Trauma Exposure Prevalence and PTSD Symptoms in Women Who Are Incarcerated: Implications for Nurse Practitioner–Led Clinical Support and Intervention

Background Women develop post-traumatic stress disorder (PTSD) at higher rates than men, with women who are incarcerated (WI) facing a markedly higher burden of potentially traumatic events (PTEs). Yet, cumulative exposure patterns and specific symptom clusters remain understudied. Objective To define the prevalence and patterns of Criterion A PTEs and PTSD symptom severity among WI across correctional facilities, establishing a foundation to inform a future nurse practitioner (NP)–led interventional pilot trial. Methods A cross-sectional study of 148 WI who self-identified as female across 3 state-run correctional facilities in a single Midwestern state, in which NPs and nurses administered validated instruments to collect social and demographic data, and evaluate trauma exposure, PTSD symptom severity, and substance use risk in confidential encounters. Results Participants reported an average PCL-5 score of 47.0 (SD = 16.3), with 87% meeting the threshold for probable PTSD. Interpersonal violence was nearly universal: 94% experienced physical assault, 76% sexual abuse, and 72% weapon-based assault. Additionally, 74% reported the violent death of a loved one. Item-level symptom cluster analysis showed elevated severity in intrusion and avoidance domains. Conclusions These findings highlight a critical disparity regarding PTSD burden and its impact. Universal trauma screening can function as a clinical entry point to identify unrecognized PTSD, prevent symptom exacerbation during incarceration, and facilitate linkage to NP-delivered, trauma-focused interventions.