Intimate Partner Violence Victimization and Post-Traumatic Stress Disorder Among Incarcerated Women: The Role of Homelessness Prior to Incarceration

Background: Prevalence rates of post-traumatic stress disorder (PTSD) for incarcerated women are four to ten times higher than rates for non-incarcerated women. These high rates are linked to extensive histories of childhood abuse and adulthood victimization, including experiences with intimate partner violence (IPV). Victimization is also a leading cause of homelessness for women, and women involved in the criminal justice system experience especially high rates of homelessness that exacerbate their experiences of social and economic marginality. Feminist pathways theory has examined victimization and homelessness in relation to incarceration risk and cumulative adversity theory suggests connections between victimization, homelessness, and PTSD. This study empirically tested the associations between forms of adulthood victimization (i.e., IPV and non-intimate partner violence victimization), homelessness, and PTSD symptoms for incarcerated women.

Methods: A survey was conducted with all incarcerated women in a state prison. Within the sample of 832 women who completed the survey, women were, on average, 38 years old (SD= 11.05; range 18-65). Approximately 40 percent were serving sentences of five years or less, and half had served two years or less. Almost half (49.2%) identified as White/Caucasian, 35% as Black/African American, and 15.4% as another race. Women completed measures of victimization across the life course, homelessness, and current PTSD symptoms. Descriptive statistics and a mediational path analysis were conducted using Mplus software (version 8.1, 2012-2020) to examine the relationships between victimization (i.e., IPV and non-IPV victimization) and PTSD symptoms. Indirect relationships were tested to see if these victimization experiences were associated with PTSD symptoms via pre-prison homelessness. Covariates included race (2 variables: 1 = Black/African American, 1 = White, 0 = Another race), time served, age, and childhood abuse (1 = experienced abuse, 0 = did not experience abuse).

Results: A majority (69.9%) of women had experienced IPV, and 46.8% had experienced non-IPV victimization during adulthood. Half (52.5%) of the women had experienced at least one form of housing insecurity/homelessness prior to prison. Over half (64.5%) of the women met clinical threshold criteria for PTSD symptoms. Similarly, 60.2% of the women had experienced childhood abuse. Results from the mediational path analysis indicated that non-IPV victimization (B = 0.09, p = .02) and IPV (B = 0.10, p = .02) were positively associated with pre-prison homelessness. Pre-prison homeless was positively associated with PTSD symptoms (B = 1.84, p < .001). Mediation analyses showed that non-IPV victimization was associated with PTSD symptoms via pre-prison homelessness (B = 0.17, p = .03). IPV was also associated with PTSD symptoms via pre-prison homelessness (B = 0.18, p = .04).

Implications: Experiences of homelessness are often traumatic experiences, contributing to PTSD symptoms for women involved in the criminal justice system, and can also serve as a mechanism linking victimization and PTSD symptomology. These findings inform trauma theory and gender-responsive practices and policies designed to improve women’s lives. In particular, victimization and homelessness prior to incarceration are factors to screen for, as they were both associated with women’s PTSD symptomology while incarcerated.