Date of Graduation

5-2015

Document Type

Dissertation

Degree Name

Doctor of Philosophy in Psychology (PhD)

Degree Level

Graduate

Department

Psychological Science

Advisor/Mentor

Patricia Petretic

Committee Member

Jeffrey Lohr

Second Committee Member

Ellen Leen-Feldner

Keywords

Exposure Therapy, Group Therapy, Incarcerated Women, Sexual Violence

Abstract

Incarcerated women report higher rates of sexual victimization and mental illness than the average woman and incarcerated men. Researchers have argued that sexual victimization is a pathway to prison for women, and that there is a lack of trauma-focused treatments in prisons. Some researchers have evaluated trauma-focused group treatments for incarcerated women (Bradley & Follingstad, 2003; Cole et al., 2007; Ford, Chang, Levine, & Zhang, 2013; Kubiak, Kim, Fedock, & Bybee, 2012; Paquin, Kivlighan, & Drogosz, 2013; Roe-Sepowitz, Bedard, Pate, & Hedberg, 2014; Zlotnick, Johnson, & Najavits, 2009), with mixed results and several limitations. Most of these treatments are lengthy and resource intensive (cf. Ford et al., 2013) and they provide few, if any, additional benefits compared to treatment as usual or support groups. They also do not include exposure therapy, despite research supporting exposure's efficacy (Foa, Hembree, & Rothbaum, 2007). Future studies could benefit from evaluating briefer treatments that target specific mechanism known to maintain posttraumatic stress disorder (PTSD) and other common trauma outcomes. Although there are empirically-supported treatments (ESTs) for PTSD that would fit these criteria, the prison context might provide several unique contextual factors that are likely to make it difficult to implement and/or may impact the efficacy of these treatments. The current group treatment for incarcerated women was designed to overcome concerns with implementing ESTs in this population as well as limitations with previous studies evaluating trauma treatments among female prisoners. Results from 58 incarcerated women showed significant reductions in PTSD, depression, and anxiety/worry symptoms as well as trauma-related cognitions from pre-to post-treatment. Approximately 40-50% of participants who were above the clinical cutoff for possible PTSD (n = 30), depression (n = 25), and generalized anxiety disorder (GAD; n = 26) at pre-treatment were below at post-treatment (PTSD: n = 14; depression: n = 18; GAD: n = 18). Additionally, 40-60% reported a clinically significant improvement (reliable change index > 1.96; Jacobsen & Truax, 1991) in depression (n = 21) and GAD symptom severity (n = 13). Results suggest that it is feasible to implement a brief exposure-based group treatment with incarcerated women.

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