Intra familial adverse childhood experiences and recidivism: the mediation effect of substance use among a sample of male tunisian prisoners

While the link between intra-familial Adverse Childhood Experiences (ACEs) and recidivism is increasingly supported by evidence, the underlying mechanisms explaining this relationship remain less explored. In the current study, we, for the first time, investigated the path from intra-familial ACEs to recidivism, with a focus on the mediating role of substance use among a sample of male prisoners in Tunisia. We conducted a cross-sectional survey in April 2023 among 403male adult prisoners with a median age of 31 [26; 40] years. Using a self-administered, anonymous questionnaire in Arabic, we asked about ACEs using the World Health Organization (WHO) ACEs questionnaire as well as substance use and criminal history. Participation in the study was voluntary. Mediation analyses investigate the indirect effect of an independent variable on a dependent variable through a mediator. We found that the most prevalent forms of intra-familial ACEs were physical abuse (74.6%) and emotional abuse (73%). Regarding substance use, 76.9% were smokers, 59.1% reported alcohol consumption and 52.1% used cannabis. Recidivism was observed in 52% in our sample, with 18% re-incarcerated twice and 34% at least three times. Mediation analysis indicated that substance use was a mediator between intra-familial ACEs and recidivism. Specifically, emotional neglect and physical abuse were found to mediate recidivism through substance use. These findings underscore the importance of addressing intra-familial ACEs and substance use in efforts to reduce recidivism among incarcerated individuals.