Purpose of Study: A theoretical integration of
the life course perspective, cumulative advantage,
disadvantage or inequality, and stress processing
theories provide an important integrated lens to study
the relationship between accumulated interpersonal,
social-structural, and historical trauma and stressful
experiences on mental well-being mental well-being
in later life. Design and Methods: This study
builds upon the extant literature by examining the
mediating role of coping resources on the relationship
between trauma and stressful life experiences,
post traumatic stress symptoms, and mental
well-being among a sample of 677 adults aged
50 and older in prison. Results: The majority
(70%) reported experiencing one or more traumatic
or stressful life experiences during their life
span. Participants also reported on average 11
occurrences of multilevel trauma and stressful life
events and lingering subjective distress related to
these events. Results of a structural equation model
revealed that internal and external coping resources
(e.g., cognitive, emotional, physical, spiritual, and
social) had a significant and inverse effect on the
relationship between trauma and stressful life experiences
and mental well-being. Implications: As
prisons are forced to deal with an aging population,
research in this area can take the preliminary steps to
enhance understanding of risk and resilience among
older adults in prison. This understanding will aid in
the development and improvement of integrated theory-based
interventions seeking to increase human
rights, health, and well-being among older adults in
prison.
Key Words: Trauma, Violence, Abuse, Stress, Older
adults, Prisoners, Well-being, Coping, Coping
resources, Structural equation modeling, Life stressors
checklist, Coping Resources Inventory, Post Traumatic
Stress Scale, Brief Symptom Inventory
United States’ prison system is increasingly
aging and overcrowded. In 2010, adults aged 50
and older comprised nearly 11% (246,600) of
the 2.3 million general prison population (ACLU,
2012). The aging prison population is now over
twice as large as it was in 2001 (n = 113,358) and
nearly eight times (33,499) larger than it was in
1990 (Aday, 2003). This growth in the aging prison
population has been attributed to an overall growth
in the older adult population and the passage of
the stricter sentencing laws in the 1980s, such as
“Three Strikes You’re Out,” that resulted in longer
prison sentences (Rikard & Rosenberg, 2007). As
a result, the adult correctional system is grappling
with an aging population in need of specialized
long-term care (HRW, 2012).
Older adults in prison pose a significant challenge
because of their complex health and social
care needs; between 16% and 36% of older adults
in prison have been diagnosed with mental health
problems (James & Glaze, 2006). Older adults in
prison also have a host of physical health problems,
including arthritis (33%), hypertension
(32%), tuberculosis (16%), and HIV/AIDS (10%)
(Maruschak, 2008). Furthermore, the stressful conditions
of prison confinement are associated with
an accelerated aging process such that incarcerated
persons aged 50 and older have health profiles
equivalent to their counterparts in the community
who are aged 65 and older (Aday, 2003). The literature
also suggests that older adults in prisons fear
for their physical safety because of their diminishing
ability to defend themselves from younger prisoners
(Kerbs & Jolley, 2007).
Despite exposures to traumatic experiences
and stressful life experiences, not all incarcerated
persons have compromised mental well-being.
Protective factors, such as coping resources, may
account for the apparent resilience of those incarcerated
who also have cumulative trauma and
stressful experiences (Baum and Singer, 1982).
Marting and Hammer (2004) defined coping
resources as “those resources inherent in individuals
that enable them to handle stressors more effectively,
to experience fewer or less intense symptoms
upon exposure to a stressor, or to recover faster
from exposure” (p. 2). Social support may be a
particularly beneficial coping resource by increasing
an individual’s capacity to lessen emotional
and psychological distress in response to trauma
and stressful life experiences (traumatic and stressful
life experiences; Jacoby & Kozie-Peak, 1997;
Haslam and Reicher, 2006). In a sample of 102
older adults in prison, Aday (2005) explored how
family and institutional social support influenced
incarcerated persons’ feelings of distress related to
dying and found that higher levels of social support
had a significant and inverse relationship to
older adults’ fear of death.
Theoretical Perspectives
A theoretical integration of the life course perspective,
cumulative advantage, disadvantage or inequality, and stress processing theories provide an
important integrated lens to study the relationship
between accumulated interpersonal, social-structural,
and historical trauma and stressful experiences
on mental well-being in later life (Elder, 2003;
Pearlin & Skaff, 1996; Pearlin, Schieman, Fazio, &
Meersman, 2005; Sampson & Laub, 1997). Based
on Elder’s (1974) work, the life course perspective
posits that significant life events, which can be personal
(e.g., sexual victimization) and/or historical or
social-structural (e.g., world war or unfair policies
and practices), influence the life course trajectories
of individuals. Stress process theory informs the life
course theory by emphasizing how the magnitude of
a single adverse event or the stacking of cumulative
events influence individuals’ life course subjective
experiences, including later life mental well-being
(Pearlin et al., 2005). Similarly, cumulative advantage/disadvantage
theories posit that social-structural
disadvantages, such as socioeconomic status
and education, may influence later life health and
well-being (Sampson & Laub, 1997).
According to stress process theory, individuals
who have relatively stable life experiences, such as
being mostly free of traumatic and stressful life experiences,
generally develop relatively stable life course
trajectories, including stable mental well-being
(Pearlin et al., 2005). On the other hand, individuals
who experience one or more difficult periods of
chaos or change, combined with the stressful conditions
of institutional confinement, are exposed
to heightened risk of adverse mental well-being.
Among older adults in prison, these experiences may
include being exposed to childhood physical and
sexual victimization, the unexpected death of a loved
one, being diagnosed with a serious illness, combat,
natural, and manmade disasters, and financial stress
or poverty (Maschi, Dennis, Gibson, Sternberg, &
Hom, 2011; Maschi, Kwak, Ko & Morrissey, 2012;
Maschi, Morgen, Viola & Koskinen, 2013).
As a collective, these theories provide a conceptual
model in which internal and external coping
resources act as a protective mediating mechanism
that can reduce the adverse consequences of life
course cumulative trauma on mental well-being in
later life. This is especially important to consider
for vulnerable populations, such as older adults in
prison who may experience a lifetime of cumulative
trauma and stress, INCLUDING REENTERING
THE COMMUNITY FROM PRISON (Maschi,
Leigey, & Morrissey, 2013).
The adaptive use of internal and external coping
resources may help foster a resilient response or
The Gerontologist
the accumulation of “protective advantages” over
prior and current adverse experiences to help older
adults better manage the prison experience (Maschi
et al., 2013). The adoption of internal coping
resources, (e.g., cognitive, emotional, physical,
and spiritual) and external coping resources (e.g.,
social support) can help to explain why some older
adults in prisons with histories of trauma may
experience decreased mental well-being, whereas
others remain resilient to their adverse affects.Summary and Hypotheses
In summary, research shows that there is a high
frequency of accumulating traumatic and stressful
life experiences among criminal justice populations,
including older adults in prison. Cumulative
traumatic and stressful life experiences are positively
correlated with decreased mental well-being.
Consistent with life course and stress process theories,
internal and external coping resources offer a
protective advantage for mental well-being in later
life. Yet, an often overlooked vulnerable population
in older adults in the criminal justice system,
including in prison (Maschi, Sutfin, & O’Connell,
2012). This study builds upon the extant literature
by examining the mediating role of coping
resources on the relationship between traumatic
and stressful life experiences, post traumatic stress
symptoms, and mental well-being among a sample
of 677 older adults in prison. Using self-report
data from an anonymous mail survey and structural
equation modeling, the following mediational
model was tested: Coping resources will significantly
influence the relationship between traumatic
and stressful life experiences, post traumatic stress
symptoms, and mental well-being among older
adults in prison (Figure 1). This information can be
used to develop or improve mental well-being prevention,
intervention, and advocacy efforts geared
toward older adults at risk of or involved in the
criminal justice system.
Methods
Research Design
This cross-sectional study was conducted in
September 2010 in the New Jersey Department of
Corrections (NJ DOC). The survey sample consisted
of 677 English speaking incarcerated persons
(aged 50 and older). Of the approximately
25,000 adults housed in the NJ DOC in January
2010, 7% (n = 1,750) were aged 50 and older.
The NJ DOC generated the sampling frame for
the study with a list of names, so that invitations
and anonymous questionnaires could be mailed to
potential participants and return correspondence
could be received. We used the Dillm