Social Work Research – Professor M. Ragonese 10/10/12 Hillel Greene Examining the Similarities of Negative Adjustment by Veterans and Ex-Offenders in the Re-Entry Process Research Problem: The distress veterans encounter when returning home and re-integrating into society have been well documented (Doyle & Peterson, 2005; Ritchie,2005; Zajtchuk, 1995). Post Traumatic Stress Disorder is much discussed (Riggs & Sermanian, 2012), but a soldier's return home can also be accompanied by anxiety, adjustment disorder, psychotic behavior, and substance abuse, among other issues (Marshall, Prescott, Liberzon, Tamburrino, Calabrese, & Galea, 2012; Wain, 2005). While these problems arise from internal feelings, the complications grow when interpersonal/relational situations are introduced. Interpersonal relationships between returning veterans and spouses for example may be particularly troubled; extended separation can lead to growing apart, infidelity, and divorce. Such conditions can result in strained parent-child relationships with behavioral and
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Social Work Research – Professor M. Ragonese10/10/12Hillel Greene
Examining the Similarities of Negative Adjustment by Veterans and Ex-Offenders in the Re-Entry Process
Research Problem:The distress veterans encounter when returning home and re-integrating into society
have been well documented (Doyle & Peterson, 2005; Ritchie,2005; Zajtchuk, 1995). Post
Traumatic Stress Disorder is much discussed (Riggs & Sermanian, 2012), but a soldier's return
home can also be accompanied by anxiety, adjustment disorder, psychotic behavior, and
substance abuse, among other issues (Marshall, Prescott, Liberzon, Tamburrino, Calabrese, &
Galea, 2012; Wain, 2005). While these problems arise from internal feelings, the complications
grow when interpersonal/relational situations are introduced. Interpersonal relationships between
returning veterans and spouses for example may be particularly troubled; extended separation
can lead to growing apart, infidelity, and divorce. Such conditions can result in strained parent-
child relationships with behavioral and adjustment problems becoming a byproduct contained
within the next generation (Galovski & Lyons, 2004).
Of significant concern are the high levels of stress and severe adjustment veterans face
as they attempt to re-enter society, which have led them to experience depression and trigger
As noted above (Adamson et. al. 2008), PTSD seems to be a pervasive diagnosis in
veterans returning from deployment and recent literature has indicated that PTSD symptoms are
predictive of alcohol abuse (Marshal, 2012), associated with greater marital distress (Riggs,
Byrne, Weathers, & Litz,1998), and lead to higher rates of intimate partner violence (Taft, Street,
Marshall, Dowdall, Riggs, 2007) and higher rates of divorce (Prigerson, Maciejewski &
Rosenheck, 2001). Additionally, studies of children of veterans with PTSD show they experience
greater rates of behavioral problems, academic difficulties, and social impairments
(Harknass,1991; Jordan,1992). Further stress is added to the family when employment is
factored in – previous literature documents soldiers' difficulties coming back to work
(Manderscheid, 2007), concerns with finances (Doyle & Peterson, 2005), and spouses' feelings
of sole responsibility for meeting financial needs of the family (Solomon et al.,1992; Solomon,
Kotler, and Mikulincer,1998). While much literature (Dettbarn, 2012;Mental Health, 2012) has
discussed the prevalence of mental health disorders within the prisoner population, a
significantly smaller amount of attention has been devoted to the damaging effects incarceration
can have on the psyche. Existing research (Woolddredge, Wolff et al., & O'Donnell and Edgar as
cited in Boxer, Middlemass, & DeLorenzo, 2009) would indicate that between 10 to 20% of the
prison population experience physical victimization, thereby creating an environment with an
ever-present threat of physical harm. These encounters with violent victimization and trauma
inducing conditions while incarcerated very well could lead to elevated anxiety for a significant
number of prisoners.
Securing full-time employment continues to be one of the most formidable tasks ex-
offenders face when returning to society (Travis, Solomon, Waul, 2001), and previous research
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records their difficulty engaging with family (Phillips and Lindsay, 2011; Kleis, 2010). Turney,
Schnittker, and Wildeman (2012) documented that recent paternal incarceration increases a
mother's risk of a major depressive episode and her level of life dissatisfaction while a majority
of domestic violence crimes are committed by those who have previously been arrested, with a
significant number having previously violated community supervision (Feder & Henning, 2004).
Exposure to parental incarceration is also associated with higher rates of
maladjustment in children. Similar to the children of certain soldiers
mentioned above who experience behavioral issues, the offspring of
incarcerated parents are more likely than their peers to drop out of school
(Trice and Brewster, 2004) and to be arrested (Murray and Farrington, 2005).
Ex-offenders also cite staying away from negative influences, and abusing drugs or alcohol
(Bahr, Harris, Fisher, Armstrong, 2010) as common issues during community supervision.
Studies (Phillips and Lindsay, 2011) characterize the use of drugs and alcohol as
coping mechanism for ex-offenders in the reentry process and indicate that the onset of
alcohol/substance abuse has been shown to parallel the onset of PTSD in combat veterans
(Gaylord, 2006; Bremner, Southwick, Darnell, Charney,1996). Moreover the level at which one
engages in self-destructive behavior correlates to the severity of one's PTSD symptoms
(Galovski & Lyons, 2004).
Theory:
Modified labeling theory (as described in Winnick & Bodkin, 2008) presumes
stereotyped beliefs are pervasive, and even shared by those so labeled. To account for or manage
a highly discredited status, those labeled will adopt some sort of stigma management strategy,
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including hiding the discredited status (secrecy), avoiding social interaction (withdrawal), and
education (preventative telling). Some ex-offender's deal with their label as an "ex-con" by
immediately owning up to their status; rather than a boss or new personal contact finding out
about their conviction somehow, they will preventatively inform them about their crime or parole
status with the belief that their honesty and forthrightness will be proof of their reform. While
this method of stigma management could result in immediate rejection and further
stigmatization, it also gives the individual greater prospects than withdrawal, which keeps one
positioned outside the opportunity structure, and secrecy which increases tension and precludes
close personal relationships. In modified labeling theory, secondary deviance, such as an arrest
or substance abuse while on parole, is not a direct result of the internalization of the negative
label, but rather an indirect result of coping or stigma management which make deviant behavior
more likely (for example, a parolee who avoids talking to his child's mother might put additional
stress on the relationship, thereby prompting further arguments and her reporting any non-
compliance by the ex-offender to police or parole). Phillips and Lindsay (2011) studied the
struggles of those who were not successful during reentry to identify how these parolees coped
when faced with an impediment to their success reintegration. They identified avoidance as the
predominant method, in which people seek to evade the precipitators of stress with methods such
as abusing substances, avoiding stressors, such as family and treatment, isolating oneself from
friends or family, and engaging in high risk sexual behavior. While avoidance may produce
positive outcomes shortly after applying the strategy, it is associated with negative long-term
outcomes (Suls & Fletcher, 1985).
Ex-offenders' internalization of society's label as pariahs leads them to anticipate
rejection and believe they will be better off if they can hide their status or withdraw from social
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situations where their presence may create a negative reaction. Veterans of OIF and OEF may be
experiencing modified labeling theory in similar ways for various reasons; encountering
tremendous fanfare and proclamations of heroism may reinforce the military culture into which
they were indoctrinated, which trains them to think they should be able to withstand any amount
of pressure and manage any challenge. This mindset increases the stigma surrounding obtaining
mental health treatment and may result in a soldier who is suffering from PTSD, depression or
another disorder, to resort to alternative coping mechanisms. Alternatively, the increased reports
by news media and scholarly journals has drawn attention to the numbers of soldiers returning
from deployment with PTSD and other issues – an individual may seek to avoid being
collectively diagnosed with a group of cohorts simply due to his/her veteran status with a label
that society has characterized as damaged. As with ex-offenders, coping by avoidance may lead
veterans to further isolation and secrecy, the maintenance and stressors of which compel them to
cope via maladaptive mechanisms (e.g. lashing out at family, drug/alcohol abuse, etc.).
Rational for Research:
The similarities in environment and perpetual reproduction of experiences resulting in negative
adjustment requires that researchers examine--in the hopes of determining and alleviating--the
causes of the issues that individuals face upon their reentry into society. Ex-offenders'
internalization of society's label as pariahs leads them to anticipate rejection and believe they will
be better off if they can hide their status or withdraw from social situations where their presence
may create a negative reaction. Veterans of OIF and OEF may be experiencing modified labeling
theory in similar ways for various reasons; encountering tremendous fanfare and proclamations
of heroism may reinforce the military culture into which they were indoctrinated, which trains
them to think they should be able to withstand any amount of pressure and manage any
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challenge. This mindset increases the stigma surrounding obtaining mental health treatment and
may result in a soldier who is suffering from PTSD, depression or another disorder, to resort to
alternative coping mechanisms. Alternatively, the increased reports by news media and scholarly
journals has drawn attention to the numbers of soldiers returning from deployment with PTSD
and other issues – an individual may seek to avoid being collectively diagnosed with a group of
cohorts simply due to his/her veteran status with a label that society has characterized as
damaged. As with ex-offenders, coping by avoidance may lead veterans to further isolation and
secrecy, the maintenance and stressors of which compel them to cope via maladaptive
mechanisms (e.g. lashing out at family, drug/alcohol abuse, etc.). This study proposes
exploratory research to examine and compare the reentry processes, with particular attention to
the barriers and supports both returning soldiers and ex-offenders encounter when returning
home, seeking to determine if they are negatively affected by their label. It will consider
approaches that may allow for other means of coping with an aim of identifying treatment
models that would be effective when applied to both populations. Research questions will
include: Do veterans associate a level of stigma with their label which precludes them from
obtaining mental health treatment? If so, is it due to a feeling of invulnerability inculcated by
military culture, or their anticipation of being classified as part of a damaged population? Do
veterans, like ex-offenders, incur problems during reentry due to developing maladaptive coping
mechanisms due to avoidance and secrecy? Would the preventative education strategy
successfully used by many ex-offenders produce positive results for veterans or would they feel
further stigmatized? Are there coping mechanisms veterans have used successfully during
reentry which ex-offenders might attempt to use? These questions indicate further research is
needed in this area and that these populations could benefit from being studied in conjunction.
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What is Negative Adjustment?
Merriam-Webster defines adjusted as having achieved an often specified and usually harmonious
relationship with the environment or with other individuals. A negative adjustment therefore
would involve a person with a disharmonious relationship with their environment and/or other
individuals. The literature documents individuals from these populations having issues in their
personal lives regarding employment, substance abuse, a predilection for risk-taking behavior,
their personal behavior within the family unit, and how the family unit is affected by the person's
behavior. These categories are explored below with operationalized definitions as indicators of
negative adjustment.
Variables:
Population:
In attempting to examine the difficulties faced by veterans and ex-offenders for this study we
must first look at the existing literature to see how previous researchers have defined these
populations and measured their adjustment to reentering society. The term veteran can apply to
individuals associated with a host of many different branches of service and time periods. For the
purposes of this study, U.S. military servicemembers who were deployed overseas since 2001,
with Operation Iraqi Freedom (OIF) or Operation Enduring Freedom (OEF) will be focused on
based on their recent experiences and the possible therapeutic implications this study may find
for this population which continues to struggle with issues of readjusting to society. Most studies
involving ex-offenders utilize individuals on parole, or those reentering society from prison, jail,
or another detention facility of some kind. Participants of this study will be on federal
supervised release following a custody term in the Bureau of Prisons. As these populations are
both heavily compromised of men, the study will focus on recruiting men over the age of 18.
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Reentry is often referred to as the process after which prisoners are released and return back to
the community, for the purposes of this study it will be expanded to refer to the time period
veterans return home from deployment.
Employment:
As mentioned above, securing and maintaining full-time employment continues to be a major
challenge for both ex-offenders face and veterans,(Travis, Solomon, Waul, 2001; Manderscheid,
2007). Concerns with finances (Doyle & Peterson, 2005), and spouses' feelings of sole
responsibility for meeting financial needs of the family (Solomon et al.,1992; Solomon, Kotler,
and Mikulincer,1998) has been documented as well. As such, the variable for participants'
employment status will be considered with unemployment for a period over 6 months or having
worked numerous jobs since the start of reentry with each lasting on average less than 3 months,
as measures of indicators of negative adjustment.
Personal Behavior within Family:
The most notable effects currently being reported regarding veterans returning from Iraq and
Afghanistan are portrayed as symptoms of Post-Traumatic Stress Disorder (PTSD). Adamson et.
al. (2008), notes that PTSD seems to be a pervasive diagnosis in veterans returning from
deployment and recent literature has indicated that PTSD symptoms are associated with greater
marital distress (Riggs, Byrne, Weathers, & Litz,1998), lead to higher rates of intimate partner
violence (Taft, Street, Marshall, Dowdall, Riggs, 2007) and higher rates of divorce (Prigerson,
Maciejewski & Rosenheck, 2001). Previous research (Phillips and Lindsay, 2011; Kleis, 2010)
similarly records the difficulty ex-offenders encounter engaging with family upon returning
home. Turney, Schnittker, and Wildeman (2012) documented that recent paternal incarceration
increases a mother's risk of a major depressive episode and her level of life dissatisfaction while
13
a majority of domestic violence crimes are committed by those who have previously been
arrested, with a significant number having previously violated community supervision (Feder &
Henning, 2004). In order to measure any stress in the relationship between the participant and his
spouse, researchers would include reports of withdrawal by participant from family activities,
and changes in marital status such as divorce or separation, complaints by participant's spouse of
decrease in their own mental wellbeing or abuse by the participant (physical, verbal or
emotional), and conversely, reports of feeling supported by loved ones.
Effects on Family:
The presence of children in the home adds an additional factor to measure in the participant's
reintegration into the family unit. The offspring of incarcerated parents are more likely than their
peers to drop out of school (Trice and Brewster, 2004) and to be arrested (Murray and
Farrington, 2005). Similarly, studies of children of veterans with PTSD show they experience
greater rates of behavioral problems, academic difficulties, and social impairments
(Harknass,1991; Jordan,1992). Measurement of academic or behavioral problems being
experienced by participant's children would include drug or alcohol use, arrest, formal discipline
by school officials (including academic probation for poor grades), and an uncharacteristically
negative attitude toward other family members/withdrawal from family activities.
Substance Abuse:
Ex-offenders advise that abuse of drugs or alcohol (Bahr, Harris, Fisher, Armstrong, 2010) is a
common recurring problem during community supervision. Phillips and Lindsay, (2011)
characterize the use of drugs and alcohol as coping mechanism for ex-offenders in the reentry
process and research that indicates that the onset of alcohol/substance abuse has been shown to
parallel the onset of PTSD in combat veterans (Gaylord, 2006; Bremner, Southwick, Darnell,
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Charney,1996), is indicative that soldiers may similarly be using alcohol to cope with PTSD
symptoms. As such, abuse of alcohol or prescription medication (having 5 or more drinks per
occasion at least once per week/taking medication that was prescribed for someone else or taking
one's own prescription in a manner or dosage other than what was prescribed), and use of any
illegal drug would be included as a measure of negative adjustment under this study's variables.
Predilection toward Risk:
Ex-offenders also cite staying away from negative influences as an issue during community
supervision (Bahr, Harris, Fisher, Armstrong, 2010) as association with others who have been
previously incarcerated can often lead to poor decision making and a groupthink mentality
leading to adverse consequences. Veterans are not as notorious for criminal behavior when they
are in one another's company as ex-offenders, however Killgore et al. (2008), found that soldiers
who saw combat were more likely to engage in risky behavior upon their return from
deployment. This finding, coupled with the idea that only a fellow soldier can truly understand a
veteran's experiences, may lead to evidence of cohorts of veterans engaging in various dangerous
activities and risky behavior that has negative costs similar to the groups of ex-offenders. The
final determinant of negative adjustment will be the participant's self-report of association with
cohorts previously convicted of a felony, involved in criminal activity, or consistently (at least
once a month) engaged in risky behavior (driving while under the influence, promiscuous sexual
behavior without protection, fighting, carrying a weapon, regular gambling(weekly), arrest,
incarceration, and hospitalization – depending on circumstances).
Methodology:
As no research has yet been undertaken comparing this populations, this study would use a
mixed methods approach seeking to administer surveys and perform qualitative interviews as
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needed for follow-up purposes with a minimum of ten and as many as twenty participants from
each population over the course of six weeks in order to determine if further studies with larger
groups are warranted.
Participants:
Criteria for ex-offenders would include a term of imprisonment of at least 6 months and veterans
would need to have been deployed overseas for at least the same amount of time. Participants
from both populations would have begun the reentry process at least 6 months prior to the
interview in order to provide adequate time for assessment.
Data Collection:
Possible participants will be screened at a local parole office and veteran's hospital (permission
to be obtained by administrators) following which interviews will take place either immediately
onsite or at a time and place convenient to the interviewee. If needed, additional participants may
be collected via snowball sampling. Upon IRB approval, the Coping Inventory for Stressful
Situations (Endler & Parker, 1999) would be purchased and administered to determine if
participants are coping via avoidance or other methods, and a customized questionnaire
(attached) would be utilized to assess level of difficulty participants have experienced in
adjustment.
Analysis:
Participants of the study would need to indicate a moderate level of difficulty in adjustment in at
least 2 out of the 5 variables defined above (employment, personal behavior within family,
effects on family, substance abuse, and predilection towards risk) or severe difficulty in one
variable on the attached survey to qualify as experiencing a negative adjustment during reentry.
This data would be broken down into the two populations and compared with one another to
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measure where each is having issues adjustment issues, the possible causes, and the supports
each have received to evaluate where further resources should be focused for future research and
programming.
As such, it is this researcher's contention that this study will appropriately measure trouble in
reintegration based on the previous literature with a definition of negative adjustment
incorporating the factors of employment status, home life, abuse of alcohol and illegal
substances, and association with peer groups in which they engage in self-destructive behavior as
explained above. Follow-up qualitative interviews of veterans who have experienced little issue
in adjusting upon their return may help shed light on how they have avoided the pitfalls into
which their comrades are becoming increasingly entrenched. Such information on positive
supports or coping strategies may also be helpful for ex-offenders returning to society from long
periods of incarceration who have a history of failing to positively reintegrate during reentry.
Simultaneously, the previous research and continued study of ex-offenders, who have long-
suffered negative effects due to ill-repute, can possibly benefit veterans who are currently
experiencing their own epidemic of stigmatization and assist them in obtaining the interventions
needed to make their safe return home successful.
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