Behind bars: gendered pathways, trauma and psychological functioning in incarcerated women and fathers

In recent decades, the number of incarcerated women has increased worldwide, surpassing the rate of growth observed among male prison populations (Fair & Walmsley, 2024). Despite this rise, the experiences of women in prison remain comparatively underrepresented in both empirical research and theoretical discussions. Most studies either exclude women entirely or subsume them under mixed-gender samples, thereby neglecting the specific trajectories, vulnerabilities, and psychological profiles that characterize female incarceration (Cúnico & Lermen, 2020; Anderson et al., 2020). Women entering the criminal justice system often carry cumulative histories of trauma, victimization, and social marginalization that differ qualitatively from those of men (Tripodi et al., 2019; Messina & Grella, 2006). While the literature on gendered pathways in female incarceration has acknowledged the relevance of developmental trauma, far less attention has been given to the psychological factors associated with such trauma within the framework of developmental psychopathology. Existing studies have tended to focus more on social or criminological aspects rather than on dynamic psychological processes. Yet, their representation in contemporary scientific literature remains marginal. This dissertation aims to shed new light on the psychological functioning of incarcerated women, focusing on the interplay between trauma, dissociation, mentalized affectivity, and epistemic trust, dimensions that have received limited empirical attention in this population. While the primary focus of this work is on incarcerated women, attention is also given to fathers in prison, whose experiences are similarly neglected, not as offenders or men, but specifically as caregivers. The emotional, relational and symbolic dimensions of fatherhood in prison have rarely been explored in depth. However, promoting more reflective and emotionally attuned forms of fatherhood may contribute to alleviating part of the caregiving burden traditionally imposed on women, both inside and outside prison. Integrating fathers into parenting and rehabilitation programs could therefore serve as a broader strategy to foster family cohesion, reduce 7 intergenerational transmission of trauma, and support gender equity in caregiving responsibilities. This dissertation is organized into three main chapters. Chapter 1 offers a theoretical framework, focusing on the relationship between incarceration, gender and mental health. It first examines the structural barriers to adequate mental health care in prisons and the tensions between custodial control and therapeutic practice. The chapter concludes by addressing parenting behind bars, highlighting the emotional challenges faced by imprisoned mothers and fathers and the importance of attachment-based programs in preserving family bonds and supporting post-release reintegration. Chapter 2 focuses on the psychological variables investigated in this work: trauma, dissociation, mentalized affectivity, epistemic trust, symptomatology and perceived social support, discussing their conceptual relevance in correctional contexts. Finally, Chapter 3 presents three empirical studies conducted over the course of the doctoral research. • Study 1: in line with the gendered pathways perspective (Anderson et al., 2019), this study examines the psychological functioning of incarcerated women by comparing them with a non-clinical control group of women from the general population. Key dimensions include trauma exposure, mentalized affectivity, epistemic trust, psychopathological symptoms, dissociative experiences and perceived social support, which is hypothesized to moderate the relationship between trauma and pathways to incarceration, functioning as a protective factor. • Study 2: this study compares incarcerated women engaged in psychodynamic psychotherapy for at least six months with those not receiving treatment, examining differences in trauma exposure, psychopathological symptoms, mentalized affectivity, and epistemic trust. • Study 3: focusing on a population of incarcerated fathers, this interdisciplinary project sought to explore how imprisonment shapes paternal experiences and understandings 8 of caregiving. The study aimed to engage fathers as active participants in reflecting on their emotional lives and caregiving roles within the restrictive environment of the prison. A mixed-methods, three-session small-group design was implemented within a large Italian men’s prison. Fathers took part in focus groups and psychoeducational sessions grounded in the Circle of Security (COS) framework, which encouraged exploration of attachment dynamics, parenting challenges, and the emotional dimensions of fatherhood in confinement. Data were collected through an integration of qualitative and quantitative approaches, including focus group discussions, self-report questionnaires and assessments of participants’ expectations and perceived experiences.