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

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...

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Published in:Clinical psychology review 2021-11, Vol.89, p.102069-102069, Article 102069
Main Authors: Liu, Huinan, Li, Tsz Wai, Liang, Li, Hou, Wai Kai
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Language:English
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Ex-prisoners
Mental health
Meta-analysis
Prisoners
Social support
Trauma
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description 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 
doi_str_mv 10.1016/j.cpr.2021.102069
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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. •Overall trauma exposure was related to higher symptoms/odds of mental disorders.•Stronger effect size was shown for mixed trauma and stress-related disorders.•Effect size varied with both trauma type and timeline of occurrence.•Social support but not coping mediated the trauma-disorders associations.•Trauma-informed assessment and intervention is needed for correctional populations.]]></description><identifier>ISSN: 0272-7358</identifier><identifier>EISSN: 1873-7811</identifier><identifier>DOI: 10.1016/j.cpr.2021.102069</identifier><language>eng</language><publisher>Elsevier Ltd</publisher><subject>Ex-prisoners ; Mental health ; Meta-analysis ; Prisoners ; Social support ; Trauma</subject><ispartof>Clinical psychology review, 2021-11, Vol.89, p.102069-102069, Article 102069</ispartof><rights>2021 The Authors</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c373t-c537d44616fbe3d8ab6a9950ecb07e5118fd5dccc63a11cafb2bccdfa0a634543</citedby><cites>FETCH-LOGICAL-c373t-c537d44616fbe3d8ab6a9950ecb07e5118fd5dccc63a11cafb2bccdfa0a634543</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids></links><search><creatorcontrib>Liu, Huinan</creatorcontrib><creatorcontrib>Li, Tsz Wai</creatorcontrib><creatorcontrib>Liang, Li</creatorcontrib><creatorcontrib>Hou, Wai Kai</creatorcontrib><title>Trauma exposure and mental health of prisoners and ex-prisoners: A systematic review and meta-analysis</title><title>Clinical psychology review</title><description><![CDATA[The present meta-analytic review examined the associations between different forms of trauma and mental disorders among prisoners and ex-prisoners. 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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. •Overall trauma exposure was related to higher symptoms/odds of mental disorders.•Stronger effect size was shown for mixed trauma and stress-related disorders.•Effect size varied with both trauma type and timeline of occurrence.•Social support but not coping mediated the trauma-disorders associations.•Trauma-informed assessment and intervention is needed for correctional populations.]]></description><subject>Ex-prisoners</subject><subject>Mental health</subject><subject>Meta-analysis</subject><subject>Prisoners</subject><subject>Social support</subject><subject>Trauma</subject><issn>0272-7358</issn><issn>1873-7811</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNp9kEtPwzAQhC0EEqXwA7j5yCXFj8RJ4VRVvKRKXMrZ2thrNVUexXag_fekpOLIabW7MyPNR8gtZzPOuLrfzszOzwQTfNgFU_MzMuFFLpO84PycTJjIRZLLrLgkVyFsGWO8SPmEuLWHvgGK-10Xeo8UWksbbCPUdINQxw3tHN35KnQt-vD7xn3yd3igCxoOIWIDsTLU41eF36eQCAm0UB9CFa7JhYM64M1pTsnH89N6-Zqs3l_elotVYmQuY2Iymds0VVy5EqUtoFQwn2cMTclyzDgvnM2sMUZJ4NyAK0VpjHXAQMk0S-WU3I25O9999hiibqpgsK6hxa4PWmRKMaGGyEHKR6nxXQgenR5KNeAPmjN9ZKq3emCqj0z1yHTwPI4eHDoMTb0OpsLWoK08mqhtV_3j_gFHS4FE</recordid><startdate>202111</startdate><enddate>202111</enddate><creator>Liu, Huinan</creator><creator>Li, Tsz Wai</creator><creator>Liang, Li</creator><creator>Hou, Wai Kai</creator><general>Elsevier Ltd</general><scope>6I.</scope><scope>AAFTH</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>202111</creationdate><title>Trauma exposure and mental health of prisoners and ex-prisoners: A systematic review and meta-analysis</title><author>Liu, Huinan ; Li, Tsz Wai ; Liang, Li ; Hou, Wai Kai</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c373t-c537d44616fbe3d8ab6a9950ecb07e5118fd5dccc63a11cafb2bccdfa0a634543</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Ex-prisoners</topic><topic>Mental health</topic><topic>Meta-analysis</topic><topic>Prisoners</topic><topic>Social support</topic><topic>Trauma</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Liu, Huinan</creatorcontrib><creatorcontrib>Li, Tsz Wai</creatorcontrib><creatorcontrib>Liang, Li</creatorcontrib><creatorcontrib>Hou, Wai Kai</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical psychology review</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Liu, Huinan</au><au>Li, Tsz Wai</au><au>Liang, Li</au><au>Hou, Wai Kai</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Trauma exposure and mental health of prisoners and ex-prisoners: A systematic review and meta-analysis</atitle><jtitle>Clinical psychology review</jtitle><date>2021-11</date><risdate>2021</risdate><volume>89</volume><spage>102069</spage><epage>102069</epage><pages>102069-102069</pages><artnum>102069</artnum><issn>0272-7358</issn><eissn>1873-7811</eissn><abstract><![CDATA[The present meta-analytic review examined the associations between different forms of trauma and mental disorders among prisoners and ex-prisoners. 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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. 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subjects Ex-prisoners
Mental health
Meta-analysis
Prisoners
Social support
Trauma
title Trauma exposure and mental health of prisoners and ex-prisoners: A systematic review and meta-analysis
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