Project Summary/Abstract
Substance use costs society $740 billion dollars each year, placing an enormous burden on our nation’s health
care and criminal justice systems. Approximately 85% of incarcerated offenders in the United States have a
history of substance use and/or are imprisoned for crimes involving or motivated by alcohol and/or drug use.
Incarcerated individuals tend to show poorer outcomes following substance use treatment, and forced
abstinence via imprisonment is associated with risk for future substance use, which likely contributes to
substance-related antisocial behavior following imprisonment. Over the past few decades, women have been
sentenced to prison for drug-related reasons at alarming rates, with a growth rate exceeding that for men.
Further, women offenders tend to be impacted more heavily by substance use with co-morbid
psychopathology, placing greater demands on the system in terms of substance use and mental health
treatments. Using the world’s largest forensic neuroimaging database on women offenders (SWANC-F), this
proposal investigates substance use and related antisocial behavior following release from prison in a large
sample of women offenders, with a focus on neurobiological mechanisms, to demonstrate the utility of brain
measures in estimating long-term substance use outcomes in at-risk women. Substance-related antisocial
behavior, defined as committing crime(s) related to substance use after release from prison, will be obtained
from re-arrest data in institutional files and comprehensive background checks on all women enrolled in the
study. A random sample (n = 100) will then be followed-up with via phone to gather data on substance use and
obtain supplemental information to corroborate re-arrest data from files and background checks. Employing
regression analyses and machine learning/pattern classifier approaches, models will be compared testing
effects of psychiatric and socioeconomic variables, along with resting-state functional connectivity (rsFC) brain
measures, to examine unique and combined effects in differentiating among heterogeneous etiological
mechanisms driving substance use outcomes of interest in women. Specifically, this proposal seeks to test the
extent to which psychiatric and socioeconomic factors confer risk for substance-related antisocial behavior
following release from prison in women (Aim 1), and integrates and compares the utility of rsFC brain
measures in improving these prediction models (Aim 2). Then, similar methods will be applied to test the
prediction of substance use following release from prison (Aim 3). It is expected that psychiatric risk factors
and socioeconomic protective factors, as well as rsFC brain measures, will be useful in predicting substance use
and related antisocial behavior following incarceration, along with time elapsed between release from prison
and initiation of substance use and related behavior. Testing factors that aid in predicting these behaviors in
women has the potential to be far-reaching by informing the development of targeted treatments, including
those that help to account for sex differences and co-morbid conditions related to substance use.
