Posttraumatic stress, panic disorder, violence, and recidivism among local jail detainees

• DOI: https://doi.org/10.1108/IJPH-06-2018-0036
• Published date: 05 December 2019
• Pages: 366-375
• Date: 05 December 2019
• Author: Elizabeth Combs,Kaitlin Guston,Albert Kopak,Alyssa Raggio,Norman G. Hoffmann
• Subject Matter: Health & social care,Criminology & forensic psychology,Prisoner health,Sociology,Sociology of crime & law,Public policy & environmental management,Policing,Criminal justice

Posttraumatic stress, panic disorder,

violence, and recidivism among local

jail detainees

Elizabeth Combs, Kaitlin Guston, Albert Kopak, Alyssa Raggio and Norman G. Hoffmann

Abstract

Purpose –Most research on posttraumatic stress disorder (PTSD) and offending has been conducted with

special populations (e.g. veterans and female inmates) and generally overlooks the additive effect of panic

disorder (PD) in offending patterns. The purpose of this paper is to assess the prevalence of PTSD and PD

among jail inmates, while simultaneously examining the relationships between these disorders, offending

types and frequency.

Design/methodology/approach –A random sample of adults recently booked into a local county jail

participated in the Comprehensive Addictions and Psychological Evaluation-5 (CAAPE-5), a structured

psychological assessment. The study sample was comprised of 200 male and 83 female inmates.

Findings –Indications of PTSD were observed among 44.0 percent of male inmates and 57.8 percent of

female inmates. Most male inmates (78.4 percent) with positive PTSD indications also met criteria for PD, with

a similar proportion (78.1 percent) of female inmates also meeting criteria for both. The combination of PTSD

and PD was not associated with offending frequency, but inmates presenting indications of both PTSD and

PD were more likely to be charged with a violent offense relative to those with only PTSD.

Practical implications –Inmates with PTSD who also have panic attacks may have a more severe condition

with possible implications for other risks. Observations of these conditions among adults recently booked into

local jails should coincide with each other.

Originality/value –Few studies have examined mental health conditions among local jail detainees, despite

the ever-present need to address them. The current study considers this important population and

investigates the prevalence of co-occurring conditions.

Keywords Mental health, PTSD, Panic disorder, Inmates, Jail, Correctional sample

Paper type Research paper

Introduction

Posttraumatic stress disorder (PTSD) is an intrusive mental health condition which impacts 8

percent of the general population at some point in their lives (Kessler et al., 2005). PTSD

symptomology, such as dissociative reactions or “flashbacks,”avoidance of reminders of the

trauma, sleep disturbance and negative cognitions, often disrupt day-to-day life (American

Psychiatric Association (APA), 2013). There is also a significant gender discrepancy in PTSD

development with more women reporting symptoms consistent with PTSD compared to men

(First et al., 2002; Kessler et al., 2005). Furthermore, PTSD ranks highly among the many mental

health disordersthat are disproportionatelyrepresented in jails and prisons in the USA (Goff et al.,

2007; James and Glaze, 2006; Ulzen and Hamilton, 2003; Wolff et al., 2014; Zlotnick, 1997).

Another widespread mental health issue, panic disorder (PD), affects 2.7 percent of the general

population (National Institute of Mental Health, 2016). Panic attacks, the primary criterion for PD,

disrupt dailyfunctioning in a manner similarto the way in which symptoms representative of PTSD

can significantly affect behavior. Symptoms include heart palpitations, dizziness, shortness of

breath, nausea, derealization, depersonalization and fear of losing control (APA, 2013). Less is

Received 12 June 2018

Revised 17 February 2019

Accepted 18 March 2019

Data collection for the current

project was supported by C4

Recovery Foundation.

Elizabeth Combs and Kaitlin

Guston are both based at the

Department of Psychology,

Western Carolina University,

Cullowhee, North Carolina, USA.

Albert Kopak is based at the

Department of Criminology &

Criminal Justice, Western

Carolina University, Cullowhee,

North Carolina, USA.

Alyssa Raggio is based at

Mission Health, Asheville, North

Carolina, USA.

Norman G. Hoffmann is based at

Evince Clinical

Assessments, Waynesville,

North Carolina, USA.

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INTERNATIONALJOURNAL OF PRISONER HEALTH

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VOL. 15 NO. 4 2019, pp. 366-375, © Emerald Publishing Limited, ISSN 1744-9200 DOI 10.1108/IJPH-06-2018-0036