This is a review of An Inside View: Women in Prison, Depression and Family Ties by Jennifer D. Johnson.

Family Ties, Depression and Adjustment of Women in Prison in North Carolina

    Since most persons in prison are released, what happens to the incarcerated is of great social importance. The goal of prison may be debated, the effects of prison on those who are deprived of their freedom ideally should be to return to society a functioning adult who is able to get on with life in a normal manner. Do prison programs help?

    Even though far fewer women than men are confined to prisons, in 1998 84,427 women were under the jurisdiction of state and federal correction authorities (Greenfield and Snell 1998). For women, the main concern upon being arrested remains, "Where are my children?" The majority of women in prison are mothers. The loss of self-esteem and identity of women in prison is associated closely with loss of contact with children and family.

    It would seem that the loss of contact with family results in a serious problem of depression for women in prison. Daniel (et al. 1988) found that 22 percent of women in prison may be meet the DMS-III criteria for major depression. In North Carolina Martin (et al. 1995) found 70 percent of women in prison had levels suggesting clinical depression using the well-known CES-D scale (see Radloff 1977). A control group of women not in prison using the same scale showed only 20-30 percent so affected.

    Like many 20-item scales, the CES-D scale asks respondents to answer a question using a Likert scale. For example, in the past week you might be asked, "I had trouble keeping my mind on what I was doing." The possible responses are: rarely or none of the time (score 0); some of the time (1-2 days) (score 1), occasionally or a moderate amount of time (3-4 days) (score 3); and finally, most or all of the time (5-7 days) (score 3).

    The literature on adjustment of women to prison also suggests that women who participate in prison activities such as bible clubs, attend classes on child rearing skills or participate in similar activies may be more successful upon release than those women who simply ignore the prison programs designed by officials to 'help' them.

    The current study was designed to study the effects of prison visitation, family contact and prison programs on measured depression in women. A facility for women in North Carolina was studied with a total of 62 women responding, a majority of those in the facility. A factor analysis of the 20 questions of the CES-D scale revealed 5 groupings reflecting depression, feelings of despair, expressions of happiness, feelings of dejection and lastly expressions of failure and disappointment. These variables were considered dependent while prison activities, visitations and other factors such as a history of alcohol abuse are the independent variables.

    The results find that symptoms of depression among women in prison decrease as the number of visits goes up. Happiness also increases with the number of visits. Women who have no children under the age of 18 are also happier than average, showing that separation of children from the mother is a major problem for the prison system. The young show more symptoms of distress than older offenders, while white inmates show more despair than non-whites. A history of alcohol abuse is another predictor of increased depressive symptoms in prison.

    Women who were most likely to participate in prison groups were in fact least happy when stepwise regression analysis was undertaken, confirming the zero-order correlation (see Table 1). From a policy point of view this is somewhat surprising, since prison activity programs are set up to help an inmate adjust not only to prison, but to life on the outside.

                   Table 1

          Stepwise Regession Analysis of Happiness
                  Among Women in Prison

Variable           multiple r   Standardized Beta  Significance
Number of visits
in the past week     .331          .343               .004

Total number of
prison groups
participated in      .443         -.323               .007

Children under 
age 18: 1=yes,
2= no.               .502          .238               .044

On the other measures, there was no correlation beteween the number of prison groups participated in and any of the scales.

    In conclusion, there is no doubt that the more involved women were with the outside world, the fewer symptoms of depression they showed. Happiness went up. The findings do show that women in prison need frequent visitations from family and friends to maintain positive mental health.

    But from a policy view, it would seem that prison programs designed to help the inmate adjust to prison are probably irrelevant in relieving symptoms of depression or boosting happiness among the inmates. For most scales, group participation had no effect, whole those who were in the most groups were unhappy. Perhaps the best interpretation which can be put on this finding is one of self-selection. Those who were least happy were jumping into activities to take their minds off their current situation.

    Or, could we conclude that prison programs need to be reconsidered and that they actually increase unhappiness? That is certainly one possibility raised. Is it really surprising to find that family contact helps while contact with officials reduces happiness? Of course, perhaps we should not even consider such a reductionistic possibility!


Daniel, A. E. et al (1988). "Lifetime and six-month Prevalence of Psychiatric Disorders among Sentenced Female Offenders." Bulletin of the American Academy of Psychiatry and the Law 16(4): 333-342.

Martin, S. (et al.) (1995). "Family Violence and Depressive Symptomology among Incarcerated Women." Journal of Family Violence 10 (4):399-411.

Greenfield. L.A. and T. Snell (1999). Bureau of Justice Statistics Special Report: Women Offenders. U.S. Department of Justice, Washington, DC.

Radloff, L. S. (1977). "The CES-D Scale: A Self-Report Depression Scale for Research in the General Population." Applied Psychological Measurement 1 (3): 385-401.

Review by George H. Conklin
Thesis advisor: George H. Conklin
Source: Sociation 26:3, October/November 2000, p. 2.

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