Gender Differences in Complex Posttraumatic Stress Symptoms, and Its Relationship to Mental Health and Substance Use Outcomes in Incarcerated Adults

Most research on psychosocial outcomes with adults involved in the criminal justice system has been conducted with men, but as women are increasingly involved in the criminal justice system there is a need for studies that examine gender differences on these outcomes, particularly in regards to complex trauma and posttraumatic stress symptoms, which are often reflected as mental health and substance abuse problems and highly prevalent among forensic populations.  It is important to determine if C-PTSD accounts in part for these relationships between gender and psychiatric and substance use disorders.  This secondary data analysis examined gender differences among childhood abuse, C-PTSD symptom severity, and mental health and substance use problems in 497 recently incarcerated adults using multiple regression analyses across a variety of measures.  We hypothesized that women would have a stronger relationship between childhood abuse and C-PTSD symptom severity, and consequently result in greater mental health and substance use problems.  Findings indicate that women are more likely to report childhood abuse and to have higher C-PTSD symptoms than men. Childhood abuse accounted for the gender difference in C-PTSD symptom severity, and C-PTSD symptoms partially accounted for the relationship between gender and psychiatric morbidity and fully for the relationship between gender and drug use. C-PTSD symptoms was similarly rather than differentially associated with each of those adverse outcomes for men as well as women.  Findings highlight the association between childhood abuse and severity of C-PTSD symptoms, and its relationship to psychiatric problems and drug use in women.  Many women within the prison system are among the most severely traumatized beginning in childhood, tend to experience harsher consequences, and have limited access to specialized treatment.