The nature and impact of trauma in young adult prisoners: screening for trauma and exploring the past and present experiences

Background: Despite the available evidence identifying the high prevalence rates of experiences of trauma in forensic populations, there is still a lack of evidence to support the use of suitable assessment tools, especially for young males in custody. If services are to be able to identify, support and offer trauma interventions to this cohort then it is important that reliable and valid assessment tools are available to practitioners. Aim: The aim of this systematic review was to conduct a full review of the empirical literature of all current measures of trauma with young males in custody. It also sought to evaluate the quality of the psychometric properties of the identified measures, and to synthesise the evidence in order to evaluate if there are any best practice measures available for use with this population. Method: An initial scoping search took place to validate the need for the review and inform the search strategy. A systematic search was then performed in five electronic databases: PsycInfo, The Cochrane Library, ProQuest Dissertations and Theses, PsycTests and PTSDPubs and forward and backward citations for studies published between database inception and July 24th 2020. Grey literature was sourced to identify measures of trauma in this cohort. Authors were approached to obtain unpublished studies. The author screened the records for eligibility and a peer reviewer screened a sample to review for accuracy. Inclusion criteria: studies of tools to assess for trauma with males aged between 14-25yrs-old in a custodial setting, from any year of publication, and available in the English language. Exclusion criteria: studies not about psychological trauma or reporting primary data, or about an assessment tool with a standalone trauma scale. A three-step quality assessment method was used. Firstly, the psychometric properties of the measures were evaluated using the COnsensus-based Standards for the Selection of health Measurement INstruments (COSMIN) taxonomy of measurement properties using pre-set psychometric criteria. Then the methodological quality assessment step was carried out and finally the overall quality of the psychometric properties of the measures were evaluated (Cordier et al., 2017; Terwee et al., 2007). The study is registered on the Open Science Framework https://osf.io/r6hbk as it was not eligible for PROSPERO registration. Results: Fourteen studies including 12 measures met the inclusion criteria and were selected for review. The studies sampled a total of approximately 1,768 male participants and an age range of 12-25yrs. The studies reported on various types of psychometric evidence and due to the lack of homogeneity a narrative synthesis was used to discuss, interpret, and evaluate each measure. Discussion: Robust quality assessment of the methodological and psychometric quality of the studies concluded that this is a developing field and many of the measures in scope were seeking to test for predictive validity, and so were rated as having limited evidence for reliability and validity. It is not possible to strongly recommend any specific measure, as none gained unequivocal support from the three-step quality assessment method which analysed both the methodological quality of each study, as well as the psychometric quality of the measures in each. Therefore, practitioners in custodial settings should be wary of using any particular measure until such time further empirical work establishes support for measures that have greater empirical validation. The overall quality of the psychometric properties of the measures in this review showed that the currently available instruments for the assessment of trauma with young males in custody is limited but promising