An Examination of the ACE Study and Complex Trauma in High-Risk Forensic Inpatients

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Exposure to abuse, neglect, and familial dysfunction in childhood is connected to long-term negative effects on mental and physical health in adulthood. Current research of adverse childhood experience is overwhelmingly focused on community samples. Those populations that tend to experience a greater number of adversities (e.g., high-risk forensic populations) are largely overlooked. Studies investigating differential risk factors and outcomes among those in high-risk populations could indicate environmental 2015 Appalachian Student Research Forum Page 107 responsiveness to experiences of abuse, neglect, and household dysfunction in early development. A pilot study was conducted to investigate the prevalence and severity of childhood trauma, maltreatment, and familial dysfunction using the Adverse Childhood Experience (ACE) survey in a sample of forensic mental health offenders. Participants were randomly selected forensic inpatients (n = 185) from a maximum- and intermediate-security psychiatric facility. The sample is predominantly male (81.0%) and majority Caucasian (56.0%), African American (40.0%), and Hispanic (2.0%) with a mean age of 42.5 (SD=13.2). Approximately 29.0% of the current forensic sample has experienced 4 or more adversities in childhood (e.g., intrafamilial sexual abuse). This is a significantly higher percentage compared to the Center for Disease Control community norms of 12.5% indicating that a greater number of childhood adversities were experienced by the current sample of forensic mental health inpatients than in the general population. Additionally, significant percentages of diagnosed mental health disorders have been revealed. Diagnosed mental disorders in the current sample include, but are not limited to: psychotic disorders (59.0%), intellectual disability or cognitive developmental disorders (57.3%), mood disorders (45.0%), impulse disorders (22.2%), and post-traumatic stress disorder (13.0%). Comprehension of type, severity, and length of exposure to adversities, environmental responsiveness to abuse, maltreatment and familial dysfunction, and the onset and severity of mental and behavioral health outcomes are needed to better inform treatment, intervention, and rehabilitation of forensic psychiatric inpatient populations.


Johnson City, TN

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