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 Childhood trauma and PTSD in prison populations: Using an attachment lens Vittoria Ardino* The British Psychological Society Annual Conference 2013 9-11.

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Presentation on theme: " Childhood trauma and PTSD in prison populations: Using an attachment lens Vittoria Ardino* The British Psychological Society Annual Conference 2013 9-11."— Presentation transcript:

1  Childhood trauma and PTSD in prison populations: Using an attachment lens Vittoria Ardino* The British Psychological Society Annual Conference 2013 9-11 April, Harrogate International Centre * London School of Economics and Political Science, PSSRU Unit, London, UK;

2 “Although not all disturbed children grow up into anti- social adults, most adults who regally commit crimes or drink excessively or exhibit seriously unacceptable social behaviour have suffered disturbed relationships during childhood.”(Howe,1995) The lack of secure attachment is lined to a dysfunctional theory of mind (important for the development of morality and to several difficulties in emotion regulation

3 Implications for re-offending risk and rehabilitation of offenders Complex intersection of criminal behaviour and traumatic attachments Histories of complex trauma Trauma at hands of attachment figures Complex PTSD and attachment: Dysregulation of emotions Impulse dyscontrol Shame and Guilt

4 What does attachment theory in conjunction with psychotraumatology help us understand about antisocial-individuals?  Abuse, neglect or rejection raise anxiety and intensify a child ’ s defensive strategies.  There is a risk that children will recreate their previous experiences of caregiving re-enacting the trauma (Ardino, 2009)  “trauma dependency”(Van der Kolk, 1984)

5 Dimensions of parenting interact secure base star

6 Being available Child’s needs/ behaviour What does this child expect from adults? How can I show this child that I will not let him down? Alert to child’s needs/signals Verbal and non- verbal messages of availability I matter, I am safe I can explore and return for help Other people can be trusted Helping children to trust Carer thinking/ feeling Parenting behaviour Child thinking/feeling

7 Children who lack trust  Offenders have often lacked consistent care and protection from reliable caregivers  Caregivers unavailable through drugs, mental health, learning disabilities, own childhoods  Caregivers may have  rejected the child ' s emotional demands  responded unpredictably  been frightening or frightened  Children will have developed defensive strategies to cope with this lack of trust

8 Responding sensitively Child ’ s needs/ behaviour What might this child be thinking and feeling? How does this child make me feel? Tuning in to the child. Helping child to understand /express feelings appropriately My feelings make sense -and can be managed Other people have feelings and thoughts Helping children to manage feelings and behaviour Carer thinking/feeling Parenting behaviour Child thinking /feeling

9 Children who find it difficult to manage their feelings and behaviour  Feelings have often not been acknowledged or understood in their birth families  From infancy, overwhelmed by feelings that can ’ t be managed  Feelings often mislabelled/distorted –what is the truth?  Cannot appropriately express feelings – so excessively expressed or denied and repressed or dysregulated and chaotic or dissociated.  Feelings expressed through their bodies in confused ways

10 Children who do not feel effective- can ' t compromise/co-operate  Lack confidence in getting their needs met  Have rarely experienced co-operative parenting – parents were often either too controlling and intrusive or too passive and ineffective  Children have often felt powerless or too powerful NB Feelings like this can be made worse in poor communities and in the care system

11  The study…. A focus on neglect as a predictor of PTSD in offenders

12 Attachment risk factors Childhood trauma (neglect) Extremely insensitive parenting Disconnected parenting Re- offending risk Pathway: “traumatic attachments to criminal behaviour” Criminal behaviour

13 Pathway: “traumatic attachments to criminal behaviour”  The role of traumatic attachments in predicting PTSD?  Inconsistent care  Emotional and physical abuse from primary attachment figures  The mediating role of cognitive strategies (crucial in the maintainance of PTSD?  Re-offending risk?

14 Trauma & PTSD in offenders: what do we know? Studies of posttraumatic stress disorder (PTSD) have predominantly focused on victims of trauma (Foa & Riggs, 1995). Offenders present histories of trauma, prior to and after becoming a known offender (Farrington, 2004; Gibson et al., 1999; Jordan, et al, 1996).

15 Trauma and attachment in offender populations Longitudinal studies: – Early traumas predispose to antisocial behaviour (Falshaw, Browne, & Hollin, 1996; Haapasalo & Pokela, 1999) Prospective studies: – Early victimisation predicts higher risk of being arrested (Widom, 1989; 1996) – PTSD is more prevalent in prison populations than in community sample: from 21.4% (Butler et al., 2003) to 78% (Jordan et al., 1996)

16 Past traumas: Ceca-Q (Bifulco, 2003), a semi-structured questionnaire assessing childhood experiences of abuse and neglect. Scales: Antipathy; Neglect; Care; Physical abuse; Sexual abuse. PTSD: LASC ( Los Angeles Symptoms Checklist ; King, King, Leskin, & Foy, 1995 ), a 43-item self-report questionnaire. Seventeen of the items correspond closely with the B, C, D, symptoms of PTSD C-PTSD: DAPS (Detailed Assessment of Post-Traumatic Stress; Briere, 2006), is a 104- item self-report questionnaire assessing traumatic exposure, associated features of PTSD Worry: PSWQ (Penn state worry questionnaire; Meyer, Miller, Metzger, & Borkovec, 1990), a 16-item self-report questionnaire which assesses an individual’s general tendency to worry excessively. Perception of Social Support : assessed by a 7-point Likert scale self-report questionnaire (6-item). Dunmore et al. (1999; 2001). Re-offending risk: IORNS ( Inventory of offender risk, needs and strengths ; Miller et al., 2006), a 130-item self report questionnaire which assesses static, dynamic risk factors and protective factors. Variables & Measures Dysfunctional cognitive processes Trauma & PTSD C-PTSD Trauma & PTSD C-PTSD Criminal behaviour

17 METHODS: Participants MARITAL STATUS Total N% Married 70 41.7 Single 77 45.8 Divorced 15 11.9 Widow 1 0.9 Missing data 68.0 EDUCATION Elementary school 34 20.2 Secondary school 110 65.5 High school 2016.0 Degree 21.2 Total 168 100 168 prisoner males (mean of age = 37.27; range= 20-74). Nationality: 92.3% (N=155) Italian; 6.0% (N=10) other nationalities. Violent crime = 22.6% (N=38)

18 Type of trauma% (N)N Accidents64.476 Natural disasters34.741 Domestic or work accidents26.331) Physical assault20.324 Threat of violence or sexual abuse 13.516 Shooting39.046 War13.616) Armed robbery or assault19.523 Sexual abuse0.81 Sexual abuse prior to age 163.34 Other injuries36.643 Witnessing someone else being killed or injured 77.191 Being beaten by an adult prior to age 16 34.741 DAPS Trauma exposure

19 CECA-Q (Childhood Experience of Care and Abuse; Bifulco et al, 2003) TotalFemalesMales N%N%N% Antipathy (mother) 1418.7728.0714.0 Antipathy (father) 1317.3728.0612.0 Care (mother) 1824.0728.01122.0 Care (father) 2736.0624.02142.0 Neglect (mother) 1621.3624.01020.0 Neglect (father) 3040.0520.02550.0 Physical abuse Mother 2128.0936.01224.0 Father 2026.7520.01530.0 Sexual abuse 1114.7936.024.0 Study Results: 1) early trauma

20 R 2 =.152; F=8.63; p<.01 ß=.391** Regression analyses (1) CECA as a predictor of PTSD as measured by LASC

21 R 2 =.170; F=11.67; p<.01 ß=.412** Regression analyses (2) CECA as a predictor of re-offending risk

22 R 2 =.145; F=9.69; p<.01 ß=.381** Regression analyses (3) CECA as a predictor of re-offending risk

23 R 2 =.084; F=5.21; p<.05 ß=.290* Regression analyses CECA as a predictor of re-offending risk

24 R 2 =.262; F=9.93; p<.01 ß=.311* Regression analyses CECA as a predictor of negative cognition

25 Mediation analyses ß=.370** ß=.158* ß=.265** ß=.233** C) ß=.286** A) ß=.303** B) ß=.350** a)R 2 =.314; F=32.90; p <.01 b)R 2 =.160; F=13.40; p <.01 c)R 2 =.304; F=31.38; p <.01

26 General conclusions  CECA predicts PTSD as measured by LASC  CECA predicts re-offending risk  CECA does not predict PTSD as measured by DAPS  Attachment does matter!  Poor family attachment/bonding  Child victimization and maltreatment  Pattern of high family conflict  Family violence

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