Traumatology 19(1) 73–81 © The Author(s) 2012 Reprints and permission: sagepub.com/journalsPermissions.nav DOI: 10.1177/1534765612437378 http://tmt.sagepub.com Background Scope of the Problem In 2007, of the approximately 1.6 million incarcerated adults, about 1 out of 10 (12%, n = 186,700) was aged 50 and older (Sabol & Couture, 2008; West & Sabol, 2008). Adults aged 50 and older comprise the fastest-growing sector of the inmate population. In fact, this population is 5 times larger than it was in 1990 (Sabol & Couture, 2008). Warehousing older adults in prison comes at an extremely high price. For instance, housing an adult older than 60 in prison costs the taxpayer approximately US$70,000 per year, which is 3 times more expensive than housing younger adults in prison (Kinsella, 2004). The correctional system, which was not designed to be a long-term care nursing facility, is unpre- pared to address the age-related physical and mental health needs of the aging prison population (Falter, 2006). Despite this exponential growth there is a dearth of information on the specialized needs of incarcerated older adults, particu- larly related to their trauma histories. Trauma Among Offenders Research has shown a high prevalence of trauma, such as being a victim of and/or witness to physical or sexual assault, in upwards of 93% of criminal offenders (Abram et al., 2007; Harlow, 1999). In a nationally representative sample of approximately 984,000 state prisoners of all age groups, about 1 out of 5 reported being a victim of violence (i.e., physical and/or sexual assault) multiple times throughout the life course. Male prisoners reported being maltreated during childhood or adolescence at higher rates (i.e., aged 17 or younger) than during adulthood (14.4%; Harlow, 1999; James & Glaze, 2006). Traumatic experiences such as these are significant because after experiencing a trauma, such as sexual assault, victims may have psychological reactions. This includes internal messages to continually prepare the self for defensive action, which creates the basis of develop- ing disturbing physical and psychological (or subjective) symptoms associated with the traumatic event (Rothschild, 1998). This initial subjective response may have a lingering effect and can help explain why trauma that occurs in childhood 437378TMT XX X 10.1177/15347656124 37378Courtney and MaschiTraumatology 1 Fordham University Graduate School of Social Service, NY, USA Corresponding Author: Tina Maschi, PhD, LCSW, ACSW, Fordham University Graduate School of Social Service, 420 Montgomery Street, Highland Park, NY 10023, USA. Email: tmaschi@fordham.edu Trauma and Stress Among Older Adults in Prison: Breaking the Cycle of Silence Deborah Courtney 1 and Tina Maschi 1 Abstract Research consistently shows that incarcerated juveniles and adults experience high levels of prior traumatic experiences and stressful life events. Yet there is a gap in the literature addressing incarcerated older adults’ life-course experiences of traumatic and stressful life events and their initial and current subjective interpretations of these events. Given that untreated trauma has been linked to decreased health and mental well-being, and recidivism, the current study attempts to address this gap. A secondary data analysis was conducted of the Risk and Resilience Study on older adults in prison. It used a cross- sectional correlation design from an anonymous self-report, self-administered survey of a sample of 667 incarcerated older adults with a mean age of 56.5 years. Cumulative trauma (objective and subjective) was measured using the Life Stressors Checklist-Revised (LSC-R). Up to 70% of participants reported at least one of 31 types of lifetime traumatic or stressful events occurring in childhood and/or adulthood. On average, they also reported higher degrees of current subjective distress about being a victim as opposed to a witness of violence or other stressful experiences. This study helps to break the cycle of silence of trauma and stress among older adults in prison. The complex trauma histories and resulting needs of older adults in prison are a significant public health challenge that must be addressed. Specialized trauma-informed assessment and intervention strategies that may work more effectively with this sensitive population, especially in the challenging prison environment, are discussed. Keywords lifetime trauma, older adults, stressful life events, prisoners, cumulative trauma