Abstract
A growing body of work estimates the prevalence of childhood victimization among incarcerated people. The present study seeks to descriptively and quantitatively summarize this abundant literature by reviewing studies that report childhood victimization prevalence among people incarcerated in the United States. The review includes any study of childhood victimization that uses a sample of incarcerated adults (age eighteen or older) and that reports the proportion of the sample that experienced child abuse and/or neglect. Sixty-seven studies met these criteria and were analyzed, encompassing 1,187,044 incarcerated individuals. The studies vary in sample characteristics, methodological features, and employ an exceedingly wide range of victimization measures. Meta-analyses for pooled prevalence rates revealed that the inter-study heterogeneity was too great to draw conclusive summary estimates of childhood victimization from this literature, even when disaggregating by victimization type. Exploratory t-tests and correlation analyses suggest that a study’s sample size, racial, ethnic, and gender composition, and variation in victimization measurement can influence reported child abuse and neglect, but more research is needed to fully assess how study characteristics influence reported victimization prevalence. Understanding the extensiveness of childhood victimization histories among incarcerated people emphasizes the need for robust screening and treatment for people within correctional facilities, as well as improved community prevention and intervention efforts.
Introduction
Incarcerated people are a vulnerable, high-risk, and high-need population. Compared to those in the United States general population, incarcerated people are more likely to suffer from mental illness, physical disability, substance abuse disorders, unemployment, and marital problems (Travis et al., 2014). Scholars suggest that in addition to these physical and social hardships, incarcerated people are more likely to have experienced victimization both in childhood and across the life course (Browne et al., 1999; Harlow, 1999; Grella et al., 2013; Komarovskaya et al., 2011; Wolff et al., 2009). Several studies investigate the prevalence of childhood abuse and neglect among people who are incarcerated; but within this literature, there is a great deal of variation in studies’ findings, methodologies, and the way childhood victimization is operationalized. The present study offers an assessment of sixty-seven studies that focus on experiences of childhood victimization among individuals incarcerated in the United States. We aim to (1) assess the prevalence, or proportion of, incarcerated adults that report child abuse and/or neglect across studies; (2) identify differences in study characteristics and methodologies; and (3) determine if and how reported prevalence rates vary in relation to these differences.
To our knowledge, no review to date has summarized this body of literature in its entirety, aggregated data to explore study characteristics, or utilized meta-analytic techniques. A study of this scope is necessary for four reasons. First, a conclusion about the prevalence of childhood victimization among incarcerated people cannot be drawn by examining individual studies because of the wide range of prevalence rates reported. Using meta-analytic techniques provides a framework to pool data from existing studies and estimate how common childhood victimization is within correctional populations, while considering heterogeneity across studies. Second, taking stock of how study characteristics (i.e., measures of victimization and sample characteristics) vary within this literature can lead to higher quality, more standardized research on this topic. Third, by aggregating data, one can quantify the differences in and influences of methodological features on reported childhood victimization, which is necessary for explaining divergent prevalence estimates and guiding future research in this area. Fourth, a better understanding of the prevalence of abuse and neglect among incarcerated people can inform treatment efforts in correctional settings and encourage communities to prevent and intervene in childhood victimization.
Background
Risk factors and consequences of childhood victimization
Child abuse and neglect are varied experiences. Abuse can be intentional physical, sexual, or emotional harm to a child, and neglect involves “failure to meet the child’s physical and emotional needs” (Leeb et al., 2008). Childhood victimization is common in the United States. According to the Behavioral Risk Factor Surveillance System (BRFSS), the Center for Disease Control and Prevention’s (CDC) nationally representative telephone survey of adults, 34.42% of adults report experiencing emotional abuse, 17.94% report physical abuse, and 11.60% report sexual abuse occurring prior to the age of eighteen (Merrick, 2018). The Fourth National Incidence Study (NIS), which uses a combined measure of abuse and neglect, estimates that approximately one in twenty-five children in the United States are victims (Sedlack et al., 2010). More recently, a national report by the Children’s Bureau found that among the 684,568 victims with substantiated reports of abuse and neglect to Child Protective Services (CPS) in 2019, the most common type of victimization was neglect (74%), followed by physical abuse (17.50%), and sexual abuse (9.30%) (Children’s Bureau, 2021).
Though common, childhood victimization is not evenly distributed across children in the United States; certain populations face greater risk. The NIS reports that girls are considerably more likely to be abused than boys. Girls’ risk for sexual abuse is especially high, at almost five times the rate of boys (Sedlack et al., 2010). Black and other non-White children are overrepresented in CPS reports and validated cases of abuse and neglect relative to their White counterparts (Fluke, 2003; Maguire-Jack et al., 2018). Furthermore, children from families with low socioeconomic status and within economically disadvantaged areas are at greater risk for abuse and neglect, and are overrepresented in CPS reports and investigations (Maguire-Jack et al., 2018; Sedlack et al., 2010).
Victimization leaves children vulnerable to a variety of hardships. Those impacted often suffer from delayed language and psychosocial development, attention deficits, weakened social controls, behavioral problems, and lack of emotional stability (Thompson et al., 2004; Widom, 1995). These adversities are not limited to childhood and adolescence; scholars warn that childhood victimization can lead to substance abuse, depression, low educational attainment, and economic instability over the entire life course (Elwyn & Smith, 2013; Henry et al., 2018; Mersky & Topitzes, 2010). Though both male and female child victims are more likely to suffer these consequences than non-abused children, the mental health consequences of childhood victimization may be more severe among females (Espinosa et al., 2013; Thompson et al., 2004; Wamser-Nanney & Cherry, 2018).
Child abuse and neglect may also be predictors of delinquency, criminal behavior, and contact with the justice system. The work of Widom and colleagues shows that abused and neglected children are more likely to be arrested as juveniles and adults (e.g., Widom, 1995; Widom & Ames, 1994; Widom & Maxfield, 2001). Official records indicated that compared to non-victimized children, abused and neglected children were 53% more likely to be arrested as juveniles and 38% more likely to be arrested as adults (Widom, 1995). This relationship is confirmed by data from additional longitudinal studies such as the National Longitudinal Study of Adolescent Health (Add Health), the Chicago Longitudinal Study, and the National Youth Survey (NYS) (Fagan, 2005; Lantos et al., 2019; Mersky & Topitzes, 2010; Papalia et al., 2018). To be clear, not all child victims go on to offend or get entangled in the criminal justice system. A number of individual, genetic, familial, and social factors protect against delinquency and offending among child victims (Forsman & Långström, 2012; Wright et al., 2016), but a discussion of these protective factors is beyond the scope of the present study.
Childhood Victimization and Incarceration
There is substantial overlap in the risk factors for child abuse and neglect, crime, and incarceration. For example, substance abuse and mental health problems are widely recognized consequences of childhood victimization, precursors to incarceration, and exceedingly common within correctional populations (Elwyn & Smith, 2013; Mersky & Topitzes, 2010). Social disorganization and economic disadvantage are associated with high rates of childhood victimization and are commonly found in the communities disproportionately affected by crime and incarceration (Coulton et al., 1995; Rose & Clear, 1998; Travis et al., 2014). The link between childhood victimization and incarceration may not be direct or the same for all people. Scholars argue that victimized girls are more likely to run away, become involved in prostitution, and suffer from drug and alcohol abuse, which in turn increases their risk for incarceration (Gilfus, 2002). Men, on the other hand, are more likely to have delinquent peers, join gangs, and be incarcerated for violent or property crimes (Bronson & Carson, 2019; Warr, 2002).
Not surprisingly, scholars name childhood victimization itself as a risk factor for incarceration. For example, Mersky & Topitzes (2010) found that one-third of victimized children in their sample were incarcerated by twenty-four years old, an incarceration rate double that of their non-abused or neglected counterparts. Wolff and colleagues (2009) found that 54% of incarcerated females and 56% of incarcerated males experienced physical abuse in childhood. Rates of child sexual abuse seem particularly high among incarcerated women; some studies report estimates above 70% (e.g., Roe-Sepowitz et al., 2007). These studies suggest that childhood victimization is more pervasive among incarcerated adults than in the general United States population (between 11% and 34%) (Merrick, 2018).
Because the risk factors for incarceration mirror the consequences of childhood victimization, high prevalence estimates of victimization among people who are incarcerated are not overly surprising. But, there is a lack of consistency across studies of incarcerated individuals pertaining to the prevalence of childhood victimization. For example, Roxburgh and MacArthur (2014, 2018) found that in a nationally represented sample of 13,328 incarcerated males and females in the United States, only 9.90% experienced sexual abuse and 14.60% experienced physical abuse in childhood. Haugebrook and colleagues (2010) found similarly low rates in a sample of people in prison in New Jersey: approximately 10% experienced sexual abuse, 9% reported physical abuse, and 1.80% reported experiencing emotional abuse as children. Such estimates are markedly lower than those reported in other studies on the same topic and even lower than those reported by the Behavioral Risk Factor Surveillance System (BRFSS) for the United States general population (11.60%–34.42%) (Merrick et al., 2018).
Part of the divergence in findings within this literature could be explained by the diverse methodologies used, the way childhood victimization is defined, and/or differences in the samples employed in each study. Karlsson and Zielinski (2018) reviewed the literature of childhood and lifetime sexual abuse of incarcerated women, highlighting how studies utilized markedly different methodologies and sexual abuse measures. Their findings indicated high, but varied rates of lifetime sexual abuse, ranging from 56% to 82% across studies and variation in methodology was associated with reported sexual abuse prevalence rates.
The Current Study
Expanding upon the work of Karlsson & Zielinski (2018), the present review summarizes relevant studies measuring the prevalence of child abuse and neglect among incarcerated people in the United States. This review considers more varied forms of childhood victimization, including many types of abuse (i.e., physical, sexual, and emotional abuse) and neglect (i.e., physical, emotional, and general neglect) and incorporates samples of incarcerated males to assess victimization prevalence for the entire incarcerated population. This study uses a variety of review strategies and statistical techniques in an attempt to provide a holistic summary of the literature on childhood victimization and incarceration. In addition to describing the characteristics of this literature, we also utilize meta-analytic techniques to ascertain the overall pooled prevalence of childhood victimization and by the type of abuse or neglect. This technique allows for aggregating and weighting data from all studies toward obtaining a more credible prevalence estimate from the literature than could be obtained by only narrative review or simply pooling data from across studies. Meta-analytic techniques also provide a quantitative assessment of both the amount of heterogeneity in victimization prevalence and the degree to which aggregate prevalence estimates are driven by differences in study characteristics. Finally, we identify differences in study characteristics and victimization measures, and consider the impact of such methodological choices on reported childhood victimization prevalence. By aggregating data and providing a descriptive summary of study characteristics, this review offers a clear picture as to the state of knowledge on childhood victimization and incarceration, and the extent to which this knowledge is contingent upon the features of individual studies.
Methodology
Search Strategy
Following the Campbell Collaboration’s guidance for methods and information retrieval, a comprehensive search strategy was conducted between January and July of 2020 (Kugley et al., 2016). To acquire articles measuring the prevalence of child abuse and neglect among incarcerated adults, academic databases and journal subscriptions available through an online library catalog were searched. Databases included Artsor, EBSCOhost, Elsevier, JSTOR, PubMed, Emerald, Gale, CJ Abstracts, SOCIndex, and PsychAbstracts, among others. The following search terms were used: “prior victimization among prisoners,” “victimization as a risk factor for incarceration,” “history of victimization AND incarceration,” “childhood victimization AND incarceration,” “child victims AND inmates or prisoners or offenders or incarceration,” “child sexual abuse AND incarceration or inmates,” “child physical abuse and incarceration or inmates,” “child emotional abuse AND incarceration or inmates,” “childhood trauma AND offending,” “adverse childhood experiences AND incarceration,” “child abuse and inmates,” “child maltreatment and incarceration,” and “child neglect and inmates.” To ensure sensitivity and precision of the searches, the terms and phrases were mixed, and search terms were entered both individually and in combination to yield exhaustive results. In addition, searches were conducted with Google Scholar using the same search protocol and terms from the academic databases. The reference lists of the included articles were also screened for additional studies.
Eligibility Criteria and Identification of Relevant Studies
The studies included in this review were required to be empirical, quantitative studies of childhood victimization and incarceration. All studies had to be published in English and use data from individuals incarcerated in jails or prisons in the United States. Only studies with samples of adults aged 18 years or older were included. Studies with samples consisting only of people in juvenile detention centers, on probation, in outpatient programs, and the general population were excluded. Studies were required to report the percentage of incarcerated people in the sample that reported abuse and/or neglect before the age of eighteen.
Each study must have defined how victimization was measured, including at least one of the following types of childhood victimization: physical abuse, sexual abuse, emotional abuse, or various forms of neglect (i.e., physical, emotional, or a combination of the two). Articles measuring abuse or exposure to violence across the life course without disaggregated measures of abuse or neglect occurring prior to the age of 18 were excluded. Only studies of incarcerated people in which victimization was a primary focus were included for analysis. For example, if a study of the relationship between substance abuse and recidivism among formerly incarcerated males had a measure of childhood victimization as a control variable, the study was not included in our review, as it is not part of the literature on childhood victimization prevalence among incarcerated people. There were no restrictions based on the publication date, the sex of the sample, the data collection method (i.e., surveys or interviews), or sample size. While there were no restrictions based on the data type (i.e., self-report vs. official records), all studies included in this review used retrospective, self-report data.
Google Scholar and database search results were screened by two independent reviewers. Titles and abstracts were screened simultaneously. Search results were sorted based on relevance to the search term and the first fifteen pages of search results were screened. It is estimated that 16,000 titles and abstracts were screened for inclusion. If a study was deemed potentially relevant based on its title, the abstract was scanned to identify if 1) childhood victimization was a central focus of the study; 2) the study used a sample of adults incarcerated in jail or prison; and 3) the study was not a narrative literature review or other qualitative study. If a study met the criteria, or if a study’s relevance could not be determined based on the information provided in the abstract, the full text was retrieved for a more detailed review. Altogether, the full text of 251 studies was retrieved for further review.
Of the articles retrieved in full text, 212 studies were excluded because they did not meet one or more of the inclusion criteria. As an example, six studies were excluded that only provided Childhood Trauma Questionnaire (CTQ) scores to quantify experiences of childhood victimization, without reporting the exact proportions of people in their sample that experienced childhood victimization. Ten studies were excluded because the authors provided disaggregated estimates of victimization for specific subsets of incarcerated people (e.g., according to mental health diagnoses or drug dependency) without including the number of people comprising each category, so it was not possible to calculate weighted prevalence of child abuse and neglect for the entire sample. Seven studies were excluded that only provided estimates for any experience of child trauma, as their measure of overall trauma might have included experiences other than abuse or neglect, such as witnessing violence, parental drug use, or parental incarceration. Finally, multiple publications used the same secondary data sources (e.g., 2004 Survey of State and Federal Inmates) or reported data from the same samples. In these cases, only the earliest published study meeting the inclusion criteria was included. Sixteen studies were excluded on this basis. In total, sixty-seven studies were included and analyzed.
Operationalizing Childhood Victimization and Measuring Victimization Prevalence Estimates
The current study focuses on the prevalence of direct experiences of child abuse and neglect. This review does not distinguish the sources of abuse or neglect, frequency, severity, or age at the time of victimization. Only the percentage of incarcerated adults within a study that reported experiencing a given type of childhood victimization was included. For the purposes of this review, childhood victimization experiences were disaggregated into categories based on the type of abuse or neglect incurred. Specifically, the current study focuses on sexual abuse, physical abuse, emotional abuse, physical neglect, emotional neglect, and general neglect.
For the purposes of this study, sexual abuse is operationalized as forced or unwanted sexual experiences including, but not limited to kissing, touching or molestation, oral sex, and/or rape (Johnson et al., 2006). Physical abuse includes experiences of physical violence that may or may not result in severe injury or hospitalization including, but not limited to being kicked, punched, beat up, burned, and/or choked (Browne et al., 1999). Emotional abuse consists of experiences of psychological and verbal abuse such as being called names, being yelled at or insulted, and/or being made to feel embarrassed or guilty (Roe-Sepowitz et al., 2007; Sharp et al., 2012). Neglect, or the failure to meet children’s basic needs, can include both physical and emotional neglect. Here, physical neglect includes experiences like not having enough to eat, having to wear dirty clothes, or not being taken care of when sick. Emotional neglect can refer to feeling unloved, unimportant, or that nobody cared about their well-being (Jones et al., 2017). Some studies used combined measures of experiences that constitute both physical and emotional neglect (e.g., DeHart et al., 2013; Sheridan, 1996), so a separate measure for general neglect is included in our analyses.
If studies reported estimates of childhood victimization for a comparison group of individuals in the general population in addition to estimates from an incarcerated sample, only prevalence estimates from the incarcerated sample were included. Finally, if a study reported estimates of lifetime victimization as well as in childhood, only childhood victimization prevalence rates were included in the analyses.
Some studies disaggregated estimates of abuse or neglect by individuals’ race/ethnicity, gender, the perpetrator, or age at which the events occurred, without providing an overall estimate of victimization (i.e., childhood sexual abuse by relative vs. stranger; physical abuse in early childhood vs. teenage years). Weighted averages were calculated any time full sample estimates were not provided, if the study provided the necessary disaggregated estimates and sample characteristics to do so. In some cases, information about specific experiences considered part of the definition of sexual abuse were provided separately. Disaggregated estimates by sexual abuse type (e.g., exposure, touching or molestation, or rape) presented without a summary measure were combined in a weighted average of prevalence rates reported for each experience.
Measuring Study Characteristics
In addition to measuring prevalence estimates of childhood victimization, study sample and methodological characteristics were documented. We recorded the number of incarcerated people from which a study collected childhood victimization data, the sample sex (i.e., male, female, or mixed-sex) and the percentage of males and females comprising mixed-sex samples. When information on race and ethnicity was available, the percentage of each sample that consisted of White, Black, Latinx, and those of other racial or ethnic categories was documented. Whenever possible, disaggregated estimates of childhood victimization by sex or race and ethnicity were recorded to assess potential group differences in these experiences. Also documented were the correctional settings (i.e., jail or prison), as well as the study locations within the United States (i.e., single-state, multi-state, or nationally representative samples). 1
Lastly, we recorded how studies measured childhood victimization experiences. Specifically, we documented whether a study used or adapted a recognized instrument (e.g., Childhood Trauma Questionnaire and Conflict Tactics Scale) to measure abuse and neglect, or if a study developed their own survey or interview questions to measure childhood victimization. Due to inconsistent reporting among studies, other dimensions of victimization measurement such as the wording, sequencing, and number of items were not documented or assessed.
Analysis Plan
To summarize the literature on childhood victimization and incarceration, descriptive statistics were calculated such as the percentage of studies using certain sample types (i.e., male or female samples) and the percentage of studies measuring a given victimization type (i.e., physical or sexual abuse). Aggregate prevalence estimates for each type of victimization and tests of heterogeneity present within this literature are provided using meta-analysis. Meta-analyses were conducted in Stata 16.1 using the metaprop package for pooled prevalence estimates. Prevalence rates were calculated for each type of abuse and neglect in addition to an aggregate prevalence using random effects models. Per the recommendation of Nyaga and colleagues (2014), we also employed the Freeman-Tukey double arcsine transformation, since some studies include prevalence estimates close to zero and one. Confidence intervals (95%) for all pooled prevalence estimates are provided. Additionally, we report I2 statistics for each victimization type and a significance test to determine how much of the variation in reported prevalence rates is attributable to differences in studies within and between victimization types. To determine the extent to which the average reported victimization relates to features of studies’ samples, measures, and other methodological features, differences in victimization prevalence were analyzed with t-tests and correlations.
Results
Characteristics of the Literature on Childhood Victimization among Incarcerated Adults
Overview of Study Characteristics.
Over half (64.18%) of the studies used female-only samples, approximately 16% used male-only samples, and just under 20% used mixed-sex samples. Among the studies with mixed-sex samples, males comprised 73.30% and females comprised 26.77% of the samples, on average. Less than 14% of all studies directly assessed gender differences in victimization histories. Most studies contained a larger proportion of White people relative to any other racial or ethnic group; however, racial and ethnic distributions varied greatly across studies. For example, Black people comprised between 6% and 81% of samples across studies. And surprisingly, though 98% of studies reported the racial and ethnic distribution of their samples, approximately 12% examined racial or ethnic differences in child abuse and neglect experiences.
Meta-Analysis of Existing Studies
In the sixty-seven studies described above, there were a total of 172 prevalence rates of childhood victimization reported. Across all studies, the percentage of people reporting childhood abuse and neglect ranged from less than 2% in one study to over 80% in another. To synthesize and assess the diversity of prevalence rates reported in this literature while minimizing bias encountered when pooling estimates, meta-analytic techniques were employed.
Meta-Analysis of Childhood Victimization among Incarcerated People, by Victimization Type.
**p < 0.01.
More importantly, the vast majority of variation in reported prevalence was due to unobserved differences in studies within a single category. The I 2 statistics in Table 2 indicate that for each type of victimization, well over 90% of variation in reported prevalence was due to differences in the studies that comprise the category. In other words, almost all differences in prevalence rates were attributable to variation in the characteristics of studies that measure the same type of child abuse or neglect. Because of the variety present in the literature, pooled prevalence estimates likely capture differences in study populations and attributes of the diverse victimization measures used, rather than “true” victimization prevalence (Jones et al., 2008). The pooled prevalence estimates reported in Table 2 should not be interpreted as an accurate summary of childhood victimization among incarcerated populations. In light of this finding, we follow the recommendation of Ruppar (2020) and turn our attention to the sample characteristics and victimization measures that vary across studies and assess how these factors individually relate to reported victimization prevalence.
Measurement Instruments and Variation in Reported Childhood Victimization
Type of Instruments Used According to Victimization Type Measured.
Number of Studies Using or Adapting Recognized Instruments According to Abuse of Neglect Type Measured.
T-tests indicated no differences in the prevalence rates derived from recognized instruments relative to author-derived measurements, for any type of abuse or neglect, when all victimization types were pooled together. Table 4 shows that the most commonly employed recognized instruments are the Childhood Trauma Questionnaire (CTQ), the Life Stressor Checklist-Revised (LSC-R), and the Conflict Tactics Scale (CTS). T-tests disaggregated by the type of victimization measured revealed that when measured by the LSC-R, sexual abuse prevalence rates were marginally higher, but physical abuse and physical neglect prevalence estimates were marginally lower, compared to the estimates derived from all other measurement instruments. When measured with the CTS, physical abuse estimates were marginally higher, compared to those derived from all other instruments. 2 These slight differences in reported prevalence by measurement instrument may seem trivial, but with so many different tools available, we must question the extent to which our understanding of childhood victimization among incarcerated people is instrument-driven. These analyses provide tentative evidence that diversity in measurement instruments partly contributes to variation in reported prevalence rates.
Sample Characteristics and Reported Prevalence Rates of Childhood Victimization
The remainder of analyses presented were conducted using a pooled sample of prevalence rates from all sixty-seven studies, regardless of the type of abuse or neglect measured. These findings do not account for potential differences in the relationship between study characteristics and reported prevalence that are unique to the victimization type that was potentially indicated by the meta-analysis heterogeneity statistics. Due to the limited number of studies using each victimization type, we lacked statistical power to examine study characteristics and prevalence rates with disaggregated data, so we relied on analyses that pool all victimization types to identify overall patterns. 3 Only bivariate relationships between a single study characteristic and reported prevalence of all victimization types are presented. Like analyses reported in Table 2 above, caution should be used when interpreting the pooled prevalence estimates across studies with greatly varying methodological characteristics.
Sample size. There was a significant negative correlation (r = −0.170, p < 0.001) between sample size and reported victimization prevalence. The negative correlation indicates that larger samples yielded smaller victimization estimates. Among studies in or above the 90th percentile of sample size (the largest samples), the average prevalence of childhood victimization was 24.48% (sd = 14.50%). The average victimization prevalence in the remaining 90% of studies was 40.70% (sd = 19.02%). Evidently, there is an association between sample size and the prevalence of childhood victimization captured in each study.
Sample Race and Ethnicity. Racial and ethnic diversity may also account for some of the differences in reported victimization prevalence across studies. Studies with a larger percentage of White people reported significantly higher prevalence estimates of childhood victimization (r = 0.187, p < 0.01), while the proportion of Latinx people in each sample was significantly negatively correlated with prevalence rates (r = −0.323, p < 0.001). Furthermore, the percentage of Black people in each study’s sample was marginally negatively correlated with reported victimization prevalence (r = −0.146, p < 0.1). The negative correlation between reported victimization prevalence and the percentage of Latinx and Black individuals that comprise a study’s sample was unexpected, as the extant literature suggests that non-White children are overrepresented in CPS reports and investigations.
Sample Sex. As Table 1 demonstrates, studies overwhelmingly relied on all-female samples. In fact, 107 of the 172 total prevalence estimates in this literature were derived from all-female samples. Within all-female samples, 43.29% (sd = 17.68%) of incarcerated people reported experiencing childhood victimization, on average. This average prevalence is greater than the average reported victimization prevalence of all-male samples, (average 37.00%, sd = 19.78%), and mixed-sex samples (average 27.05%, sd = 18.37%). T-tests confirmed that all-female samples had significantly higher victimization prevalence estimates than all-male samples or mixed-sex samples (significant at p < 0.001). Among studies that contained men and women, there was a positive but insignificant relationship between the percentage of the sample that was female and the victimization prevalence (p = 0.184). These patterns confirm data from the general population and the extant literature on the incarcerated population, suggesting that females experience childhood victimization at higher rates than males.
Location, Correctional Setting, and Reported Prevalence Rates of Childhood Victimization
Studies most commonly used single-state samples (86.57%), as opposed to multi-state (10.45%) and nationally representative samples (2.99%). This distinction is likely due to data access and availability; it is much more common for researchers to obtain data from and conduct research in a single state. Among the estimates derived from studies using single-state samples, the average victimization prevalence was 39.45% (sd = 19.44%). The average prevalence of abuse and neglect among studies with multi-state samples was 38.76% (sd = 14.45%). These prevalence estimates are substantially larger than those yielded from nationally representative samples, which suggested that only 10.75% (sd = 14.16%) of incarcerated people experience childhood victimization. Despite having only four prevalence estimates from studies with nationally representative samples, a t-test confirmed that studies with nationally representative samples reported a significantly lower victimization prevalence than other studies (p < 0.001). Studies using jail, prison, and combined jail and prison samples all reported average victimization prevalence estimates between about 38% and 39%. T-tests confirmed that there were no significant differences in average abuse and neglect prevalence reported by studies with samples from different correctional settings.
Discussion
The results of this review tentatively support the claim that a high proportion of incarcerated people in the United States have been abused and/or neglected as children; however, the results raise more questions than answers. Findings suggest that methodological diversity across studies accounts for most of the variation in reported childhood victimization prevalence. Theoretically, methodological and sampling diversity can be advantageous and speak to the robustness of a finding when results are replicated across different settings and methodological strategies. However, the current study finds that reported prevalence rates of childhood victimization among incarcerated people may be dependent on the type of victimization measured, how it is measured, and other sample characteristics. Thus, the studies comprising this literature do not seem entirely comparable, and readers should consider how methodological choices influence reported child abuse and neglect prevalence in the incarcerated population.
The relationship between study characteristics, operational definitions, and reported victimization prevalence is well documented (see, for example, Fisher & Cullen, 2000; Lyberg et al., 1997), but can be difficult to quantify. The meta-analysis performed here confirms the existing belief of the influence of study characteristics, while also drawing attention to just how sensitive childhood victimization prevalence is to such methodological choices. Given the vast array of instruments used to measure childhood victimization among incarcerated people (and in general) and the specific samples used, there must be some standardization before a quantitative summary of this literature is possible. For example, an instrument may simply ask whether a person was physically abused as a child, while others may provide specific examples of physical abuse. Not seeing oneself as a victim or wanting to be labeled that way, the former instrument may yield lower prevalence estimates. Child abuse and neglect are multidimensional and different instruments also capture unique features of these varied experiences. As an example, the Conflict Tactics Scale (CTS) asks respondents to identify the occurrence of a wide variety of physical abuse experiences before the age of eighteen including being kicked, bit, or hit with a fist; hit with an object; beaten up; burned; and threatened or assaulted with a knife or gun (Browne et al., 1999). Other instruments may not include all of these experiences.
Further, this review of the literature uncovered stark differences in the amount of information reported by authors regarding their methodological choices. Lack of transparency in the nature of the instruments (e.g., question wording, sequencing, and number of items) used and characteristics of the samples (e.g., racial/ethnic or age distributions) prohibits inquiries into how such methodological choices impact reported prevalence rates. We recommend that if standard instruments to measure childhood victimization are not instituted, then standard reporting practices for all future studies in this field be developed.
Aside from the inability to report an aggregate prevalence of childhood victimization in incarcerated populations across studies, there are several substantive findings from this review worth noting. First, the studies in this review focus heavily on particular types of victimization, while others are scarcely measured. Of the sixty-seven studies included, almost all measured sexual and physical abuse, but only twenty-one reported the prevalence of emotional abuse, eleven measured general neglect, thirteen measured physical neglect, and eight studies reported the prevalence of emotional neglect. Therefore, our assessment of study characteristics and prevalence are biased and may pertain only to sexual and physical abuse. (For an assessment of study characteristics and prevalence that is disaggregated by victimization type, see Appendix A). Child sexual abuse and physical abuse are undoubtedly significant traumatic experiences among incarcerated people. However, it is equally important to study emotional abuse and neglect among incarcerated people to understand the extent to which these experiences affect their health and well-being, and to identify potential disparity in experiences. Future studies should focus on the prevalence of all victimization types, especially emotional abuse and neglect.
Next, the studies included in this review overwhelmingly relied on all-female samples. Findings revealed higher rates of child abuse and neglect among incarcerated females relative to males. It is important for prisons and jails to recognize the high prevalence of women’s traumatic experiences, especially given that incarcerated women represent an already vulnerable and overlooked population with unique needs. In its current state, the literature highlights the prevalence of victimization, mainly sexual abuse, among women as a problem that clearly needs to be addressed. Even so, we know little about the abuse and neglect histories of incarcerated men, who predominantly comprise incarcerated populations. Accordingly, the findings of this review may be biased insofar as the goal was to provide an assessment of all incarcerated people, but the data largely reflect only women. Future work should use mixed-sex samples to extend knowledge of child victimization to both men and women, and to make gender comparisons.
A sample’s racial and ethnic composition was also related to the prevalence of child abuse or neglect reported. Samples with a higher percentage of non-White people, particularly Latinx people, appeared to report lower prevalence of childhood victimization, while the proportion of White people in a study’s sample was positively correlated with victimization prevalence estimates. This pattern directly conflicts with prior research which suggests that non-White children are overrepresented in CPS reports and investigations of child abuse and neglect, whereas White children are largely underrepresented (Fluke et al., 2003).
Such a discrepancy could be due to multiple factors. Many studies investigating racial differences in the prevalence of child abuse and neglect among the United States general population rely on official records, while the studies included in this review relied on retrospective, self-report data from incarcerated people. Findings from official data may be confounded by CPS identification and intervention procedures. If CPS is more likely to investigate families in the areas where non-White children reside, this could lead to more detection of abuse and neglect among non-White children relative to White children. However, even in studies from the United States general population that do use retrospective, self-report data, such as the Behavioral Risk Factor Surveillance System (BRFSS), a higher prevalence of childhood victimization is reported among non-White individuals compared to White people (Merrick et al., 2018). Given the findings of past work and those of this review, it is unclear which racial disparities, if any, exist in experiences of child abuse and neglect. Future research is needed to investigate disparities in victimization experiences and the mechanisms behind them.
As with all research, this study has limitations that should be acknowledged. First, we focused only on bivariate relationships between childhood victimization estimates and study characteristics through t-tests and correlations. This methodological approach did not allow us to discern whether single methodological characteristics independently determine the amount of abuse and neglect reported by incarcerated people. For example, our findings suggest that females reported a higher prevalence of childhood victimization than males and that Latinx people reported lower prevalence rates than others. However, this review cannot speak to whether these samples yield higher or lower prevalence estimates than others independent of sample size, the victimization measures used, or the study location. We encourage future research to use multivariate analyses. This study also did not examine specific aspects of victimization experiences such as the frequency, severity, sources of victimization, or age at which victimization occurred. Additional research on the nuances of childhood victimization would be useful for understanding the complexities of incarcerated people’s past experiences.
If a high percentage of incarcerated people have experienced abuse and neglect, as this review tentatively suggests, it may be appropriate to address the emotional, psychological, and social consequences of childhood victimization in an incarceration setting. Prisons and jails should continue to screen for childhood victimization among those entering and already residing in their facilities to (1) assess the pervasiveness of this issue among the people in their facilities, and (2) determine if individuals’ behavior and health are impacted by their victimization experiences. Insight into the extent to which people in their care have experienced victimization as children may lead prisons and jails to consider expanding any existing (or implementing new) evidence-based treatments that are designed to address the effects of early traumatic events. Further, those with extensive victimization histories may disproportionately experience psychological and behavioral issues, which could lead to aggression or violence toward others, post-traumatic stress disorder and other mental health issues, and difficulty adjusting to the prison environment. Recognizing childhood victimization as a contributing factor to prison misconduct and people’s health could help to improve the quality of life of incarcerated people.
The findings from this review also support the use of trauma-informed care in correctional environments. Correctional settings are often characterized by control and fear. These oppressive environments can create conditions reminiscent of traumatic experiences, such as victimization in childhood (Levenson & Willis, 2019). Trauma-informed care integrates what is known about the effects of trauma into policies and practices to provide safe, effective, and humanizing services. The use of trauma-informed methods of service delivery is meant to individualize treatment, as well as build trust and respect to foster an environment conducive to positive change (Levenson & Willis, 2019). The use of trauma-informed corrections reduces re-victimization and re-traumatization of incarcerated individuals. By quantifying childhood victimization prevalence and using trauma-informed care and rehabilitation, we can take steps to ensure the well-being of those living and working in a correctional setting.
Critical Findings
Sixty-seven studies utilized incarcerated samples to assess the pervasiveness of childhood victimization. These studies encompassed 1,187,044 individuals. Prevalence rates varied based on the type of victimization in question. General neglect appeared to be less common than physical, sexual, and emotional abuse. There was little standardization in the type(s) of victimization measured, measurement instruments used, and sample characteristics, which may partly account for variation in reported victimization prevalence. A total of 103 unique measures were used to operationalize childhood victimization: twenty-two recognized instruments and eighty-one author-derived measures. The literature appraising child victimization among incarcerated adults focused heavily on women and physical or sexual abuse. There was not enough data to assess the influence of study characteristics on prevalence for each type of victimization.
Implications for Practice, Policy, and Research
More research is needed to determine the possible racial disparities and sex differences in childhood victimization experiences among incarcerated people. Particular attention should be paid to the disproportionate experiences of childhood victimization among Latinx individuals. Future studies should focus on experiences of emotional abuse and neglect among incarcerated people, as they are less commonly measured. Research should identify how the prevalence of emotional abuse and neglect may relate to study characteristics. Future research should focus on specific aspects of incarcerated individuals’ experiences, including their age at the time of victimization and the frequency, severity, and/or source(s) of victimization. Future research should examine the effects of various aspects of victimization measurement (e.g., question wording and sequencing) on reported prevalence rates. Standardized victimization measurement should be developed. Multivariate assessments should be conducted to discern whether certain methodological and sample characteristics independently increase or decrease reported childhood victimization estimates. Prisons and jails should screen for childhood victimization and other early traumatic events, and assess the psychological impact of these experiences. Corrections agencies can then implement treatment protocols for those struggling with behavioral or emotional issues resulting from victimization.
Footnotes
Declaration of conflicting interests
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding
The author(s) received no financial support for the research, authorship, and/or publication of this article.
Notes
Influence of Study Characteristics Disaggregated by Type of Childhood Victimization
The meta-analysis reported in Table 2 suggests that there is significant between-category variation, meaning that prevalence of childhood victimization depends on the type of abuse or neglect being measured. As such, in addition to the pooled analyses presented in the main text, we consider whether the observed relationships between childhood victimization and study characteristics are unique to specific types of victimization, or if there are patterns that span all victimization types.
Table 5A presents bivariate relationships between study characteristics and prevalence of various types of childhood victimization among incarcerated adults. Like the findings presented in the main text, focus should not be placed on the average prevalence value, because this number is likely driven by multiple study characteristics. Instead, relationships between study characteristics and prevalence can be discerned based on comparisons of the average prevalence values presented (more or less) and through correlation coefficients. Influence of Study Characteristics, by Type of Childhood Victimization.
Type of Victimization (Number of Studies)
Sexual Abuse (65)
Physical Abuse (53)
Emotional Abuse (21)
General Neglect (11)
Physical Neglect (13)
Emotional Neglect (8)
Correlation between Prevalence and Sample Size
−0.22
−0.26
−0.18
−.0.26
−0.38
−0.33
Average Prevalence for All-Female Samples
0.46
0.46
0.45
0.27
0.28
0.48
Average Prevalence for All-Male Samples
0.28
0.44
0.47
0.26
0.33
0.54
Average Prevalence for Mixed-Sex Samples
0.26
0.35
0.26
0.21
0.10
0.19
Correlation Prevalence and Percent Female (Mixed-Sex Samples)
0.19
0.27
0.37
0.65
—
—
Correlation Prevalence & Percent White
0.29
0.08
0.07
−0.38
0.45
0.10
Correlation Prevalence and Percent Black
−0.20
−0.03
0.03
0.34
−0.75
−0.70
Correlation Prevalence and Percent Latinx
−0.29
−0.21
−0.66
−0.50
−0.55
−0.47
Average Prevalence for Prison Samples
0.38
0.44
0.41
0.22
0.26
0.44
Average Prevalence for Jail Samples
0.42
0.36
0.32
0.28
—
—
Average Prevalence for Combined Prison-Jail Samples
0.37
—
—
—
—
—
Average Prevalence for Single-State Samples
0.40
0.44
0.41
0.25
0.27
0.45
Average Prevalence for Multi-State Samples
0.43
0.46
0.35
—
0.21
—
Average Prevalence Nationally Representative Samples
0.08
0.14
—
—
—
—
The findings presented in Table 5A mirror those from the pooled analysis. Across all abuse types there is a consistent negative relationship between sample size and reported victimization prevalence. Female samples tend to yield higher estimates of abuse and neglect than all-male or mixed-sex samples, and a larger proportion of females in mixed-sex samples is associated with higher prevalence. Such a pattern tentatively suggests that there are gender differences in abuse histories among incarcerated adults; abuse and neglect seem to be more pervasive among incarcerated women. It is also worth noting that sexual abuse is remarkably high among female samples. There appear also to be racial and ethnic differences in childhood victimization prevalence among incarcerated adults. Across all abuse types the percentage of White individuals in a sample positively relates to victimization prevalence while the percentage of sample that is Latinx negatively relates to prevalence. Interestingly, the relationship between the percentage of the sample that is Black and victimization prevalence seems to depend on the type of victimization measured. There are not consistent patterns in prevalence for studies that use all-prison compared to all-jail samples, or studies conducted in single versus multiple states. The prevalence estimates drawn from studies described as nationally representative by the authors are markedly lower than those reported in any other study.
The small number of studies that use certain victimization types prohibits the use of t-test and correlations to identify statistically significant relationships between prevelance and study characteristics. Such tests lack the statistical power to produce credible results. We recommend reviewing these findings with caution; they should only be interpreted as providing tentative evidence of a relationship that can be the subject of future research. However, the fact that these disaggregated analyses largely corroborate the pooled analyses adds robustness to our study’s findings. These supplemental analyses suggest that that the findings in the main pooled analysis are not driven only by one type of abuse or neglect.
