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Victimization, Social Support, and Psychological Well-BeingA

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DOI: 10.1177/0093854810376338

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 Criminal Justice and
Behavior
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Victimization, Social Support, and Psychological Well-Being : A Study of Recently

Released Prisoners
Shelley Johnson Listwan, Mark Colvin, Dena Hanley and Daniel Flannery
Criminal Justice and Behavior 2010 37: 1140
DOI: 10.1177/0093854810376338

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VICTIMIZATION, SOCIAL SUPPORT,
AND PSYCHOLOGICAL WELL-BEING
A Study of Recently Released Prisoners

SHELLEY JOHNSON LISTWAN

MARK COLVIN
Kent State University
DENA HANLEY
University of Akron
DANIEL FLANNERY
Kent State University

The effect of violence on individual behavior has been well documented. However, the empirical literature surrounding the
relationship between coercive prison environments and inmate well-being is limited. This is important not only for correc-
tional administrators but also for reentry planning. Using a sample of 1,616 recently released male inmates, this study exam-
ines the psychological effect of victimization and of perceptions of threat and coercion arising from the prison environment.
The study also examines whether social support affects cognitions and psychological symptoms and whether it moderates the
effect of victimization and coercion. The findings reveal that coercion and social support are related to posttraumatic cogni-
tions and trauma symptoms; however, social support does not provide a moderating effect.

Keywords:  prison violence; victimization; reentry; social support

V ictimization in prison has long been a concern for researchers as well as prison admin-
istrators. Although many believe the rate of violence and victimization in prison is
grossly underreported (McCorkle, 1993), even the existing statistics are disquieting. Chen
and Shapiro (2007) reported that 16% of federal minimum security inmates and 22% of
federal maximum security inmates have been seriously injured while incarcerated. In their
sample of a state prison population, Blitz, Wolff, and Shi (2008) found that 35% of male
inmates and 24% of female inmates reported being physically victimized in prison.
Moreover, Mumola (2005) reported that in 2002, there were nearly 3,000 deaths in prison,
48 of them classified as homicide. In their investigation of sexual victimization among
prisoners, A. J. Beck and Harrison (2007) reported that 4.5% of the individuals sampled
had experienced at least one episode of sexual violence, either by staff or by other inmates.
Perhaps more important, many inmates either witness victimization or experience the fear
of living in a threatening, coercive prison environment (Toch, 1977).

AUTHORS’ NOTE: Shelley Johnson Listwan is now at the University of North Carolina, Charlotte.
Correspondence may be addressed to Shelley Johnson Listwan, Department of Criminal Justice and Criminology,
University of North Carolina Charlotte, Charlotte, NC 28223; e-mail: slistwan@uncc.edu.

CRIMINAL JUSTICE AND BEHAVIOR, Vol. 37 No. 10, October 2010 1140-1159
DOI: 10.1177/0093854810376338
© 2010 International Association for Correctional and Forensic Psychology

1140
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 Listwan et al. / RECENTLY RELEASED PRISONERS   1141

The correctional system has developed a variety of initiatives in an attempt to make

prisons safer, including better classification practices designed to match treatment services
to needs (Andrews, Bonta, & Wormith, 2006), increased use of education (DeBlasio, 2005)
and treatment programs (Lowenkamp & Latessa, 2005), and enhanced staff training proto-
cols (see Listwan, Jonson, Cullen, & Latessa, 2008, for discussion). In addition, federal
initiatives, such as the Prison Rape Elimination Act (PREA), are designed to detect and
prevent sexual victimization of inmates. Although policy initiatives have focused on mak-
ing prisons safer, there is still relatively little attention paid to the effect of prison violence
on the psychological well-being of inmates.
This study examines whether self-reported victimization combined with perceptions of
the prison environment is associated with psychological well-being among a sample of
formerly incarcerated inmates. The study also investigates how social support may moder-
ate the effect of victimization and coercion. Understanding the effect of prison on an inmate’s
psychological well-being has implications for prison administrators and those planning for
and supporting inmates upon their release.

LITERATURE REVIEW

The psychological effects of stressful or traumatic situations have been widely discussed
in the psychological literature. According to the Diagnostic and Statistical Manual of
Mental Disorders (4th ed.) (DSM-IV; American Psychiatric Association, 1994), a traumatic
event elicits emotions such as intense fear or helplessness and involves actual or threatened
death that can be witnessed or directly experienced. Research suggests that the vast majority
of individuals (60% of men and 40% of women) have experienced a traumatic event in their
lifetime (Harvard Mental Health Letter, 2007). A well-documented relationship between
trauma exposure and the occurrence of posttraumatic stress syndrome (PTSD) exists, but not
all individuals exposed to trauma or potentially traumatic situations will continue to have
enduring symptoms of PTSD or other psychological problems (Benotsch et al., 2000). The
differences in vulnerability seem to be a combination of factors involving the individual and
the situation. According to Hobfoll and his colleagues, the response to stressful situations
seems to be predicted not only by the intensity of the event but also by the resources and
support available to cope with the stressor (Hobfoll et al., 1991). For example, victims of
sexual assault are likely to have more severe PTSD symptoms when they receive negative
reactions from others, and conversely, PTSD symptoms are mitigated when support and
positive reactions are received (Ullman & Filipas, 2001). Similarly, Scarpa and colleagues
have found in numerous studies that individuals who are exposed to community violence but
who have poor coping skills and low levels of perceived social support are significantly
more likely to experience PTSD symptoms, depression, and aggressive behavior outcomes
(Haden & Scarpa, 2008; Scarpa, 2003; Scarpa et al., 2002; Scarpa & Haden, 2006; Scarpa,
Haden, & Hurley, 2006; Scarpa, Hurley, Shumate, & Haden, 2005).
Individuals can experience traumas that result from “unanticipated single events” (Type I
trauma) and those that result from long-standing or repeated exposure to multiple events
(Type II trauma). Although brief traumas may have only limited effects on the individual,
repeated trauma may lead to significant mental health and behavior problems (Davies &
Flannery, 1998; Terr, 1991) as well as long-term health consequences from exposure to
constant stress (Flannery, 2006; Kotulak, 1997).

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1142   CRIMINAL JUSTICE AND BEHAVIOR

Although variability in responses among individuals exists, the research finds that exposure
to violence is related to a multitude of problems. Victimization research indicates that indi-
viduals who either witness or are direct victims of violence are substantially more likely to
experience long-term negative outcomes (Kilpatrick, Saunders, & Smith, 2003). These victims
of violence often suffer from increased levels of stress, anxiety, emotional discomfort, and a
variety of health-related concerns (Briere & Jordan, 2004; Krupnick et al., 2004; Nicolaidis,
Curry, McFarland, & Gerrity, 2004; Sommers & Buschur, 2004; Stein et al., 2004). The con-
sequences, for both adults and juveniles, can involve diagnoses of PTSD and depression
(Briere & Jordan, 2004; Campbell, 2002; Flannery, Singer, Van Dulmen, Kretschmar, &
Belliston, 2007; Flannery, Singer, & Wester, 2001; Gavranidou & Rosner, 2003; Koss, Bailey,
Yuan, Herrera, & Lichter, 2003; Lang et al., 2003; Nicolaidis et al., 2004; Nishith, Resick, &
Mueser, 2001), physical effects, including sexual dysfunction (Briere & Jordan, 2004; Elliott,
Mok, & Briere, 2004), economic costs such as increased use of medical facilities (Stein et al.,
2004), and potential legal costs associated with future criminal behavior.
Research specific to prison inmates finds that they are more likely to have higher levels
of trauma exposure, anxiety, depression, and rates of suicide and self-harm (Cooper &
Berwick, 2001; Cooper & Livingston, 1991; Green, Miranda, Daroowalla, & Siddique, 2005;
Winfree, 1985; Zamble & Porporino, 1990). Although some mental health issues may be
imported into the prison with the inmate (Adams, 1983), research also supports the notion
that the prison environment can have an effect. Research has explored the structural aspects
of prison (loss of control, inadequate living conditions) and its effect on emotions such as
anxiety and depression (Haney, 2001, 2006; Paulus, Cox, McCain, & Chandler, 1975;
Zamble & Porporino, 1988) as well as hostility and personality functioning (see Bukstel &
Kilmann, 1980, for a review).
Violence and victimization in prison are clearly significant stressors or traumatic events
that could affect psychological well-being. Victimized inmates often have increased rates
of disciplinary infractions, requests for services, and requests for housing transfers (Ireland,
2001). However, the focus of much of the existing research is on prison violence, not vic-
timization. For example, a meta-analysis by Gendreau, Goggin, and Law (1997) found that
antisocial attitudes, peer associations, criminal history, and institutional factors affect
prison violence. Other research has found that staff and inmates’ race (McCorkle, Meithe,
& Drass, 1995; Steiner, 2009) and age (Mabli, Holley, Patrick, & Walls, 1979) and inmates’
housing types (Huebner, 2003) and lifestyles are significant predictors of prison violence
(Wooldredge, 1998). But none of these studies directly examine the effect of prison victim-
ization on an individual’s psychological well-being.
One study of interest by Hochstetler, Murphy, and Simons (2004) did examine the rela-
tionship between prison victimization and psychological distress. The research explored
inmates’ self-reported frequency of victimization per month (theft, con games and scams,
robbery, destruction of property, assault, and serious threats of bodily injury) and its rela-
tionship to depressive and posttraumatic stress symptoms. The study also examined
whether social support from family and friends (measured by number of letters mailed to
family and friends, letters received, and telephone calls) was an important predictor of
distress. The authors confirmed the relationship between victimization and psychological
distress; however, they failed to find a relationship between social support and distress. Of
particular importance, prison victimization was correlated with both depressive and post-
traumatic stress symptoms. Wooldredge (1999) also found that being a direct victim of

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 Listwan et al. / RECENTLY RELEASED PRISONERS   1143

aggravated assault while incarcerated has significant negative effects on psychological

well-being. More recent, Boxer, Middlemass, and Delorenzo (2009) found that exposure to
violence while incarcerated (using a combined measure of direct and witnessed violence)
increased emotional distress and tendencies toward antisocial behavior.
The studies mentioned above support a relationship between victimization in prison and
psychological distress, but none of the existing research examines victimization as part of
a broader understanding of coercion in prison. In particular, few studies examine the effects
of both direct and witnessed victimization, of various forms of victimization, or of inmates’
perceptions of living in a threatening environment on psychological health. Direct and
witnessed forms of both violent and nonviolent victimization and perceptions of living in
a threatening environment contribute to a generalized coercive experience for inmates. In
addition, despite Hochstetler et al.’s (2004) findings, social support has been found in pre-
vious research (both in general and in prisons) to produce better psychological outcomes
and to reduce the effects of trauma (Biggam & Powers, 1997; Cohen & Wills, 1985; Cullen,
1994; B. R. Sarason, Sarason, & Pierce, 1990). A highlight of this study is that it situates
prison victimization research within a broader theoretical framework from which the findings
can be understood and interpreted.

THEORETICAL FRAMEWORK

This study is informed by two theoretical perspectives, differential coercion theory

(Colvin, 2000) and social support theory (Cullen, 1994), which were recently combined to
form an integrated theory (Colvin, Cullen, & Vander Ven, 2002). Both perspectives indicate
that coercion and social support affect psychological states. This study focuses on the psy-
chological effect of coercion and social support, specifically their effect on producing post-
traumatic stress cognitions and symptoms among inmates. Theoretically, coercion should
increase these posttraumatic stress cognitions and symptoms whereas social support should
reduce them. It is important to understand their origins given that such psychological well-
being may affect the success of inmates returning to the community.
According to Colvin (2000), coercion can be both direct and indirect. Direct coercion
involves the use of force, threats and intimidation, and/or the removal or threatened removal
of material and emotional supports. A prominent example of direct coercion is being vic-
timized physically (being beaten up or threatened with beatings) and materially (having
items stolen). Indirect coercion involves witnessing others being victimized and living in
what is perceived as a threatening environment, in which fear and intimidation become
prevailing aspects of life. According to Colvin (2000), coercion creates a set of “social-
psychological deficits” (p. 50). Although Colvin does not specifically include posttrau-
matic stress cognitions and symptoms in his list of social-psychological deficits, it is
assumed that psychological distress would arise from coercive treatment because coercion
is clearly stressful and often traumatic, especially in the forms of direct and indirect victim-
ization. In his development of differential coercion theory, Colvin draws on Agnew’s
(1992) concept of “negative stimuli” as a type of strain (p. 50). Direct and indirect coercion
are prominent forms of negative stimuli that produce negative psychological and behavioral
outcomes. Differential coercion theory has been found to predict negative psychological
states among juveniles and street youth and to be both directly and indirectly related to seri-
ous delinquency and violent crime (S. W. Baron, 2009; Unnever, Colvin, & Cullen, 2004).

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1144   CRIMINAL JUSTICE AND BEHAVIOR

However, the theory has not been used to study psychological outcomes among prison-
ers. The only studies that suggest that differential coercion is related to negative psycho-
logical outcomes and violence in prisons are two qualitative studies of a particular prison
(Colvin, 1992, 2007).
Prisons are settings in which coercion may become a prominent feature. Victimization
and perceptions of a threatening prison environment (produced by perceived coercive
actions of both inmates and correctional officers) are experienced to varying degrees by
prisoners. As found with individuals who witness community violence, coercion while in
prison may produce posttraumatic cognitions and symptoms. In fact, given the inescapable
nature of the prison setting, it may be that experiencing victimization in prison may be
worse than experiencing it in the community. Regardless, these experiences may act to
decrease an inmate’s probability of successful reentry into society.
Although discussed less in the criminological literature, social support is a concept
widely noted in the psychological and mental health literature (Barrera, Sandler, & Ramsey,
1981; B. R. Sarason et al., 1990). Many researchers suggest that social support creates a
buffer against effects of stressful and traumatic events (Cohen & Wills, 1985; Cummins,
1988). Social support can help reduce strain, lessen subsequent negative emotions, and
produce higher levels of self-control and environmental stability (Cullen, 1994; Cullen,
Wright, & Chamlin, 1999); thus, social support may have an effect on psychological well-
being opposite to that of coercion (Colvin et al., 2002).
Social support (Cullen, 1994) can be both expressive and instrumental. Expressive social
support involves the sharing and ventilation of emotions and the affirmation of one’s self-
worth and dignity. Instrumental social support involves material support in the form of
financial assistance and the giving of advice and guidance. Social support creates bonds of
trust between the giver and recipient of the support and can cushion the effect of trauma
and serve as a buffer against stressful events (Cohen & Wills, 1985; Cummins, 1988).
Perceptions of available social support (i.e., a belief that there are people one can rely
on) for dealing with traumatic events may be more important than the actual receipt of
support. In fact, perceptions of available social support may change the appraisal of a
stressful event and mitigate the negative effects of imprisonment. For example, Paterline
and Petersen (1999) found that inmates who perceive greater social support report lower
alienation, higher “identity salience” (greater importance of family, friendships, and social
involvements), higher postrelease expectations (including expectations of better family and
social relations), and lower levels of prisonization.
Social support, therefore, should reduce the psychological effect of trauma and moderate
the effects of a stressful, coercive environment and perceptions of living in a threatening
environment. The greater the sources of social support, the less likely inmates will suffer
from posttraumatic cognitions and symptoms. In this regard, Biggam and Powers (1997)
reported that inmates who perceive low levels of support experience higher levels of anxiety.
To the extent that prisoners are victimized or perceive the environment as threatening, social
support will moderate (reduce) the effects of these coercive forces on psychological distress.
Thus, following social support theory, two additional propositions tested in this study are
(a) Social support reduces posttraumatic cognitions and symptoms in recently released pris-
oners, and (b) social support moderates (reduces) the psychological effect produced by
coercion. In short, social support may reduce posttraumatic cognitions and symptoms among
prisoners, which may improve their chances for successful reentry into society.

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 Listwan et al. / RECENTLY RELEASED PRISONERS   1145

THIS STUDY

Based on the literature concerning victimization, coercion, social support, and the effect
on psychological distress, this study hypothesized that coercion (including victimization)
would be negatively related to psychological well-being among prisoners and social sup-
port would be positively related. Furthermore, the study examined the relationship between
coercion and posttraumatic cognitions and symptoms and whether it is moderated by social
support. Specifically, under conditions of greater social support, coercion will have less of
a negative effect on psychological well-being than under conditions of less social support.
The study extended previous research by combining measures of prisoners’ experiences
with direct victimization, witnessed victimization, and their perceptions of the prison envi-
ronment as threatening. The following hypotheses were examined:

Hypothesis 1: Coercion decreases psychological well-being among prisoners.

Hypothesis 2: Social support increases psychological well-being among prisoners.
Hypothesis 3: Social support moderates the effect of coercion on psychological well-being.

In addition to the three core hypotheses, the study examined differential effects of indi-
vidual and institutional factors on psychological well-being. As discussed earlier, previous
research indicates that both individual and institutional factors affect inmate adjustment
(Bukstel & Kilmann, 1980). Some factors, such as mental health diagnosis, age, race, edu-
cation, marriage, having children, and prior prison experience, are imported into the prison
as individual attributes. Other factors, such as victimization/coercion, participation in treat-
ment and religious programs, time in prison on current admission, type of housing assign-
ment, and (to some extent) current perceptions of social support, are institutional in nature.

METHOD

PARTICIPANTS

The participants include 1,616 recently released male inmates. The participants had
served time in state prison and at the time of the interviews were residing in halfway houses
in the community. We attempted to contact all participants within 6 months of release from
the halfway house (mean time from release to interview: 52.7 days; SD = 51.5). Participants
were recruited across 25 halfway houses all within the same Midwestern state from August
2006 through August 2007. It should be noted, however, that not all individuals released
from prison in this particular state return to halfway houses. However, an analysis revealed
that the demographic characteristics of the final sample were similar to those of prisoners
across the state. Given that former inmates were interviewed at one time only for this study,
the study is cross-sectional.

PROCEDURES

The data were collected through face-to-face interviews at the various halfway house
locations during a 13-month period. The locations housed clients who had served time
across nearly all institutions in the state’s penal system. The use of halfway houses to
recruit participants had several advantages. In particular, interviewing the former inmate in

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1146   CRIMINAL JUSTICE AND BEHAVIOR

the community as opposed to the institution reduces the likelihood that victimized inmates
could be identified by either other inmates or institutional staff. We anticipated that par-
ticipants would also feel more comfortable in this community setting, thereby increasing
the level of disclosure.
The project team contacted staff from all of the halfway houses included in the study
to obtain a list of eligible participants. Eligible participants included those who had been
recently released from prisons across the state. The list of participants was ordered by release
date and interviewers were instructed to interview first those clients who were released
earlier, to reduce the time elapsed between the inmate’s release and the interview. Interviewers
then met individually with the former inmate to explain the study and its purposes. Interviews
lasted, on average, 60 to 90 minutes. Those who agreed to volunteer for the study were
compensated for their time with a gift card worth $15 to a local retail chain.
In terms of response rate, there were 2,315 eligible participants. However, not all of the
former inmates could be reached to introduce the study for a variety of reasons (e.g., some
were off campus at work and others were terminated or were released before they could
be contacted). As a result, of the eligible 2,315 individuals, the interviewers were able to
contact 1,709 to introduce the study. Of those who were contacted, 1,616 agreed to par-
ticipate and 93 refused, for a response rate of 95%. However, for all eligible participants
(e.g., those not contacted and those who refused), the overall response rate was 70%.

MEASUREMENT OF VARIABLES

Dependent Variables: Two Indicators of Psychological Well-Being

We measured psychological well-being through two established indexes that measure

posttraumatic cognitions and symptoms. Although the two indexes correlate strongly (.60)
in this analysis, they tap two distinct posttraumatic states (cognitions and symptoms),
which may be affected differently by various independent variables.
The first dependent variable was measured with the Posttraumatic Cognitions Inventory
(PTCI; Foa, Ehlers, Clark, Tolin, & Orsillo, 1999), a 36-item scale that measures cognitions
related to psychological trauma. The scale has been found to be highly predictive of PTSD
and therefore is a strong indicator of psychological trauma (Beck et al., 2004). In the cur-
rent study of recently released prisoners, the Cronbach’s alpha reliability coefficient is .92
for the PTCI scale.
The second dependent variable was measured with the Trauma Symptoms Checklist
(TSC-40; Briere, 1996; Briere & Runtz, 1989), a 40-item scale that measures trauma symp-
toms, including anxiety, depression, dissociation, post-abuse trauma, sleep disturbance, and
sexual problems. The TSC scale has been related to a variety of traumatic experiences
(Bagley, Wood, & Young, 1994; Briere & Elliott, 2003; Dunn, Ryan, & Dunn, 1994; Dutton,
1995; Elliott & Briere, 1992; Follette, Polusny, Bechtle, & Naugle, 1996; Gold, Milan,
Mayall, & Johnson, 1994; Zlotnick et al., 1996). In the current study, the Cronbach’s alpha
reliability coefficient is .93 for the TSC-40 scale.

Independent (Predictor) Variables: Coercion and Social Support

Coercion. Our measure of coercion is a 24-item scale that includes 8 items related to
direct victimization while in prison, 6 items related to witnessing victimization in prison,

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 Listwan et al. / RECENTLY RELEASED PRISONERS   1147

9 items related to perceptions about the coerciveness and threatening nature of the prison
environment, and 1 item related to being locked in solitary confinement. (See Appendix A
for items included in the coercion scale.) Each victimization question refers only to victim-
ization by another inmate, not a staff member. The 24 items’ responses (1 or 0, for yes or
no) were summed to create a scale with a range from 0 to 24, a higher value meaning more
coercion.1 The Cronbach’s alpha reliability coefficient is .80 for the coercion scale.2

Social support. Social support was measured using the short form of the Social Support
Questionnaire, also known as the SSQ6 (I. G. Sarason, Sarason, Shearin, & Pierce, 1987).
Although the short form contains only 6 questions, as opposed to the 27 questions included in
the original longer form of the SSQ, the researchers found high correlations between the scales
(see Appendix B for items included in the social support scale). The current study relied on a
summed total of each item (measured as counts of number of people, 0 to highest) to create
the social support scale. Higher scores indicate more people who can be relied on and thus
greater social support. The Cronbach’s alpha coefficient is .89 for the social support scale.3

Control Variables

We controlled for the following variables because they may affect levels of psychologi-
cal distress, including posttraumatic cognitions and symptoms.
Age was measured by the participant’s reported age at the time of the interview. It is
likely that age is related to psychological distress because older inmates are likely, all else
being equal, to feel traumatic cognitions and symptoms, such as depression and anxiety, as
they age in prison (MacKenzie, 1987), although the relationship is complex. Research sug-
gests that younger inmates have lower psychological distress than do older inmates (Bonta
& Gendreau, 1987; Wooldredge, 1999).
Race was measured with dummy variables for White, Hispanic, Black, and Other Race.
In the analysis, “Race White” was the reference category left out of the analysis, so the
results of PTCI and TSC for each race were compared to those for Whites. Research has
shown that White inmates have higher levels of psychological distress (Hochstetler et al.,
2004; Wooldredge, 1999).
Marital status was a dummy variable in which married was coded as 1 and not married
(single, widowed, divorced, etc.) was coded as 0. Inmates who are married may experience
greater psychological well-being, because marriage may involve a potentially important
source of social support. In general, married persons experience lower levels of psycho-
logical distress than those who are not married (Turner, Lloyd, & Wheaton, 1995). Research
on inmates, however, has found that married inmates have higher levels of mental distress
than do unmarried inmates (Lindquist & Lindquist, 1997). Inmates’ psychological distress
and feelings of loneliness, however, are reduced when married inmates are able to maintain
communication with spouses (Segrin & Flora, 2001).
Children was a variable created by asking participants if they had children, coded 1 if
yes, 0 if no. Imprisonment undermines the quality of parenting and undermines social sup-
port related to families (Arditti & Few, 2006). Research has found that psychological dis-
tress increases among inmates due to separation from and infrequent contact with children
(Houck & Loper, 2002; Poehlmann, 2005).

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1148   CRIMINAL JUSTICE AND BEHAVIOR

Education was measured on a 1 to 6 scale, with 1 being less than high school and 6 being
a graduate degree. Wooldredge (1999) found that less educated inmates have higher levels
of psychological distress. Those with higher education may display fewer posttraumatic
cognitions and symptoms because education provides them social capital and cognitive
skills that allow them to cope with adverse circumstances.
Prior prison measured whether a participant had been in prison before the current incar-
ceration. Prior prison was a dummy variable (1 = yes, in prison before, 0 = no, not in prison
before). It is assumed that if imprisonment has a psychological effect, this will be greater
if the individual has prior prison experience.
Months in prison was measured by the number of months a participant had been in
prison on the current imprisonment. As with prior prison, it was assumed that the longer
one had been in prison, the greater the psychological effect would be on the individual.
Hochstetler et al. (2004), however, found no relationship between months in prison and
psychological distress.
Lived in dorm measured whether the participant resided primarily in a dormitory setting
during the imprisonment. Dormitories offer less protection against victimization and offer
little respite from the prison setting, especially if this setting is threatening and chaotic. Thus,
living in a dorm may enhance the coercive experience of inmates and increase the negative
psychological effect of the prison setting on the individual (Seymour, 1982; Toch, 1977).
Mental illness diagnosis is an obvious control variable when looking at mental health
outcomes as dependent variables. Inmates were diagnosed by prison psychologists as having
or not having a mental disorder at the time of their admission to prison. Participants were
asked whether they had received a diagnosis while in prison. For our study, if they received
a mental illness diagnosis, they were assigned a score of 1, and if not, they were assigned a
score of 0. Research indicates that inmates enter prison with high rates of depression, PTSD,
and other mental problems (Brinded et al., 2001; Hodgins & Cote, 1990; James & Glaze,
2006; Steadman, Osher, Robbins, Case, & Samuels, 2009). Prisoners diagnosed with mental
illness have higher rates of physical victimization (Blitz et al., 2008) and sexual victimization
(Wolff, Blitz, & Shi, 2007) than do prisoners with no mental illness diagnosis. Also, a pattern
of disruptiveness, including violence and disciplinary infractions, more often occurs among
inmates who have histories of mental problems (Adams, 1992; Toch & Adams, 1986).
Attend religious services ascertains whether or not the individual participated in reli-
gious services. It is assumed that religious services provide spiritual resources and possibly
social support networks that may help overcome posttraumatic cognitions and symptoms.
In addition, religious services provide a safe sanctuary within the prison setting (Seymour,
1982) and offer a structured activity (Wooldredge, 1999), which may improve inmates’
sense of well-being. Participants who attended religious services were assigned a 1, and
those who did not were assigned a 0.
Participate in treatment determined whether the individual participated in any treatment
programs while in prison. It is assumed that participation in a treatment program reduces
posttraumatic cognitions and trauma symptoms. Wooldredge (1999) found that psycho-
logical well-being is improved among inmates when they are involved in structured pro-
gram activities, including counseling programs. Adams (1992) notes that poorly adjusted
inmates are less likely to participate in programs. Those who participated in treatment were
assigned a 1, and those not participating were assigned a 0 on this variable.

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 Listwan et al. / RECENTLY RELEASED PRISONERS   1149

ANALYSIS

We used a three-step hierarchical regression analysis for each of the dependent variables,
PTCI and TSC. In step 1, we entered all of the control variables; in step 2, we entered all
of the control variables plus the two hypothesized predictor variables, coercion and social
support. This second step tested Hypotheses 1 and 2. If significant, we expected that coer-
cion would have a positive relationship with both PTCI and TSC and that social support
would have a negative relationship with both PTCI and TSC. These two predictor variables
should also add significantly to the variance explained (change in R2). The first and second
steps also allowed us to examine the relative contributions of individual (imported) and
institutional factors to PTCI and TSC.
In step 3, we tested Hypothesis 3, which posits a moderating effect (Baron & Kenny,
1986; Holmbeck, 1997) of social support on the relation between coercion and posttrau-
matic cognitions and symptoms. For this step, we “centered” the coercion variable and the
social support variable prior to computing the interaction term (Coercion × Social Support)
to reduce any multicollinearity between the interaction term and its two component vari-
ables (Aiken & West, 1991). The control variables, the centered coercion variable, centered
social support variable, and the interaction term were entered into the regression equations
(one predicting PTCI and one predicting TSC). If a moderating effect is present, we would
expect the interaction term (Coercion × Social Support) to be significant and to add sig-
nificantly to the variance explained for each model. We would also expect that the
b-coefficient for the coercion variable would drop in step 3 from its value in step 2, indicat-
ing that the effect of coercion on psychological well-being is reduced as social support
increases. We would thus conclude that social support moderates the effect of coercion on
psychological well-being, thus supporting Hypothesis 3.

RESULTS

Table 1 illustrates the characteristics of the sample. With regard to race, the sample
is nearly evenly split between Caucasians and African Americans. The average age was
34 years. The majority was single, had a high school diploma or GED, and had at least one
child younger than age 18. Approximately 17% were diagnosed with a mental illness. The
majority had served time in prison before their current period of incarceration. The par-
ticipants, on average, had served slightly more than 1 year in prison. Approximately half of
the sample participated in both religious and treatment groups while in prison. Finally, the
majority did reside in a dormitory setting while in prison.
The descriptive statistics (means, standard deviations) and correlations are presented in
Table 2. A review of the correlation matrix indicates that multicollinearity is not a problem
for any of the variables used in the regression analyses. Furthermore, collinearity diagnos-
tics indicate that the highest variance inflation factor (VIF) value is 1.28, well below the
cutoff for being concerned about multicollinearity. The Durbin-Watson statistic in the
regressions indicates that the residuals in the models are independent (values are close to
2.00) (Field, 2005). Examination of regression plots indicated that assumptions of linearity,
homoscedasticity, and normal distribution of residuals were met; no obvious outliers were

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1150   CRIMINAL JUSTICE AND BEHAVIOR

TABLE 1:  Percentage and Frequency Distribution of Sample Characteristics

Characteristic N %

Race
African American 810 50.2
Caucasian 751 46.6
Other 52 3.2
Mean age 34.5
Marital status
Single 1356 84.1
Married 225 14.2
Other 18 1.1
Education
Less than high school 393 24.5
High school/GED 821 51.1
Post high school 393 24.5
Children (yes) 1128 70.4
Mental illness diagnosis (yes) 283 17.8
Prior prison (yes) 858 53.4
Months in prison (median) 14
Treatment services in prison (yes) 785 50.2
Religious services in prison (yes) 881 54.8
Lived in dorm 881 54.8
Mean coercion score 12.5
Mean TSC score 93.1
Mean PTCI score 27.4

Note. TSC = Trauma Symptoms Checklist; PTCI = Posttraumatic Cognitions Inventory.

detected (Field, 2005). The final sample sizes (N) after listwise deletion of missing data are
1,061 cases for the model predicting PTCI and 1,097 for the model predicting TSC.
The results of the regression analyses are reported in Table 3. This table is divided into
two regression models, one predicting PTCI and the other predicting TSC. Within each set
of regressions are three steps. The first step includes only the control variables. The second
step adds to the analyses the hypothesized predictor variables (Coercion and Social
Support). The third step adds to the analyses the interaction term (Coercion × Social Support)
to test for moderator effects.
The regression analyses indicate support for Hypotheses 1 and 2. Coercion is signifi-
cantly and positively associated with both PTCI and TSC in the regression analyses (indi-
cating a negative effect on psychological well-being). Social support is significantly and
negatively associated with both PTCI and TSC (indicating a positive effect on psychologi-
cal well-being). These two predictor variables add significantly to the variance explained
in both models (adding 5.7% to the explained variance of PTCI and 6.8% to the explained
variance of TSC).
The moderator analyses (displayed in the third step of each regression model) indicate
that Hypothesis 3 is not supported. The interaction term (Coercion × Social Support) is not
significant in either model. It adds nothing to the variance explained for either PTCI or TSC
and does not alter any of the relationships found in steps 1 or 2. Thus, social support does
not moderate the effect of coercion on posttraumatic cognitions or symptoms. Instead,
social support and coercion are independent, additive contributors to posttraumatic cognitions

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 TABLE 2:  Correlations, Means, and Standard Deviations of All Variables Used in Regression Analyses

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19

  1.  PTCI scale —

  2.  TSC scale .601** —
  3.  Age -.050 .067* —
  4. Race Whitea .017 .074** .014 —
  5. Race Hispanic .011 .001 -.071** -.193** —
  6.  Race Black -.028 -.082** .020 -.861** -.219** —
  7.  Race Other .017 .027 -.011 -.148** -.038 -.168** —
  8.  Married -.033 -.013 .106** .000 -.028 .008 .011 —
  9.  Education -.097* -.008 .087** .045 .000 -.066** .066** .010 —
10. Lived in
dormitory -.014 -.060* -.062* .009 .003 -.008 -.005 .014 .003 —
11. Months in
prison .044 .047 .157** .003 -.015 .002 .005 -.015 .104** -.101** —
12.  Prior prison .016 .022 .189** -.129** -.050* .154** -.018 -.026 -.009 -.077** .065** —
13. Has children -.089** -.043 .224** -.128** .040 .114** -.014 .151** -.001 .053* -.073** .036 —
14. Mental illness
diagnosis .255** .320** .082** .142** -.056* -.140** .069** -.010 -.014 -.047 .035 .030 -.075** —
15. Attends
religious
services -.057* .048 .203** -.133** -.012 .133** .011 .024 .052* -.025 .060* .003 .057* -.010 —
16. Participates
in treatment .065* .156** .114** .028 -.004 -.017 -.028 .008 .031 -.096** .147** -.011 .068** .156** .249** —
17. Centered .217** .263** -.19** .052* -.040 -.063* .084** -.022 .068** -.043 .148** .021 -.121** .109** -.002 .118** —
coercion
18. Centered
social support -.156** -.145** -.022 -.054* .029 .030 .037 .014 -.061* .001 .031 -.003 .016 -.045 .049 -.006 -.033 —

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19. Centered
Coercion ×
Centered
Social Support -.066* .001 -.018 .021 .021 -.034 .014 .023 .041 .003 -.025 -.018 -.013 .036 -.026 -.017 .005 .083** —
Mean 93.04 27.38 34.52 0.43 0.05 0.49 0.03 0.09 2.51 0.83 28.27 0.63 0.70 0.18 0.55 0.50 0.00b 0.00c -7.96
Standard deviation 31.60 18.16 10.08 0.50 0.21 0.50 0.16 0.29 1.15 0.37 39.71 0.48 0.46 0.38 0.50 0.50 4.01 56.93 227.28

Note. TSC = Trauma Symptoms Checklist; PTCI = Posttraumatic Cognitions Inventory.

a. “Race White” left out of regression analyses as reference category for race dummy variable.
b. Noncentered coercion mean = 12.59. (Centering sets mean to zero but does not affect standard deviation, correlations, or regression coefficients.)
c. Noncentered social support mean = 37.76. (Centering sets mean to zero but does not affect standard deviation, correlations, or regression coefficients.)
*p < .05. **p < .01.

1151
1152   CRIMINAL JUSTICE AND BEHAVIOR

TABLE 3: Hierarchical Regression Results Predicting Posttraumatic Cognitions (PTCI) and Traumatic
Symptoms (TSC-40)

Dependent Variables

PTCI TSC

Variable b (SE b) Beta b (SE b) Beta

Constant 94.76 (4.66)** 20.21 (2.51)**

Step 1: Control variables
Age .07 (0.10) .025 .21 (0.05)** .117
Race: Hispanic 5.77 (4.34) .040 1.61 (2.48) .018
Race: Black 3.08 (1.93) .050 -.89 (1.06) -.025
Race: Other 3.79 (5.42) .020 .44 (3.12) .004
Married -2.76 (3.03) -.027 -.68 (1.66) -.012
Children -2.51 (2.07) -.037 -.21 (1.13) -.005
Education -3.28 (0.78)** -.122 -.69 (0.43) -.045
Prior prison -1.52 (1.89) -.024 -.45 (1.05) -.012
Months in prison .02 (0.02) .034 -.01 (0.01) -.030
Live in dorm .40 (2.56) .005 -1.38 (1.35) -.028
Mental illness 18.69 (2.46)** .227 13.10 (1.33)** .279
Religious participation -3.11 (1.91) -.050 .56 (1.06) .016
Treatment 1.84 (1.89) .030 2.85 (1.05)** .080
R 2 change .090** 1.33**
Step 2: Hypothesized predictors
Coercion 1.48 (2.39)** .189 1.09 (0.13)** .241
Social support -.08 (0.01)** -.150 -.03 (0.01)** -.123
R 2 change .057** .068**
Step 3: Interaction term
Coercion × Social support -.01 (.01) -.027 .00 (0.00) -.006
R 2 change .000 .000
R 2 (adjusted) .147 (.134) .201 (.189)
Durbin-Watson 1.955 1.876
Number of cases (n) 1061 1097

Note. Race/ethnicity reference = White. TSC = Trauma Symptoms Checklist; PTCI = Posttraumatic Cognitions
Inventory.
*p < .01. **p < .001.

and symptoms. Social support reduces posttraumatic cognitions and symptoms; coercion
increases them.
Some of the control variables also had independent additive effects on posttraumatic
cognitions and symptoms. Mental illness diagnosis is the only other variable (besides coer-
cion, social support, and the constant) to be significantly related to both PTCI and TSC. As
expected, a mental illness diagnosis was positively related to both these indicators of psy-
chological distress. Education had a significant negative association with PTCI (but no
relation with TSC), indicating that more educated participants have less posttraumatic cog-
nitions than do less educated participants. Age had a significant positive relationship with
TSC (but no relationship with PTCI), indicating that older participants display more trauma
symptoms than do younger participants. Also, and somewhat unexpected, participation in
treatment had a significant and positive relationship with TSC (but no relationship with
PTCI), indicating that those who participate in treatment have more trauma symptoms
than those who do not. It is likely that trauma led them to seek treatment (Gavrilovic,
Schutzwohl, Fazel, & Priebe, 2005), and it does not necessarily mean that treatment led to

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 Listwan et al. / RECENTLY RELEASED PRISONERS   1153

their psychological distress. (A longitudinal analysis would be needed to establish cause

and effect.) None of the other control variables was significant.

DISCUSSION

Our results suggest that coercion decreases psychological well-being (by increasing both
PTCI and TSC). This finding supports our first hypothesis. Our results also suggest that
social support increases psychological well-being (by reducing both PTCI and TSC). This
finding supports our second hypothesis. However, we found no support for the third
hypothesis, which posits that social support moderates the relationship between coercion
and psychological well-being. No moderating or interaction effect was detected. Coercion
and social support are thus independent and additive, not interactive, in their relation to
psychological health.
Our findings also indicate that some individual (imported) and institutional factors affect
psychological well-being. Significant individual factors include age (affecting TSC), edu-
cation (affecting PTCI), and mental illness diagnosis upon admission (affecting both PTCI
and TSC). A significant factor that is clearly institutional is coercion, which includes direct
victimization while in prison, witnessing victimization in prison, and perceptions of the
prison environment as threatening, hostile, and coercive. The social support variable is also
significant. However, whether the perceived social support is from institutional sources or
from relations that existed prior to prison admission (thus imported) is not clear from the
data. Participants presumably were reporting their current perceptions of social support,
which, if from external or internal sources, would be affected by their placement in an
institutional setting.
There are limitations to this study. The study is cross-sectional, so it is not possible to
establish cause and effect relationships. For instance, we are unable to ascertain with cer-
tainty whether social support reduces posttraumatic cognitions and trauma symptoms or
whether those suffering from these cognitions and symptoms merely remove themselves
from, or fail to seek out, social support networks. (However, it should be noted that the
literature does suggest that perceptions of available support may be more important than
actual support.) It is also possible that those experiencing posttraumatic cognitions and
symptoms may elicit victimization and other coercive actions and may perceive an environ-
ment as more threatening than do inmates not experiencing these cognitions and symptoms.
Further research needs to identify the causal order of these relationships and ascertain if the
relationships are reciprocal (i.e., explore the possibility that coercion produces these cogni-
tions and symptoms, which in turn elicits more coercion, or that social support enhances
psychological well-being, which in turn leads to further enhancement of social supports).
Other limitations include measurement of variables. For instance, although social sup-
port shows strong content validity and reliability, it may be capturing only one aspect of
social support by asking how many people the participant can rely on. It does not tap the
quality of these social supports or, as noted earlier, indicate the source of the social sup-
ports. These social support networks could include family, correctional officers, other staff
members, counselors, and law-abiding friends outside the prison. However, as is likely,
they could also include other inmates or friends in the community who are engaged in
illegal behavior. It would seem that the sources of social support and their quality would be

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1154   CRIMINAL JUSTICE AND BEHAVIOR

important areas of research, especially if these are related in further research to recidivism
and other reentry outcomes.
The limitations notwithstanding, this study demonstrates that coercion and social sup-
port are important for understanding psychological well-being among recently released
inmates. The clear implication of the findings is that to maximize a reduction of psycho-
logical distress among inmates, coercion (direct victimization, indirect victimization, and
other coercive elements of the prison environment) must be reduced at the same time that
social supports (from institutional and noninstitutional sources) are enhanced. This would
create an additive effect beyond the effects of only reducing coercion by itself or of only
increasing social support by itself. Both need to occur simultaneously for maximum reduc-
tions in psychological distress.
There are several clinical implications from this study. Although this study is unable to
claim that the majority of victimized inmates are likely to be diagnosed with PTSD, the
study does suggest that victimized inmates being released from prison do exhibit depres-
sion, anxiety, and posttraumatic cognitions that may interfere with their ability to seek
employment, reunite with family members, or adhere to conditions of parole. The prison
staff should screen inmates for psychological difficulties before they are released. Screening
and treatment for these conditions should begin in prison, but they must continue once the
inmate is released.
Further research needs to investigate if coercion, social support, and posttraumatic cog-
nitions and symptoms (and other forms of psychological distress) have an effect on offend-
ers after reentry into the community, looking at such outcomes as recidivism, employment,
and other negative and positive outcomes of reentry. The current research suggests that if
psychological distress is related to recidivism, some of this effect may be due to experi-
ences of victimization, coercion, and social support while in prison. Further research thus
should explore direct and indirect effects of victimization, coercion, social support, and
psychological distress on recidivism and other reentry outcomes.

Appendix A
24 Items Used in Coercion Scale (α = .80)
(Responses for all items were yes = 1, no = 0.)
  1. Witnessed stealing
  2. Witnessed attempt to hurt another
  3. Witnessed fight
  4. Witnessed emotional coercion
  5. Witnessed sex coercion
  6. Witnessed rape
  7. Directly victimized: Items attempted stolen from you
  8. Directly victimized: Items were stolen from you
  9. Directly victimized: Attempt to hurt you
10. Directly victimized: You were hurt by others
11. Directly victimized: Involved directly in fight
12. Directly victimized: Emotional coercion
13. Directly victimized: Attempted sex coercion
(continued)

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 Listwan et al. / RECENTLY RELEASED PRISONERS   1155

Appendix A (continued)
14. Involved in fight with CO
15. Locked in solitary confinement
16. Perceives inmates feel afraid
17. Perceives weak inmates are property
18. Perceives inmates feel threatened
19. Perceives inmates are beaten up
20. Perceives inmates feel no control
21. Perceives gang fights in prison
22. Perceives COs make fun of inmates
23. Perceives COs belittle inmates
24. Perceives COs pit inmates against each other

Appendix B
Six Items Used in Social Support Scale (α = .89)
(Responses are counts 0 to highest number of people.)
1. How many can you count on to be dependable?
2. How many can you count on to help you relax?
3. How many accept you totally?
4. How many can you count on to care about you?
5. How many can you count on to help you feel better?
6. How many can you count on to console you?

NOTES
1. Inmates were asked to report only witnessed incidents that they directly saw or heard.
2. Originally, 29 items were identified as conceptually related to coercion. Primary component analysis (see Appendix A)
indicated that 5 of the items did not load strongly enough (<.20) to be included. Twenty-one of the items included in the
24-item scale had factor loadings above .30 (17 items were above .40). Three other items fell between factor loadings of .20
and .30, but we decided that there were strong conceptual reasons for their inclusion, and the factor loadings were sufficiently
strong given our sample size of more than 1,000 (Field, 2005) (Determinate = .005; Kaiser-Meyer-Olkin measure of sampling
adequacy (KMO) = .809; Bartlett test of sphericity significance = .000).
3. All six social support items loaded strongly (>.40) in a principal component analysis (Determinate = .010; KMO = .838;
Bartlett test of significance = .000).

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Shelley Johnson Listwan is an assistant professor in the Department of Criminal Justice and Criminology at the University
of North Carolina, Charlotte. Her research focuses on the relationship between criminology and correctional rehabilitation,
with an emphasis on individual level differences. Her work has appeared in Criminal Justice and Behavior, Crime &
Delinquency, and Criminology and Public Policy.

Mark Colvin is a professor of sociology at Kent State University. His recent publications investigate the theoretical links
between coercion, social support, and crime. His third book, Crime and Coercion, was the winner of the Outstanding Book
Award for 2002 from the Academy of Criminal Justice Sciences and co-winner of the Outstanding Scholar Award for 2001
from the Crime and Delinquency Section of the Society for the Study of Social Problems.

Dena Hanley is an associate professor in the Political Science Department at the University of Akron.

Daniel Flannery is a professor of public health and director of the Institute for the Study and Prevention of Violence at Kent
State University, where he was named a University Distinguished Scholar in 2006. His primary areas of research are in youth
violence prevention, the link between violence and mental health, and applied community-based research and evaluation.
He has published more than 100 papers and chapters that have appeared in a variety of academic journals including the
New England Journal of Medicine, Developmental Psychology, Journal of the American Academy of Child and Adolescent
Psychiatry, Pediatrics, Psychological Review, and Violence and Victims.

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