Date of Degree

9-2015

Document Type

Dissertation

Degree Name

Ph.D.

Program

Criminal Justice

Advisor(s)

Hung-En Sung

Subject Categories

Criminology | Criminology and Criminal Justice

Keywords

Correctional Health; Corrections; New York City Jail; Prison/Jail; Rikers Island; Traumatic Brain Injury

Abstract

There is a higher prevalence of traumatic brain injury (TBI) among incarcerated population than in the general population. It is possible that head injuries can lead to behavioral difficulties, increasing the risk of criminal justice involvement and custodial difficulties. Principles of bio-social criminology put forth that the interaction between people's environment and their biological makeup that can lead to maladaptive behaviors. One of the main domains within the bio-social criminology approach is neurocriminology; neurocriminology uses principles of neuroscience to better understand delinquent and antisocial behaviours and suggests that brain injury can interact with environmental factors to produce seemingly aggressive and antisocial behaviors. Using this theoretical framework, the current study set out to investigate neurological anomalies related to TBIs and custodial challenges among adolescents in Rikers Island, New York City Jail. Goals of the study included establishing the prevalence of TBI in this population; exploring and characterizing TBI as a predictor of custodial arguments, fights, injuries, and sentences to punitive segregation; and examining TBI as a predictor of recidivism and perceived challenges with reentering the community. A mixed methods approach attained these goals through two major objectives: Quantitative analysis of survey, clinical, demographic and criminal history data collected from 262 detainees; and 2) Qualitative analysis of in depth semi-structured interviews with 20 detainees. Subjects included 16-18 year old males. In the quantitative phase, secondary data analyses was conducted using an existing data set compiled by the New York City Department of Health and Mental Hygiene from participants (N=262) who were screened for TBI using the Traumatic Brain Injury Questionnaire (TBIQ). Binary logistic regressions and survival Cox regression analyses discovered that in this sample, TBI was not a predictor of injuries, punitive segregation terms or recidivism, while controlling for demographic, socioeconomic, and other risk factors. However, mental health service utilization was a strong predictor of all outcomes and was highly correlated with TBI. Structural equational modelling suggested that TBI had an indirect effect on all outcome variables through mental health service utilization. It is possible that those who were involved in arguments, fights, infractions, punitive segregation, and who recidivated had accessed mental health services in Rikers due to TBI-related difficulties. These difficulties could have predisposed them to custodial and reentry challenges. The qualitative phase involved in depth semi-structured interviews with 20 detained adolescents. Participants were screened for TBI using the TBIQ, and then asked open ended questions about custodial arguments, fights, and injuries, as well as about their experiences with punitive segregation and perceived challenges upon their release from Rikers. Interviews were transcribed, and organizational and substantive categories were developed to facilitate open coding. Comparative analyses were made between participants with and without TBI, and emergent themes were presented. Findings suggest that participants with TBI experienced unique challenges in relation to verbal arguments and physical fights with other inmates, rapidly escalating physical altercations with corrections officers, weapons-related infractions, punitive segregation, and associated difficulties with coping mechanisms such as self-injury and attempted suicide, and feelings of hopelessness about their reentry into the community. Five themes emerged and detail how what participants with TBI experience in the facility were transferred into their daily activities. Themes included inmates experiencing the following: (a) violence as a norm, (b) the need to survive by all means, (c) a life of ongoing trauma, (d) punitive deprivation and shame, and (e) hopelessness. In converging results from both methods, findings suggest that some inmates with TBI are experiencing custodial challenges, and are being mislabelled as having a mental illness. In addition, many arguments, fights, and injuries were intentionally unreported and therefore undocumented. It is possible that this led to inconclusive findings in analyses of administrative data. Future research should seek to disaggregate the behavioral consequences of TBI and of mental illness, and should attempt to pursue more reliable measures of custodial fights and injuries. Education and training of correctional staff about TBI, its symptoms, and long-term consequences could improve correctional management of these inmates. Screening at intake and at multiple points in an inmate's custodial stay, along with assessment of cognitive functioning can inform appropriate custodial therapy; keeping in mind that brain injury is not synonymous with mental illness, successful interventions will be social rather than medical. Information about TBI should also be considered before (e.g., courts) and after (e.g., reentry planning) an individual is placed in jail. Overall, increased community awareness is essential for prevention and adequate care of people who are suffering from TBIs.

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