Prisoner Post Traumatic Stress

It is well known by now that prisoners have a much higher prevalence of post-traumatic stress disorder (PTSD) than the general population, ranging from 4% to 21% of the sample. Many more females than males are affected by PTSD in prison.

Credit: karanik yimpat/Shutterstock.com

Causes

Trauma is almost ubiquitous among a male prison population, with rates of exposure to violence or traumatic events being reported as anywhere between about 62% to 100% - roughly double that in a community-based male population. This includes physical assault and sexual abuse, the latter affecting almost 15-16% of male prisoners in sharp contrast to the 1-3% in the general male population.

It is established that being exposed to trauma increases the link to psychiatric illness, and most importantly PTSD. This disorder is found to affect 5% of men in general, which is in turn about 7-14% of those who have undergone significant trauma.

However, it is noteworthy that no less than 60% of men in prison have symptoms and signs of severe to moderate PTSD, which reflects 30-60% of those who are exposed to physical trauma including assault, and 43-75% of men who were victims of sexual violence in prison.

The highest rates of PTSD occur in male prisoners who have any other mental health condition. These are horrifying statistics, especially in the light of the meager resources available to diagnose and treat this volume of male prisoners.

Types of trauma

Prisoners are subject to various forms of trauma. Just being imprisoned is an extremely traumatic event for many prisoners, which may be responsible for precipitating PTSD following their release from detention.

Other factors are interwoven into the pathogenesis of this condition, including the many risk factors that underlie the behavioral and thought patterns of many criminals. These include childhood traumas such as extreme poverty, child abuse by their parents or caregivers, experiences of neglect, physical and sexual abuse, as well as other forms of mistreatment.

These extremely painful and devastating childhood memories may often be awakened when these offenders experience prison life, with its dehumanizing, harsh and unloving environment and lifestyle.

The violence that is rampant among many prisons in close proximity to uninvolved prisoners, along with the demands of obedience to a rigid and impersonal prison discipline and the need to escape from cruel or domineering co-prisoners, as well as the urgent necessity of not being a victim of rape or violence oneself, all conspire to produce an intolerable re-enactment of childhood memories which the prisoner would gladly forget.

These memories, by bringing back the earlier experiences, may cause the prisoner to go through the crippling mental and emotional reactions that they evoked earlier, as well as their painful consequences. Thus the stage is already set in many cases for the development of a full-fledged PTSD following incarceration.

Yet these are not revealed readily, especially under the training of a harsh and disciplined institution like a prison. They are internalized, instead, leading to outwardly well-adjusted individuals who are seething within with rage, frustration, disorganization, helplessness and fear. This causes them to eventually fail to adjust to the world outside prison.

This dysfunction is especially obvious when the prisoner does not have a support network upon returning to the free world. This means that there is nobody who can discover that something is wrong.

The internal conflict bursts to the surface when such individuals are faced by an overwhelming challenge, which acts like the proverbial straw on the camel’s back, leading to the fall of the external supports which sustained them so far and causing them to behave in unexpectedly destructive or abnormal fashion.

Symptoms

PTSD causes physical, emotional and behavioral symptoms. Early symptoms of PTSD may be classified as:

  • Reliving the traumatic event
  • Avoiding anything which brings back memories of the trauma
  • Abnormal jumpiness or irritability, feeling stressed out constantly
  • Low or depressed mood most of the time
  • Feelings of self-blame or anger towards some other figure supposed to be responsible for the present situation

Management

For the prisoner to deal with the PTSD, it is necessary to provide tools for the individual to understand the trauma in the right light. This will probably entail dealing with the background traumas as well.

Following this, it will be necessary to help such victims to deal with the avoidance, stress levels, depression, self-blame and anger which inevitably haunt them. Relaxation, breathing, and grounding techniques may all be taught to help in this process, along with psychotherapy and teaching coping skills. Medications may be necessary in some cases, and the prison staff must be involved for this process to be fruitful.

References

  1. http://onlinelibrary.wiley.com/doi/10.1002/cbm.653/full
  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4321801/
  3. https://aspe.hhs.gov/basic-report/psychological-impact-incarceration-implications-post-prison-adjustment
  4. https://www.selfhelpguides.ntw.nhs.uk/
  5. https://web.ntw.nhs.uk/selfhelp/leaflets/Prisoner%20Post%20Traumatic%20Stress%20ER.pdf

Further Reading

Last Updated: Dec 29, 2022

Dr. Liji Thomas

Written by

Dr. Liji Thomas

Dr. Liji Thomas is an OB-GYN, who graduated from the Government Medical College, University of Calicut, Kerala, in 2001. Liji practiced as a full-time consultant in obstetrics/gynecology in a private hospital for a few years following her graduation. She has counseled hundreds of patients facing issues from pregnancy-related problems and infertility, and has been in charge of over 2,000 deliveries, striving always to achieve a normal delivery rather than operative.

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Comments

  1. Tyler DeVito Tyler DeVito United States says:

    As someone who was just released from prison myself (for a drug offense during college which led to my incarceration directly after surviving a stabbing) I can attest that the toxic environment of prison, including both rampant correctional officer cruelty and corruption coupled with horrifically sadistic and malevolent inmate culture, is a breeding ground for not just post-traumatic stress disorder but the continuation of and worsening of substance abuse disorders. Reform of the prison system in favor of renewed focus on rehabilitation and prison alternatives would benefit society far more than mass incarceration and it's pseudo-slavery reality as an overtly negative and archaic practice (particularly for majority non-violent offenses related to substance abuse).

  2. Allison Conley Allison Conley United States says:

    As the wife of someone who spent a large portion of his adult life in and out of the Pennsylvania State Prison System who has also watched more Youtube "Prison Creators" than I care to admit to (simply so that I could learn more about the things my husband experienced while in there) I can say with 100% certainty that there is ABSOLUTELY Prison related PTSD.  Everyone seems to experience the same mental health issues after having spent any time in prison.  There has got to be something done to reform the Prison systems in this country.  Not only are we putting these men and women in there to fend for themselves we are letting them out with no resources.

  3. James Miller James Miller United States says:

    I've been in and out of prison 8 times since May of 1989 and spent more than 9 of the first 13 years in solitary confinement for bad behavior. I have 22 plus years of incarceration. I've been out almost 8 years this Feb. 17th 2024. I only wish I could express the difficulties I'm experiencing with PTSD and the physical problems I'm having. I need assistance, bad! I don't know how to take care of myself now that I can't work. I've only been able to maintain work this far because I paint. When I flip out at work, "over what-nots", I could usually get a painting job anywhere. And I'm ganna have to do something for a week or two right now so i can get food for my cats and pay bills. I've burned most all those bridges now though in this area, not to mention it's almost a 100 mile commute. I've had probably 50 jobs or more in the last 5 plus years and 7 cars, I've either blown them up making the commute or the 4 deer I hit and killed in 3 years because of my extreme anxiety about getting to work about 30 or 40 minutes early everyday so I wouldn't lose my job and go back, yet I  would end up losing that job anyway. Seems kinda redundant. I'm called crazy, I'm a nut job. Etc. Etc.
    I can't even keep up with my taxes anymore, and I  dont care, and especially now since I have a pinched nerve in my low back and often paralysis my left side, at random, and I can't walk. And no, I don't go out committing crimes. I have a lot of bad thoughts about myself already. I lost my parents during all this and my sister hates me now.
    I don't know what I can do to survive. Going back or just ending everything. There only seems to be 2 options for someone like me. I wander what the suicide rate is for people with PTSD from incarceration that have actually been able to make it this long?  And Who are those people, if we can consider them as people anymore? Do they have value of life at this stage? They need to have an ex-cons veterans association set up to help people financially that can't help themselves.

The opinions expressed here are the views of the writer and do not necessarily reflect the views and opinions of News Medical.
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