What came first, PTSD or the prison system? A review of cumulative trauma exposure and PTSD prevalence and development while incarcerated

Abstract

While incarcerated, people can be exposed to events that are specific to a prison environment. Experiencing a traumatic event is not uncommon for men and women that are incarcerated as the events that occur tend to include physical assault, victimization, and coercion. Cumulative trauma exposure (CTE) is a concern as inmates have little control over the environment they inhabit and the experiences they are exposed to. This article sought to determine whether, and how, CTE and traumatic exposure during incarceration is associated with developing PTSD to identify whether incarceration functions as a moderator for PTSD outcomes. CTE increases the likelihood of developing posttraumatic stress disorder (PTSD) during and after incarceration. Three factors were observed: (a) interpersonal trauma exposures are connected to more severe, life-long problems than non-interpersonal, (b) cumulative trauma exposure, which is multiple, repeated, or chronic exposure to traumatic events before and during incarceration, results in an increased likelihood of developing PTSD, and (c) experiencing multiple types of exposures—especially physical and sexual abuse as a form of victimization—are positively associated with PTSD symptoms. Understanding the type of traumatic events incarcerated individuals are exposed to (e.g. interpersonal and mixed trauma) while simultaneously considering their individual characteristics assisted with navigating ways incarceration moderated PTSD symptoms. Investigating the exposure to traumatic events while incarcerated can increase understanding, and treatment, of the PTSD-related consequences that may arise from incarceration.