Risk Factors for Depressive Symptoms Among Women Ex-Offenders: A Nationally Representative Study

Background and Purpose:Women with an incarceration history experience a greater number of depressive symptoms compared to their counterparts without an incarceration history. Previous qualitative studies have suggested that women ex-offenders are exposed to more stressors than women without an incarceration history, and exposure to these additional stressors may have contributed to their depressive symptoms. However, this speculation has not been comprehensively examined by quantitative studies with nationally representative samples. In this study, we used the National Longitudinal Study of Adolescents to Adult Health (Add Health) to explore the extent to which women ex-offenders are exposed to stressors, and to investigate the underlying explanatory mechanism for their depressive symptoms.

Methods: A sample of 15,701 adolescents enrolled in grades 7-12 were recruited for Add Health baseline data collection between 1994 and 1995, and followed-up between 2007 and 2008 when they were 24-32 years old. This study was conducted with women with (n=626) and without (n=7,237) an incarceration history. Participants self-reported their sociodemographic characteristics, exposure to stressors (i.e. incarceration history, victimization experiences, substance abuse), and depressive symptoms in adolescence and adulthood. Chi-square and t-tests were conducted to examine whether women ex-offenders are exposed to more depressive symptoms and stressors than women without an incarceration history. Given evidence of mental health disparities between these two groups of women, multiple linear regression was conducted to identify risk factors for depressive symptoms among women ex-offenders.

Results: Findings indicate that women ex-offenders experienced more stressors (i.e., low socioeconomic status, substance abuse, and victimization in both adolescence and adulthood) and significantly more depressive symptoms in adulthood compared to women without an incarceration history. Regression analysis revealed that total length of incarcerations and episodes of incarceration are not significantly associated with the depressive symptoms of women ex-offenders. Instead, emotional abuse in adolescence (β=1.74, SE=0.65, p<.01), sexual abuse (β=1.66, SE=0.57, p<.01) or physical abuse in adulthood (β=2.18, SE=0.91, p=0.02), and marijuana abuse in the previous year (β=2.25, SE=1.09, p=0.04) are significant risk factors for depressive symptoms among women ex-offenders. In addition, women ex-offenders who self-identified as Black (β=1.39, SE=0.63, p=0.03) reported significantly more depressive symptoms compared to their White counterparts. The overall model fit is R²=.1882.

Conclusions and Implications: Women ex-offenders are differentially exposed to stressors compared to women without an incarceration history, and these stressors are significantly risk factors for their depressive symptoms in adulthood. Although criminal justice involvement was not significant in predicting depressive symptoms among women ex-offenders, scholars should be cautious in generalizing this finding to other groups of women ex-offenders as the level of criminal justice involvement among women in this study (x̅=one month) is distinct from majority of other women ex-offender groups (x̅=five years). Due to the high prevalence of substance abuse and traumatic experiences among women ex-offenders, trauma-informed behavioral health treatment and trauma-specific services should be adopted by correctional-based and community-based mental health service providers. Moreover, the social work profession need to recognize the unique mental health needs and to develop customized services for these disproportionately incarcerated but underserved minority women.