Offenders as victims: post-traumatic stress disorder and substance use disorder among male prisoners

April 2014
Sindicich, N., Mills, K. L., Barrett, E. L., Indig, D., Sunjic, S., Sannibale, C., Rosenfeld, J., Najavits, L. M. (2014). Offenders as victims: post-traumatic stress disorder and substance use disorder among male prisoners. Journal of Forensic Psychiatry, 25(1): 44-60. DOI: 10.1080/14789949.2013.877516.

Co-occurring substance use disorder and post-traumatic stress disorder (SUD-PTSD) is common among prisoners and linked to an increased risk of criminal reoffending; however, little is known about the characteristics of prisoners with this comorbidity. In this paper, the authors aim to redress this by examining the clinical and criminal profile of male prisoners with symptoms of SUD-PTSD. The authors also investigate whether there are differences between the profiles of those who have experienced trauma in prison versus those who have not. 

Thirty male inmates from two correctional centres in Sydney were recruited and interviewed. The sample had a median age of 34.5 years, 93% were Australian born, and 23% identified as Aboriginal and/or Torres Strait Islander. 

Results showed extensive criminal, substance use and trauma history in the group as a whole. Ninety per cent reported a history of substance dependence and 50% reported a history of injecting drug use. Fifty-seven per cent met diagnostic criteria for PTSD, with the remainder experiencing sub-threshold symptoms. Forty-three per cent reported a traumatic event while in prison, most commonly experiencing a serious physical assault, witnessing a serious physical assault, and experiencing a sexual assault. Those who had experienced trauma in prison, compared to those who had not, were more likely to nominate heroin as their main drug of concern and to be receiving drug treatment in prison.

The authors note that despite such prisoners’ vulnerability and the severity of their clinical profile, they receive little by way of treatment, even though such efforts could ultimately lead to reduced reoffending upon release and improvements to prisoner safety and psychological well-being.