New Study Highlights PTSD and Trauma Among Youths in Prison

Of the approximately 2.1 million arrests of youths each year in the United (81,000 per day according to some estimates), approximately two-thirds of males and three-quarter of females in prison meet the criteria for at least one psychiatric disorder with many having two or more.  Despite the critical need for better mental services for youth offenders,  the full extent of the problem has been largely ignored.   Though posttraumatic stress disorder (PTSD) diagnoses in youths living in the community is believed to be as low as 2.8 percent of males and 3.5 percent of females,  the prevalence of PTSD is substantially higher though estimates vary across the different research studies.

A new study released by the Office of  Juvenile Justice and Delinquency Prevention shows that trauma and related psychiatric problems are dramatically overrepresented among youths in prison.   Conducted by Karen M. Abram of Northwestern University's Feinberg Medical School and her colleagues, the study presents the results of the Northwestern Juvenile Project, a longitudinal look at young offenders detained at the Cook County Juvenile Temporary Detention Center in Chicago, Illinois.   The researchers chose this facility because the youth offenders there were ethnically diverse (77.9 percent African American, 5.6 percent non-Hispanic white, 16 percent Hispanic, and 0.5 percent other racial/ethnicgroups).

Of the 1,829 youth offenders participating in the study (ranging in age from 10 to 18),  a final sample of 898 youths were stratified for age, race and gender with 532 males (59.2 percent) and and 366 females (40.8 percent).   All of the youths were interviewed using the Diagnostic Interview Schedule to measure incidence of PTSD and other psychiatric problems.  The youths reporting traumatic experiences were also questioned about the nature of the life event as well as related issues such as substance abuse and behavioural problems.    

The study results showed that:

  • 92.5 percent of the youths in the study had experienced at least one trauma with most (84.0 percent) experiencing more than one.
  • Older youths (14-18) were more likely to experience trauma than younger youths (10-13)
  • The most common type of trauma was "witnessing violence" (reported by 74.9 percent of males and 63.5 percent of females) with other common traumas including "being threatened with a weapon",  and "being in a situation where they thought they or someone close to them was going to be badly hurt or die"
  • Sexual abuse was far more common in females than males (29.6 percent vs 2.4 percent
  • 11.2 percent of the sample reported PTSD in the year before their arrest
  • Males and females with PTSD were between  2 and 3.7 times more likely to have a substance abuse problems than offenders without PTSD
  • Males with PTSD were 3.4 times more likely than females with PTSD to have a psychiatric disorder
  • Alcohol abuse significantly increased PTSD risk in females

Overall, exposure to trauma appears far more prevalent in detained youths than in the general population, especially for severe and violent trauma.   The prevalence of PTSD reported by detained youths in the twelve months leading up to their arrest far exceeds the the PTSD reported in community samples across their entire lifetime.    The findings are also consistent with research linking traumatic victimization in childhood to later problems such as delinquency, substance abuse, and psychiatric problems.     There also seemed to be little real difference in incidence of trauma or psychiatric problems between difference ethnic groups or between males and females.   Still, there were differences in terms of the nature of the trauma experienced with females being far more likely than males to have been sexually victimized.   

Though the study's authors recognize that all the subjects for the study came from a single site, these findings have important implications for further research and policy regarding youths in prison.   This is especially true concerning how vulnerable youths exposed to traumatic situations are to later problems.    Learning more about chronic community violence and the role it can play in PTSD is vitally important, especially for high-risk youths.    Treatment programs for PTSD sufferers in custody are especially important, since the criminal justice system can often retraumatize victims.   Along with providing care in prisons and detention centres, that care should be linked to programs in the community to help traumatized youths become reintegrated after their release.   As the authors themselves point out, given the correlation between PTSD and subsequent community violence, effective treatment is also a matter of public safety. 

In a closing statement to the bulletin describing the study, the authors state, "This nation’s delinquent children are among its most traumatized. The resources used to punish them must bebalanced with the resources needed to treat them."    Focusing on incarceration while ignoring the factors contributing to criminal offending will only worsen a prison system already strained to the breaking point.

For the study (PDF)            

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