Trauma exposure and mental health of prisoners and ex-prisoners: A systematic review and meta-analysis

Huinan LIU, Tsz Wai LI, Li LIANG, Wai Kai HOU

Research output: Contribution to journalArticlespeer-review

Abstract

The present meta-analytic review examined the associations between different forms of trauma and mental disorders among prisoners and ex-prisoners. Studies published from 1998 to March 31 2021 were identified by searching PsycINFO, PubMed, Medline and Web of Science. Data were meta-analyzed using a random-effect model. Moderator and mediator analyses were conducted. The protocol was registered in PROSPERO (CRD42020181587). We identified 62 studies (50 non-duplicated samples) with 15,115 (97.86%) prisoners and 330 (2.14%) ex-prisoners in 16 countries. A multi-level meta-analysis found that overall trauma was positively associated with more diagnoses or symptoms of mental disorders (Zr = 0.198, 95% CI = [0.167, 0.229], p < 0.001). Stronger effect sizes were found between childhood trauma (Zr = 0.357, 95% CI = [0.147, 0.568], p < 0.01) and sexual trauma (Zr = 0.326, 95% CI = [0.216, 0.435], p < 0.001) and stress-related disorders. Multilevel moderator analysis showed that effect size was stronger in imprisonment trauma (β = 0.247, 95% CI = [0.177, 0.316], p < 0.01), mixed trauma (β = 0.234, 95% CI = [0.196, 0.272], p < 0.001), and stress-related disorders (β = 0.261, 95% CI = [0.214, 0.307], p < 0.01). Associations between trauma and mental disorders were mediated by social support but not coping. Our findings provide an evidence base for future research on the impact of trauma and inform assessments and interventions in correctional settings. Copyright © 2021 Elsevier Ltd. All rights reserved.
Original languageEnglish
Article number102069
JournalClinical Psychology Review
Volume89
Early online dateAug 2021
DOIs
Publication statusE-pub ahead of print - Aug 2021

Citation

Liu, H., Li, T. W., Liang, L., & Hou, W. K. (2021). Trauma exposure and mental health of prisoners and ex-prisoners: A systematic review and meta-analysis. Clinical Psychology Review, 89. Retrieved from https://doi.org/10.1016/j.cpr.2021.102069

Keywords

  • Meta-analysis
  • Trauma
  • Mental health
  • Prisoners
  • Ex-prisoners
  • Social support

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