Journal of Forensic and Legal Medicine 91 (2022) 102407 Contents lists available at ScienceDirect Journal of Forensic and Legal Medicine journal homepage: www.elsevier.com/locate/yjflm Research Paper Peer victimization, prison climate, resilience and psychological distress of incarcerated juvenile offenders in Ghana: A serial mediation examination Kenneth Owusu Ansah a,b,*, Samuel Atindanbila a, Paul Narh Doku c, Jessica Osei Owusu a, Caleb Agyemang Duah a, Francis Pharin a, Morrison Fosu a a Department of Psychology, University of Ghana, Ghana b Department of Psychiatry, Komfo Anokye Teaching Hospital, Ghana c Department of Mental Health, University of Cape Coast, Ghana A R T I C L E I N F O A B S T R A C T Keywords: Most Ghanaian research in the area of victimization among children has focused on the school setting. Little Victimization research has been done in an attempt to understand inmate-on-inmate victimization within the juvenile Psychological distress correctional facilities in Ghana. This study, therefore, investigated the extent to which peer victimization in- Resilience fluences psychological distress among juvenile offenders in the Senior Correctional Center of Ghana. A cross- Prison climate Juvenile offenders sectional design was used to purposively sample 115 juvenile offenders for the study. Following mediation analysis performed in PROCESS, the results revealed that prison climate and resilience serially mediated the relationship between peer victimization and psychological distress. Independently, both prison climate and resilience mediated the relationship between peer victimization and psychological distress. It was recommended that anti-bullying programs ought to be institutionalized to create mental health awareness within the correc- tional facilities. Also, support systems such as the Listener Scheme need to be deployed within the correctional facilities. 1. Introduction Child and other international treaties.9 To address the phenomenon of victimization, the United Nations (UN) captured it as a goal under the Violence is commonly accepted as an unavoidable aspect of prison Sustainable Development Goals (SDGs, 16.2) to put an end to abuse, life.1,2 This is attributed primarily to the confinement of several people exploitation, trafficking, and all forms of abuse against children by with antisocial behaviors in an overcrowded facility with limited re- 2030.10 To achieve this goal, Ghana, a UN member, has strengthened sources and social deprivation.3 Extreme violence in some instances The Children’s Act (Act 560, 1998) by putting in place systems to pre- culminates in murder: for instance, from 1993 to 2000, 53 deaths as a vent any form of correction that is “unreasonable in kind or degree ac- result of inmate assault were reported among all prisoners held in fed- cording to age, the physical and mental condition of a child” (p. 8).11 eral, private, and state prisons in the United States.4 While homicide is Even though necessary stakeholders have made numerous efforts to considered to be rare in most prison centers, victimization is more combat the menace of victimization, some international treaties have common.5 Victimization in this context happens when victims experi- yet to be ratified at the national level. Ghana, for instance, has ratified ence direct and/or indirect aggression on several occasions primarily by eight of the ten core international human treaties. The International the same or different perpetrators.6 Prisoners experience diverse forms Convention for the Protection of All Person from Enforced Disappear- of assault such as direct (being hit, slapped or punched) and indirect ance and the Optional Protocol to the Convention against Torture and physical assault (coerced to stand, sit, and lie in awkward positions), Other Cruel, Inhuman, or Degrading Treatment or Punishment are the theft-related and verbal assault such as speech belittled.6–8 two treaties that remain to be ratified.12 Besides, according to the United Several stakeholders worldwide advocate against the victimization States’ standard minimum rules for the treatment of prisoners, every of adolescents. The protection of children from various forms of violence prison or correctional facility should have a health-care service aimed at is a fundamental right guaranteed by the Convention on the Rights of the improving the physical and mental health of prisoners.13 Most of the * Corresponding author. Department of Psychology, University of Ghana, Legon, Accra, Ghana. E-mail address: kinetic55@hotmail.com (K. Owusu Ansah). https://doi.org/10.1016/j.jflm.2022.102407 Received 14 May 2022; Received in revised form 27 July 2022; Accepted 28 July 2022 Available online 5 August 2022 1752-928X/© 2022 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved. K. Owusu Ansah et al. J o u r n a l o f F o r e n s i c a n d L e g a l M e d ic i n e 91 (2022) 102407 correctional facilities in Ghana, however, have no mental health pro- resilience serially mediated the relationship between peer victimization fessional (psychologist or psychiatrist) stationed in the facility to pro- and psychological distress. vide mental health support for the young offenders.8 On a global dimension, a plethora of studies have been done on victimization and its 1.2. Hypotheses consequences.6,7,14,15 Though victimization has received considerable attention in developed countries, only a few studies have examined The present study was guided by two hypotheses. Based on existing victimization in juvenile prisons in African countries. Anecdotal evi- research, it was first hypothesized that prison climate and resilience dence however suggests that there is a significant rise in the prevalence would independently mediate the relationship between peer victimiza- of victimization among juveniles in prison centers, especially in Africa tion and psychological distress. Finally, it was also hypothesized that the with a prevalence rate of 30–64% in South Africa,16 Ghana8,17 and prison climate and resilience would serially mediate the relationship Kenya.18 between peer victimization and psychological distress. Most studies indicate that prison environments that are not condu- cive and also expose prisoners to victimization could have a crimino- 2. Method genic effect on some prisoners.15,19 That is, a harsh prison environment to some extent could lead to physical confrontations among prisoners. 2.1. Study sample This as such, creates opportunities for those who are perceived to be easy targets due to their age, race, level of education, employment history, A total of 115 juvenile offenders from Ghana’s Senior Correctional and family status, to be victimized.20 Center were purposively sampled for the study. For regression analysis, Generally, it is well placed in the literature that, prisoners who a sample size of 115 was adequate. This was based on a software known witness or are direct victims of assault are significantly more likely to as G Power (version 3.0.10).31 From the analysis of this software, a suffer from long-term negative effects such as depression, suicide, anx- minimum sample size required for multiple regression at 0.05 significant iety, post-traumatic stress disorder, and other health-related errors and a medium effect size (0.15) was determined as 107. Partici- issues.14,21–23 These psychological impacts of victimization are consid- pants’ age ranged from 15 to 17 years with a mean age of 16.13 years ered to be more problematic among juveniles. This situation is a great (SD = 1.96). Approximately 69.6% (n = 80) of the juvenile offenders concern since the adolescent stage is the period these individuals are have been given a maximum sentence of 3 years, with 3.5% (n = 4) building a healthy personality into adulthood.24 sentenced for a year and the remaining 27% sentenced within 2 years. Although victimization is considered a risk factor for psychological Nearly, half of the sample (49.6%) were Junior High School (JHS) distress, the mechanisms by which the environment, specifically, prison dropouts, while only 18 (15.7%) and 21 (18.3%) were Senior High conditions, can cause psychological distress are not well documented. School (SHS) and primary school dropouts, respectively. Research is increasingly highlighting the mediating role of factors such as low social support and parental maltreatment that may serve to 2.2. Research setting illuminate the link between victimization and psychological distress.25,26 However, to the best of our knowledge, no studies have The current study was carried out in Ghana’s Senior Correctional been done to establish the extent to which prison climate mediates the Facility. The facility is home to 198 male young offenders aged 14–20 link between victimization and psychological distress. years old from Ghana’s 16 administrative regions. Before being trans- Also, some individuals who happen to have experienced victimiza- ferred to the Senior Correctional Facility, a young offender is transferred tion tend to exhibit internal and external attributes of resilience.27 In- to a Remand Home until the person is finally convicted of the crime by a ternal resiliency has been found to marginally mediate the relationship Ghanaian court.32 Young offenders are imprisoned for offenses such as existing between victimization and internalizing problems such as defilement, theft, armed robbery, murder, possession of stolen goods, depression, anxiety, and somatic complaint.27,28 Sygit-Kowalkowska and fraud. A juvenile who commits a serious crime usually faces a et al. postulate that there is a significant negative relationship be- maximum sentence of 36 months in prison.32 When incarcerated in the tween resilience and the HADS-M scale (depression and anxiety). This correctional facility, the young offender is either enrolled in a basic indicates that higher levels of resilience lead to lower levels of depres- education or vocational skills program based on the literacy level. sion and anxiety.29 The dearth of research on victimization in developing countries 2.3. Study design and protocol leaves a glaring gap that needs to be filled regarding understanding the scope and nature of the influence of victimization on psychological A cross-sectional study was used for this study. The study began distress since findings in the western countries cannot be generally immediately after the researchers received ethical approval from the applied to the Ghanaian context. Context and culture play a significant University of Ghana’s Ethics Committee for Humanities (ECH: 033/ role in victimization experiences among adolescents and young adults.30 17–18). Following that permission was sought from the Ghana Prisons Again, no anti-bullying policy has been implemented within Gha- Service (OC/1082/V.1/2018/150A) in the administration of in- naian prisons despite the high prevalence rate of victimization reported struments to the prisoners. After approval was granted, a questionnaire among adolescents.17 This, therefore, highlights the need for researchers package that included informed consent, demographic information, and to conduct a contextually relevant study that addresses the various instruments assessing the various variables were administered to the psychological distress associated with victimization. The findings of this participants. We announced in advance, through brochures and regular study would help in the development of anti-bullying intervention intercom announcements, that researchers will be conducting in- programmes for correctional facilities in Ghana. terviews the following week. The advertisement assured the juvenile offenders of the confidentiality of information given out for the study 1.1. Objectives of the study and also about their right to refuse to answer any question. Individuals under the age of 18 who were willing to participate in the study were As described above, research indicates that these variables (peer considered for inclusion in this study. Participants provided data for victimization, prison climate, resilience, and psychological distress) are victimization during periods they had free time in prison schools or closely related; however, the underlying processes tying some of these workshops. Participants who needed assistance to fill out the question- variables together are not yet understood. To expound on the unique naire were assisted by the investigators. It took approximately 20 min to relationships among these variables, this study aimed at proposing and complete the questionnaire and questionnaires were collected on the evaluating a novel conceptual model to examine how prison climate and same day. Participants did not receive any form of compensation for 2 K. Owusu Ansah et al. J o u r n a l o f F o r e n s i c a n d L e g a l M e d ic i n e 91 (2022) 102407 their participation in this study. mediator’s independent effects from the outcome variable.38 With 5000 bootstrap samples, we determined the statistical significance of the 2.4. Study instrument mediating variable at 95% confidence intervals (CI). Indirect effects that did not include zero indicating a statistically significant mediation.38 Three instruments were used in this study. These instruments were the Kessler Psychological Distress Scale (K-10), Multidimensional Peer 3. Results Victimization Scale and Measuring Quality of Prison Life. K-10 is a well- structured instrument that consists of 2 subscales of 5 items each 3.1. Preliminary analyses measuring depression and anxiety. The internal consistency for K-10 was 0.92. Items on the K-10 are scored on a 4-point Likert scale ranging For normality, the skewness, kurtosis, and outliers of the continuous from 0 = never to 4 = always. The reliability of K-10 has been well variables were examined. Skewness and kurtosis were within acceptable established within the African context.33 A composite score of the entire limits of − 3 to +3.39 Table 1 shows the means, standard deviations, and items is taken to obtain a minimum score of 10 and a maximum score of Cronbach’s alphas for each scale. The predictors were significantly 50. A low score indicates lower levels of psychological distress whiles a related, and the medium effect sizes were found to indicate that multi- high score indicates higher levels of psychological distress. A score of collinearity was not an issue in the path analysis.40 20–24 indicates mild psychological distress, whereas a score of 25–29 signifies moderate psychological distress. Also, a score of 30–50 in- 3.2. Intercorrelation matrix dicates severe psychological distress. Victimization was measured using Mynard and Joseph’s Multidi- The results of Table 2 indicated that peer victimization positively mensional Peer-Victimization Scale (MPVS) which is a 16-item scale that correlated with psychological distress (r = 0.69, p < .001). This suggests assesses the extent to which individuals experience victimization.34 that elevated levels of victimization are associated with higher levels of MPVS consists of four subscales namely physical victimization, verbal psychological distress (depression and anxiety) among juvenile pris- victimization, social manipulation, and attacks on property. Social oners. It was also noted that prison climate negatively correlated with manipulation is described as acts intended to manipulate another per- victimization. This implies that lower levels of fairness, policing and son’s social surroundings to hurt or harm that person. Furthermore, safety, caring for the vulnerable, and prisoners’ safety, lead to elevated these four subscales consist of four items each. The reliability for levels of psychological distress among juvenile prisoners. physical victimization, verbal victimization, social manipulation, and attacks on the property are 0.85, 0.75, 0.77, and 0.73 respectively.34 3.3. Serial multiple mediation analyses Prison Climate was assessed using Measuring Quality of Prison Life (MQPL) which consists of 140 items rated by inmates to examine their 3.3.1. The total effect of peer victimization on prison climate, resilience, experiences of staff-prisoner relationships, respect, safety, order, and and psychological distress other aspects of prison life. MQPL consists of 21 subscales which Total effects models produced significant results, firstly with peer comprise entry into custody, respect/courtesy, relationships, humanity, victimization being directly related to prison climate (B = − 1.14, p < decency, care for the vulnerable, help and assistance, staff profession- .001) (see Table 3). Second, peer victimization (B = − 0.19, p < .05) was alism, bureaucratic legitimacy, fairness, organization and consistency, related to resilience after controlling for prison climate (B = 0.15, p < policing and security, prisoner safety, prisoner adaptation, drugs and .01). Finally, peer victimization was discovered to be a significant pre- exploitation, conditions, family contact, personal development, personal dictor of psychological distress (B = 0.13, p < .05). See Table 3. Ac- autonomy, well-being, and distress.22 cording to these findings, increasing victimization was independently For this study, only four subscales of the MQPL were used. The four related to low levels of prison climate, low levels of resilience, and high subscales of MQPL used in this study were “caring for the vulnerable”, levels of psychological distress. It also demonstrates that prison climate “fairness”, “policing and security”, and “prisoner safety”. Care for the was significantly related to resilience. vulnerable is a five-item subscale, which was used to assess the kind of care and support provided to inmates who are at risk of self-harm, sui- 3.3.2. Direct effects of peer victimization, prison climate, resilience on cide, and bullying. Fairness, on the other hand, consists of six items that psychological distress measured the perceived impartiality, proportionality, and legality of In the direct effect model, peer victimization (B = 0.13, p < .05), punishments and procedures within the correctional center. Concerning prison climate (B = − 0.12, p < .05), and resilience (B = − 0.43, p < .001) policing and security, it consists of 9 items that assessed staff supervision were all found to be directly related to psychological distress. See and control of the prison environment. Lastly, prisoner safety consists of Table 3. This result indicates that while controlling the effects of prison five items that assessed inmates’ feelings of protection from harm, climate and resilience, victimization was significantly related to psy- threat, or danger. The reliability of care for the vulnerable, fairness, chological distress. policing and security, and prisoner safety is 0.80, 0.82, 0.75, and 0.73 respectively.22 The scale was measured on a five-point Likert scale 3.3.3. Indirect effects of peer victimization on psychological distress ranging from 0 (never) through 2 (sometimes) to 4 (always). The scale mediated by prison climate and resilience was scored such that negative items were reverse-scored. Fig. 1 depicts the serial multiple mediation analysis, with peer victimization as the predictor variable, prison climate and resilience as 2.5. Statistical analysis mediator variables, and psychological distress as the outcome variable, all with unstandardized coefficients on each regression pathway. Ac- We began by examining the data for consistency with the parametric cording to these findings, peer victimization was linked to psychological assumptions, such as normality. All items were normally distributed. To distress via prison climate and resilience. In other words, a higher level confirm construct dimensionality, exploratory factor analyses with the of peer victimization was related to lower levels of prison climate (a1 = factor loading criterion (≥0.50) were used.35 The dependability of in- − 1.14, p < .001), which increased psychological distress (B b1 = − 0.12, ternal consistency was then determined. Following that, we ran bivar- p < .05). Also, a higher level of peer victimization was related to lower iate correlations between the main study variables. We then tested the levels of resilience (a2 = − 0.18, p < .05), which increased psychological mediating effects of prison climate (M1) and resilience (M2) between distress (B b2 = − 0.43, p < .001). Collectively, reporting high levels of peer victimization (X) and psychological distress using the PROCESS peer victimization was associated with high psychological distress due macro (Model 6).36,37 This method allows for the separation of each to decreased levels of prison climate, which resulted in less resilience (B 3 K. Owusu Ansah et al. J o u r n a l o f F o r e n s i c a n d L e g a l M e d ic i n e 91 (2022) 102407 Table 1 Summary of descriptive statistics of variables in the study. Variable Mean SD Min. Max. Skewness Kurtosis Alpha Peer Victimization 34.49 15.31 1 58 − .60 − .82 .92 Resilience 16.90 10.43 2 40 .54 − 1.15 .91 Prison Climate 38.17 22.44 7 91 .87 − .58 .94 Psychological Distress 30.37 10.82 10 47 − .35 − 1.40 .92 relationship between victimization and psychological distress. The Table 2 current study’s findings shed light on the mechanisms by which peer Bivariate correlation matrix for the study variables. victimization is linked to psychological distress, providing insight into Variables 1 2 3 4 5 6 the process by which these psychological variables (prison climate and 1. Psychological – resilience) affect the association. Distress Prison climate and resilience independently mediate the relationship 2. Level of education .24*** – between peer victimization and psychological distress. This current 3. Served one year in .20* − .17* – prison result is consistent with previous studies documenting that resilience 4. Served two years in − .20* .17* − .83*** – can serve as a mediator linking peer victimization and psychological prison distress.41,42 From the finding, peer victimization undermines resilience 5. Peer Victimization .69** .20* .20** − .12 – and consequently affects the mental health of juvenile offenders. Given 6. Prison Climate − .68*** − .10 − .18* .09 − .82*** – the foregoing, one possible explanation is that adolescents with low * Correlation significant at the 0.05 level. resilience are disadvantaged in acquiring assets or resources for ** Correlation significant at 0.01 level. combating adversities, and thus their risk of experiencing psychological *** Correlation significant at 0.001. distress can be high when bullied. As a result, it explains why decreased resilience can significantly mediate the relationship between victimi- d21 = 0.15, p < .05). Overall, these findings confirmed that prison zation and psychological distress. Peer victimization, thus, reduces climate and resilience mediated the relationship between peer victimi- resilience in areas such as supportive growing environments, social zation and psychological distress. support, and attachment, as well as internal elements such as The bootstrap estimation procedure (with a defined bootstrap sam- self-esteem, self-control, and self-efficacy.28 Limited access to some of ple of 5000) supports these significant indirect effects, as shown in these external and internal elements could engender frustration, stress, Table 3. Peer victimization, had a statistically significant indirect effect and depression among these young offenders.43 Bullying victims also on psychological distress via prison climate (a1b1 = 0.10; 95% CI: 0.03, 0.19), resilience (a2b2 = 0.18; 95% CI: 0.09, 0.30), and a combination of both mediators (a1d21b2 = 0.07; 95% CI: 0.01, 0.15), as each confi- dence interval completely excluded zero. To summarize, mediational analyses revealed an indirect relation- ship between high peer victimization and a high level of psychological distress. Lower levels of prison climate and low levels of resilience mediated this association. 4. Discussion Bullying is a serious issue within any context. However, it is espe- cially so among teenagers since these teens are in a critical and very Fig. 1. An observed serial mediational model with unstandardized coefficients. sensitive stage of their development. A key finding of the current study Regression pathways a = IV to mediator path, b = mediator to DV path, c = which sought to investigate peer victimization and psychological total effect path, c’ = direct effect path controlling for both mediators and d = distress was that prison climate and resilience significantly mediated the serial mediation path. *p ≤ .05; ***p ≤ .001. Table 3 Results of serial mediation pathways of Peer Victimization (PV), prison climate (PC), resilience (RS), and psychological distress (PD). Paths B SE B β p-value R R2 95% CI Lower Upper Total effect PV→PD .40 .06 .56 <.001 .56 .32 .29 .51 PV→PC − 1.14 .09 − .78 <.001 .78 .60 − 1.31 − .97 PV→RS − .18 .09 − .25 <.05 .53 .28 − .34 − .12 PC→RS .15 .06 .32 <.05 .53 .28 .03 .26 Direct effect PV→PD .13 .08 .16 <.05 .70 .49 .04 .27 PC→PD − .12 .05 − .25 <.01 .70 .49 − .23 − .02 RS→PD − .43 .08 − .41 <.001 .70 .49 − .59 − .26 Indirect effect BLLCI BULCI PV→PC 0.14 0.07 0.07 0.27 PV→RS 0.07 0.05 0.02 0.13 PV→PC→RS 0.07 0.04 0.01 0.12 Note. B = unstandardized coefficient; β = standardized coefficient; 95% CI = confidence interval; SE = standard error. Bootstrapped samples = 5000. BLLCI=Bootstrapped Lower Limit. BULCI= Bootstrapped Upper Limit. 4 K. Owusu Ansah et al. J o u r n a l o f F o r e n s i c a n d L e g a l M e d ic i n e 91 (2022) 102407 typically report more negative emotions and higher levels of emotion offenders’ rights and teaching them how to follow up on abuse allega- dysregulation than non-bullied individuals.44,45 It has been established tions. Correctional facility stakeholders should also form a disciplinary that disruptions in emotion regulation may increase the risk of adoles- committee to investigate juvenile abuse cases. Furthermore, based on cents’ internalizing problems, leading to depression and anxiety.46 It the prevalence of bullying within the facility, anti-bullying programs was further noted that prison climate independently mediated the that create awareness of prison policies and practices regarding juvenile relationship between peer victimization and psychological distress. Peer offenders’ rights need to be institutionalized. Support systems such as victimization threatens the safety net of the environment.47 Victimiza- the Listener Scheme needs to be deployed. This Scheme would offer tion may instill fear in victims, which may influence victims’ perception social support for juvenile offenders, by introducing individual officers of the prison environment as unsafe.15 This recurring assessment of the to render support to assigned inmates. Again, mental health screening facility as unsafe may cause victims to be constantly on the edge, ought to be done for juvenile offenders before incarceration. This would increasing their stress and anxiety levels.48 ensure that juvenile offenders with mental health problems would be The findings further revealed that prison climate and resilience easily identified for immediate psychological intervention. To have a jointly played the role of serial mediators in the relationship between broader positive impact on the mental health of juvenile offenders, peer victimization and psychological distress. From the finding, peer resilience-based intervention programs that focus on developing a sense victimization influenced psychological distress through prison climate of relatedness, optimism, trust, and tolerance must be nurtured. The and subsequently resilience. Victims of bullying are less likely to regard correctional facility does not provide counseling to young offenders who the environment as friendly, accommodating, fair and safe, and their have been traumatized or have had any psychological experiences. The sense of belonging and participation in school or workshop activities in Ghana Prisons Service thus should make a concerted effort to recruit the correctional facility will significantly decline.15,47 Accordingly, both clinicians to teach stress management techniques such as progressive internal and external resilience elements such as supportive growing muscle relaxation, and meditation, among others to juvenile offenders environments, social support, and attachment, as well as internal ele- and prison officers. ments such as self-esteem, self-control, and self-efficacy will be nega- tively affected, ultimately leading to a significant increase in their Declaration of conflicts of interest psychological distress. No conflicts of interest declared. 5. Limitations and future directions Acknowledgment The current study was not short of limitations. The first limitation has to do with the use of self-reports on peer victimization. Data on peer We acknowledge the Ghana Prisons Service for permitting us to use victimization was solely based on self-reports from juvenile offenders. the Senior Correctional Facility for this study. This probably could lead to juvenile offenders’ magnifying their reports Funding of victimization to seek attention. Future research should therefore No funds were received for this study. make effort to obtain prison officers’ views and reports about victimi- zation in correctional facilities. This would ensure that the personal References experiences of the officers are captured and analyzed. It would further enrich the data and yet at the same time validate the responses from the 1. Irwin J. Prisons in Turmoil. Brown: Little; 1980. 2. Johnson R. Hard time: understanding and reforming the prison. In: Acts of Ghana; juvenile offenders. The current study was also conducted with a sample 1987. http://challengingheights.org/wp-content/uploads/2014/11/JUVENILE of male juvenile offenders from only one Ghanaian institution. Care -JUSTICE-ACT-2003-ACT-653.pdf. should, therefore, be taken in an attempt to generalize these findings to 3. Travis J, Western B, Redburn FS. The Growth of Incarceration in the United States: other prison centers. Research has suggested, for instance, that males Exploring Causes and Consequences; 2014. https://academicworks.cuny.edu/jj _pubs/27/. and females differ in their preferred coping styles.49,50 The scope of 4. Stephan JJ, Karberg JC. Census of State and Federal Correctional Facilities. 2003, 2000. coverage of the study should thus, be expanded to include other areas or 5. Blitz CL, Wolff N, Shi J. Physical victimization in prison: the role of mental illness. institutions in Ghana. This would increase the degree to which the re- Int J Law Psychiatr. 2008;31(5):385–393. https://doi.org/10.1016/j. ijlp.2008.08.005. sults can be generalized to a larger population of Ghanaian young of- 6. Ireland JL, Archer J, Power CL. Behaviours indicative of bullying among young and fenders. Furthermore, the study was conducted using a cross-sectional juvenile male offenders: a study of perpetrator and victim characteristics. Aggress design. This may have not been enough to gain adequate insight into Behav. 2007;33(3):220–229. https://doi.org/10.1002/ab.20182. 7. Klomek AB, Marrocco F, Kleinman M, Schonfeld IS, Gould MS. Peer victimization, juvenile offenders’ experiences with the facility in terms of possible depression, and suicidiality in adolescents. Suicide Life-Threatening Behav. 2008;38 fluctuations in experiences over time, as a result of potential changes in (2):166–180. https://doi.org/10.1521/suli.2008.38.2.166. juvenile offenders’ conditions and circumstances surrounding victimi- 8. Owusu Ansah K, Atindanbila S, Osei Owusu J, Agyemang Duah C. Patterns of victimization in Ghana’s Senior Correctional Center: the experiences of juvenile zation. Future researchers should consider a longitudinal study to gain offenders. Int J Law Psychiatr. 2022;83, 101808. https://doi.org/10.1016/j. sufficient information about potential trends in the juveniles’ experi- ijlp.2022.101808. ences of victimization and other potential factors in the correctional 9. UNICEF. Convention on the Rights of the Child. For Every Child. Every Right; 2022. https://www.unicef.org/child-rights-convention. facility. 10. WHO. Violence against Children. https://www.who.int/news-room/fact-sheets/det ail/violence-against-children; 2020. 6. Implications and conclusion 11. Children’s Act Act 560. http://www.unesco.org/education/edurights/media/docs/f 7a7a002205e07fbf119bc00c8bd3208a438b37f.pdf; 1998. 12. Mendez J. Report/Submitted by the Special Rapporteur on Torture and Other Cruel, In this population-based cross-sectional study that included juvenile Inhuman or Degrading Treatment or Punishment, Juan E. Méndez. https://www.ohchr. offenders, we found that victimization was significantly associated with org/Documents/HRBodies/HRCouncil/RegularSession/Session22/A.HRC.22.53_En psychological distress; more importantly, resilience and prison climate glish.pdf 13. United nations Office on Drugs and Crime. The United Nations standard minimum independently as well as combined to explain the association between rules for the treatment of prisoners. https://www.unodc.org/documents/justice-a victimization and psychological distress. The findings of the study have nd-prison-reform/Nelson_Mandela_Rules-E-ebook.pdf; 2015. implications, in that, increased awareness of youth exposure to bullying 14. Allison MD, Ireland JL. Staff and prisoner perceptions of physical and social environmental factors thought to be supportive of bullying: the role of bullying and and its potential health consequences may lead to mental health pro- fear of bullying. Int J Law Psychiatr. 2010;33(1):43–51. https://doi.org/10.1016/j. motion and disease prevention programs within the prison centers. To ijlp.2009.10.002. avoid victimization, stakeholders should develop education programs aimed at explaining prison policies and practices regarding young 5 K. Owusu Ansah et al. J o u r n a l o f F o r e n s i c a n d L e g a l M e d ic i n e 91 (2022) 102407 15. Listwan SJ, Colvin M, Hanley D, Flannery D. Victimization, social support and 33. Myer L, Stein DJ, Grimsrud A, Seedat S, Williams DR. Social determinants of psychological well-being: a study of recently released prisoners. Crim Justice Behav. psychological distress in a nationally-representative sample of South African adults. 2010;37(10):1140–1159. https://10.1177/0093854810376338. Soc Sci Med. 2008;66(8):1828–1840. https://doi.org/10.1515/9783112412886- 16. Kiessl H, Würger M. Victimization of incarcerated children and juveniles in South 025. Africa. Int Rev Vict. 2002;9(3):299–329. https://doi.org/10.1177/ 34. Mynard H, Joseph S. Development of the multidimensional peer-victimization scale. 2F026975800200900305. Aggress Behav. 2000;26(2):169–178. https://doi.org/10.1002/(SICI)1098-2337 17. Darko G, Björkqvist K, Österman K. Low intensity intimate partner aggression in (2000)26:2%3C169::AID-AB3%3E3.0.CO;2-A. Ghana: support for the revised gender symmetry theory in an African country. 35. Hair JF, Black WC, Babin BJ, Anderson RE. Multivariate Data Analysis. Prentice Hall; Aggress Behav. 2019;45(1):52–61. https://doi.org/10.1002/ab.21796. 2012. 18. Chepkemoi F. The Challenges Faced by Inmates at Langata Women Prison; 2011. 36. Hayes AF. PROCESS: A Versatile Computational Tool for Observed Variable Mediation, Nairobi http://erepository.uonbi.ac.ke/handle/11295/4401. Moderation, and Conditional Process Modeling; 2012. http://www.afhayes.com/ pub 19. Windzio M. Is there a deterrent effect of pains of imprisonment? The impact of lic/process2012.pdf. ‘social costs’ of first incarceration on the hazard rate of recidivism. Punishm Soc. 37. Hayes AF. Conditional process analysis: concepts, computation, and advances in the 2013;28(3):341–364. https://doi.org/10.1177/2F1462474506064701. modeling of the contingencies of mechanisms. Behav Sci. 2020;64(1):19–54. https:// 20. Wooldredge J, Steiner B. Violent victimization among state prison inmates. Violence doi.org/10.1177/0002764219859633. Vict. 2013;28(3):531–551. https://doi.org/10.1891/0886-6708.11-00141. 38. Hayes AF. Introduction to Mediation, Moderation, and Conditional Process Analysis: A 21. Baldry AC. The impact of direct and indirect bullying on the mental health and Regression Based Approach. Guilford Publications; 2018. physical health of Italian youngsters. Aggress Behav. 2004;30(5):343–355. https:// 39. Garson GD. Testing Statistical Assumptions. Statistical Associates Publishing; 2012. doi.org/10.1007/s10826-018-1122-4. 40. Tabachnick BG, Fidell LS. Using Multivariate Statistics. sixth ed. Pearson; 2012. 22. Crewe B, Liebling A, Hulley S. Staff-prisoner relationships, staff professionalism, and 41. Anderson JR, Mayes TL, Fuller A, Hughes JL, Minhajuddin A, Trivedi M. the use of authority in public-and private-sector prisons. Law Soc Inq. 2015;40(2): Experiencing bullying’s impact on adolescent depression and anxiety: Mediating 309–344. https://doi.org/10.1111/lsi.12093. role of adolescent resilience. J Affect Disord. 2022. https://doi.org/10.1016/j. 23. Kowalski RM, Limber SP. Psychological, physical, and academic correlates of jad.2022.04.003. cyberbullying and traditional bullying. J Adolesc Health. 2013;53(1):S13–S20. 42. Shemesh DO, Heiman T. Resilience and self-concept as mediating factors in the https://doi.org/10.1016/j.jadohealth.2012.09.018. relationship between bullying victimization and sense of well-being among 24. Owusu A, Hart P, Oliver B, Kang M. The association between bullying and adolescents. Int J Adolesc Youth. 2021;26(1):158–171. https://doi.org/10.1080/ psychological health among senior high school students in Ghana, West Africa. J Sch 02673843.2021.1899946. Health. 2011;81(5):231–238. https://doi.org/10.1111/j.1746-1561.2011.00590.x. 43. Nurse J, Woodcock P, Ormsby J. Influence of environmental factors on mental 25. Ruiz AP, Oteiza-Nascimento A, Toldos MP, Serrano-Marugan I, Martin-Babarro J. health within prisons: focus group study. Br Med J. 2003;327(7413):480. https:// Bullying and depression: the moderating effect of social support, rejection and doi.org/10.1136/bmj.327.7413.480. victimization profile. Ann Psychol. 2019;35(1):1–10. https://doi.org/10.6018/ 44. Adrian M, Jenness JL, Kuehn KS, Smith MR, Mclaughlin KA. Emotion regulation analesps.35.1.301241. processes linking peer victimization to anxiety and depression symptoms in 26. Seeds PM, Harkness KL, Quilty LC. Parental maltreatment, bullying, and adolescent adolescence. Dev Psychopathol. 2019;31(3):999–1009. https://doi.org/10.1017/ depression: evidence for the mediating role of perceived social support. J Clin Child S0954579419000543. Adolesc Psychol. 2010;39(5):681–692. https://doi.org/10.1080/ 45. Morelen D, Southam-Gerow M, Zeman J. Child emotion regulation and peer 15374416.2010.501289. victimization: the moderating role of child sex. J Child Fam Stud. 2016;26(6): 27. Quinn AH. The Moderating Effect of Resilience Factors on Bully Victimization and 1941–1953. https://doi.org/10.1007/s10826-016-0360-6. Subsequent Psychological Adjustment Problems Among Adolescent Girls. 2015. 46. Klemanski DH, Curtiss J, McLaughlin KA, Nolen-Hoeksema S. Emotion regulation Published online. and the transdiagnostic role of repetitive negative thinking in adolescents with 28. Zhou ZK, Liu QQ, Niu GF, Sun XJ, Fan CY. Bullying victimization and depression in social anxiety and depression. Cognit Ther Res. 2017;41(2):206–219. https://doi. Chinese children: a moderated mediation model of resilience and mindfulness. Pers org/10.1007/s10608-016-9817-6. Indiv Differ. 2017;104:137–142. https://doi.org/10.1016/j.paid.2016.07.040. 47. Eccles JS, Roeser RW. Schools as developmental contexts during adolescence. J Res 29. Sygit-Kowalkowska E, Szrajda J, Weber-Rajek M, Porazynski K, Ziolkowski M. Adolesc. 2011;21(1):225–241. https://doi.org/10.1111/j.1532-7795.2010.00725.x. Resilience as a predictor of mental health of incarcerated women. Psychiatr Pol. 48. Douglas N, Plugge E, Fitzpatrick R. The impact of imprisonment on health: what do 2017;51(3):549–560. https://10.12740/PP/OnlineFirst/62617. women prisoners say. J Epidemiol Community Health. 2009;6(3):749–754. https:// 30. Nguyen AJ, Bradshaw C, Townsend L, Bass J. Prevalence and correlates of bullying doi.org/10.1136/jech.2008.080713. victimization in four low-resource countries. J Interpers Violence. 2020;35(19): 49. Matud MP. Gender differences in stress and coping styles. Pers Indiv Differ. 2004;37 3767–3790. https://doi.org/10.1177/0886260517709799. (7):1401–1415. https://doi.org/10.1016/j.paid.2004.01.010. 31. Faul F, Erdfelder E, Lang AG, Buchner AG. *Power 3: a flexible statistical power 50. Jorge KO, Ferreira RC, e Ferreira EF, Kawachi I, Zarzar PM, Pordeus IA. Influência analysis program for social, behavioral, and biomedical sciences. Behav Res Methods. do grupo de pares e uso de drogas ilícitas entre adolescentes Brasileiros: Um estudo 2007;39(2):175–191. https://doi.org/10.3758/BF03193146. transversal. Cad Saúde Pública. 2018;34(3). https://doi.org/10.1590/0102- 32. Juvenile Justice Act. Acts Of Ghana; 2003. http://challengingheights.org/wp-co 311X00144316. ntent/uploads/2014/11/JUVENILE-JUSTICE-ACT-2003-ACT-653.pdf. 6