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PubMed1997

Clinical specificity of prison inmates with severe mental disorders. A case-control study.

BACKGROUND: We wished to determine whether prison inmates with severe mental disorders possess specific clinical characteristics compared with psychiatric in-patients suffering from similar problems. METHOD: Under a case-control design, 69 male prison inmates suffering from a schizophrenic or major affective disorder were matched for age and diagnostic spectrum to 60 male psychiatric in-patients. Standardised interviews were used to diagnose psychiatric disorders according to DSM-III-R and social functioning criteria. Case-notes were reviewed to cull data regarding social life, criminal record and service use. RESULTS: Inmates were more likely to suffer from delusional/NOS psychotic disorders (72%) or major depression (70%), and psychiatric in-patients from schizophrenic or bipolar disorder (62% and 71%, respectively). Comorbidity was more prevalent among inmates than among in-patients, while in-patients presented less social autonomy than did inmates. CONCLUSIONS: The clinical specificity of prison inmates with severe mental disorders clearly differentiates them from psychiatric in-patients, and warrants recognition of their special needs for assessment and integrated treatment approaches.

Adaptation, Psychological↗
PubMed2002

Psychosis and drug dependence: results from a national survey of prisoners.

BACKGROUND: The links between drug use and psychosis are of major aetiological and prognostic significance. Psychosis and drug dependence frequently co-occur within the prison population, providing the opportunity to study this link more closely. AIMS: To explore the relationship between psychosis and drug dependence in a sample of prisoners. METHOD: A total of 3142 prisoners were surveyed nationally, and structured clinical data were obtained from a subsample of 503 respondents. Psychiatric assessment was based on the Schedules for Clinical Assessment in Neuropsychiatry (version 1.0). Measures of amphetamine, cannabis, cocaine and heroin use and dependence were obtained through self-report. RESULTS: Logistic regression analyses indicated that first use of amphetamines or cocaine before the age of 16 years and severe cannabis or cocaine dependence were related to an increased risk of psychosis. In contrast, severe dependence on heroin was associated with a reduced risk of this classification. CONCLUSIONS: Severe dependence on cannabis and psychostimulants is associated with a higher risk of psychosis and is in contrast to severe dependence on heroin, which has a negative relationship with psychosis.

Adolescent↗
PubMed2003

Drugs, prisons, and harm reduction.

The use of drugs in society raises important considerations for health and social policy. Critical health and social care issues arise when drugs are used inside prisons. This paper argues that there is an urgent need for prison drug policies to adopt the principles of harm reduction. However, current policy orthodoxy emphasises the control of drugs and punishment for drug taking. Key components of harm reduction are operationalised in this article by exploring the potential for harm reduction in prison within the context of English drug policy. Whilst the focus is on English policy debates, the discussion will have wider international resonance.

Community Health Services↗
PubMed2006

Tyranny, freedom and social structure: escaping our theoretical prisons.

Reicher and Haslam's (2006) BBC prison study undermines the idea that people passively accept and enact social roles. In this commentary, I point out that this idea is an example of Moscovici's (1976) conformity bias and a wider stability bias in social psychological theorizing. In many key areas, the science prefers analyses that explain how and why social structures, intergroup and power relations, personalities and beliefs maintain and reproduce themselves, and indeed cannot be changed, rather than how and why society constantly generates forces for social change from within itself. This bias distorts reality and produces ideas of limited theoretical or practical power. Human psychology does not make us prisoners of social structure. It makes us capable of collective action to change social structures and in turn re-fashion our identities, roles, personalities and beliefs. Society is not a psychological prison but a means of expanding human possibilities. A reorientation of theoretical emphasis is overdue.

Dominance-Subordination↗
PubMed2001

Reducing postrelease risk behavior among HIV seropositive prison inmates: the health promotion program.

The prevalence of AIDS is five times higher among prison inmates than in the general population. Because recidivism is common and many inmates are serving short sentences for parole violation, HIV-seropositive inmates move frequently between prison and their home communities. We designed an eight-session prerelease intervention for HIV seropositive inmates to decrease sexual and drug-related risk behavior and to increase use of community resources after release. The intervention sessions were delivered at the prison by community service providers. We found that a prerelease risk reduction intervention for HIV seropositive inmates was feasible. Descriptive results support the effectiveness of the program in reducing sexual and drug-related behaviors and in increasing use of community resources after release. Compared with men who signed up for the intervention but were unable to attend, men who received the intervention reported more use of community resources and less sexual and drug-related risk behavior in the months following release. We recommend dissemination and continued evaluation of this risk-reduction intervention.

Adult↗
PubMed2003

HIV risk behavior history of prison inmates in Hungary.

As part of an intervention in correctional facilities in Hungary, we conducted research on AIDS-related attitudes and the HIV risk behavior history of 551 male and 81 female inmates to assess needs for and to tailor AIDS education programs. Although lifetime injection drug use was uncommon (8% of men, 3% of women), many Hungarian inmates had engaged in unprotected sex and had had high-risk sex partners: a quarter of men had primary partners who sold sex, about half of them had sex with female prostitutes, 13% of women had worked as prostitutes, and 9% of all inmates indicated having had sex in prison. Because many prison inmates may constitute a potential bridge population for the sexual transmission of HIV between the general population and high-risk populations, interventions among prison inmates may provide an opportunity to reach an at-risk population and to prevent the wider spread of sexually transmitted HIV.

Adult↗
PubMed2001

Examination of the screening properties of the personality diagnostic questionnaire 4+ (PDQ-4+) in a prison population.

There is a high prevalence of personality disorder in most prison populations. Many pass through the system undiagnosed. A screening instrument would improve identification. This study examined the screening properties of the Personality Diagnostic Questionnaire-4+ (PDQ-4+) in prisoners convicted of violent and sexual offenses. A sample of British prisoners completed the self-report PDQ-4+ and were interviewed using the Structured Clinical Interview for DSM-IV Axis II disorders. When used to generate a total score, the PDQ-4+ had an acceptable overall accuracy as measured by the area under the Receiver Operating Characteristics (ROC) curve. The PDQ-4+ appears to have the properties suitable for use as a screening instrument, particularly when screening for the presence or absence of personality disorder rather than for individual personality disorder categories. A graph is presented from which choices of cut-off score for different combinations of sensitivity and specificity can be made. A cut off total score of 25 or above yielded near optimal sensitivity and specificity. The suggested cut off score for this population is lower than that previously suggested.

Adult↗
PubMed1990

[Seroprevalence and risk factors for hepatitis B virus infection by AgHBs and anti-HBs markers in prisoners and prime blood donors].

Two cross-sectional surveys on hepatitis B virus (HBV) infection were carried out among 1,033 volunteer first-time blood donors in five blood banks (3 private, 2 public) and among 201 prisoners in the Penitentiary Center of Industrial Activity, in Goiania, Central Brazil, between June 1988 and February 1989. Those surveys were part of a major study designed to estimate seroprevalence of HBsAg and anti-HBsAg markers by ELISA test, and to study risk factors associated with seropositivity. The presence of any serum marker was considered as previous exposure to HBV. A standard questionnaire was applied to both populations to evaluate previous blood transfusion, number of sexual partners, homo/bisexual activity, history of sexually transmitted diseases, drug abusers, use of parenteral medicine, acupuncture, tattooing and VDRL seropositivity. Seroprevalence varied from 12.8% to 26.4% in blood donors and prisoners, respectively, (p less than 0.05) and increased with age (X2 trend=14.0 p less than 0.05%). Prisoners had higher percentages of all risk factors investigated than blood donors, with the exception of number of sexual partners. Among all risk factors studied, age, imprisonment and tattooing were statistically associated with seropositivity, even after multivariate analysis controlling for age and reclusion. The paper discusses the methodologic issues related to this epidemiologic investigation.

Adult↗
PubMedDate not supplied

Prevalence of HIV-1/2, HTLV-I/II, hepatitis B virus (HBV), hepatitis C virus (HCV), Treponema pallidum and Trypanosoma cruzi among prison inmates at Manhuaçu, Minas Gerais State, Brazil.

The purpose of this study was to determine the seroprevalence of human immunodeficiency virus (HIV-(1/2)), human T-cell lymphotropic virus (HTLV-I/II), hepatitis B virus (HBV), hepatitis C virus (HCV), Treponema pallidum and Trypanosoma cruzi among 63 male prisoners in Manhuaçu, Minas Gerais, Brazil and to compare this with data from eligible blood donors. The positive results were as follows: 11/63 (17.5%) for HBV, 5/63 (7.4%) for syphilis, 4/63 (6.3%) for HCV, 3/63 (4.8%) for Chagas' disease, 2/63 (3.2%) for HIV-1/2 and 1/63 (1.6%) for HTLV-I/II. The seroprevalence in prisoners was higher than among blood donors, mainly for antibodies to HIV-1/2, HCV and HBV. This is probably due to low social economic level, illiteracy, higher proportion with a prior history of intravenous drug use and/or unsafe sexual behavior. Therefore, these prisoners constitute a high-risk group and routine screening and counseling are recommended.

Adult↗
PubMed2004

The vulnerability of Brazilian female prisoners to HIV infection.

The purpose of the present study was to determine the vulnerability of women in prison to HIV infection. The study was carried out from August to October 2000 in a São Paulo State Penitentiary, where 299 female prisoners were serving time. We interviewed and obtained a blood sample from 290 females who agreed to enter the study. Sera were tested for the presence of antibodies to HIV, hepatitis C virus (HCV) and syphilis and the odds ratio (OR) was calculated for variables related to HIV positivity on the basis of a questionnaire. The overall prevalence data were: 13.9% for HIV (37 of 267), 22.8% for syphilis (66 of 290), and 16.2% for HCV (47 of 290). Sexual partnership variables were significantly related to HIV infection. These included HIV-positive partners (OR = 7.36, P = 0.0001), casual partners (OR = 8.96, P = 0.009), injectable drug user partners (OR = 4.7, P = 0.0001), and history of sexually transmitted disease (OR = 2.07, P = 0.05). In addition, a relationship was detected between HIV infection and drug use (OR = 2.48, P = 0.04) and injectable drug use (OR = 4.2, P = 0.002). Even women with only one partner presented a significant OR for HIV infection (OR = 2.57, P = 0.009), reflecting their vulnerability due to their trust in their partner, who did not use a condom. Although the use of injectable substances is associated with HIV infection, our results point to sexual behavior as the most important component of HIV transmission in the female prisoner population.

Brazil↗
PubMed2004

Contingencies of reinforcement in a five-person prisoner's dilemma.

As in studies of self-control, a tit-for-tat contingency in an iterated prisoner's dilemma game creates a conflict between maximization of local and global reinforcement. The present experiments examine this conflict in a multiplayer prisoner's dilemma game. Versus tit for tat, cooperation corresponds to self-control; defection, always immediately reinforced, corresponds to impulsiveness. Three experiments examined sensitivity of behavior to the global reinforcement contingency imposed by tit for tat. Undergraduates played a five-player prisoner's dilemma game against four dummy players programmed to play tit for tat or randomly. With tit for tat, a player's cooperation (or defection) increased dummy players' cooperation (or defection) on subsequent trials-reinforcing cooperation and punishing defection in the long run. Participants cooperated at a higher rate when the dummy players played tit for tat than when the dummy players played randomly. These results are consistent with findings in corresponding studies of self-control. Some participants, caught in a trap of mutual defection with the tit-for-tat playing dummy players, came to cooperate when the tit-for-tat contingency was reset ("forgiving" participants' previous defections) during a pause in the game. This increase was a result of the combined effects of a pause and reset; neither pausing nor resetting independently resulted in an increase in cooperation.

Adult↗
PubMed2005

Get Connected: an HIV prevention case management program for men and women leaving California prisons.

Individuals leaving prison face challenges to establishing healthy lives in the community, including opportunities to engage in behavior that puts them at risk for HIV transmission. HIV prevention case management (PCM) can facilitate linkages to services, which in turn can help remove barriers to healthy behavior. As part of a federally funded demonstration project, the community-based organization Centerforce provided 5 months of PCM to individuals leaving 3 state prisons in California. Program effects were measured by assessing changes in risk behavior, access to services, reincarnation, and program completion. Although response rates preclude definitive conclusions, HIV risk behavior did decrease. Regardless of race, age, or gender, those receiving comprehensive health services were significantly more likely to complete the program. PCM appears to facilitate healthy behavior for individuals leaving prison.

Adult↗
PubMed1987

Prisoners as medical patients.

Nonpsychiatric and nonobstetrical principal diagnoses of 527 prison inmates discharged in 1981 from one referral hospital were reviewed. Male prisoners had the following discharge diagnoses more frequently than an age-matched and sex-matched sample of the general population: lymphadenopathy, viral hepatitis, foreign body insertion into the gastrointestinal tract, dental caries, and pulmonary tuberculosis. Some differences may be due to lifestyles preceding incarceration, others may result from conditions of the prison environment.

Adolescent↗
PubMed1989

HIV testing in prisoners: is mandatory testing mandatory?

We studied 977 newly incarcerated Oregon inmates to compare voluntary versus mandatory human immunodeficiency virus antibody (HIVAb) testing in the prison setting. All inmates were offered HIVAb counseling and testing. Blood drawn for routine syphilis serology from those who declined this offer was also tested for HIVAb after personal identifiers had been removed. Only 1.2 percent (12) prisoners were HIV positive. However, 62.5 percent (611) inmates were at risk for HIV infection by being an intravenous drug user, a male homosexual, or hepatitis B core antibody (HBcAb) positive. The ratio of at-risk, as yet uninfected inmates to those already HIV infected was 53 to 1. Two-thirds of all inmates including those at-risk chose to receive counseling and testing. In areas where most at-risk inmates are not yet infected, it may be more appropriate for HIV prevention activities in prison to focus on voluntary programs that emphasize education and counseling rather than mandatory programs that emphasize testing.

Adolescent↗
PubMed1990

HIV seroprevalence and the acceptance of voluntary HIV testing among newly incarcerated male prison inmates in Wisconsin.

In 1986-88, voluntary and blinded HIV testing was conducted among Wisconsin male prison entrants. The HIV seroprevalence was 0.30 percent in 1986, 0.53 percent in 1987, and 0.56 percent in 1988. The seroprevalence rates among entrants tested voluntarily did not differ from those tested blindly. Voluntary HIV testing was accepted by 71 percent of male prison entrants in 1988; among entrants reporting intravenous drug use 83 percent consented to voluntary HIV testing. Voluntary HIV testing of entrants appears to be an effective screening strategy in Wisconsin prisons.

AIDS Serodiagnosis↗
PubMed1990

Emotional, social, and physical health characteristics of older men in prison.

A competitive survey was carried out in three medium-security Federal prisons in British Columbia, Canada. The purpose was to compare the social, emotional, and physical health characteristics of older and younger inmates. The results showed that when compared with younger inmates, the older men had more contacts with friends and family, more friends in prison, and experienced less stress than the younger men. Aside from problems with vision and hearing, their physical health did not appear to be any worse when compared to that of younger inmates. This was surprising in light of age-related declines in health found in both the general population and in previous research with inmates. The study uncovered several unique problems concerning older prisoners, and a number of policy and program recommendations were generated.

Adult↗
PubMed1991

Accidental and unspecified deaths among prisoners as disguised suicides.

Analysis of 1987 data from the US Department of Justice for prisoners under the jurisdiction of state and federal correctional authorities indicated that suicide rates were not negatively correlated with accidental or unspecified death rates. These findings do not provide evidence of disguised suicides among prisoners. Possible explanations for high rates of unspecified death among prisoners are presented.

Accidents↗
PubMed1991

Psychological distress and psychiatric morbidity in women prisoners.

The population of a women's prison (n = 92) was screened for psychological distress and psychiatric morbidity with the 12-item General Health Questionnaire, the Hamilton Depression Rating Scale, a Recent Stressful Life Events questionnaire and the Structured Clinical Interview for DSM-III-R. High levels of symptoms of psychological distress were recorded. Distress was correlated with recent stressful life events and was more severe in women awaiting trial. Fifty-three per cent of the prisoners were diagnosed as current cases of a psychiatric disorder and the most frequent diagnoses were adjustment disorder with depressed mood and personality disorders. Lifetime prevalence of psychoactive substance use disorders was 54 per cent. Aboriginal women were over-represented in this prison population. A follow-up survey after 4 months showed no fall in the prevalence of psychological distress and psychiatric morbidity.

Adolescent↗