(PS10-13) Incarceration as a Traumatic Event: Insights from the National Epidemiologic Survey on Alcohol and Related Conditions-iii (NESARC-III)

Justice-involved individuals report disproportionately high rates of traumatic events (TEs) across the lifespan. Extant research has explored select types of TEs, including interpersonal violence, childhood abuse, and community violence exposure. However, incarceration as a discrete TE has yet to be explored. This study examined incarceration as a TE with a large nationally representative sample of noninstitutionalized US adults.

Participants were 36309 adults (43.7% male, 52.9% identified as White). Incarceration history was based on endorsement of incarceration in a jail, prison, or juvenile detention center (< 18 years old)/correctional facility (18+ years old). Incarceration as a TE was examined in 2 ways: whether incarceration was listed as any of the 4 TEs assessed in the NESARC-III, and whether incarceration was listed as the main TE. We used chi-square to examine demographic differences among people with vs without an incarceration history and, within this subsample, demographic differences among those who did vs did not endorse incarceration as a TE.

Of the full sample, 4811 (13.3%) participants endorsed an incarceration history, where 681 (1.9%) participants were incarcerated < 18 years old only, 3267 (9.0%) 18+ years old only, and 863 (2.4%) before and since 18 years old. Participants self-reported an average incarceration length of 310.8 days (SD=853.5). Individuals who endorsed an incarceration history were more likely to be male vs female (χ²=1435.06, p< .001), identified as Black or American Indian/Alaska Native vs any other race and/or ethnicity (χ²=371.16, p< .001), were separated/divorced/widowed or never married vs married/cohabitating (χ²=171.56, p< .001), had a high school education or less vs some college or higher (χ²=441.91, p< .001), made < $35,000 vs ≥$35,000 (χ²=534.04, p< .001), and lived in the Midwest, South, or West regions vs the Northeast (χ²=98.43, p< .001). Of these 4811 individuals, 906 (26.2%) endorsed incarceration as a TE, with 294 (8.5%) listing incarceration as their main TE. People who endorsed incarceration as a TE were more likely to be never married (χ²=44.47, p< .001), were at least a high school graduate (χ²=6.60, p=.037), and lived in an urban (vs rural) area (χ²=25.55, p< .001). A similar pattern emerged when examining endorsement of incarceration as the main TE, except there was a difference in sex (male > female; χ²=5.81, p=.016) and no difference in education level.

These results support emerging research that has identified incarceration itself as a TE and a risk factor for subsequent development of mental health problems, including posttraumatic stress disorder. Despite using a nationally representative sample, findings may not generalize to currently incarcerated adults. Further examination of currently and formerly incarcerated individuals is needed to effectively assess rates and downstream impacts of incarceration as a primary TE. Collectively, our findings attest to the importance of regular comprehensive assessment and early intervention efforts for trauma-related psychopathology within both carceral and community settings. Additionally, further prioritization of culturally responsive trauma-informed care to address wider systems of oppression is needed.