Albert Einstein College of Medicine, Bronx, NY, 10461, USA.
Montefiore Medical Center, 111 E. 210th Street, Bronx, NY, 10467, USA.
J Urban Health. 2018 Apr;95(2):141-148. doi: 10.1007/s11524-017-0138-1.
This study assessed the relationship between solitary confinement and post-traumatic stress disorder (PTSD) symptoms in a cohort of recently released former prisoners. The cross-sectional design utilized baseline data from the Transitions Clinic Network, a multi-site prospective longitudinal cohort study of post-incarceration medical care. Our main independent variable was self-reported solitary confinement during the participants' most recent incarceration; the dependent variable was the presence of PTSD symptoms determined by primary care (PC)-PTSD screening when participants initiated primary care in the community. We used multivariable logistic regression to adjust for potential confounders, such as prior mental health conditions, age, and gender. Among 119 participants, 43% had a history of solitary confinement and 28% screened positive for PTSD symptoms. Those who reported a history of solitary confinement were more likely to report PTSD symptoms than those without solitary confinement (43 vs. 16%, p < 0.01). In multivariable logistic regression, a history of solitary confinement (OR = 3.93, 95% CI 1.57-9.83) and chronic mental health conditions (OR = 4.04, 95% CI 1.52-10.68) were significantly associated with a positive PTSD screen after adjustment for the potential confounders. Experiencing solitary confinement was significantly associated with PTSD symptoms among individuals accessing primary care following release from prison. Larger studies should confirm these findings.
本研究评估了在一组最近获释的前囚犯中,单独监禁与创伤后应激障碍(PTSD)症状之间的关系。该横断面设计利用了出狱后医疗保健多地点前瞻性纵向队列研究——过渡诊所网络的基线数据。我们的主要自变量是参与者最近一次监禁期间自我报告的单独监禁;因变量是参与者在社区开始初级保健时,由初级保健(PC)-PTSD 筛查确定的 PTSD 症状的存在。我们使用多变量逻辑回归来调整潜在的混杂因素,如先前的心理健康状况、年龄和性别。在 119 名参与者中,43%有单独监禁的历史,28%有 PTSD 症状筛查阳性。与没有单独监禁的人相比,有单独监禁史的人更有可能报告 PTSD 症状(43%比 16%,p<0.01)。在多变量逻辑回归中,单独监禁史(OR=3.93,95%CI 1.57-9.83)和慢性心理健康状况(OR=4.04,95%CI 1.52-10.68)在调整潜在混杂因素后与 PTSD 筛查阳性显著相关。在从监狱获释后接受初级保健的个体中,单独监禁与 PTSD 症状显著相关。更大规模的研究应该证实这些发现。