Childhood Trauma, Mental Health, and Victimization Among Incarcerated Women in Iran: A Cross-sectional Study

Abstract

Background: Victimization represents a complex challenge in the lives of incarcerated women, often rooted in adverse childhood experiences. The consequences of early trauma may be further intensified within the violent and stressful prison context. Understanding these pathways is essential for designing effective interventions. Objectives: This study examined the relationships among childhood trauma, mental health, and victimization experiences among incarcerated women in Iran. Methods: A cross-sectional survey was conducted from July to November 2023 among 106 female prisoners from Yazd and Shiraz prisons. Participants were selected through purposive non-probability sampling, and recruitment from two prisons was used to achieve an adequate sample size. Eligible participants were women aged 18 - 60 years with a minimum of one year of incarceration and documented or self-reported histories of childhood abuse. Data were collected using the Childhood Trauma Questionnaire (CTQ), the Childhood Adverse Experiences Questionnaire (CEQ), the Bullying-Victimization Scale (BVS), and the Mental Health Questionnaire (MHQ). Standardized procedures, interviewer training, validated instruments, and confidentiality safeguards were applied to reduce bias. Data were analyzed using correlation tests and structural equation modeling (SEM) in SPSS 25 and AMOS 27, with age, education, and socioeconomic status controlled as covariates. Results: Participants ranged in age from 18 to 60 years (34.4 ± 11.02). Regarding education, 49.1% had less than a high school diploma. In terms of socioeconomic status, 44.3% reported low and 55.7% reported middle to high status. Childhood trauma significantly predicted poorer mental health outcomes and higher levels of victimization during incarceration [β = 0.41, 95% CI (0.23, 0.58), P < 0.001]. The structural model demonstrated acceptable fit indices (CFI = 0.92, RMSEA = 0.032, TLI = 0.91). The SEM indicated that childhood trauma and mental health explained 23% of the variance in victimization, while the multiple regression model with control variables explained 52.9%. Conclusions: Findings highlight the critical role of childhood trauma in shaping mental vulnerability and victimization among incarcerated women. The results emphasize the need for trauma-informed and mental health–focused interventions in correctional settings. However, due to the non-probability sampling and modest sample size, generalizability should be approached with caution.