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September 2, 2019

"Association of Parental Incarceration With Psychiatric and Functional Outcomes of Young Adults"

The title of this post is the title of this notable new article recent published via JAMA Network Open and authored by Elizabeth Gifford, Lindsey Eldred Kozecke, Megan Golonka, Sherika Hill, E. Jane Costello, Lilly Shanahan and William Copeland. Here are its "Key Points" and its "Abstract":

Key Points

Question Is parental incarceration associated with increased odds of offspring receiving psychiatric diagnoses during young adulthood and experiencing obstacles that can derail a successful transition to adulthood (eg, in health, legal, financial, and social domains)?

Findings This cohort study, using data from a community-representative, longitudinal study, found that parental incarceration was associated with young adults’ increased odds of having an anxiety disorder, having a felony charge, spending time in jail, not completing high school, becoming a parent when younger than 18 years, and being socially isolated.

Meaning The findings suggest that parental incarceration is associated with offspring’s functional outcomes during young adulthood.


Importance In 2016, an estimated 8% of US children younger than 18 years had experienced the incarceration of a parent, and rates were substantially higher among children from racial and ethnic minority backgrounds and disadvantaged groups.  Little is known about whether parental incarceration during childhood is associated with adult psychiatric problems and functional outcomes.

Objective To examine whether parental incarceration is associated with increased levels of psychiatric diagnosis and poor outcomes in health, legal, financial, and social domains in adulthood.

Design, Setting, and Participants This cohort study used data from the community-representative, prospective, longitudinal Great Smoky Mountains Study. Children and their parents were interviewed up to 8 times from January 1993 to December 2000 (ages 9-16 years; 6674 observations of 1420 participants) using the Child and Adolescent Psychiatric Assessment, which assessed parental incarceration, childhood psychiatric diagnoses, and other adversities.  Young adults were followed up at ages 19, 21, 25, and 30 years from January 1999 to December 2015 (4556 observations of 1334 participants) to assess psychiatric diagnoses and functional outcomes indicative of a disrupted transition to adulthood. Data analysis was conducted from June 2018 to June 2019.

Results By age 16 years, 475 participants (weighted percentage, 23.9%) had a parental figure who had been incarcerated, including 259 young men (22.2%) and 216 young women (25.5%).  Parental incarceration was associated with higher prevalence of childhood psychiatric diagnoses (eg, any depressive diagnosis: adjusted odds ratio [aOR], 2.5; 95% CI, 1.3-4.6; P = .006; attention-deficit/hyperactivity disorder: aOR, 2.3; 95% CI, 1.0-5.5; P = .06; and conduct disorder: aOR, 2.5; 95% CI, 1.4-4.3; P = .001).  After accounting for childhood psychiatric diagnoses and adversity exposure, parental incarceration remained associated with increased odds of having an adult anxiety disorder (aOR, 1.7; 95% CI, 1.0-3.0; P = .04), having an illicit drug use disorder (aOR, 6.6; 95% CI, 2.6-17.0; P < .001), having a felony charge (aOR, 3.4; 95% CI, 1.8-6.5; P < .001), incarceration (aOR, 2.8; 95% CI, 1.4-5.4; P = .003), not completing high school (aOR, 4.4; 95% CI, 2.2-8.8; P < .001), early parenthood (aOR, 1.7; 95% CI, 1.0-3.0; P = .04), and being socially isolated (aOR, 2.2; 95% CI, 1.2-4.0; P = .009).

Conclusions and Relevance This study suggests that parental incarceration is associated with a broad range of psychiatric, legal, financial, and social outcomes during young adulthood. Parental incarceration is a common experience that may perpetuate disadvantage from generation to generation.

September 2, 2019 at 03:33 PM | Permalink


I didn't read past Doug's post but it seems a robust study. My main concern would be this: "Great Smoky Mountains Study". It other words, Appalachia. I'm not sure that what we see in that area of the country would be generalizable to other areas of the country. I suspect it would but a study with a broader geographical base would be better,

Posted by: Daniel | Sep 2, 2019 6:02:06 PM

"Is associated" isn't particularly helpful from a policy point of view. For example, perhaps having a parent who is apt to commit crimes causes both an incarcerated parent and poor outcomes for the children.

Posted by: William C Jockusch | Sep 5, 2019 10:23:18 AM

To follow up on the prior post, are we talking correlation or causation. In other words, is the increased risk comparing these children to children in your "typical" family. Or are we comparing these children to the children in your typical "probationer" family.

Given what we know (or at least think we know), a significant segment of the criminal population have psychiatric/behavioral issues and these psychiatric/behavioral issues are likely to create a home environment that lead to psychiatric/behavioral problems in the next generation. So I would expect to find that both children of incarcerated parents and children of parents who are merely under supervision would be more likely to have psychiatric/behavioral problems than the children of parents who do not have any serious psychiatric/behavioral issues. So the real issue is whether most of the increased risk comes from having "criminal" parents or from having incarcerated parents.

Posted by: tmm | Sep 6, 2019 5:42:04 PM

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