Disentangling the relationship between posttraumatic stress disorder, criminogenic risk, and criminal history among veterans.

Abstract

Objective: Posttraumatic stress disorder (PTSD) is positively associated with involvement in the criminal justice system among veterans. Research that examines whether this association is confounded by risk factors ("criminogenic needs") from the risk-need-responsivity model of correctional rehabilitation can inform risk management with this population. Hypotheses: We hypothesized that (a) veterans with probable PTSD would score higher on all criminogenic needs than veterans without PTSD and (b) probable PTSD would be associated with criminal history but not after accounting for criminogenic needs. Method: We conducted secondary analyses of data from 341 veterans (95.3% male; 57.8% White/non-Hispanic/Latinx; M age = 46.2 years) with a history of criminal justice system involvement who were admitted to mental health residential treatment. At treatment entry, participants completed interviews to assess criminal history, risk-needresponsivity-based criminogenic needs, and PTSD symptom severity. Cross-sectional analyses tested for differences between participants with and without probable PTSD on criminogenic needs and criminal history, and a multiple regression model examined the unique contributions of probable PTSD and criminogenic needs on criminal history. Results: The majority of the sample (74%, n = 251) met probable criteria for PTSD. Compared with veterans without PTSD, those with probable PTSD scored significantly higher on criminogenic needs of antisocial personality patterns, antisocial cognitions, antisocial associates, substance use, and family/marital dysfunction but did not differ on multiple indices of criminal history (Cohen's ds = 0.60-0.86). In the regression model, higher age (β = 0.52, p < .001) and higher scores on measures of antisocial personality patterns (β = 0.19, p = .04) and antisocial cognitions (β = 0.22, p = .02) were significantly associated with higher scores on a criminal history index. Conclusions: The findings suggest that veterans with probable PTSD may score higher on a number of criminogenic needs that are known to be drivers of recidivism. An approach that integrates trauma-informed and risk-need-responsivity principles to address veterans' dynamic criminogenic and clinical needs may be critical to risk management in this population. Public Significance StatementIn some prior research, involvement in the criminal justice system among veterans of the U.S. military has been linked to posttraumatic stress disorder (PTSD). This study found that veterans with PTSD and a history of criminal justice system involvement are likely to have other risk factors for justice system involvement, but that PTSD by itself does not increase the likelihood of a criminal history. Risk management for justiceinvolved veterans should consider both the mental health needs of these veterans as well as risk factors for criminal justice system involvement that are typically monitored by correctional system staff.