Hit, Hurt, and Distressed: How Violence and Trauma Put Women at Risk of Incarceration


This is the first in a series of blog posts on the issue of violence against women and girls. The blog series is brought to you by the APA Committee on Women in Psychology.

By Shannon Lynch, PhD (Professor of Clinical Psychology, Idaho State University)

People in the United States make up approximately 5% of the world’s population but incarcerated people in the U.S. represent 22% of all incarcerated individuals across the world. To illustrate this another way, I live in Idaho, which is ranked 39th for state population in the U.S., but is fourth highest in the rate of incarceration of women (113 per 100,000).

According to the Sentencing Project, the number of women incarcerated between 1980 and 2016 increased by over 700% for a total of 213,722 women in jails or prisons.   More than a million additional women are under correctional supervision on probation or parole. We also know that intersections of identity increase risk of incarceration. Women of color are over-represented in jails and prisons.

sentencing project1
Chart 1

Although the rate of incarceration of Black women declined 50% between 2000 and 2016, Black women are still incarcerated at twice the rate (96 per 100,000 women) of non-Hispanic white women. Rates of incarceration of White and Latina women have increased by 44% and 12% respectively between 2000 and 2016.  Women who are sexual minorities are also incarcerated at higher rates, at about three times that rate of straight identified women9. Living in disadvantaged neighborhoods with higher crime rates also confers increased risk for incarceration3.

sentencing project3
Chart 2

How are women’s experiences of interpersonal violence associated with entry into the criminal justice system?

Feminist pathways theorists argue that women and girls have different risk factors then men for entry into the criminal justice system2. In particular, there is growing recognition that incarcerated women experience high rates of interpersonal violence (IPV) and that their exposure is often repeated and includes multiple forms of violence.

For example, in a study that I coauthored with 491 women in jail, fewer than 10% of women reported no exposure to interpersonal violence while about half reported child sexual abuse, adult sexual assault, and childhood physical abuse with witnessing violence and partner violence reported as the most common experiences (see Chart 37). As you can see from the rates of exposure, most women reported experiencing multiple forms of IPV, with an average of 3.6 types (SD = 2.02) of violence exposure, and just over a third reporting five or more forms of violence.

Chart 3

Experiences of multiple forms of trauma as well as specifically experiencing sexual violence have been linked in longitudinal studies to increased risk of PTSD and substance use in women4, 13. Incarcerated women have high rates of both. In our pathways study of 491 randomly selected women in jail, 53% met criteria for lifetime PTSD and over 80% for substance use disorders6.

We know from qualitative studies with incarcerated women that women link entry into the system to running away to escape abuse, using drugs to cope with abuse, and involvement with violent partners1. There are also a growing number of studies that illustrate intersections of trauma exposure, particularly polyvictimization, and mental health problems among incarcerated women. In our pathways study, we found that mental health (including mental health and substance use disorders) significantly mediated the association between child and adult trauma exposure and offending7.



The Substance Abuse and Mental Health Administration is disseminating information on trauma informed approaches that provide guidance on how to work with survivors of interpersonal violence. They highlight the importance of recognizing the prevalence of trauma and providing trauma informed programming and environments. SAMSHA provides information on evidence-based trauma specific programs as well as elements of developing a trauma informed approach within a care system. These are important tools that could aid our corrections system in identifying and responding to incarcerated women’s treatment needs.

In addition, it is critical that systems coordinate one with another.  The National Commission on Correctional Healthcare issued a policy statement on women’s health in 2014 encouraging collaboration among corrections, public health, community, and public assistance agencies. There are some studies to suggest that coordinated care efforts positively influence women’s outcomes and reduce recidivism (e.g., Matheson et al, 2014), but there is limited information about efforts to coordinate care between corrections and community health care systems and the effectiveness of coordinating care.

Finally, we must take a step back and consider what we label as criminal behavior. Currently, running away from abusive situations, using drugs, and sex work are labeled as criminal acts in the United States. We also label individuals who use illegal substances, engage in sex work or trade sex for drugs, or who “disrupt the peace” as criminals.  We can see direct associations between the reduction in psychiatric beds and increases in incarceration rates11. We are well aware of “victim-offender” overlap, recognizing that many of the individuals at greatest risk of incarceration are also at greatest risk of violence. If we want to change the rate of incarceration in the United States, we must consider how we label and respond to these behaviors, and that in our current system, our social identities (e.g., gender, ethnicity, sexual orientation, SES), experiences of violence, and mental health status are associated with risk of incarceration.



1DeHart, D. (2008). Pathways to Prison. Violence Against Women, 14(12), 1362-1381. doi: 10.1177/1077801208327018

2DeHart, D., Lynch, S., Belknap, J., Dass-Brailsford, P., & Green, B. (2014). Life history models of female offending: The roles of serious mental illness and trauma in women’s pathways to jail. Psychology of Women Quarterly, 38(1), 138-151. http://dx.doi.org/10.1177/0361684313494357

3Harris, B., & Kearney, M.S. (2014). The Unequal Burden of Crime and Incarceration on America’s Poor [Blog]. Retrieved from https://www.brookings.edu/blog/up-front/2014/04/28/the-unequal-burden-of-crime-and-incarceration-on-americas-poor/

4Hedtke, K. A., Ruggiero, K. J., Fitzgerald, M. M., Zinzow, H. M., Saunders, B. E., Resnick, H. S., & Kilpatrick, D. G. (2008). A longitudinal investigation of interpersonal violence in relation to mental health and substance use. Journal of Consulting and Clinical Psychology, 76(4), 633-647. http://dx.doi.org/10.1037/0022-006X.76.4.633

5The Sentencing Project. (2018). Incarcerated Women and Girls, 1980-2016 [Ebook]. Washington, DC. Retrieved from http://www.sentencingproject.org/wp-content/uploads/2016/02/Incarcerated-Women-and-Girls-1980-2016.pdf?eType=EmailBlastContent&eId=de14f0d2-e381-4095-93b8-43ebd6c64b5c

6Lynch, S., DeHart, D., Belknap, J., Green, B., Dass-Brailsford, P., Johnson, K., & Whalley, E. (2014). A Multisite Study of the Prevalence of Serious Mental Illness, PTSD, and Substance Use Disorders of Women in Jail. Psychiatric Services, 65(5), 670-674. doi: 10.1176/appi.ps.201300172

7Lynch, S., DeHart, D., Belknap, J., Green, B., Dass-Brailsford, P., Johnson, K., & Wong, M. (2017). An Examination of the Associations Among Victimization, Mental Health, and Offending in Women. Criminal Justice And Behavior, 44(6), 796-814. doi: 10.1177/0093854817704452

8Matheson, F. I., Smith, K. L. W., Fazli, G. S., Moineddin, R., Dunn, J. R., & Glazier, R. H. (2014). Physical health and gender as risk factors for usage of services for mental illness. Journal of Epidemiology and Community Health, 68(10), 971-978. http://dx.doi.org/10.1136/jech-2014-203844

9Meyer, I. H., Flores, A. R., Stemple, L., Romero, A. P., Wilson, B. D. M., & Herman, J. L. (2017). Incarceration Rates and Traits of Sexual Minorities in the United States: National Inmate Survey, 2011–2012. American Journal of Public Health, 107(2), 267–273. http://doi.org/10.2105/AJPH.2016.303576

10National Commission on Correctional Health Care. (2014). Women’s Health Care in Correctional Settings [Ebook]. Chicago, Illinois. Retrieved from https://www.ncchc.org/filebin/Positions/Womens_Health_Care_in_Correctional_Settings.pdf

11Primeau, A., Bowers, T., Harrison, M., & XuXu. (2013). Deinstitutionalization of the mentally ill: Evidence for transinstitutionalization from psychiatric hospitals to penal institutions1. Comprehensive Psychology, 2(1), Article 2. doi: 10.2466/16.02.13.cp.2.2

12Trauma-Informed Approach and Trauma-Specific Interventions | SAMHSA – Substance Abuse and Mental Health Services Administration. (2018). Retrieved from https://www.samhsa.gov/nctic/trauma-interventions

13Ullman, S. (2016). Sexual revictimization, PTSD, and problem drinking in sexual assault survivors. Addictive Behaviors, 53, 7-10. doi: 10.1016/j.addbeh.2015.09.010






Shannon Lynch, PhD, is a licensed clinical psychologist, a member of the APA Committee on Women in Psychology (2016-2019), a Professor at Idaho State University, and an Associate Editor for Psychology of Women Quarterly. Her research combines quantitative and qualitative methodologies to examine women’s experiences of interpersonal violence and use of resources to cope with and to recover from traumatic events.  For the past 14 years, she has worked with her research team of graduate and undergraduate students and collaborators to assess women’s pathways to incarceration with a specific focus on trauma exposure, mental health, and treatment needs of incarcerated women. Dr. Lynch and her students have provided and evaluated treatment for incarcerated women as well as conducting studies of the prevalence of serious mental illness among incarcerated women and examining potential mediators of trauma exposure and psychological distress. She is currently coauthoring a book with Dana DeHart for Cognella Publishing on intersections of adversity, interpersonal violence, and mental health as risk factors for women entering the criminal justice system.


Image source:

Header image – Getty Images, first two charts (included with permission from The Sentencing Project), third chart (author’s own)


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