Victimized women within the criminal justice system are an important group and understanding their substance use is critical. Substance use was examined among 406 victimized women on probation and parole in an urban community from 2010 to 2013. Ninety-three percent reported lifetime use of an illicit substance, while 58% and 45% reported use of at least one illicit substance in the past two years and 12 months, respectively. Among probationers, having been in a controlled environment was associated with a higher prevalence of illicit substance use as compared to parolees. Implications for practice, policy and future research are discussed.

The present analysis was guided by a gendered pathways-based theoretical model and examined relationships between childhood victimization and current attachment, psychological distress and substance use among 406 women with histories of victimization who were on probation and parole in an urban Kentucky county. Structural equation modeling examined relationships among childhood victimization, attachment, psychological distress, and substance use. Additionally, we examined the mediational role that attachment plays in relationships between childhood victimization and both psychological distress and substance use. The data fit the models properly. Psychological distress was significantly predicted by childhood victimization, and adult attachment partially mediated this relationship. Childhood victimization did not significantly predict substance use; however, attachment did. The findings suggest that attachment may be an important factor to further understand and address in relation to psychological distress and substance use among women with histories of victimization who are involved in the criminal justice system.

Justice-involved women report high rates of victimization across their life span, and these experiences contribute to their involvement in the criminal justice (CJ) system. Within this population, research has identified an overlap among victimization and substance use, a high-risk coping mechanism. Furthermore, research indicates attachment style is related to coping and high-risk behaviors. Research is needed to understand the relationship among these mechanisms as they relate to intimate partner violence (IPV). To address this gap, this study investigated the relationship between attachment, coping, childhood victimization, substance use, and IPV among 406 victimized women on probation/parole. Results of 6 multivariate regression analyses were statistically significant, accounting for 8%-13% of the variance in IPV. Particularly, childhood sexual victimization and negative coping were significant in all analyses. Findings provide practitioners, administrators, and policymakers information about the specific needs of justice-involved women.

This study contributes to understanding of relationships between CSA and HIV sexual risk behaviors and key correlates associated with HIV sexual risk behaviors among women in methadone treatment. It also highlights the complexity of measuring CSA and its association with sexual risk behaviors and the importance of comprehensive approaches to HIV prevention that address psychological, relational, situational, and substance use experiences associated with sexual risk behaviors among this population.

The purpose of this study was to develop and test a conceptual model of the pathways through which childhood victimization influences adult health outcomes. Specifically, measures of high-risk behaviors, tobacco use, alcohol use, illegal substance use, and HIV risk behaviors were hypothesized to mediate the relationship between childhood victimization and adult physical health. The sample consisted of 406 women on probation and parole with a history of childhood victimization in Jefferson County, Kentucky. Structural equation modeling was used to examine the relationship between childhood victimization, high-risk behaviors, and physical health outcomes. The findings indicate partial mediation, with health risk behaviors accounting for 12.5% of the variance in the relationship between childhood victimization and health outcomes. Implications for policy and treatment practice in the health and criminal justice arena are discussed.

This article examines HIV risks among a sample of 406 women on probation and parole with lifetime histories of victimization who were recruited from an urban community in the southern U.S. Guided by the Comprehensive Health Seeking and Coping Paradigm, we analyze the significance of sociodemographic characteristics, substance use, posttraumatic stress disorder, and social support in relationship to three sexual risks and one drug use risk using multivariable regression. Findings indicate that substance use is a significant correlate of nearly all HIV risks examined, including lifetime sexual partners and sexual partners during the past 12 months. Age, race/ethnicity, homelessness, lifetime traumatic event exposure, regular use of alcohol to intoxication and other drugs, functional social support, and substance use treatment in the past 12 months are associated with specific HIV risks. The findings identify potential targets to address in HIV prevention with women on probation and parole who have experienced victimization.

DEDICATIONThis dissertation is dedicated to:1. My husband, Kyle, who encouraged and supported me throughout this process as we both pushed ourselves past what we thought was possible on our quest to build our life together. My parents, Charles and Karen Efstration, who made numerous sacrifices so Icould have the best educational opportunities and taught me to care deeply about underdogs. I am also deeply thankful for my in-laws, the Winhams and the Whites, for the love and support. Results of the second MIMIC analysis (X 2 (147) =439.71, p < .001; CFI = .90; TLI = .89; RMSEA = .07; SRMR = .07) provided good fit to the data and indicated that exposure to childhood sexual victimization versus other types of victimization significantly predicted differences in PTSD symptom structure and greater severity (B= .29, β = .10, SE= .14, p =.04). However, childhood victimization accounted for only 1% of the variance in PTSD symptomology. Implications for assessment and treatment of this highly-victimized and traumatized population are discussed including the usefulness of addressing the symptoms of dysphoric arousal including sleep disturbance, irritability, and difficulty concentrating. Suggestions for public policy include increasing economic insecurity and revisiting current legal climate linking substance use with criminal justice involvement.