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Abstract

BackgroundRelationships between posttraumatic stress disorder (PTSD), comorbid illness and experiences of traumatic stressors have been reported for large and different groups. The present study investigated this relationship specifically for patients with psychiatric disorders admitted to a forensic ward because of criminal behavior.MethodsIn sixteen German and fifteen Sudanese forensic patients the prevalence of PTSD and comorbid symptoms of anxiety and depression were assessed and related to traumatic experiences, emotional distress, and stressful life events over four developmental periods.ResultsIn the total sample, subjects had experienced an average of five traumatic events, the first one occurring early in childhood, and 39% met criteria of current, 55% of lifetime PTSD, the diagnosis being more likely in patients with a greater number of reported traumatic experiences. Neglect and emotional abuse in childhood were associated with current PTSD diagnosis. As reported for other populations, comorbid symptoms were frequent with 60% of the sample displaying comorbid anxiety symptoms and 64% comorbid depression. PTSD and comorbidity did not differ between cultures.ConclusionResults suggest that forensic patients experience multiple traumatic events, usually beginning early in development, so that the assessment of PTSD and comorbid anxiety and depression is recommended for the clinical evaluation. Further studies have to substantiate, whether traumatic stress during developmental stages interact with other factors leading to routes of forensic psychopathology.

Gender Differences in Complex Posttraumatic Stress Symptoms, and Their Relationship to Mental Health and Substance Abuse Outcomes in Incarcerated Adults

“…CT has been associated with a wide variety of behavioral health problems that involve dysregulation of emotion (e.g., inability to cope with or recover from intense affective distress including anger and shame, as well as anxiety and dysphoria), behavior (e.g., reactive aggression toward self or others), and self/identity (e.g., pathological dissociation or self-hatred; Girieballa et al, 2006; Spitzer, Chevalier, Gillner, Freyberger, & Barnow, 2006; Trestman, Ford, Zhang, & Wiesbrock, 2007). Although these forms of trauma-related dysregulation involve symptoms that are similar to those of numerous psychiatric and substance use disorders, evidence is accumulating that implicates a distinct syndrome, which has been described as C-PTSD (i.e., affect, interpersonal, and self-dysregulation; Cloitre, Garvert, Brewin, Bryant, & Maercker, 2013; Ford, 2015; Herman, 1993).…”

“…CT exposure is of particular relevance for forensic populations, based on evidence that it may also increase individuals’ risk of criminal involvement (Cuadra, Jaffe, Thomas, & DiLillo, 2014; Widom, 1989; Widom & Ames, 1994). Past exposure to CT, particularly childhood abuse is highly prevalent in adult forensic populations, compared with community samples (Carlson & Shafer, 2010; Girieballa et al, 2006; Roe-Sepowitz, Bedard, & Pate, 2007; Spitzer et al, 2006). Incarcerated adults also have heightened rates of behavioral health problems and symptoms consistent with C-PTSD (Fazel & Seewald, 2012; Girieballa et al, 2006; Spitzer et al, 2006; Widom & White, 1997).…”

“…Past exposure to CT, particularly childhood abuse is highly prevalent in adult forensic populations, compared with community samples (Carlson & Shafer, 2010; Girieballa et al, 2006; Roe-Sepowitz, Bedard, & Pate, 2007; Spitzer et al, 2006). Incarcerated adults also have heightened rates of behavioral health problems and symptoms consistent with C-PTSD (Fazel & Seewald, 2012; Girieballa et al, 2006; Spitzer et al, 2006; Widom & White, 1997). This population tends to experience many challenging issues, which may be especially difficult for women, given what we know about trauma.…”

The Perceived Impact of Trauma-Focused Research on Forensic Psychiatric Patients With Lifetime Victimization Histories

“…Surveys among individuals found not criminally responsible for an offense on account of mental disorder suggest that 37% to 100% have experienced childhood and/or adulthood potentially traumatic events (Garieballa et al, 2006; Kristiansson, Sumelius, & Søndergaard, 2004; Papanastassiou, Waldron, Boyle, & Chesterman, 2004; Spitzer et al, 2001). A significant number of these individuals subsequently develop posttraumatic stress disorder (PTSD), a mental health condition characterized by persistent symptoms of reexperiencing the traumatic event, hyperarousal, changes in feelings and beliefs, and avoiding trauma-related triggers (American Psychiatric Association, 2013).…”

“…A significant number of these individuals subsequently develop posttraumatic stress disorder (PTSD), a mental health condition characterized by persistent symptoms of reexperiencing the traumatic event, hyperarousal, changes in feelings and beliefs, and avoiding trauma-related triggers (American Psychiatric Association, 2013). Research suggests that an estimated 33% to 75% of forensic patients could be diagnosed with current PTSD (Garieballa et al, 2006; Gray et al, 2003; Henrichs & Bogaerts, 2012; Kristiansson et al, 2004; Papanastassiou et al, 2004). To contrast, prevalence rates for current PTSD were 3.5% in the United States (Kessler et al, 2005) and 2.4% in the Canadian (Van Ameringen, Mancini, Patterson, & Boyle, 2008) general population, and 4% to 21% across correctional populations (Goff, Rose, Rose, & Purves, 2007).…”