Comorbidity Among Female Detainees in Drug Treatment: An Exploration of Internalizing and Externalizing Disorders

• Published in: Psychiatric rehabilitation journal 2015-03, Vol.38 (1), p.35-44
• Main Authors: Scott, Christy K., Dennis, Michael L., Lurigio, Arthur J.
• Format: Article
• Language: English
• Subjects: Adult; Antisocial Personality Disorder - epidemiology; Antisocial Personality Disorder - psychology; Anxiety Disorders - epidemiology; Anxiety Disorders - psychology; Attention Deficit and Disruptive Behavior Disorders - epidemiology; Attention Deficit and Disruptive Behavior Disorders - psychology; Borderline Personality Disorder - epidemiology; Borderline Personality Disorder - psychology; Chicago - epidemiology; Comorbidity; Criminal Rehabilitation; Criminals - psychology; Criminals - statistics & numerical data; Criminology; Depressive Disorder, Major - epidemiology; Depressive Disorder, Major - psychology; Disruptive, Impulse Control, and Conduct Disorders - epidemiology; Disruptive, Impulse Control, and Conduct Disorders - psychology; Drug Abuse; Externalization; Female; Female Criminal Offenders; Females; Human; Humans; Internalization; Mental Disorders; Mental Disorders - classification; Mental Disorders - epidemiology; Mental Disorders - psychology; Middle Aged; Prevalence; Prisoners; Prisoners - psychology; Prisoners - statistics & numerical data; Prisons; Recidivism; Stress Disorders, Traumatic - epidemiology; Stress Disorders, Traumatic - psychology; Substance abuse treatment; Substance Use Treatment; Substance-Related Disorders - epidemiology; Substance-Related Disorders - rehabilitation; Thinking; Young Adult
• ISSN: 1095-158X; 1559-3126
• DOI: 10.1037/prj0000134

Objective: The current study explored the prevalence and comorbidity of major internalizing and externalizing psychiatric disorders in a sample of female detainees participating in drug treatment programs in the nation's largest single-site jail, the Cook County (Chicago) Department of Corrections. Methods: A total of 253 women participated in a Needs Inventory. The study incorporated an extensive combination of measures, which captured the women's demographic characteristics and psychological problems as well as their substance use and drug treatment histories and their criminal thinking tendencies. For the purpose of analyses, women were combined into 3 groups: women with substance use problems but no comorbid psychiatric disorders, women with 1 comorbid psychiatric disorder (either internalizing or externalizing), and women with both internalizing and externalizing disorders. Results: More than 3/4 of the women were comorbid for another psychiatric (an internalizing or externalizing) disorder. Comorbid disorders were related to lower self-esteem, greater drug use severity, and higher levels of criminal thinking. For example, measures of reported histories of criminal activities and trauma exposure increased with comorbidity. The most critical variables in differentiating between female detainees with no and both internalizing and externalizing disorders were criminal thinking and exposure to trauma. Conclusions: The women in the present investigation and other female detainees in drug treatment programs require interventions that focus on both criminal and psychiatric recidivism. These interventions are most effectively delivered in a person-focused recovery framework that provides integrated modules of services.