Adverse childhood experiences in forensic psychiatric patients: Prevalence and correlates from two independent Canadian samples

There is a lack of research examining Adverse Childhood Experiences (ACEs) in forensic psychiatric patients despite research consistently demonstrating a relationship between ACEs and later life mental and physical health issues and likelihood of incarceration. The current study sought to examine the relationships between ACEs and indicators of health and offending among forensic psychiatric patients. Medicolegal files were reviewed and coded for 313 patients from two independent high and low/medium security Canadian forensic psychiatric programs. Findings from both samples revealed higher than previously reported average and cumulative rates of childhood adversity compared to the general population, and rates which were comparable to other forensic samples. Both samples revealed positive relationships between ACEs and both mental health and offending history, while differential patterns between samples emerged for physical health outcomes. Results are interpreted via comparisons between the samples, as well as in reference to previous forensic, correctional, clinical, and community research findings. Although it is clear from these results that ACEs are a significant factor in the forensic psychiatric population, more research is needed to better understand the interactions among, and mechanisms through which, ACEs contribute to offending onset and risk, treatment response, and both mental and physical health outcomes.