Childhood Trauma, Psychiatric Disorders, and Criminal Behavior in Prisoners in Germany: A Comparative Study in Incarcerated Women and Men

Objectives: Previous studies indicate high rates of childhood trauma experiences as well as of mental disorders among prisoners. In this study, we investigate (1) the prevalence of different kinds of early traumatic experiences in female and male incarcerated prisoners, (2) their associations with mental disorders, and (3) their associations with characteristics of criminal behaviors.

Method: The Childhood Trauma Questionnaire, Structured Clinical Interviews for DSM-IV Axis I and II Disorders, and Symptom Checklist-90-Revised (current psychopathology) were administered, and the subjects' criminal and arrest histories were obtained. All assessments were performed between May 1, 2002, and June 1, 2003.

Results: Comparable sample groups of 63 incarcerated women and 76 men participated. Apart from low rates of short stay prisoners and foreign nationals, the sample was comparable with all prisoners in North-Rhine Westfalia (largest state in Germany). A history of at least 1 type of moderate or severe childhood trauma was reported by 50.4% of the prisoners. In 86.3%, >= 1 lifetime Axis I disorder was found (current, 83.5%), and a high mean number of comorbid diagnoses was found (mean ± SD lifetime = 3.6 ± 3.3, current = 2.9 ± 2.7). In 53.2% of the sample, at least 1 Axis II (personality) disorder was diagnosed. The numbers of comorbid Axis I lifetime and current disorders as well as the number of lifetime Axis II disorders were significantly (p < .001) associated with the severity of childhood trauma history, indicating a dose-response relationship. Negative associations were observed between the severity of childhood trauma and age at first offense.

Conclusion: Severity of childhood trauma experiences is associated with the presence and number of Axis I and Axis II mental disorders and may play a crucial role in the development of these disorders.

J Clin Psychiatry 2006;67(10):1486-1492