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Cusack, Karen J.; Herring, Amy H.; & Steadman, Henry J. (2013). PTSD as a Mediator between Lifetime Sexual Abuse and Substance Use among Jail Diversion Participants. Psychiatric Services, 64(8), 776-781.


OBJECTIVE: Many of the individuals with serious mental illness involved in the criminal justice system have experienced interpersonal victimization, such as sexual abuse, and have high rates of alcohol and drug use disorders. Little attention has been paid to the prevalence of posttraumatic stress disorder (PTSD) and its potential role in the substance misuse of offenders with mental illness.
METHODS: The study used a path analytic framework to test the hypothesis that PTSD mediates the relationship between sexual abuse and level of alcohol and drug use among individuals (N=386) with mental illness enrolled in a multisite (N=7) jail diversion project.
RESULTS: Sexual abuse was strongly associated with PTSD, which was in turn associated with both heavy drug use and heavy drinking.
CONCLUSIONS: These findings suggest that PTSD may be an important target for jail diversion programs.


Reference Type

Journal Article

Year Published


Journal Title

Psychiatric Services


Cusack, Karen J.
Herring, Amy H.
Steadman, Henry J.