Incarcerated offenders are more likely to experience Posttraumatic Stress Disorder (PTSD) and associated symptoms than the general population. This study examined the symptoms and predictors of PTSD in 150 male offenders incarcerated for committing a violent offense. Participants rated symptoms of PTSD for acts of reactive and instrumental violence, poorly recalled violence, and subjectively disturbing events on the Impact of Events Scale (IES). The results show that subjectively disturbing events were associated with higher IES scores than acts of violence. Furthermore, recent events were associated with a greater number of trauma symptoms and peritraumatic dissociation was positively associated with trauma symptoms. This is the bottom line of a recently published article in The International Journal of Forensic Mental Health. Below is a summary of the research and findings as well as a translation of this research into practice.
Featured Article | International Journal of Forensic Mental Health| 2020, Vol. 19, No. 1, 68-83
The Perpetration of Violence and the Experience of Trauma: Exploring Predictors of PTSD Symptoms in Male Violent Offenders
Marguerite Ternes, Psychology, Saint Mary’s University
Barry S. Cooper, Private Practice; Department of Psychiatry, University of British Columbia
Dorthee Griesel, Gesellschaft fur Wissenschaftliche Gerichts-und Rechtspsychologie
Incarcerated offenders are more likely to experience Posttraumatic Stress Disorder (PTSD) and associated symptoms than the general population. PTSD may develop from a variety of events, including being a victim of violence, witnessing violence, or from committing a violent offense. This study examined symptoms and predictors of PTSD in 150 male violent offenders. Participants recalled acts of reactive and instrumental violence, poorly recalled violence, and subjectively disturbing events (e.g., victim of violence), and rated each event for symptoms of PTSD using the Impact of Events Scale (IES). Subjectively disturbing events were associated with higher IES scores than the acts of violence. Hierarchical linear modeling showed that more recent events were associated with a greater number of trauma symptoms and peritraumatic dissociation was positively associated with trauma symptoms. As well, trauma symptoms were more likely to develop if the victim was a family member or a friend, as compared to a stranger or acquaintance. These results support the need for trauma-informed assessment and treatment for offenders. Knowing more about the predictors of trauma symptoms is a first step in effectively treating PTSD in this population.
Male offenders; PTSD symptoms; violence; correctional psychology
Summary of the Research
“…Although many offenders have been exposed to numerous trauma and are, thus, at risk to develop PTSD [Posttraumatic Stress Disorder]…PTSD has rarely been examined in offender populations. Of the studies that have focused on this issue, the majority have found that offenders present a higher prevalence of PTSD and associated symptoms compared to the general population…In offending populations, symptoms of PTSD tend to be associated with childhood physical and/or sexual abuse, but offenders may also develop PTSD from committing an offense…The consequences of traumatic experiences can be far-reaching, negatively affecting mental and physical health and increasing the chances of victimization or revictimization, aggression, and violence…” (p.68).
“…the present study aimed to explore the experience of PTSD symptoms [in offenders] in relation to different types of acts of perpetrated violence, as well as subjectively disturbing (traumatic) experiences. A secondary aim was to explore the potential correlates of PTSD symptoms, including a history of trauma and offense characteristics…Hypothesis 1. It was hypothesized that the participants would report a higher number of PTSD symptoms in relation to their subjectively disturbing experiences than their acts of perpetrated violence. Hypothesis 2. It was hypothesized that the participants would report higher levels of PTSD symptoms in relation to reactive acts of violence in comparison to instrumental acts of violence. Hypothesis 3…It was hypothesized that psychopathy would be negatively related to PTSD symptoms and that peritraumatic dissociation would be positively related to PTSD symptoms. It was also expected that participants would report higher levels of PTSD symptoms if the victim was someone close to them…rather than an acquaintance or stranger…” (p.71-72).
“The sample consisted of 150 male incarcerated violent offenders…The results supported existing research that has shown that offenders are likely to have been exposed to trauma and are likely to develop PTSD…Although we expected participants to experience PTSD symptoms in relation to their perpetrated acts of violence, we expected that they would experience stronger PTSD symptoms in relation to their subjectively disturbing events. We found support for the first hypothesis…Based on previous studies that had shown that offenders are more likely to receive PTSD diagnoses in relation to committing reactive violence in comparison to instrumental violence…we had expected participants to experience stronger PTSD symptoms for memories for perpetrated reactive violence, as compared to perpetrated instrumental violence. This hypothesis was not supported…” (p.72-79).
“…as expected, dissociation at the time of the event was associated with increased PTSD symptoms…Also, as expected, committing a violent offense against someone the participant cared about (i.e., a friend or family member) resulted in stronger PTSD symptoms than violence against a stranger or acquaintance…In the present study, psychopathy was not related to trauma symptoms. Time elapsed since the event predicted trauma symptoms. Specifically, the more time that had passed between the event and recall, the fewer trauma symptoms…The investigation concerning the effect of intoxication at the time of the event or a history of traumatic experiences in childhood on subsequent PTSD symptoms was exploratory. In the present study, neither of these variables predicted PTSD symptoms…” (p.79).
Translating Research into Practice
“The fact that a considerable number of the participants reported extreme levels of PTSD symptoms in relation to their subjectively disturbing experiences and, to a lesser extent, their acts of perpetrated violence, suggests PTSD is a considerable problem among male incarcerated offenders, as others have reported…This suggests that properly assessing for PTSD in offenders during the intake process may facilitate appropriate intervention and aid in rehabilitation efforts…Proper assessment should include considering personal and event characteristics that might contribute to the development of PTSD, such as peritraumatic dissociation, nature of the event, and relationship with the victim. Assessors should also be aware that the development of PTSD symptoms may be a factor or product of the act of violence” (p.80).
“Rehabilitation programs and psychological treatments for incarcerated offenders aim to increase the offenders’ understanding and responsibility taking for their offense, which involves closely examining the offense and the decisions leading up to it…Offenders who wish to avoid thinking about their offense because it was a traumatic experience may not fare well in traditional correctional treatment programs. Trauma-informed interventions seem to be effective in reducing PTSD in offenders and increasing pro-social coping skills, as long as criminal justice priorities are considered” (p.80).
Other Interesting Tidbits for Researchers and Clinicians
“Harry and Resnick (1986) were the first researchers to suggest that PTSD might develop as a consequence of committing a violent act. Although they considered only three murderers, Harry and Resnick suggested a number of factors that may contribute to the development of PTSD following perpetrated homicide, including younger age, a chaotic childhood, a problematic developmental history, a minimal criminal history, having a significant relationship with the victim, and being in an altered mental state at the time of the homicide. Since then, other researchers have also explored factors related to the development of PTSD as a consequence of committing violence…Gray et al. (2003) found that those who had an affective diagnosis and who regretted their violent acts were more likely to develop symptoms of PTSD…” (p.69-70).
“…Payne et al. (2008) also found that PTSD symptoms were unrelated to the nature of a violent act. They hypothesized that their lack of findings may be due to the overlap between the acts of reactive and instrumental violence. In their study, and in ours, it was common for an act of violence to have both reactive and instrumental elements (e.g., a confrontation during a planned robbery leads to a provoked assault). Therefore, it is possible that the nature of these aggressive acts is too complex for a simple dichotomy” (p.79).
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