Typologies of adversity in childhood & adulthood as determinants of mental health & substance use disorders of adults incarcerated in US prisons

Abstract Background Incarcerated people have disproportionately high rates of adverse experiences, mental health and substance use disorders. Objective This study identifies typologies of adversity among adults incarcerated in US prisons. Typologies are used to predict mental health and substance use disorders. Disparities by gender, race and ethnicity are also examined. Participants and Setting Data come from the 2004 Survey of Inmates in State and Federal Correctional Facilities (SI-SFCF), a cross sectional survey of incarcerated adults (n = 18,185). Methods Bivariate statistics compared rates of adverse experiences, mental health and substance use disorders by gender, race and ethnicity. Latent class analysis was conducted using adverse experiences as indicators of latent classes of adversity. Using multinomial regression, latent class membership was predicted by gender, race and ethnicity. Finally, logistic regression predicted mental health and substance use disorders by latent classes. Results Incarcerated people identifying as either women or white experienced higher rates of nearly all types of adverse experiences, as compared to either men or non-white people. Women also had higher rates of mental health and substance use disorders, except for alcohol use disorder. Four typologies of adverse experiences were found: Class-1) low exposure, Class-2) moderate deprivation, high violence exposure, Class-3) high deprivation, low violence exposure, and Class-4) high exposure. As compared to the low exposure group, all other typologies predicted mental health and substance use disorders. Conclusions Given that incarcerated people experience high rates of adverse experiences, mental health and substance use disorders, findings can inform how to tailor services to typologies of adversity.