Understanding the Arrest Experiences of Women with Co-Occurring Posttraumatic Stress and Substance Use Disorders

Background and Purpose: Research shows that women in the criminal justice system are disproportionately affected by multiple emotional and economic struggles. Even though men continue to make up the majority of overall arrests in the United States, the total number of men arrested over the past ten years has decreased by 6.8% while the total number of women arrested has risen by 10.5%. This dramatic increase of women’s arrests is cause for investigation. The aim of my study was to use general strain theory to test for associations between arrests at follow-up and changes in women’s strain severity over time. I hypothesized that as women’s strains decreased over the course of an intervention, so would their likelihood of arrest.

Methods: This secondary analysis used data from the National Institute on Drug Abuse’s  Clinical Trials Network, Protocol #15 titled “Women’s treatment for trauma and substance use disorders: A randomized clinical trial.” This study was designed to test the efficacy of Seeking Safety, a trauma-informed substance abuse treatment program. Using a multi-level model, nesting time within individual, I tested for associations between women’s arrests at follow-up and changes in each strain over the course of the intervention (N=138). Variables were collected using the Addiction Severity Index, Basic Symptom Inventory, and Clinician Assisted PTSD Scale. The dichotomous (yes/no) arrest variable was the dependent variable and was collected at 3-, 6-, and 12-months post intervention. The changes in the raw scores between baseline and one-week post intervention were calculated for the following independent strain variables: drug use, alcohol use, depression, posttraumatic stress disorder (PTSD), limited employment achievement, and low levels of social support.

Results: Most of the variables provided null results, except for the PTSD and alcohol strain variables. Women whose alcohol (OR = 1100, 95% CI = 22 – 53000, p < 0.001) and PTSD (OR = 1.0, 95% CI = 1.0 – 1.1, p < 0.01) severity change increased over the course of the intervention were more likely to be arrested during follow-up. The results also showed that women assigned to treatment as usual (OR = 3.6, 95% CI = 1.4 – 9.7, p< 0.01) were more likely to be arrested when compared to those assigned to Seeking Safety.

Conclusions and Implications: According to these results, there was a positive relationship between alcohol and PTSD strain severity increase over the course of the intervention and likelihood of arrest at follow-up. Additionally, those assigned to the trauma-informed program were less likely to be arrested. For women with histories of trauma, PTSD symptoms may increase once they begin sobriety. Unable to manage these symptoms alone, women may use alcohol to cope, eventually leading to arrest. Implications from these results include: providing therapeutic support to women with trauma histories in the beginning of their sobriety in an effort to help them use healthier coping mechanisms; incorporating trauma-informed policies and strategies in women’s substance abuse treatment; and expanding the research examining the link between women’s arrest and PTSD and alcohol strain severity.