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Research ArticleRegular Article

Civilian PTSD Symptoms and Risk for Involvement in the Criminal Justice System

Sachiko Donley, Leah Habib, Tanja Jovanovic, Asante Kamkwalala, Mark Evces, Glenn Egan, Bekh Bradley and Kerry J. Ressler
Journal of the American Academy of Psychiatry and the Law Online December 2012, 40 (4) 522-529;
Sachiko Donley
Ms. Donley is Graduate Student, Department of Social Ecology, University of California, Irvine, CA. Dr. Habib, Dr. Jovanovic, and Dr. Bradley are Assistant Professors, Dr. Egan is Associate Professor, and Ms. Kamkwalala is Senior Research Assistant, Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA. Dr. Bradley is also Assistant Professor at the Atlanta Veterans Affairs Medical Center, Atlanta, GA. Dr. Evces is Senior Psychologist, Department of Psychiatry, NYU School of Medicine, New York, NY. Dr. Ressler is Investigator, Howard Hughes Medical Institute, Chevy Chase, MD, and Associate Professor, Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA. This work was primarily supported by National Institutes of Mental Health Grant MH071537. Support was also received from Emory and Grady Memorial Hospital General Clinical Research Center supported by NIH National Centers for Research Resources Grant M01RR00039, the Brain and Behavior Research Foundation (formerly the National Alliance for Research on Schizophrenia and Depression) (C.F.G.), the American Foundation for Suicide Prevention (B.B.), and the Burroughs Welcome Fund (K.J.R.).
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Leah Habib
Ms. Donley is Graduate Student, Department of Social Ecology, University of California, Irvine, CA. Dr. Habib, Dr. Jovanovic, and Dr. Bradley are Assistant Professors, Dr. Egan is Associate Professor, and Ms. Kamkwalala is Senior Research Assistant, Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA. Dr. Bradley is also Assistant Professor at the Atlanta Veterans Affairs Medical Center, Atlanta, GA. Dr. Evces is Senior Psychologist, Department of Psychiatry, NYU School of Medicine, New York, NY. Dr. Ressler is Investigator, Howard Hughes Medical Institute, Chevy Chase, MD, and Associate Professor, Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA. This work was primarily supported by National Institutes of Mental Health Grant MH071537. Support was also received from Emory and Grady Memorial Hospital General Clinical Research Center supported by NIH National Centers for Research Resources Grant M01RR00039, the Brain and Behavior Research Foundation (formerly the National Alliance for Research on Schizophrenia and Depression) (C.F.G.), the American Foundation for Suicide Prevention (B.B.), and the Burroughs Welcome Fund (K.J.R.).
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Tanja Jovanovic
Ms. Donley is Graduate Student, Department of Social Ecology, University of California, Irvine, CA. Dr. Habib, Dr. Jovanovic, and Dr. Bradley are Assistant Professors, Dr. Egan is Associate Professor, and Ms. Kamkwalala is Senior Research Assistant, Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA. Dr. Bradley is also Assistant Professor at the Atlanta Veterans Affairs Medical Center, Atlanta, GA. Dr. Evces is Senior Psychologist, Department of Psychiatry, NYU School of Medicine, New York, NY. Dr. Ressler is Investigator, Howard Hughes Medical Institute, Chevy Chase, MD, and Associate Professor, Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA. This work was primarily supported by National Institutes of Mental Health Grant MH071537. Support was also received from Emory and Grady Memorial Hospital General Clinical Research Center supported by NIH National Centers for Research Resources Grant M01RR00039, the Brain and Behavior Research Foundation (formerly the National Alliance for Research on Schizophrenia and Depression) (C.F.G.), the American Foundation for Suicide Prevention (B.B.), and the Burroughs Welcome Fund (K.J.R.).
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Asante Kamkwalala
Ms. Donley is Graduate Student, Department of Social Ecology, University of California, Irvine, CA. Dr. Habib, Dr. Jovanovic, and Dr. Bradley are Assistant Professors, Dr. Egan is Associate Professor, and Ms. Kamkwalala is Senior Research Assistant, Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA. Dr. Bradley is also Assistant Professor at the Atlanta Veterans Affairs Medical Center, Atlanta, GA. Dr. Evces is Senior Psychologist, Department of Psychiatry, NYU School of Medicine, New York, NY. Dr. Ressler is Investigator, Howard Hughes Medical Institute, Chevy Chase, MD, and Associate Professor, Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA. This work was primarily supported by National Institutes of Mental Health Grant MH071537. Support was also received from Emory and Grady Memorial Hospital General Clinical Research Center supported by NIH National Centers for Research Resources Grant M01RR00039, the Brain and Behavior Research Foundation (formerly the National Alliance for Research on Schizophrenia and Depression) (C.F.G.), the American Foundation for Suicide Prevention (B.B.), and the Burroughs Welcome Fund (K.J.R.).
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Mark Evces
Ms. Donley is Graduate Student, Department of Social Ecology, University of California, Irvine, CA. Dr. Habib, Dr. Jovanovic, and Dr. Bradley are Assistant Professors, Dr. Egan is Associate Professor, and Ms. Kamkwalala is Senior Research Assistant, Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA. Dr. Bradley is also Assistant Professor at the Atlanta Veterans Affairs Medical Center, Atlanta, GA. Dr. Evces is Senior Psychologist, Department of Psychiatry, NYU School of Medicine, New York, NY. Dr. Ressler is Investigator, Howard Hughes Medical Institute, Chevy Chase, MD, and Associate Professor, Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA. This work was primarily supported by National Institutes of Mental Health Grant MH071537. Support was also received from Emory and Grady Memorial Hospital General Clinical Research Center supported by NIH National Centers for Research Resources Grant M01RR00039, the Brain and Behavior Research Foundation (formerly the National Alliance for Research on Schizophrenia and Depression) (C.F.G.), the American Foundation for Suicide Prevention (B.B.), and the Burroughs Welcome Fund (K.J.R.).
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Glenn Egan
Ms. Donley is Graduate Student, Department of Social Ecology, University of California, Irvine, CA. Dr. Habib, Dr. Jovanovic, and Dr. Bradley are Assistant Professors, Dr. Egan is Associate Professor, and Ms. Kamkwalala is Senior Research Assistant, Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA. Dr. Bradley is also Assistant Professor at the Atlanta Veterans Affairs Medical Center, Atlanta, GA. Dr. Evces is Senior Psychologist, Department of Psychiatry, NYU School of Medicine, New York, NY. Dr. Ressler is Investigator, Howard Hughes Medical Institute, Chevy Chase, MD, and Associate Professor, Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA. This work was primarily supported by National Institutes of Mental Health Grant MH071537. Support was also received from Emory and Grady Memorial Hospital General Clinical Research Center supported by NIH National Centers for Research Resources Grant M01RR00039, the Brain and Behavior Research Foundation (formerly the National Alliance for Research on Schizophrenia and Depression) (C.F.G.), the American Foundation for Suicide Prevention (B.B.), and the Burroughs Welcome Fund (K.J.R.).
PhD
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Bekh Bradley
Ms. Donley is Graduate Student, Department of Social Ecology, University of California, Irvine, CA. Dr. Habib, Dr. Jovanovic, and Dr. Bradley are Assistant Professors, Dr. Egan is Associate Professor, and Ms. Kamkwalala is Senior Research Assistant, Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA. Dr. Bradley is also Assistant Professor at the Atlanta Veterans Affairs Medical Center, Atlanta, GA. Dr. Evces is Senior Psychologist, Department of Psychiatry, NYU School of Medicine, New York, NY. Dr. Ressler is Investigator, Howard Hughes Medical Institute, Chevy Chase, MD, and Associate Professor, Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA. This work was primarily supported by National Institutes of Mental Health Grant MH071537. Support was also received from Emory and Grady Memorial Hospital General Clinical Research Center supported by NIH National Centers for Research Resources Grant M01RR00039, the Brain and Behavior Research Foundation (formerly the National Alliance for Research on Schizophrenia and Depression) (C.F.G.), the American Foundation for Suicide Prevention (B.B.), and the Burroughs Welcome Fund (K.J.R.).
PhD
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Kerry J. Ressler
Ms. Donley is Graduate Student, Department of Social Ecology, University of California, Irvine, CA. Dr. Habib, Dr. Jovanovic, and Dr. Bradley are Assistant Professors, Dr. Egan is Associate Professor, and Ms. Kamkwalala is Senior Research Assistant, Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA. Dr. Bradley is also Assistant Professor at the Atlanta Veterans Affairs Medical Center, Atlanta, GA. Dr. Evces is Senior Psychologist, Department of Psychiatry, NYU School of Medicine, New York, NY. Dr. Ressler is Investigator, Howard Hughes Medical Institute, Chevy Chase, MD, and Associate Professor, Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA. This work was primarily supported by National Institutes of Mental Health Grant MH071537. Support was also received from Emory and Grady Memorial Hospital General Clinical Research Center supported by NIH National Centers for Research Resources Grant M01RR00039, the Brain and Behavior Research Foundation (formerly the National Alliance for Research on Schizophrenia and Depression) (C.F.G.), the American Foundation for Suicide Prevention (B.B.), and the Burroughs Welcome Fund (K.J.R.).
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Article Figures & Data

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    Table 1

    Demographics

    Total (N = 4,113)PTSD (n = 1,265)Non-PTSD (n = 2,848)χ2
    Sex, n(%)1.29
        Female2,794 (67.9)875 (69.2)1,919 (67.4)
        Male1,319 (32.1)390 (30.8)929 (32.6)
    Race,n (%)16.55*
        African American or black3,811 (93.1)1,147 (91.5)2,664 (93.8)
        Latino30 (0.7)9 (0.7)21 (0.7)
        Asian7 (0.2)1 (0.1)6 (0.2)
        Caucasian or white150 (3.7)62 (4.9)88 (3.1)
        Mixed57 (1.4)26 (2.1)31 (1.1)
        Other39 (1.0)9 (0.7)30 (1.1)
    Highest degree, n (%)54.77†
        Less than high school979 (23.9)335 (26.7)644 (22.7)
        High school or equivalent1,745 (42.7)510 (40.7)1,235 (43.5)
        Some college1,037 (25.4)336 (26.8)701 (24.7)
        College or higher331 (8.1)73 (5.8)258 (9.1)
    Employed, n (%)34.33†
        No2,825 (69.1)946 (75.4)1,879 (66.3)
        Yes1,265 (30.9)308 (24.6)957 (33.7)
    Household monthly income, n (%)32.64†
        <$2491,036 (26.1)377 (31.1)659 (23.9)
        $250–$9991,475 (37.2)445 (36.6)1,039 (37.4)
        $1,000–$2,000996 (25.1)283 (23.3)713 (25.9)
        ≥$2,001461 (11.6)109 (9.0)352 (12.8)
    Past alcohol and/or drug problems, n (%)141.11†
        No2,933 (72.3)742 (59.7)2,191 (77.8)
        Yes1,126 (27.7)501 (40.3)625 (22.2)
    • ↵* p < .05.

    • ↵† p < .001.

    • View popup
    Table 2

    Association of Incarceration With Civilian PTSD

    TotalPTSDNon-PTSDχ2
    Arrested, n (%)67.78*
        No1,749 (44.6)425 (34.9)1,324 (49.0)
        Yes2,170 (55.4)793 (65.1)1,377 (51.0)
    Jailed, n (%)64.88*
        No1,868 (48.0)465 (38.4)1,403 (52.3)
        Yes2,024 (52.0)746 (61.6)1,278 (47.7)
    Imprisoned, n (%)22.77*
        No3,382 (87.1)1,002 (83.3)2,380 (88.8)
        Yes500 (12.9)201 (16.7)299 (11.2)
    Charge involving violence, n (%)49.36*
        No3,084 (79.9)878 (73.1)2,206 (82.9)
        Yes778 (20.1)323 (26.9)455 (17.1)
    • ↵* p < .001.

    • View popup
    Table 3

    Association of History of Incarceration With PTSD Symptom Clusters

    PSS TotalIntrusiveAvoidanceHyperarousal
    Arrested
        No10.01 (11.19)2.51 (3.47)3.93 (4.85).54 (4.01)
        Yes14.22 (12.81)3.41 (3.91)5.80 (5.68)5.01 (4.54)
    F = 116.70*F = 57.18*F = 118.23*F = 109.56*
    Jailed
        No10.22 (11.26)2.58 (3.51)4.00 (4.86)3.62 (4.05)
        Yes14.33 (12.86)3.42 (3.92)5.86 (5.72)5.06 (4.54)
    F = 111.64*F = 49.40*F = 116.88*F = 106.37*
    Imprisoned
        No11.91 (12.13)2.95 (3.73)4.73 (5.30)4.22 (4.32)
        Yes15.16 (13.01)3.38 (3.89)6.46 (5.83)5.31 (4.60)
    F = 30.63*F = 5.51†F = 44.60*F = 27.17*
    Charge involving violence
        No11.35 (11.70)2.79 (3.60)4.55 (5.14)4.01 (4.20)
        Yes16.41 (13.60)3.94 (4.19)6.65 (6.02)5.78 (4.74)
    F = 108.89*F = 59.39*F = 96.06*F = 104.03*
    • Data are expressed as the mean (SD).

    • ↵* p < .001.

    • ↵† p < .05.

    • View popup
    Table 4

    Association of History of Incarceration With Trauma

    Childhood Trauma, M (SD)Adult Trauma, M (SD)
    Arrested
        No37.72 (15.12)3.09 (2.74)
        Yes43.26 (18.20)4.98 (3.16)
    F = 119.89*F = 443.84*
    Jailed
        No37.98 (15.35)3.18 (2.79)
        Yes43.57 (18.30)5.03 (3.15)
    F = 121.85*F = 421.50*
    Imprisoned
        No40.33 (16.96)3.87 (3.01)
        Yes43.96 (18.07)5.85 (3.33)
    F = 21.92*F = 201.54*
    Charge involving violence
        No39.14 (15.87)3.78 (3.02)
        Yes47.41 (20.01)5.56 (3.16)
    F = 168.65*F = 230.25*
    • Data are expressed as the mean (SD).

    • ↵* p < .001.

    • View popup
    Table 5

    Prediction of Charges of a Violent Offense by PTSD After Accounting for Trauma

    R2F Changep
    Model (n = 3,617)
        1. Demographic information0.07541.64*
        2. Demographics+trauma history0.09744.47*
        3. Demographics+trauma history+PTSD symptoms0.10115.03†
    Final model, F(10,3616) = 40.40, p < 10−10Betatp
    Demographics
        Sex−0.088−5.25*
        Age−0.034−2.01‡
        Race−0.025−1.60
        Education−0.114−6.95*
        Employment−0.003−0.154
        Income−0.010−0.585
        Substance abuse history0.1689.55*
    Trauma history
        Childhood trauma0.0965.39§
        Adult trauma0.0603.47†
    PTSD symptoms
        Total PSS0.0713.88†
    • Dependent variable is a charge involving violence. Sex: 0, male; 1, female. Race: 0, African American/black; 1, Hispanic/Latino; 2, Asian; 3, Caucasian/white; 4, mixed; 5, other.

    • ↵* p < 10e-10.

    • ↵† p < .001.

    • ↵‡ p < .05.

    • ↵§ p < 10e-5.

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Journal of the American Academy of Psychiatry and the Law Online: 40 (4)
Journal of the American Academy of Psychiatry and the Law Online
Vol. 40, Issue 4
1 Dec 2012
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Civilian PTSD Symptoms and Risk for Involvement in the Criminal Justice System
Sachiko Donley, Leah Habib, Tanja Jovanovic, Asante Kamkwalala, Mark Evces, Glenn Egan, Bekh Bradley, Kerry J. Ressler
Journal of the American Academy of Psychiatry and the Law Online Dec 2012, 40 (4) 522-529;

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Civilian PTSD Symptoms and Risk for Involvement in the Criminal Justice System
Sachiko Donley, Leah Habib, Tanja Jovanovic, Asante Kamkwalala, Mark Evces, Glenn Egan, Bekh Bradley, Kerry J. Ressler
Journal of the American Academy of Psychiatry and the Law Online Dec 2012, 40 (4) 522-529;
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