-report self-administered survey was mailed to all 1,750 prisoners that met the study criterion as being aged 50 and older.  Using the four-step Dillman (2002) mail method, a 43% response rate was achieved. Cumulative trauma (objective and subjective) was measured use the Life Stressors Checklist-Revised (LSC-R). Additive scores were used for cumulative trauma [(31 objective occurrences of traumatic experiences) and the past year cumulative subjective impact (the extent the events bothered the person in the past year from not at all (1) to extremely (5)]. An additive score was using for coping resources using the Coping Resources Inventory (CRI; alpha=.83) and post traumatic stress symptoms using the Civilian Version of the Post Traumatic Stress Scale (PCL-C, alpha=.91).

Findings: Results of a structural equation model revealed a partial meditational model in that coping resources (cognitive, emotional, physical, spiritual, social) mediated the relationship between cumulative trauma (objective and subjective) and post traumatic stress symptoms. The model adequately fit the data [χ²=83.04,df=18,CFI=0.96,RMSEA=.08(.06 - .09].  Trauma was a significant predictor of both coping resources (Estimate = -0.36, SE = 0.07, CR = -5.56, β = -0.25, p<.001) and post traumatic stress symptoms (Estimate = 1.71, SE = 0.12, CR = 14.39, β = 0.51, p<.001).  In addition, coping significantly predicted post traumatic stress symptoms (Estimate=-0.66,SE=0.09,CR=-7.46, β=-0.29,p<.001) thus producing a partial mediating model.  To test for mediating effects, the Sobel Test was used (due to missing data, Bootstrap procedures were not an option) and was 4.48 (both one and two-tailed probabilities p<.001).  Consequently, there is a significant indirect effect of the independent variable (cumulative trauma) on the dependent variable (post traumatic symptoms) through the mediator variable of coping.

Implications: As prisons are forced to deal with an aging population, research in this area can take the preliminary steps to enhance understanding of the difficulties faced by older adults in prison.  This understanding will aid in the development and improvement of interventions that incorporate the capacity building of coping resources to better maintain the mental well-being, especially post traumatic symptoms, of older adults in prison.