Gender differences in comorbid disorders among offenders in prison substance abuse treatment programs

Brown University, Butler Hospital, Providence, RI 02906, USA.
Behavioral Sciences & the Law (Impact Factor: 0.96). 07/2008; 26(4):403-12. DOI: 10.1002/bsl.831
Source: PubMed


This study examined gender differences in a range of lifetime psychiatric disorders in a sample of 272 offenders newly admitted to a prison substance abuse program. Although these men and women did not differ in severity of substance use in the six months prior to incarceration, women were significantly more likely than men to report a lifetime psychiatric disorder and a lifetime severe disorder. Furthermore, gender differences emerged in the pattern of lifetime psychiatric comorbidity. Women reported greater lifetime major depression, posttraumatic stress disorder, eating disorder, and borderline personality disorder; men were more likely than women to meet criteria for antisocial personality disorder. Additionally, female offenders were found to have a higher degree of internalizing disorders than male offenders, but there were no gender differences in degree of externalizing disorders. The study concluded that women offenders newly admitted to a prison substance abuse program present with a greater psychiatric vulnerability and a different pattern of psychiatric comorbidity than their male counterparts.

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    • "En cuanto a la distribución de los OTP, los más prevalentes fueron los trastornos del afecto y los trastornos de la personalidad. Estos hallazgos son muy similares a los presentados por estudios realizados en otros países donde se analizan poblaciones clínicas, y en los cuales se reportan prevalencias de al menos 20% de los trastornos anteriormente mencionados en mujeres (Chiang et al., 2007; Zlotnick et al., 2008), esto sin considerar diferencias socioculturales y/o metodológicas. "
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    ABSTRACT: Introduction: women with substance use disorders (SUD) are more likely to endorse dual disorders (DD) in comparison to men with the same condition, defining DD as the co-occurrence of SUD with other psychiatric disorders (OPD). This relationship causes negative consequences in the severity of the symptomatology and treatment of both conditions. Objective: to analyze the clinical characteristics and treatment history of women with DD. Method: psychiatric interview of women receiving treatment in two residential treatment centers. Disorders and their characteristics were compared in relation to previous treatments, GEE was used to determine the differences in medical prescriptions over time. Results: data from 100 women was analyzed, 30 of them reported not having received any previous treatments, and less than 20% reported important medical illness. Women with borderline personality disorder had approximately a third of the odds of reporting previous treatments (OR= .33; IC 95% .13-.84). Significant differences were found in antidepressant (17.6% vs 41.8%; p<.05), mood stabilizers (12.1% vs 32.7%; p<.05), antipsychotics (15.4% vs 48.0%; p<.05), others (4.4% vs 29.6%; p<.05) over time. Discussion and conclusions: this study represents an approximation based on the clinical evaluation of women with SUD and OPD, where the change in medical prescription over time might be related to the pharmacological treatment needs, which are not adequately treated.
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    • "El género también juega un papel importante en el riesgo y prevalencia de la PD en esta población, siendo más común su ocurrencia en mujeres que en hombres (Baillargreon et al., 2010; Butler et al., 2011; Villagrá et al., 2013). Respecto a las diferencias en las prevalencias , resalta que mientras en reclusos hombres son más frecuentes los trastornos de ansiedad, psicóticos y antisocial de la personalidad, concurrentes con los trastornos por consumo de alcohol y por uso de cannabis, en las mujeres se presentan más los trastornos afectivos , de alimentación, por déficit de atención, de estrés postraumático y límite de la personalidad, concurrentes con el consumo de alcohol y estimulantes (Butler et al., 2011; Konstenius et al., 2015; Martínez-Lanz & Fernández Díaz, 2013; Zlotnick et al., 2008). Sobre diferencias de género en factores de riesgo, se ha visto que en hombres el abuso físico en la infancia predice más la PD, mientras que en las mujeres, el abuso sexual tiene un mayor valor predictivo (Villagrá et al., 2013). "
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    ABSTRACT: Background: dual disorders is a term that refers to the co-occurrence of a substance use disorder with other mental disorders. Epidemiological studies have reported a high prevalence of dual disorders in the general population. However, information on dual disorders in special population is limited. Objective: to give an overview of the available evidence on the epidemiology, care and other relevant aspects for public health of dual disorders in the following special populations: homeless, prison inmates, people with sexually-transmitted infections, and the elderly. Method: search in peer-review publication databases (PubMed, Science Direct, EBSCO and OVID) for research reports on the epidemiology and treatment of dual pathology in the aforementioned populations. Results: prevalence of dual disorders in these populations appears to be different than in the general population; and it is highly associated with higher mortality and morbidity rates. The majority of studies aimed specifically on the epidemiology and treatment of dual disorders and special populations has been conducted in high-income countries. Discussion and conclusions: there is a need for public policies that consider the epidemiological assessment of dual disorders in special populations, specially in low-and middle-income countries, and include integrated care interventions adequate to the specific needs of each population.
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    • "al, 2008; Van Wormer, 2010). Interventions originally designed for men have often been used as standard correctional practice for women as well, although the complexity of their needs warrants gender-specific programs (Chen, 2010 Covington, 2008; Zlotnick et al, 2008). Abuse and neglect are prominent in the stories offered by these women compared to those of men (Martin et al, 2009; Chen, 2010). "
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    ABSTRACT: The objective of this study was to examine women's perceptions after participation in a motivational and gender-sensitive program (VINN) and to explore what was experienced as helpful. The qualitative data consisted of reports and transcriptions from 13 group interviews with 65 participants on probation or imprisoned in Sweden, Denmark, Russia, Estonia and Norway. The data were analysed according to systematic text condensation. The participants' perceptions could be grouped into the following clusters: confidence and trust, deeper understanding, change and future hopes. The women appreciated the collaborative atmosphere focusing on quality of life, autonomy, strengths, coping and resources. The most beneficial experiences reported, regardless of country, were that their personal repertoires of actions were expanded during their participation, and their confidence in their ability to desist from crime and substance abuse in the future increased. The results support the program's salutogenic approach combined with motivational interviewing as a bridge to change. Future research should investigate whether the participants report sustainability of the changes.
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