775751

research-article2018
JIVXXX10.1177/0886260518775751Journal of Interpersonal ViolenceCaravaca-Sánchez and Wolff

Original Research
Journal of Interpersonal Violence
1­–27
Understanding © The Author(s) 2018
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DOI: 10.1177/0886260518775751
https://doi.org/10.1177/0886260518775751
Prison: Prevalence and journals.sagepub.com/home/jiv

Predictors Among Men

Inmates in Spain

Francisco Caravaca-Sánchez, PhD,1

and Nancy Wolff, PhD2

Abstract
Victimization—physical, sexual, and emotional—is part of prison life for a
sizable proportion of incarcerated people. Research has primarily focused
on the prevalence and predictors of physical or sexual victimization inside
prisons located in the United States. Very little prison-based victimization
research has been conducted in other countries, and even less has examined
the clustering patterns of victimization (referred to as polyvictimization),
and whether different demographic, behavioral health, and criminal risk
factors are associated with polyvictimization. This article explores variation
in victimization patterns during incarceration in Spain, and whether there
is variation in the demographic, behavioral, and criminal risk factors
predicting one type (physical, sexual, or emotional); two types (physical and
sexual, physical and emotional, or sexual and emotional); or three types
(physical, sexual, and emotional), as well as the number of different types
of victimization distinguished by type of perpetrator. Self-report data were
collected from 2,484 male inmates housed in eight adult prisons in Spain.
More than half the sample reported at least one type of victimization, and
one quarter reported two or more types of victimization. Polyvictimization

1Pablo de Olavide University, Seville, Spain

2Rutgers, The State University of New Jersey, New Brunswick, USA
Corresponding Author:
Francisco Caravaca-Sánchez, Department of Social Work and Social Services, Pablo de
Olavide University, Ctra. de Utrera, 1, Seville 41013, Spain.
Email: fcarsan@upo.es
2 Journal of Interpersonal Violence 00(0)

was found to be strongly associated with prior childhood and adulthood

victimization experienced in the community. These findings have significant
policy and practice implications.

Keywords
victimization, polyvictimization, prison, male prisoners, Spain

Introduction
Over the past decade, prison-based research has increasingly focused on the
types, levels, and predictors of victimization experienced by inmates during
incarceration. Inmate victimization is the product of institutional violence,
defined as physical, verbal, and/or sexual aggression, whether actual,
intended, or threatened in an institutional setting (Gadon, Johnstone, &
Cooke, 2006). Most often, institutional violence is divided into two general
types: physical and sexual. Aggression manifested as slapping, hitting,
punching, kicking, biting, or suffocating is categorized as physical victimiza-
tion (Wolff, Shi, & Siegel, 2009b). Sexual victimization results from two
forms of aggressive behavior: nonconsensual sexual acts—unwanted sexual
contact involving oral, anal, vaginal, and other sexual acts by another inmate
or staff—and abusive sexual contacts—unwanted sexual contacts that
involved touching inmate’s genitals or private areas by another inmate or
staff (Beck, Berzofsky, Caspar, & Krebs, 2013). Using these definitions for
physical and sexual victimization, people residing in prison have been found
to be at greater risk of victimization than people living in the community
(Wolff, Shi, & Siegel, 2009a) which by extension means that violence is
more commonplace in prison than in the community.
More recently, a third type of victimization—emotional victimization,
defined as verbal assaults or threats—has been included in the definition of
prison victimization (Kuo, Cuvelier, & Huang, 2014; Listwan, Daigle,
Hartman, & Guastaferro, 2014). The one study exploring physical, sexual,
and emotional victimization in U.S. prisons found the direct experience of
emotional victimization (39.6% of respondents) to be more prevalent than the
direct experience of either physical or sexual victimization (28.8% and 0.9%,
respectively; Listwan et al., 2014).
Most of what is known about prison-based victimization has been con-
ducted in prisons located in the United States. Of the 20 published studies
examining physical victimization, 16 were conducted in the United States.
These studies have estimated rates of physical victimization ranging from
10% (Teasdale, Daigle, Hawk, & Daquin, 2016; Wooldredge & Steiner,
Caravaca-Sánchez and Wolff 3

2013) to 35% (Wolff et al., 2009b). Studies estimating rates of sexual victim-
ization in U.S. prisons report rates ranging from less than 1% to 41% (Gaes
& Goldberg, 2004), with more recent studies estimating rates from 4.3%
(Beck et al., 2013; Wolff, Blitz, & Shi, 2007) to 8% (Kubiak, Brenner, Bybee,
Campbell, & Fedock, 2018). This literature also shows that, compared with
male inmates, rates of sexual victimization for female inmates are higher but
lower for physical victimization (Wolff et al., 2009a).
Considerably less is known about rates of prison-based victimization in
other parts of the world, especially for sexual victimization. The evidence for
physical victimization varies significantly by country, with a high of 35% in
South America (Sanhueza, Valenzuela, & de los Ángeles Smith, 2015) and
30% in Europe (Sánchez & Wolff, 2017) to a low of 13% in Asia (Kuo et al.,
2014), with a rate of 20% in between for Africa (Lindegaard & Gear, 2014).
Several non-U.S. studies have examined rates of sexual and emotional vic-
timization. One study conducted in eight Spanish prisons found that approxi-
mately 6% of male inmates (and 12% of female inmates) reported an incident
of sexual victimization during a 6-month period of incarceration (Caravaca-
Sánchez & Wolff, 2016b). Using self-report data collected from male inmates
in four Taiwanese prisons, Kuo and colleagues (2014) reported that nearly a
quarter (24.5%) of inmates experienced emotional victimization during
incarceration on the current sentence.
Rates of prison-based victimization may vary across countries for the
same reason that they vary across studies conducted in the United States:
diversity of study methodologies. Studies often use different definitions of
victimization. Some studies, for example, expand the definition of victimiza-
tion to include events perpetrated by inmates and staff, and ask general and
specific questions about types of victimization (Wolff et al., 2009b), while
others limit the definition to assaultive events that are unprovoked by the
victim (Wooldredge & Steiner, 2013). Variations in study methodologies,
particularly in the framing of the question and time frame, also have been
found to significantly affect estimated rates of prison-based victimization
(Wolff, Shi, & Bachman, 2008). Alternatively or additionally, cross-national
variation in prison-based victimization rates may reflect conditions endemic
to the country that either hinder or foster institutional violence, consistent
with deprivation theory which posits that environmental conditions of depri-
vation and coercion inside prison settings foment violence (Haney, Banks, &
Zimbardo, 1973; Sykes, 1958; Toch, 1977).
While evidence on the prevalence of prison-based victimization is grow-
ing, particularly in the United States, there has been less attention on vic-
timization in non-U.S. prison systems and on patterns of victimization
while incarcerated in the United States or other countries. With one notable
4 Journal of Interpersonal Violence 00(0)

exception (Listwan et al., 2014), prison victimization research has been

attentive to individual types of victimization (physical, sexual, or emo-
tional), not patterns in the types of victimization (one type or multiple types
of victimization, or serial victimizations). This study explores patterns of
victimization in Spanish prisons with emphasis on the prevalence and pre-
dictors of clustering among three types of victimization: physical, sexual,
and emotional, and number of different types of victimization distinguished
by perpetrator: staff or inmate. Before describing the study methodology
and findings, we summarize research on types of victimization inside prison
and the risk factors known to be associated with events of victimization.

Prison Polyvictimization
As referenced earlier, the prison literature has closely investigated rates of
sexual and physical victimization. Absent, however, has been an exploration
into patterns of victimization experienced by inmates. Polyvictimization refers
to separate events of victimization that involve different types of abuse—
physical, sexual, or emotional (Finkelhor, Ormrod, Turner, & Hamby, 2005;
Turner, Shattuck, Finkelhor, & Hamby, 2017). Experiencing different types of
victimization is thought to be event dependent, meaning that events of victim-
ization are serially linked (Finkelhor, Ormrod, & Turner, 2007). Endorsing
event dependency among events of victimization is research finding strong
correlations between childhood victimization and adult revictimization in
community samples (Classen, Palesh, & Aggarwal, 2005; Messman-Moore &
Long, 2000; Widom, 1989). Abuse (physical, sexual, and neglect) during
childhood has been found to strongly and consistently increase the risk of
lifetime revictimization during adulthood (18 years and older) among men and
women (Widom, Czaja, & Dutton, 2008).
Listwan and colleagues (2014) measured polyvictimization using four
items: sexual victimization, property theft, physical victimization, and emo-
tional victimization either experienced directly or witnessed among a sam-
ple of 1,642 men recently released from a U.S. prison system. Almost all
respondents (98%) reported at least one of the eight types of victimization
over a 1-year period, with approximately 27% experiencing four types of
victimization and nearly 10% experiencing six types of victimization. Sexual
victimization, property theft, physical victimization, and emotional victim-
ization were directly experienced by approximately 1%, 22%, 29%, and
40%, respectively, of respondents. These findings are similar to those of
Wolff and colleagues (2009a). They also found that approximately 23% of
male inmates who reported physical victimization reported sexual victim-
ization, and approximately 73% of victims of sexual victimization also
experienced physical victimization.
Caravaca-Sánchez and Wolff 5

Predictors of Victimization
Research on the predictors of prison-based victimization shows that inmates
are not at equal risk of victimization while incarcerated. Certain demographic,
behavioral health, and criminal and victimization history characteristics of
inmates significantly predict the likelihood of physical, sexual, and emo-
tional victimization while incarcerated. Different theories have been used to
predict the impact of individual characteristics on the likelihood of victimiza-
tion. Importation theory (Irwin & Cressey, 1962) posits that incarcerated
people with attributes of vulnerability characterized by age (younger or
older), prison naiveté (first-time incarcerated), race (minority racial group),
smaller size, mental illness, physical disability, or prior victimization may be
preyed upon or manipulated by other inmates, increasing the chances of peo-
ple with one or more of these vulnerability attributes being physically, sexu-
ally, or emotionally exploited or maltreated by other more dominant inmates.
Routine activities theory (Pratt & Turanovic, 2016), by contrast, focuses less
on attributes of the person and more on characteristics of time management.
In prison, inmates have the option to engage in high-risk, criminal enterpris-
ing activities (e.g., operating “stores,” gambling, using/selling drugs or other
contraband), or more restorative and socially appropriate activities (e.g.,
school, work, volunteering). Spending time participating in school, work,
religious activities may decrease the odds of victimization because the person
is choosing to spend his time in activities and with people adhering to proso-
cial values. Characteristics of the prison, in terms of how coercive or harsh
the environment, have also been used to predict violence and its corollary:
prison-based victimization (Haney et al., 1973; Sykes, 1958; Toch, 1977).
Studies estimating the risk factors of physical victimization have found
general support for the importation, routine activities, and deprivation theo-
ries. In terms of physical victimization, the chance of an inmate experiencing
victimization in prison increases if he has any of the following attributes:
young, single, a substance use or mental illness problem, incarcerated multiple
times, unemployed while in prison, had prison disciplinary infractions, or con-
victed of minor property infractions or a sex crime (Kuo et al., 2014; Steiner
& Wooldredge, 2008; Teasdale et al., 2016; Wolff et al., 2009a; Wooldredge &
Steiner, 2013). Wooldredge and Steiner (2013) also found that perceptions of
correctional staff as unfair increased the chances of victimization among
inmates who endorsed those views, whereas Kuo et al. (2014) found that
greater satisfaction with how staff handled victimization reduced the chances
of physical victimization. Similarly, the risk of sexual victimization increases
with being White, younger age, time incarcerated, had prison disciplinary
infractions or juvenile detentions, mental illness, or committed crimes against
persons or sex offenders (Austin, Fabelo, Gunter, & McGinnis, 2006; Beck
6 Journal of Interpersonal Violence 00(0)

et al., 2013; Caravaca-Sánchez & Wolff, 2016a; Hensley, Koscheski, &

Tewksbury, 2005; Hensley & Tewksbury, 2002; Morash, Jeong, Bohmert, &
Bush, 2012; Simpson et al., 2016; Struckman-Johnson & Struckman-Johnson,
2000; Wolff et al., 2007). And finally, the odds of psychological victimization
has been found to increase with younger age, sex offense, mental illness, and
negative attitudes toward the institution and staff (Kuo et al., 2014).
While characteristics of the individual and his attitudes frequently elevate
the likelihood of physical and sexual victimization during incarceration, prior
victimization in the community, especially during childhood, has been found
to consistently and robustly predict physical and sexual victimization during
incarceration (Beck, Harrison, Berzofsky, Caspar, & Krebs, 2010; Morash
et al., 2012; Simpson et al., 2016; Steiner, Ellison, Butler, & Cain, 2017;
Wolff et al., 2009a).
Only one study has examined the risk factors correlated with polyvictimiza-
tion for recently released male inmates. Listwan and colleagues (2014) examined
eight types of victimization: the direct experience and witnessing of property
theft, fighting, sexual, assault, and emotional abuse. They found that the polyvic-
timization (the number of different types of victimization) increased with: race
(being White), age (older), mental illness (being diagnosed with a mental illness),
and negative perceptions of the prison environment and correctional officers.
This study, however, did not look at clustering of types of victimization, physical,
sexual, and/or emotional, and the factors that predicted types of clustering.
Overall, very little is known about polyvictimization among inmates
located in U.S. or non-U.S. prisons, and even less is known about the predic-
tors of multiple types of victimization during incarceration. This study
advances the literature by exploring the clustering among types of victimiza-
tion, and whether there are unique individual and routine activity attributes
associated with experiencing one type, two types, or three types of victimiza-
tion, as well as number of different types of victimization distinguished by
type of perpetrator. No study to our knowledge has explored polyvictimiza-
tion among inmates in this way either in the United States or in other coun-
tries. Using victimization data reported by inmates residing in eight Spanish
prisons, the following questions are examined: (a) What are the patterns
among victimization types in Spanish prisons? and (b) What attributes of the
individual and their routine activities are associated with polyvictimization?

Method
Sample
Spain, with a prison population rate of 129 inmates per 100,000 habitants, has
a higher rate of incarceration than other European countries, including France
Caravaca-Sánchez and Wolff 7

(101 inmates per 100,000 habitants), Italy (92), or Greece (89) but signifi-
cantly lower than that found for the United States (666; International Centre
for Prison Studies, 2016). Unlike in the United States, prisons in Spain are
centralized, independent of provincial or state authorities, and there are no
private institutions. Accordingly, the Spanish Prisons Agency has sole respon-
sibility for the operations and funding of the entire Spanish prison system,
which includes 68 adult security prisons (two exclusively for women).
At the end of October 2017, there were 59,578 adult (aged 18 years and
older) inmates held in Spanish prisons; of those 55,120 (92.5%) were men,
and the remaining 4,458 (7.5%) were women (National Statistics Institute,
2017). The gender distribution in Spanish prisons is similar to the 7% female
population in prisons in the United States at the end of 2016 (U.S. Department
of Justice, 2018). Regarding nationality, the prevalence of foreign inmates in
Spanish prisons is higher than that for U.S. prisons (approximately 29% and
21%, respectively).
Among the male Spanish prison population, the three most prevalent
index offenses were property offenses (39.9%), followed by drug offenses
(21.4%) and violent offenses (13.5%) (National Statistics Institute, 2017).
The index offense distribution for men incarcerated in state prisons in the
United States is quite different with 55.9% violent offenses, 17.3% property
offenses, and 14.4% drug offenses (U.S. Department of Justice, 2018).
For this study, male inmates were randomly selected from the population
of inmates housed at eight adult prisons operated by the Spanish Prison
System, selected for their geographic proximity to the city of Murcia (where
the principal investigator is located). At the time of the study, these prisons
housed 5,110 male inmates (National Statistics Institute, 2017). To be eligible
for the study, an inmate had to meet the following criteria: (a) imprisoned
more than 6 months, (b) read and understand Spanish or French, (c) general
population residency, and (d) able to give informed consent. The exclusion
criteria were as follows: had serious behavioral or medical problems, or in
protective custody or residence in a specialized psychiatric section of the
prison. The eligible population included 4,718 inmates (392 inmates did not
meet inclusion criteria or met an exclusion criterion).
After receiving approval from the Spanish Prison System, the principal
investigator obtained an electronic list (including demographic and criminal
information) of all eligible inmates housed at each facility approximately 2
weeks prior to the fieldwork. For sampling, each inmate was assigned a ran-
dom number, and was selected for inclusion in the study by a random number
generator. To enroll a 50% random sample from each institution and assum-
ing an expected refusal rate of 40%, we randomly selected 83% of the eligi-
ble sample from each prison (n = 4,251). Participation rates across these
facilities ranged from 44% to 67%, with a mean overall response rate of 53%.
8 Journal of Interpersonal Violence 00(0)

Of the 3,915 male inmates invited to participate, 2,589 agreed to partici-

pate. Because 105 of these inmates declined to complete the survey, the final
study sample included 2,484 inmates (52.6% of the eligible population).
Participants completed a structured questionnaire under the direct observa-
tion of the research team. The questionnaire was administered in a semipri-
vate room by four research assistants (who received training on the data
collection protocol), completed in groups of 20 inmates and without the pres-
ence of prison staff. Completed surveys were returned to the research staff.
On average, participants completed the survey in approximately 45 min.
Inmates gave written consent to participate in the study in compliance with
IRB requirements.
Surveys were completed by 2,484 male inmates (M = 36.3 years; SD = 11.1
years) residing in prison from January through August 2014. The mean time of
incarceration for the full sample was 3.6 years. Among the respondents, 78.8%
were from Spain (with a mean age of 37.2), 44.5% were recidivists (i.e., more
than one admission to a prison), and 43.3% committed property crimes.
Characteristics of the sample are similar to the male prison population in (a)
all Spanish prisons (N = 55,101), where 70.7% of the inmates were from Spain
and 47.2% were recidivists, and (b) the eight sampled prisons (N = 5,110)
where 73.3% of inmates were from Spain and 46.4% were recidivists (National
Statistics Institute, 2016).

Measures
Participants completed a structured survey with 17 questions that was admin-
istered using paper and pencil. The survey included questions about the type
of trauma, history of treatment for mental illness and substance use, as well
as demographic background (e.g., age, nationality, marital status) and crimi-
nal history (e.g., previous incarcerations, type of offense). For analysis, these
responses were categorized as independent and dependent variables.

Independent Variables
Importation/vulnerability variables.  Age was dichotomized into age 18 to 34
and age 35 or older (1 = 18-34 and 0 = 35 plus), nationality (1 = Spanish, 0
= foreigner), and marital status (0 = in a relationship/married, 1 = single/
never married, 2 = divorced/widowed). Familiarity with prison was dichot-
omized into prior prison sentences (1 = yes, 0 = no), type of offense com-
mitted (1 = violent offense [defined as battery, assault, or murder] and 0 =
other offense [e.g., property offense, drug trafficking/distribution, road
traffic offenses, or fraud]), time served on the current sentence (1 = less
Caravaca-Sánchez and Wolff 9

than 2 years, 0 = 2 years or more), prior juvenile detention (before age 18;
1 = yes, 0 = no), and received any disciplinary infraction during current
incarceration (1 = yes, 0 = no).
Currently receiving mental health or substance abuse treatment was
dichotomized into yes (=1) or no (=0). Questions about receiving treatment
for any mental disorder, such as anxiety, depression, schizophrenia, bipolar
disorder, and posttraumatic stress disorder, were adapted from Wolff et al.,
2007, and questions about substance use treatment were based on those used
by Royuela, Montanari, Rosa, and Julian (2014). In Spain, inmates with men-
tal health and/or substance use disorders are treated voluntarily and most
often by a specialist, such as psychologist or psychiatrist but, in some cases,
treatment is provided by multidisciplinary teams (e.g., psychologist, social
worker, occupational monitor, jurist).
Community-based victimization variables were adapted from the Lifetime
Trauma and Victimization History (LHTV) instrument developed by Widom,
Dutton, Czaja, and DuMont (2005), and were coded yes (=1) or no (=0).
These questions included: “Has anyone else ever shot at, stabbed, struck,
kicked, beaten, punched, slapped around, or otherwise physically harmed
you?” measuring physical victimization; “Has anyone ever forced or coerced
you to engage in unwanted sexual activity?” measuring sexual victimization;
and “Has anyone else threatened you in a face to-face confrontation?” mea-
suring emotional victimization. For each question, two age ranges for victim-
ization were asked: prior to age 18 (childhood victimization), and 18 and
older and prior to imprisonment (adulthood victimization).

Routine activity: Protective/risk-enhancing variables.  Respondents were asked if

they worked (1 = yes, 0 = no) and were enrolled in school (1 = yes, 0 = no).

Dependent Variables
The recall period for victimization was 6 months. Specific questions were
asked about emotional, physical, and sexual victimization during the past 6
months while incarcerated. These questions were adapted from the question-
naire used by Wolff and colleagues (2009a), and in a victimization study
based in Spain (Caravaca-Sánchez & Wolff, 2016b). These questions were as
follows: “Have you been physically assaulted by [inmate or staff] in the pre-
vious 6 months?” measuring physical victimization, and “Have you been
sexually assaulted by [inmate or staff] in the previous 6 months?” measuring
sexual victimization. For emotional victimization, a question adapted from a
study conducted by Listwan and colleagues (2014) was used: “Have you
been insulted and/or threatened in the previous 6 months?”
10 Journal of Interpersonal Violence 00(0)

Inmates who answered positively were categorized as experiencing a type

of prison victimization: sexual, physical, or emotional. The response format
was “no” (=0) or “yes” (=1). Polyvictimization is measured by three binary
variables: One type is coded 1 if “yes” was reported for only one of the three
types of victimization; two types are coded 1 if “yes” was reported for two
types of victimization (physical and emotional; physical and emotional; or
sexual and emotional); and three types are coded 1 if “yes” was reported for
all three types of victimization (physical, emotional, and sexual), and one
continuous variable: the sum of six types of victimization: inmate-perpe-
trated emotional, physical, and sexual victimization, and staff-perpetrated
emotional, physical, and sexual victimization, with 0 equaling no inmate- or
staff-perpetrated victimization.

Analytical Procedures
The bivariate and univariate analyses were conducted in several steps: First,
the sample was divided and analyzed according to the different definitions
of polyvictimization: types of victimization (physical, sexual, or emotional)
and number of types of victimization. Percentages and 95% confidence
intervals (CIs) were calculated for any victimization and number of types of
victimization. Second, multivariate regression analysis was used to compare
groups of inmates experiencing one, two, and three types of victimization
with a group of inmates experiencing no victimization (logistic), and groups
of inmates experiencing two and three types of victimization with a group of
inmates experiencing one type of victimization (trinomial logit), and predict
the number of different types of victimization (ordinary least squares [OLS])
controlling for inmate characteristics and type of perpetrator (inmate or
staff) when possible. All the analyses were conducted using the Statistical
Package for the Social Sciences v.20 with a minimum significant level set at
95% (p ≤ .05).

Ethics Statement
The review committees for the University of Murcia and the Spanish Prison
System approved the current research and protocols for the research pre-
sented here. Inmates gave written consent to participate in the study in com-
pliance with ethics guidelines Institutional Review Board requirements.
Inmates were informed that the data would be stored and analyzed anony-
mously, and also that they could stop participating in the study any time with-
out consequences. Participants were not compensated for participating.
Caravaca-Sánchez and Wolff 11

Table 1.  Characteristics of the Sample (N = 2,484).

Inmate Characteristics Number % Range

Age group, years
 18-34 1,148 46.2 0-1
 35+ 1,336 53.8  
Nationality
 Spanish 1,928 77.6 0-1
 Foreign 556 22.4  
Marital status
  In a relationship 1,121 45.1 0-2
 Single 637 25.6  
 Divorced/widowed 726 29.2  
Mental illness treatment (yes) 600 24.1 0-1
Substance use treatment (yes) 658 26.4 0-1
Offense type
  Violent offense 497 20.0 0-1
  Other offense 1,987 80.0  
Time served of current sentence, years
 <2 1,678 67.6 0-1
  ≥2 805 32.4  
Juvenile detention (yes) 890 35.8 0-1
Prison infractions (yes) 855 34.4 0-1
Prior prison sentence (yes) 1,127 45.4 0-1
Working in prison (yes) 855 34.4 0-1
Enrolled in school (yes) 1,510 60.8 0-1

Results
Table 1 displays the characteristics of the male sample. The sample was
approximately equally split between 18 to 34 years old (46.2%) and 35 years
and older (53.8%), and was predominately Spanish (77.6%), in an intimate
relationship (45.1%), in prison for a nonviolent offense (80%), and for less
than 2 years (67.6%). Approximately one third of the sample reported a juve-
nile detention, and 45% had a prior prison incarceration. During incarcera-
tion, approximately one third of the sample reported at least one prison
infraction, one third had worked, 61% attended school, and about one quarter
received mental health or substance abuse treatment.
Table 2 shows polyvictimization during a 6-month period by type of
victimization and number of victimization types. Approximately one-in-
five inmates in the sample reported being victimized either by an inmate
12
Table 2.  Percentage of Inmates Reporting Victimization Experiences While Incarcerated by Number, Type, and Perpetrator of
Victimization During a 6-Month Period (N = 2,484).
Type of Victimization

  % of Inmates Emotional Victimization Physical Victimization Sexual Victimization

  % (95% CI) % (95% CI) % (95% CI) % (95% CI)

Victimizations by perpetratora
  Inmate perpetrated (n = 559) 22.5 [20.9, 24.1] 89.1 [86.5, 91.6] 52.2 [47.9, 56.3] 11.6 [9.2, 14.6]
  Staff perpetrated (n = 466) 18.8 [17.3, 20.4] 85.4 [82.1, 88.5] 60.5 [56.0, 64.9] 16.1 [12.7, 19.7]
  Inmate and staff perpetrated (n = 371) 15.7 [14.0, 16.8] 75.5 [70.4, 80.0] 45.8 [40.5, 51.2] 15.6 [11.9, 19.4]
Victimizations by number of type
  One type of victimization (n = 706) 28.4 [26.5, 30.2] 78.3 [75.1, 81.2] 18.6 [15.8, 21.7] 3.1 [1.9, 4.5]
  Two types of victimization (n = 552) 22.2 [20.6, 24.0] 95.4 [93.3, 96.9] 94.5 [92.3, 96.2] 10.1 [7.7, 12.9]
  Three types of victimization (n = 138) 5.6 [4.7, 6.5] 100.0 [100.0, 100.0] 100.0 [100.0, 100.0] 100.0 [100.0, 100.0]

  Number of Different Types of Victimization Experienced

  0 1 2 3 4 5 6

Inmate respondents
  Percentage of inmates (n = 2,484) 43.8 21.5 18.8 7.6 2.3 3.5 2.5
(95% CI) [41.8, 45.6] [20.0, 23.1] [17.2, 20.3] [6.5, 8.6] [1.7, 2.9] [2.9, 4.3] [1.9, 3.2]

Note. CI = confidence interval.

aTypes of victimization include physical, sexual, and emotional victimization experiences during a 6-month period.
Caravaca-Sánchez and Wolff 13

only (22.2%) or by staff member only (18.5%), while 15.7% reported being
victimized by an inmate and staff person. The patterns of victimization
were similar by type of perpetrator; the vast majority of victimized inmates
reported experiencing emotional victimization either by other inmates or by
staff, with the next most likely type of victimization being physical. While
sexual victimization was least often reported, over one-in-nine victimized
inmates reported being sexually victimized by either another inmate or staff
member.
Overall, 28.4% of male inmates reported one type of prison victimization
experience, 22.2% reported two types of victimization, and 5.6% reported
three types of victimization, indicating that 56.2% of male inmates experi-
enced at least one type of victimization during the 6-month period. Emotional
abuse was the most common type of victimization for those who reported one
type of victimization. More than three quarters of victimized inmates report-
ing one type of victimization and nearly all the victimized inmates experienc-
ing two or three types of victimization reported experiencing emotional
abuse. Physical victimization was the next most common type of victimiza-
tion, with the rates increasing with the number of types of victimization.
Sexual victimization was the least common type of victimization, although
3.1% and 10.1% of the inmates experiencing one and two types of victimiza-
tion, respectively, reported an incident of sexual victimization during the
6-month period.
The last row of Table 2 shows the frequency of different types of victim-
ization, ranging from 0 (no victimization) to 6, counting type of victimization
(physical, sexual, or emotional) by perpetrator. It was most common for
inmates to report experiencing one (21.5%) or two (18.8%) types of victim-
ization during a 6-month period. It was relatively rare for an inmate to report
experiencing four or more types of victimization. In the extreme, 2.5% of
respondents reported experiencing all three types of victimization (emo-
tional, physical, and sexual) perpetrated by both inmates and staff.
Preprison and current prison victimization experiences of male inmate
respondents are shown in Table 3. In general, rates of community-based
childhood and adulthood victimization were significantly higher among vic-
timized inmates than among nonvictimized inmates, but this difference was
most pronounced among those victimized inmates with two and three types
of victimization. Overall, victimized inmates reporting three types of prison-
based victimization had the highest rates of childhood and adulthood com-
munity-based victimization, and these rates for emotional, physical, and
sexual victimization were significantly higher than the rates for nonvictim-
ized inmates. This was generally true for victimized inmates with two types
of victimization as well, except for childhood sexual victimization. Compared
14
Table 3.  Percentage Reporting Community-Based Victimization by Different Types of Prison Victimization During a 6-Month
Period (N = 2,484).

Number of Different Types of Victimization

No Victimizations One Type Two Types Three Types

(n = 1,088) (n = 706) (n = 552) (n = 138)

Inmate Characteristics % (95% CI) % (95% CI) % (95% CI) % (95% CI)
Childhood trauma (yes)
  Emotional abuse 11.4 [9.5, 13.4] 21.7*** [18.8, 24.5] 24.8*** [21.3, 38.2] 23.9*** [17.2, 31.2]
  Physical victimization 11.9 [10.0, 13.7] 15.2 [12.7, 17.6] 20.5* [17.4, 24.0] 27.5** [20.0, 35.2]
  Sexual victimization 2.3 [1.4, 3.2] 2.4 [1.3, 3.6] 5.6 [3.5, 7.6] 9.4** [4.7, 14.4]
Adulthood trauma (yes)
  Emotional abuse 16.9 [14.7, 19.2] 44.6*** [41.1, 48.3] 56.3*** [52.0, 60.4] 57.2*** [48.6, 65.9]
  Physical victimization 10.5 [8.7, 12.3] 22.5* [19.5, 80.5] 44.7*** [40.6, 48.8] 52.9*** [44.4, 60.6]
  Sexual victimization 1.7 [1.0, 2.6] 3.4 [2.1, 5.0] 5.8* [4.0, 8.0] 23.9*** [17.0, 31.3]

Note. Reference group for bivariate analysis is no victimizations. CI = confidence interval.

*p < .05. **p < .01. ***p < .001.
Caravaca-Sánchez and Wolff 15

Table 4.  Logistic Regression Model Predicting Patterns of Victimization During 6

Months (N = 2,484).
Different Types of Victimization

One Type Two Types Three Types

(n = 706) (n = 552) (n = 138)

Inmate Characteristics OR CI OR CI OR CI

Importation: Criminological
  Age 18-34a 1.29** [1.06, 1.57] 1.20 [0.94, 1.51] 1.06 [0.72, 1.55]
 Spanishb 0.96 [0.76, 1.22] 0.78 [0.58, 1.04] 0.84 [0.52, 1.37]
  Married or in a relationshipc 0.84 [0.66, 1.09] 0.76 [0.57, 1.03] 1.16 [0.73, 1.84]
  Conviction for violent offensed 1.00 [0.78, 1.26] 1.02 [0.77, 1.35] 1.36 [0.88, 2.10]
  Served <2 years, current offensee 0.91 [0.73, 1.12] 0.73 [0.57, 0.93] 0.98 [0.65, 1.49]
  Juvenile detention (yes) 1.05 [0.84, 1.31] 1.23 [0.95, 1.59] 0.87 [0.58, 1.31]
  Prison infractions (yes) 1.61*** [1.28, 2.01] 2.53*** [1.97, 3.25] 1.65* [1.09, 2.49]
  Prior prison sentence (yes) 1.06 [0.86, 1.30] 0.84 [0.65, 1.07] 1.68** [1.25, 2.47]
Importation: Treatment/trauma
  Mental illness treatment (yes) 1.47** [1.16, 1.86] 1.82*** [1.40, 2.36] 1.71** [1.23, 2.46]
  Substance use treatment (yes) 1.14 [0.91, 1.44] 0.88 [0.67, 1.16] 1.01 [0.66, 1.55]
  Childhood trauma
   Emotional abuse (yes) 1.91*** [1.40, 2.62] 1.84** [1.30, 2.61] 0.99 [0.56, 1.72]
   Physical victimization (yes) 0.72 [0.51, 1.02] 0.94 [0.65, 1.37] 1.46* [1.26, 1.89]
   Sexual victimization (yes) 1.19 [0.67, 2.13] 1.32 [0.72, 2.41] 1.38 [0.64, 2.98]
  Adulthood trauma
   Emotional abuse (yes) 3.03*** [2.59, 4.20] 3.12*** [2.37, 4.10] 2.62*** [1.66, 4.11]
   Physical victimization (yes) 1.10 [0.81, 1.48] 2.81*** [2.07, 3.82] 3.41*** [2.13, 5.47]
   Sexual victimization (yes) 1.05 [0.57, 1.93] 1.23 [0.66, 2.24] 5.62*** [2.95, 10.69]
Routine activities
  Working in prison (yes) 1.22 [0.87, 1.42] 0.96 [0.75, 1.22] 0.68 [0.44, 1.02]
  Enrolled in school (yes) 1.05 [0.87, 1.28] 1.26 [1.00, 1.58] 0.89 [0.62, 1.29]

Note. Reference group is no reported victimizations during the 6-month period (n = 1,088). OR = odds
ratio; CI = confidence interval.
aOmitted variable: 35+ years.
bOmitted variable: Foreign.
cOmitted variable: Single, divorced, or widowed.
dOmitted variable: Other offense.
eOmitted variable: ≥2 years served on current sentence.

*p < .05. **p < .01. ***p < .001.

with nonvictimized inmates, victimized inmates reporting one type of prison-

based victimization were more likely to report emotional abuse during child-
hood and adulthood (prior to incarceration), and physical victimization
during adulthood.
Multivariate logistic regression results by number of types of victimiza-
tion (compared to no victimizations) are shown in Table 4. Compared with
nonvictimized inmates, inmates were more likely to report one, two, or three
types of victimization if they had prior prison infractions, received mental
16 Journal of Interpersonal Violence 00(0)

health treatment, and experienced emotional abuse in adulthood in the com-

munity. The risk of experiencing multiple types of victimization increased
with emotional abuse in childhood (one and two types), physical victimiza-
tion in adulthood (two and three types), prior prison sentence (three types
only), and physical victimization in childhood and adulthood, and sexual vic-
timization in childhood (three types only). Younger age increased the odds of
victimization only for inmates experiencing one type of victimization.
Table 5 shows results of trinomial logit results. Compared with victimized
inmates with one type of victimization, the likelihood of experiencing a sec-
ond type of victimization increased with receiving a disciplinary infraction
during the current incarceration, having a previous incarceration, and experi-
encing physical victimization as an adult in the community. Victims of three
types of victimization were more likely than victims of one type of victimiza-
tion to have had a prior prison sentence, experienced community-based phys-
ical victimization in childhood and adulthood, and community-based sexual
victimization in adulthood.
Multivariate OLS regression was used to identify factors associated with
the number of victimizations (ranging from no victimizations to 6 victimiza-
tion types). Results are shown in Table 6. Demographic factors were not
linked to polyvictimization. Prison infractions, prior prison sentence, and
currently working in prison positively increased the number of victimiza-
tions. Most significant, however, were experiences of community-based vic-
timization. Sexual victimization during adulthood in the community increased
the different types of victimization experienced by 0.397. Experiencing sex-
ual victimization in adulthood and childhood and adulthood physical victim-
ization in the community was associated with a 0.813 increase in the number
of different types of victimization experienced in a 6-month period of incar-
ceration. The combined impact of these three types of community-based vic-
timization was 3 times larger than the combined impact of the three other
significant factors: prison infractions, prior prison sentence, and working in
prison (.813 vs. .277) on the number of different types of victimization.

Discussion
Using a representative male sample drawn from eight Spanish prisons, we
examined cluster patterns among victimization types, and the attributes of
inmates and their routine activities associated with polyvictimization.
Overall, 56.2% of the study sample reported at least one victimization experi-
ence during the 6-month period, 27.8 reported experiencing two or three
types of victimization (emotional, physical, or sexual), and 34.7% reported
more than one victimization–perpetrator type. Our estimates are lower than
Caravaca-Sánchez and Wolff 17

Table 5.  Trinomial Logit Regression Model Predicting Different Types of

Victimization Experienced During 6 Months (N = 1,396).
Different Types of Victimization

Two Types Compared Three Types Compared

With One Type With One Type

Inmate Characteristics OR CI OR CI

Importation: Criminological
  Age 18-34a 0.97 [0.76, 1.26] 1.03 [0.67, 1.60]
 Spanishb 1.20 [0.88, 1.64] 1.53 [0.89, 2.62]
  Married or in a relationshipc 1.03 [0.90, 1.18] 0.85 [0.66, 1.09]
  Conviction for violent offensed 1.06 [0.79, 1.43] 1.26 [0.72, 2.11]
  Served <2 years, current 1.25 [0.96, 1.62] 0.91 [0.57, 1.47]
sentencee
  Juvenile detention (yes) 0.80 [0.61, 1.05] 0.97 [0.61, 1.56]
  Prison infractions (yes) 1.86** [1.68, 2.18] 0.98 [0.62, 1.59]
  Prior prison sentence (yes) 1.30* [1.04, 1.70] 2.28*** [1.43, 3.61]
Importation: Treatment/trauma
  Mental illness treatment (yes) 0.76 [0.53, 1.04] 1.04 [0.65, 1.69]
  Substance use treatment (yes) 1.03 [0.78, 1.37] 1.02 [0.63, 1.64]
  Childhood trauma
   Emotional abuse (yes) 1.14 [0.80, 1.60] 1.61 [0.86, 2.91]
   Physical victimization (yes) 1.30 [0.88, 1.90] 1.89* [1.03, 3.47]
   Sexual victimization (yes) 1.80 [0.90, 3.57] 2.07 [0.84, 5.12]
  Adulthood trauma
   Emotional abuse (yes) 0.92 [0.69, 1.21] 1.22 [0.75, 2.07]
   Physical victimization (yes) 2.10*** [1.61, 2.92] 3.19*** [1.95, 5.21]
   Sexual victimization (yes) 1.12 [0.61, 2.05] 5.94*** [3.06, 1.54]
Routine activities
  Working in prison (yes) 1.18 [0.91, 1.52] 0.86 [0.66, 1.21]
  Enrolled in school (yes) 0.81 [0.63, 1.04] 1.22 [0.80, 1.86]

Note. OR = odds ratio; CI = confidence interval.

aOmitted variable: 35+ years.
bOmitted variable: Foreign.
cOmitted variable: Single, divorced, or widowed.
dOmitted variable: Other offense.
eOmitted variable: ≥2 years served.

*p < .05. **p < .01. ***p < .001.

the 98% any victimization rate estimated by Listwan and colleagues (2014),
which included emotional, physical, and sexual victimization directly experi-
enced or witnessed over a 12-month period. Their study did not distinguish
victimization by perpetrator type. Consistent with the U.S.-based prison-
based victimization literature, our findings show emotional abuse to be the
18 Journal of Interpersonal Violence 00(0)

Table 6.  Multivariate OLS Regression Model Predicting Number of Different

Types of Victimization Experienced During 6 Months (N = 2,484).

Number of Different Types of

Victimization

Inmate Characteristics B Robust SE

Importation: Criminological
  Age 18-34 .007 0.035
 Spanish .061 0.044
  Married or in a relationship −.004 0.019
  Conviction for violent offense −.037 0.040
  Served <2 years, current sentence .030 0.038
  Juvenile detention (yes) −.021 0.039
  Prison infractions (yes) .043* 0.039
  Prior prison sentence (yes) .133* 0.033
Importation: Treatment/trauma
  Mental illness treatment (yes) .016 0.38
  Substance use treatment (yes) .013 0.040
  Childhood trauma
   Emotional abuse (yes) .093 0.050
   Physical victimization (yes) .146* 0.053
   Sexual victimization (yes) .130 0.086
  Adulthood trauma
   Emotional abuse (yes) .016 0.037
   Physical victimization (yes) .270*** 0.042
   Sexual victimization (yes) .397*** 0.072
Routine activities
  Working in prison (yes) .101* 0.037
  Enrolled in school (yes) −.006 0.035
F(10, 42)*** 73.63
R2 .341

Note. OLS = ordinary least squares.

*p < .05. **p < .01. ***p < .001.

most common form of victimization inside prison, followed by physical vic-

timization, with significantly lower rates of sexual victimization. The same
pattern was found in cluster patterns of victimization: If a male inmate expe-
rienced two types of victimization, the most common combination of victim-
ization was emotional and physical. A significantly smaller proportion of the
male sample experienced sexual victimization paired with emotional or phys-
ical victimization, and three types of victimization, which included sexual
victimization, were least common.
Caravaca-Sánchez and Wolff 19

Associations between any victimization in prison and an inmate’s behav-

ioral health, criminal history, and prior abuse history have been documented
in an expanding literature on prison violence (Beck et al., 2013; Kuo et al.,
2014; Morash et al., 2012; Simpson et al., 2016; Teasdale et al., 2016; Wolff
et al., 2007). We found polyvictimization, independent of how it was mea-
sured, to be associated with some of the same characteristics. In general,
polyvictimization was associated with two groups of variables. The first
group is comprised of vulnerability attributes associated with prior childhood
or adulthood victimization in the community. These attributes were found to
be significantly and strongly associated with polyvictimization. The second
group, which was less strongly and consistently associated with polyvictim-
ization, included four vulnerability attributes: younger age (compared with
nonvictimized inmates only), prison infractions (all comparisons except
three types of victimization to one type of victimization), mental health treat-
ment (compared with nonvictimized inmates only), prior prison sentence
(victims of three types compared with nonvictimized inmates, compared with
victims of one type of victimizations, and number of different types of vic-
timization), and one routine activities variable: working in prison (number of
different types of victimization only). Overall, with one exception (victims of
two types compared with one type) the combined impact of the prior victim-
ization attributes was 25% to 300% larger than the combined impact of the
other set of vulnerability/routine activities attributes on polyvictimization,
with the strength of prior victimization impact increasing with more types of
victimization.
The serial connection of abuse over the life course was supported by our
data: Inmates who reported experiencing victimization in childhood and
adulthood were often significantly more likely to report victimization while
incarcerated, which is consistent with the past research (Beck et al., 2010;
Morash et al., 2012; Simpson et al., 2016; Wolff et al., 2009a). Our results,
however, because the number and types of victimization were disentangled
and prior abuse was further delineated by type and age, show that the size and
significance of the association depend on the comparison group (people with
no reported victimization, people with one type of victimization) or measure
of polyvictimization (combination of types of victimization or frequency of
types of victimization). In general, community-based emotional abuse is
more consistently and strongly associated with the experience of prison-
based victimization when compared with nonvictimized inmates, whereas
community-based physical and sexual victimization are more consistently
and strongly associated with multiple prison-based victimizations. In particu-
lar, community-based adulthood victimization was more strongly associated
with multiple prison-based victimizations. This stronger association may
reflect its greater prevalence (rates of adult abuse are higher than those of
20 Journal of Interpersonal Violence 00(0)

childhood abuse as shown in Table 3) or its greater saliency because it was

more recent, the experience violated norms of expected behavior (e.g., “I
should have been able to protect myself because I am a man”), or was inflated
by memories of childhood abuse (e.g., legacy effect). Our data indicate that
childhood and adulthood victimization are strongly correlated (p < .001; χ2 =
11.01). Future research needs to explore the temporal pattern of abuse, and
how types and timing of abuse are associated with prison-based victimiza-
tion. This information will inform the development of guidance on how to
identify men at risk of victimization, and classify them in ways to minimize
their exposure to victimization during incarceration and in the community
upon release.
Our findings brighten the light on the correlation between community-
based victimization and prison-based victimization (affirming the same serial
correlation found in community-based samples). Most of the prison-based
victimization literature focuses on testing criminological theories of aggres-
sive behavior—importation, routine activities, and deprivation. These theo-
ries spotlight the prison as a unique environment; an environment defined
distinctly and interactively by attributes of the facility, its staff, and its resi-
dents, which may incrementally affect the likelihood of violence within the
walls and, hence, victimization. Testing these theories has motivated the
selection of variables that distinguish people inside prison (by their vulnera-
bility in terms of power to defend against aggression or manipulation, or use
of time in prosocial or antisocial ways) or the facility (more or less coercive,
or harsh or restrictive).
The variation in results across prison-based victimization studies reflects
in part the different attributes of the facility, staff, and inmates included in
the models; most of these studies have focused on demographic and crimi-
nal history attributes of the inmates, their attitudes about staff professional-
ism, and facility conditions (e.g., overcrowding; Farrington & Nuttall,
1980; Wooldredge, 1994; Wooldredge & Steiner, 2013). Only recently have
studies (Caravaca-Sánchez & Wolff, 2016b; Steiner et al., 2017; Wolff
et al., 2009b) begun to define vulnerability in ways consistent with commu-
nity-based research, which focuses on the vulnerability of people with men-
tal illness and people with prior trauma histories (Reavis, Looman, Franco,
& Rojas, 2013; Teplin, McClelland, Abram, & Weiner, 2005). Our research
is consistent with a deep and growing body of community-based research
that shows the powerful impact of mental illness and prior childhood and
adulthood abuse and neglect on future victimization. While the prison envi-
ronment may have unique attributes that marginally affect rates of violence,
omitting the well-documented vulnerability effect of prior victimization
from prison-based victimization studies introduces a potentially serious
Caravaca-Sánchez and Wolff 21

omitted variables bias. Such a bias can result in overestimating or underes-

timating the effect of the vulnerability, routine activities, or deprivation
variables used to predict victimization in more criminologically focused
studies. This is significant if policy or practice is guided by evidence that
directs attention to less impactful protective factors.
Our research stresses the importance of integrating prison- and commu-
nity-based research. That emotional, physical, and sexual abuse continues in
prison under the watchful eye of prison officials is a public policy concern.
Studies that identify risk factors for prison-based harm can be used to target
characteristics or experiences that elevate risks of harm while incarcerated.
Community-based organizations (e.g., medical practices, hospitals, commu-
nity mental health centers) are introducing patient screens asking about prior
abuse in an effort to improve patient care. Similar screening tools could be
used by prisons to classify and assign people to (a) housing units that are
more trauma informed, and (b) programming that treats trauma and builds
trauma resiliency.
Interventions designed to be more protective of vulnerable inmates
will need to be sensitive to perpetrator type. Keeping vulnerable inmates
away from predatory staff requires having safe and confidential mecha-
nisms in place for inmates to report predatory staff (e.g., confidential tele-
phone lines for reporting staff, “duty to inform” practices for medical
staff, mandatory reporting and prosecution of prison rape by staff), and
then keeping them safe after reporting (e.g., enforcing “keep separate”
arrangements that keep victimized inmates away from abusive staff). In
addition, officers working on specialized units must be screened and pro-
vided trauma-sensitivity training to ensure their ability to protect and help
inmates who have experienced victimization in prison or are at risk of
future victimization.
Our research, while shedding new light on polyvictimization inside prison,
must be interpreted with caution: First, because of the cross-sectional nature
of our data, we are unable to make causal inferences about (a) community-
and prison-based victimization, or (b) mental health treatment and victimiza-
tion (e.g., the time sequencing of mental health treatment is relevant here:
Victimization may have led to mental health treatment, or mental illness [sig-
naled by treatment] may indicate vulnerability to harm or predation).
Moreover, we do not have information about whether respondents reporting
community-based victimization also have diagnoses related to trauma, such
as anxiety, depression, or posttraumatic stress disorder, resulting in mental
health treatment during incarceration. Second, physical, sexual, and emo-
tional victimization were measured with reference to physical assault, sexual
assault, and being insulted or threatened, respectively. Research shows that
22 Journal of Interpersonal Violence 00(0)

how questions about victimization are framed influences responses, with

more specific questions generating higher prevalence rates than more general
questions (Wolff et al., 2009b). The reporting of emotional victimization, in
particular, would most likely had increased if it had been framed to include
being belittled, insulted, berated, or cursed upon by a particular group
(Pennebaker & Susman, 1988). For this reason, we expect our rates of com-
munity- and prison-based emotional abuse to be underreported. Given the
strong correlation between adverse childhood events and future health and
behavioral outcomes (Kessler, Davis, & Kendler, 1997; Shonkoff et al.,
2012), not including questions measuring adverse childhood events is also a
limitation.
Third, the sample only included men incarcerated in different prisons
located in the south and south east of Spain. As such, our findings may not
generalize to the full Spanish prison population of men. Our results do not
generalize to females incarcerated in Spanish prisons as previous research
shows that the victimization pattern of female inmates is unique (Wolff et al.,
2009a). Finally, demographic, criminal, and victimization data were based on
self-report questionnaires. Thus, respondents may have overreported, under-
reported, or even misreported information. However, the anonymous nature
of the survey and its self-administration likely minimized the effect of social
desirability bias on reporting (Dillman, Smyth, & Christian, 2014).
Notwithstanding these limitations, our work presents new information on
the polyvictimization experienced by male inmates and its association with
community-based victimization. Disentangling the way in which prison- and
community-based victimization was measured allows for a more granular
understanding of prison victimization and the extent to which inmates have
been chronically exposed to violence over the course of their lives. Research
that explores the connection between victimization and criminal behavior
(Zweig, Yahner, Visher, & Lattimore, 2015); community- and prison-based
victimization; victimization and behavioral health among incarcerated popu-
lations is in its infancy. Our research, while only cross-sectional, suggests the
need for research that is longitudinal, and that more robustly and delibera-
tively studies the sequential and serial impact of victimization on behaviors
that result in incarceration and harm while incarcerated. Only then, might the
cycle of harm be broken through well-informed interventions (Wolff et al.,
2011) that treat the lingering and repetitive pattern of victimization and vio-
lence in the lives of many incarcerated men.

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research,
authorship, and/or publication of this article.
Caravaca-Sánchez and Wolff 23

Funding
The author(s) received no financial support for the research, authorship, and/or publi-
cation of this article.

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Author Biographies
Francisco Caravaca-Sánchez is an honorary teacher in the Department of Forensic
Medicine at University of Murcia. He earned his PhD from University of Murcia in
forensic sciences, and also has degrees in social work from University of Murcia. His
Caravaca-Sánchez and Wolff 27

research interests include prediction of violence in individuals with mental illness,

and substance use in the criminal justice system and college population. His recent
work has been published in the Journal of Forensic Psychiatry & Psychology,
Criminal Justice and Behavior, and International Journal of Offender Therapy and
Comparative Criminology.
Nancy Wolff, an economist, is a distinguished professor in the Edward J. Bloustein
School of Planning and Public Policy, and a director of the Bloustein Center for
Survey Research. Her areas of expertise include measuring the prevalence of physi-
cal, sexual, and emotional trauma among incarcerated populations, and testing the
cost-effectiveness of trauma and addiction interventions, as well as interventions
designed to build emotional resiliency and assist with the reentry process.