Examining the Association between Incarceration Trajectories and Mental Health Diagnoses Among Imprisoned Mothers: A Nationwide Study

Background and Purpose: Imprisoned women with children have a significantly higher prevalence of mental health problems than those in the general population and imprisoned women without children. Research on the etiology of mental health problems among incarcerated mothers has proliferated. However, the association between incarceration history and their mental health problems remains unclear. Some research suggests that the mother's mental health problems are attributable to the stress originated from incarceration. Other research indicates that their mental health problems are irrelevant to the exposure to the correctional system. Instead, the experience of cumulative disadvantages that precedes the incarceration, such as trauma and victimization, are the leading causes. The inconsistent findings regarding the role of incarceration are potentially attributable to the use of a dichotomized measure (i.e., with or without incarceration history) that masks the different imprisonment histories across samples. In this study, we used comprehensive incarceration trajectories to determine the nature and array of incarceration experiences detrimental to the mental health of imprisoned mothers.

Methods: Data and samples: We used the 2004 Survey of Inmates in State and Federal Correctional Facilities (SISFCF) for analysis. The SISFCF is a cross-sectional nationally representative survey of prison inmates with a retrospective longitudinal incarceration history section. A total of 881 imprisoned mothers in the survey comprised the final study sample.

Measures: Through face-to-face interviews, participants self-reported their sociodemographic characteristics and mental health diagnoses, including depressive disorder, bipolar disorder, schizophrenia, post-traumatic stress disorder (PTSD), anxiety or panic disorder, personality disorder, and other mental conditions. Using the incarceration history data, the authors identified four incarceration trajectories among imprisoned mothers in a recent paper, including the stably escalating trajectory, moderate declining trajectory, adolescence-peak trajectory, and young-adulthood-peak trajectory. The incarceration trajectory memberships are the independent variables in this study.

Analysis: To select variables to be included in the multivariate logistic regression model, predicting variables were subjected to bivariate logistic analysis with mental health dependent variables. Only predictors that have a p-value of < .25 were retained for the final model. Multivariate logistic regressions were then conducted to examine the associations between the mother’s incarceration trajectories and mental health problems.

Results: Findings suggested that incarceration trajectories were significantly associated with PTSD diagnosis. Specifically, imprisoned mothers following the young-adulthood-peak trajectory had 19.87 the odds as mothers following the stably escalating trajectory to have PTSD diagnosis (95% CI = 1.59–248.30). Moreover, imprisoned women following the moderate declining trajectory had 13.09 the odds as incarcerated women following the stably escalating trajectory to have PTSD diagnosis (95% CI = 1.09–156.90). However, incarceration trajectories were not significantly associated with other mental health diagnoses, such as depressive disorder.

Conclusions and Implications: The significant associations between incarceration trajectories and PTSD diagnosis suggest the necessity for mental health interventions to customize to the unique challenges encountered by subgroups of imprisoned mothers with different incarceration experiences. Moreover, findings from this study suggest that comprehensive longitudinal measures should be used in future social work research to generate a nuanced understanding of the consequences of incarceration.