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ABSTRACT: BACKGROUND: Women prisoners are known to suffer from an accumulation of factors known to increase the risk for several major health problems. This study examines the prevalence of adverse childhood experiences (ACE) and the relationship between such experiences and suicide attempts and drug use among incarcerated women in Norway. METHODS: A total of 141 women inmates (75% of all eligible) were interviewed using a structured interview guide covering information on demographics and a range of ACE related to abuse and neglect, and household dysfunction. The main outcome variables were attempted suicide and adult drug abuse. RESULTS: Emotional, physical and sexual abuse during childhood was experienced by 39%, 36% and 19%, respectively, and emotional and physical neglect by 31% and 33%, respectively. Looking at the full range of ACE, 17% reported having experienced none, while 34% reported having experienced more than five ACEs. After controlling for age, immigrant background and marital status, the number of ACEs significantly increased the risk of attempted suicide and current drug abuse. CONCLUSION: The associations observed between early life trauma and later health risk behaviour indicate the need for early prevention. The findings also emphasize the important role of prison health services in secondary prevention among women inmates.
International Journal of Social Psychiatry 10/2012; · 1.15 Impact Factor
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Christine Friestad
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ABSTRACT: Most structured sex-offender programs are based on a cognitive-behavioural model of behaviour change. Within this overarching theoretical paradigm, extensive use of cognitive distortions is seen as a central core symptom among sex offenders. However, the literature on cognitive distortions lacks a clear and consistent definition of the term. It is unclear whether cognitive distortions are consciously employed excuses or unconscious processes serving to protect the offender from feelings of guilt or shame. In this article, the dominant cognitive-behavioural interpretation of cognitive distortions is contrasted with two alternative interpretations. One is based on an attributional perspective and the notion of attributional biases. The other explanation is based on a narrative approach focusing on the action elements of cognitive distortions, that is, as something people do rather than something they have. Clinical implications of these alternative conceptualizations are discussed and illustrated throughout by a case example.
International Journal of Offender Therapy and Comparative Criminology 03/2011; 56(3):465-82. · 0.84 Impact Factor
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Christine Friestad
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ABSTRACT: One problem in studies of social inequality in health is that traditional socio-economic indicators are unsuitable for groups finding themselves on the outside of those societal arenas from which measures of education, income and occupation are generated. A measure of subjective social position has accordingly been proposed as an addition to the traditional objective socio-economic measures. The present study investigates this concepts' usefulness as an addition to objective SES markers in a sample of prison inmates, known for their marginalized position in society as well as their poor health.
Analyses are based on the male part (n = 225) of a nationally representative sample of prison inmates in Norway. Outcome measures are self-rated health, long-standing illness or disability, mental health problems, perceived change in health status and drug use. Analyses of correlation as well as multivariate logistic regression analyses were performed.
Subjective social status was bivariately related to all of the health outcomes, except long-standing illness. Multivariate analyses indicated that subjective social status influenced the odds of experiencing mental health problems, but not any of the other health outcomes when controlling for the other independent variables.
Subjective social status may add important information to our understanding of the relationship between social disadvantage and mental health in a marginalized social group such as prison inmates.
The European Journal of Public Health 12/2010; 20(6):653-8. · 2.73 Impact Factor
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ABSTRACT: Using results from a large Norwegian follow-up study of former adolescent psychiatric in-patients we have traced the progression from mental disorders requiring hospitalisation in adolescence to registered criminal behaviour in adulthood, particularly highlighting gender differences. A nationwide representative sample of 1095 adolescent psychiatric inpatients (46% females) was followed up 15-33 years after admission to the National Centre for Child and Adolescent Psychiatry in Oslo, Norway. In adolescence 45% fulfilled the DSM-IV criteria for a disruptive behaviour disorder. At follow-up, 63% of the males and 39% of the females had a criminal record. Among females, psychoactive substance use disorder in adolescence seemed to be a sine qua non for later registered criminality, with intravenous drug use a potent risk factor for life-course-persistent criminality. The same strong association between drug use and criminality was not found in males. Factor analysis demonstrated that while the DSM-IV Conduct Disorder criteria structure was similar across genders, the prevalence of the various forms of expression was different in males and females. The differences between individuals with violent and non-violent crimes were more substantial in males than in females. There were marked gender differences in the criminal profiles observed, with the females' criminal career developing in a less serious manner than in males: females had later criminal debut, a lower number of acts on record, less diverse criminal behaviour, and an escalation in the severity of offences over time was less frequently encountered. However, secular trend analyses indicated that gender differences had diminished over the last several decades, with females "catching up" with their male counterparts. Overall, the results demonstrated important qualitative and quantitative gender differences in the criminal behaviour of former adolescent psychiatric in-patients. The results may be of use in prevention.
International Journal of Law and Psychiatry 01/2009; 32(1):18-22. · 1.19 Impact Factor
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ABSTRACT: To explore possible systematic differences between prison inmates serving their first sentence and inmates having experienced previous incarcerations. It is hoped that a better knowledge of these issues will make us better equipped to meet the rehabilitation needs of our prisoners and decrease their risk of reoffending and reincarceration.
In this cross-sectional study a randomly selected and nationally representative sample of 260 Norwegian prisoners, 100 serving their first sentence and 160 recidivists, was interviewed with special focus on childhood circumstances, education, work experience, and present social and economic situation. In addition their criminal records were collected from the National Crime Registry.
In males multivariate analyses identified a number of variables independently and significantly associated with being a repeat offender. The odds for reincarceration increased significantly if the person fulfilled any one of the following criteria: having experienced the incarceration of a family member during childhood (OR = 3.6); having experienced childcare interventions during childhood (OR = 3.2); current drug abuse (OR = 2.6); current housing problems (OR = 2.3). In females only one strong correlation emerged: if the person had current drug problems the odds for being a recidivist increased substantially (OR = 10.9).
While criminal reoffending and reincarceration seemed to be primarily associated with drug abuse in females, the childhood problems of male repeat offenders, compared with males serving their first sentence, indicate that these individuals' current multiple social and economic disadvantages were complex in origin and of long standing. Interventions aimed at preventing reoffending must take into account the gender differences demonstrated.
ing at primary prevention, the negative effects associated with parental incarceration are crucial: how can one prevent the perpetuation of these problems from one generation to the next?
International Journal of Social Psychiatry 12/2008; 54(6):514-26. · 1.15 Impact Factor
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ABSTRACT: Prisons all over the western world are known to be inhabited by a biased sample of the population. More information is needed on how problems in diverse areas interact. The present study investigated how general welfare deficiencies, drug use and mental health problems were related in a representative prison population. Data stem from a level-of-living survey among a nationwide representative sample of Norwegian prison inmates. The sample was drawn randomly from the official register of prison inmates. Data were collected through structured personal interviews (computer assisted). Analyses presented in this paper are based on the male part of the sample (n=225). Only 24% of male prisoners were affected by neither drug use problems nor mental health problems. Investigating the relationship between variables indicated an increasing accumulation of childhood stressors and general welfare deficiencies with increasing drug use and mental health problems. As health problems are intertwined with more general social problems, health promotion among prison inmates is clearly a multidisciplinary task, requiring close collaboration between different service providers and systems of care.
Nordic journal of psychiatry 12/2008; 63(3):237-45. · 0.99 Impact Factor
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ABSTRACT: In this paper, we investigate cross-sectional and prospective relationships between various socioeconomic indicators and different health behaviours among boys and girls at ages 13-21, and whether socioeconomic status (SES) is related to changes in health behaviour over time.
The study is based on a 10-year, two-generation prospective cohort study of health and lifestyle factors among a sample of Norwegian adolescents and their parents. Data presented here were collected at the ages of 13 (baseline), 15, 18 and 21. Parental and adolescent reports of socioeconomic factors were assessed along with a number of health-enhancing and health-compromising behaviours, both as single behaviours and as part of health behaviour indices.
Relatively few significant relationships are observed between parental occupation and adolescents' reported health behaviour when the latter is analysed as single behaviours. A significant, but weak, social gradient in health-enhancing behaviour is observed when measuring health behaviour as composite indices rather than single forms of behaviour. This is apparent both when applying parental SES variables or adolescents' own educational aspirations as proxy measures of their socioeconomic status.
Future investigations of the presence of a social gradient in adolescent health behaviour should focus on composite measures of health behaviour. Further research is needed on potential mediating mechanisms behind the SES-health behaviour relationships in youth.
The European Journal of Public Health 03/2006; 16(1):41-7. · 2.73 Impact Factor
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ABSTRACT: Increased efforts are needed to promote adolescent health in all areas investigated in this study. Differences both in prevalence and socioeconomic patterning between Norway and the United States indicate that the major challenges differ between the two countries. The results also emphasize the need to undertake joint efforts to use measurements that make national data sets comparable across countries.
Journal of Adolescent Health 11/2003; 33(4):275-8. · 3.33 Impact Factor
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ABSTRACT: This study examined utilization of psychological or emotional counseling by suicidal adolescents to answer questions about the extent to which health services can contribute to the prevention of adolescent suicide.
The study used data from Wave 1 of the National Longitudinal Study of Adolescent Health, which involved a household-based interview with a nationally representative sample of 15 483 adolescents from grades 7 to 12. Of these, 2482 adolescents were classified as suicidal, as indicated by an affirmative response to the question "During the past 12 months, did you ever seriously think about committing suicide?" For this group, the study asked the following questions: 1) What proportion receives psychological or emotional counseling? 2) What are the sources of this counseling? 3) What factors are associated with receipt of such counseling?
Less than one third (28%) of suicidal adolescents received psychological or emotional counseling. The most common sources of care were private doctors' offices (37%) and schools (34%). Factors associated with receipt of counseling in the past 12 months included age, race, degree of suicidality, depression status, and having had a physical examination during the same period.
Only one third of those who report suicidal ideation and behavior receive psychological or emotional counseling. Although not all of these young people may identify a need for counseling, this finding still suggests that many of those at risk of harming themselves do not receive professional help. However, on the positive side, those who do use counseling services tend to do so on the basis of their being in the greatest need, rather than their parents' capacity to pay for services. Counseling services have an important role to play in suicide prevention, and a variety of sources of care need to be available. Although counseling services are vital, a range of other strategies is necessary to reduce the youth suicide rate.
PEDIATRICS 05/2003; 111(4 Pt 1):e388-93. · 4.47 Impact Factor
