Clinical trial NCT04374357: Examining Prison Inmates' Attitudes and Internal Emotional States
Official title: Examining Prison Inmates' Attitudes and Internal Emotional States: Forgiveness, Anger, Anxiety, Depression, Hope, and Social Desirability
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Forgiveness
Keywords: Forgiveness
Lead sponsor: University of Wisconsin, Madison
Sponsor class: OTHER
Collaborators: name: Department of Corrections, State of Wisconsin
First posted: 2020-05-05
Enrollment: 103
Sex: MALE
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Observational model: COHORT
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Prison inmates from a maximum-security prison in Wisconsin, United States.

Brief summary: This study is the first part of a two-tiered research project to propose a novel approach-forgiveness therapy-to corrections. This study is a non-intervention study and aims to demonstrate the need to introduce the concepts of forgiveness and Forgiveness Therapy within prisons. This study is focused on the extent to which men in a maximum-security prison experienced considerable injustice against them (such as in a family context as he was growing up) prior to committing serious crimes. Variables associated with this prior unjust treatment included the level of forgiveness and variables of current psychological well-being. Since this study provided the rationale and participants' matching data (eligibility) for the subsequent interventional study (Study 2, "Proposing Forgiveness Therapy in Prison") in which psychological treatments applied to the inmates, investigator refer to this study as Study 1.

Detailed description: Current study (Study 1) consisted of 103 men in a maximum-security prison in the Midwestern United States. The research aimed to demonstrate the necessity of introducing forgiveness concepts and Forgiveness Therapy within the prison. This study collected percentage and correlational data regarding the presence of hurtful unfair treatments and psychological compromises, recognizing the style of the story-recalling (e.g. repetitive angry retelling; focus on damage; focus on fear; focus on despair, and so forth), rating of the injury types, and severity and age of occurrence. Inmates' stories were coded and analyzed by up to five researchers. The first wave of data examined a) whether participants have been treated deeply unfairly prior to their crime and imprisonment and the degree of severity; b) the degree to which the participants' show both excessive anger and unforgiveness toward those who acted unjustly as well as their expressions in crimes-direct contribution to their choice of harming the innocent; and c) the relationship among the excessive anger, forgiveness, and related emotional sufferings and psychological distresses such as anxiety and depression. Case studies were also conducted. Reliability and validation of 30-Item Enright forgiveness inventory (EFI-30) in the prison context were also tested. In general, we tested the following hypotheses:

1. Do most inmates in this maximum-security prison experience severe unfair treatment against them before their criminal perpetrations?
2. Do most inmates in this maximum-security prison have low forgiveness towards the person who deeply hurt them?
3. Do disproportional number of inmates in this maximum-security prison have clinical compromises (e.g. excessive anger, anxiety, and depression) related to their past injustice?
4. Does higher degree of anger/anxiety in inmates correlates to the less forgiving behavior towards those who hurt them in the past, prior to their crime?

Study 1 also provided participant matching data (criteria for eligible participants) for the Forgiveness Therapy experiments of subsequent interevtional study

Eligibility criteria: Inclusion Criteria:

* Male prison inmates, who have never participated in forgiveness therapies, were recruited voluntarily from a maximum-security prison in Wisconsin, United States.

Exclusion Criteria:

* have participated in forgiveness workshops
* are not from maximum security prison
* female; (due to the all-male prison context)
* are illiterate (cannot write their stories and finish the scales)
* have been diagnosed with cognitive disorders or cognitive function impairment
* receive one-on-one treatment with the psychologist in prison

Primary outcomes:
measure: Score on Patient-Reported Outcomes Measurement Information System (PROMIS) Measures of Anger
timeFrame: Baseline
measure: Score on Patient-Reported Outcomes Measurement Information System (PROMIS) Measures of Anxiety
timeFrame: Baseline
measure: Score on Patient-Reported Outcomes Measurement Information System (PROMIS) Measures of Depression
timeFrame: Baseline
measure: Score on Herth Hope Index
timeFrame: Baseline
measure: Score on Enright Forgiveness Inventory
timeFrame: Baseline
measure: Score on Marlowe-Crowne Social Desirability Scale
timeFrame: Baseline
measure: Score on Maltreatment and Abuse Chronology of Exposure (MACE) Scale
timeFrame: Baseline
measure: Type of Past Injustice/Unfair Treatment assessed through category 1-5
timeFrame: Baseline
measure: Age of participant at the time of unjust treatment
timeFrame: Baseline
measure: "Severity of Childhood Injustice" assessed on score 1-6
timeFrame: Baseline
measure: "Severity of Injustice Impact on participant's future life" assessed on score 1-6
timeFrame: Baseline
measure: Percentage on participants who shared the experience of injustice with anyone
timeFrame: Baseline
measure: Percentage on participants who seeked help after the injustice experience
timeFrame: Baseline
Secondary outcomes:
Other outcomes:
Locations:
city: Portage
country: United States
facility: Columbia Correctional Institution
state: Wisconsin
Study officials:
affiliation: University of Wisconsin, Madison
name: Robert D Enright, PhD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Erzar T, Yu L, Enright RD, Kompan Erzar K. Childhood Victimization, Recent Injustice, Anger, and Forgiveness in a Sample of Imprisoned Male Offenders. Int J Offender Ther Comp Criminol. 2019 Jan;63(1):18-31. doi: 10.1177/0306624X18781782. Epub 2018 Jun 21.
citation: Lee YR, Enright RD. A Forgiveness Intervention for Women With Fibromyalgia Who Were Abused in Childhood: A Pilot Study. Spiritual Clin Pract (Wash D C ). 2014 Sep;1(3):203-217. doi: 10.1037/scp0000025. Epub 2014 Aug 25.
citation: Waltman MA, Russell DC, Coyle CT, Enright RD, Holter AC, M Swoboda C. The effects of a forgiveness intervention on patients with coronary artery disease. Psychol Health. 2009 Jan;24(1):11-27. doi: 10.1080/08870440903126371.
citation: Hansen MJ, Enright RD, Baskin TW, Klatt J. A palliative care intervention in forgiveness therapy for elderly terminally ill cancer patients. J Palliat Care. 2009 Spring;25(1):51-60.
citation: Reed GL, Enright RD. The effects of forgiveness therapy on depression, anxiety, and posttraumatic stress for women after spousal emotional abuse. J Consult Clin Psychol. 2006 Oct;74(5):920-9. doi: 10.1037/0022-006X.74.5.920.
citation: Lin WF, Mack D, Enright RD, Krahn D, Baskin TW. Effects of forgiveness therapy on anger, mood, and vulnerability to substance use among inpatient substance-dependent clients. J Consult Clin Psychol. 2004 Dec;72(6):1114-21. doi: 10.1037/0022-006X.72.6.1114.
citation: McKay KM, Hill MS, Freedman SR, Enright RD. Towards a feminist empowerment model of forgiveness psychotherapy. Psychotherapy (Chic). 2007 Mar;44(1):14-29. doi: 10.1037/0033-3204.44.1.14.
citation: Yu, L., Gambaro, M., Komoski, M. C., Song, M. J., Song, M., Teslik, M., Wollner, B., & Enright, R. D. (2018). The Silent Injustices against Men in Maximum Security Prison and the Need for Forgiveness Therapy: Two Case Studies. Journal of Forensic Psychology, 3, 137. DOI: 10.4172/2475-319X.1000137.
citation: Enright, R. D., Erzar, T., Gambaro, M., Komoski, M. C., O'Boyle, J., Reed, G., & ... Yu, L. (2016). Proposing Forgiveness Therapy for those in Prison: An Intervention Strategy for Reducing Anger and Promoting Psychological Health. Journal of Forensic Psychology, 1, 116. DOI: 10.4172/2475-319X.1000116.