CHAPTER ONE
INTRODUCTION
Imprisonment is by all accounts seems to be an unpleasant experience wherever in the world it takes place. According to Sykes (2006) life in the prisons is a punishing and painful experience. Prisoners experience high levels of emotional stress as a result of emotional withdrawal and depression (Herreveld, Van Der Plight, Claassen & Van Dijik, 2007). For some prisoners, incarceration is so stark and psychologically painful that it represents a form of traumatic stress severe enough to produce post-traumatic stress reactions after their release (Rokach, 2007). Research on the health status of prisons inmates has had a long history and has revealed a number of findings indicating that inmates generally experience poorer health than the general population (Cooper & Livingstone, 1991). Majority of the researchers concluded that imprisonment has negative psychological and physical effects on the inmates’ well-being leading to psychological deterioration.
Well-being is a potential parameter of overall health and good life of every person (Seligman & Csikzentmihalyi, 2000). The good life refers to the factors that contribute most to a well lived life. They are positive social relationships, ability to cope in stressful environment, wisdom, sense of meaning and purpose in life (Diener, 2009; Myers, 1992). Well-being is also seen as a contentment and satisfaction (in the past), flow of happiness (in the present) and hope, optimism (for the future) (Carr, 2004). The role of individual’s adaptability, social support networks and connections are fundamental factors to achieving prisoner’s health and psychological well-being (Herreveld, Van Der Plight, Claassen & Van Dijik, 2007).
The definition of health is critical to the debate over prisoners’ health. World Health Organization (WHO) (1996) defined health as a complete state of physical, mental and social well-being and not merely the absence of disease or infirmity. World Health Organization (WHO) (1996) argues that health is created by caring for oneself and others, being able to take decisions and have control over one’s life circumstances, and ensuring that the society one lives in creates the conditions that allows for the attainment of health by all its members. According to WHO poor health is typically regarded as a manifestation of a breakdown in harmony between the individual and the wider environment.
Psychological well-being however, is the ability of an individual to live and function at a high level of behavioural, emotional, physical adjustment and adaptiveness even in the presence of stress. It denotes the extent to which a person is living a life characterized by happiness, satisfaction and hopefulness. Psychological well-being according to De Viggiani (2007) Visser and Routhledge (2007) is a good or satisfactory condition of existence characterized by health in which an individual can function psychologically well enough to realize his or her potentials and the ability of feeling good and functioning effectively. As such, psychological well-being designates one who is functioning at a high level of behavioural and emotional adjustment and adaptiveness and not one who is simply not ill. Some literature in health psychology has demonstrated the fact that the association between health status and well-being seems intuitively clear based on mind-body relationships, and that the presence of illness can be negatively correlated with the experience of psychological well-being (Compton, 2005; Shuker & Newton, 2008; Weiten, Dunn & Hammer, 2011).
It is generally agreed that three aspects of psychological well-being can be distinguished (Kahneman & Deaton, 2010). They are evaluative well-being, involving global assessments of how people evaluate their lives or their satisfaction with life, Secondly affective or hedonic well-being which involves measures of feelings such as happiness, sadness and enjoyment, and thirdly eudemonic well-being which focuses on judgments about the meaning or purpose of one’s life and appraisals of constructs such as fulfillment (Kahneman & Deaton, 2010).
Fava and Ruini (2003) and Ryff (1995) also defined psychological well-being as a state in which individual’s experiences a sense of autonomy, competence, self acceptance, belongingness, purpose and personal growth. Bar-on (1988) also in-view of the above listed the vital and major components of psychological well-being to includes self-regard, interpersonal relationships, independence, problem solving, assertiveness, stress tolerance, self actualization, happiness and mastery. According to Bar-on anybody who exhibits strength in each of these areas is in a state of good psychological well-being and low exhibition indicates poor psychological well-being.
Psychological well-being produces positive experiences such as emotions, moods and feelings (Headey & Wearing, 1997). Absence of psychological well being among prisoners may reflect in inmates’ expression of anger, depression, frustrations and this may cause a decrease in the levels of their happiness and satisfaction. Poor psychological well-being has being associated with deficiency in problem-solving, higher levels of stress-depression, lack of success and the existence of emotional problems (Myers, Sweeney & Witmer 2004;Temane & Wissing, 2006) excessive alcohol and drug usage (Visser & Routledge, 2007).
The effects of psychological well-being have also been studied in relation to physical health. According to Ryff and Singer (2008) psychological well-being has been linked to enhanced neuroendocrine functioning, better immune systems, improved sleep, lower cardiovascular danger and more adaptable neural circuitry. Recent studies also showed that higher levels of well-being are linked with better regulation of biological systems and adaptive neural response, and may serve as a protective influence on good physical health. Positive psychological well-being has also been linked to a reduction in mortality (Bronfenbrenner, 2005; Chida, 2008). Consequently individuals with higher than average psychological well-being are regarded as more successful in meeting environmental demands and pressures. It raises individual’s ability in making good decision and caring for oneself emotionally.
Social relationships are essential to personal health, happiness and general psychological well-being, and which agrees to the common adage that good friends are good medicine. An individual’s ability to have close relationships with others is one of the most important features of a healthy personality (Diener, 2009; Seligman, 2000). A lack in connection to others may lead to feelings of loneliness and poor psychological well-being.
Loneliness is a complex and usually unpleasant emotion which typically includes anxious feelings about a lack of connectedness or communality with others. It is an individual’s subjective experience of a lack in satisfying human relationships and results in negative feelings and distress to the individual. Loneliness is a common human experiences that can affect a wide range of people although some people are at a greater risk of it than others (Killeen, 1998).
Young (1982) defined loneliness as the absence of satisfying social relationships accompanied by symptoms of psychological distress that are related to the actual or perceived absence. Loneliness, feeling lonely and alone has often been used interchangeably (Karnick, 2005). However, loneliness is not the same as being alone. You might choose to be alone and live happily without much contact with other people or have lots of social contacts or be in a relationship or part of a family and still feel lonely. People feel lonely in the midst of people. Some may choose to live alone if it suits their personality. Hence, it is possible to feel lonely in a crowd or to feel socially connected when alone (Weeks & Asher, 2012; Weeks, 2010). With the exception of those who choose to be alone, loneliness can be distressing, painful and unpleasant feeling that arises due to a discrepancy between the desired and achieved quality of one’s social network (Hawkley & Cacioppo, 2010; Jones, Rose & Russell 1990).
Loneliness is detrimental to psychological health and has a deleterious effect on various aspects of psychological well-being (Heinrich & Gullone, 2006; Murphy & Kupshik, 1992). Loneliness is as a result of complex set of feelings encompassing reactions to the absence of intimate and social needs, as an emotional state in which a person experiences strong feelings of emptiness and social isolation (Victor, Bowling & Bond, 2002; Rokach & Brock, 2012). Social isolation can be defined as a situation where a person does not have a social network or is dissatisfied with the present social network. It is caused by a lack of social integration where one feels that they really do not have anyone or set of friends. Other researchers refer to social isolation by the number of contacts and integration of an individual into the surrounding social environment (Cattan, White, Bond & Learmouth, 2005). If a person is socially isolated his or her possibilities for social comparison and personal control are diminished. A socially isolated person may feel socially frustrated, feelings of nobody to count on for support, absence of social network and lack of sense of social belonginess (Cohen, 2000; Clinton & Anderson, 1999).
Loneliness is composed of negative emotions such as trouble and distress (Jones, Rose & Russell, 1990; Weeks & Asher, 2012). Studies have also shown that loneliness can have detrimental effects on physical and mental health. Loneliness places people at risk of physical ailments, such as poor cardiovascular health and impaired immune responses (Hawkley & Cacioppo, 2010; Martina & Stevens 2006). Loneliness is also associated with mental health issues, such as psychoses, personality disorders, impaired cognitive functioning, low self-esteem and depression (Benner 2011; Besevegis & Galanaki, 2010). Particular concern is the correlation between loneliness and suicide or suicidal ideation. Stravynski and Boyer, (2001) found that people who reported feeling distress about being alone were more likely to have suicidal thoughts and attempts suicide. De Jong Gierveld, Tilburg and Dykstra (2006) and Weiss (1989) also viewed loneliness as a sentiment felt by a person, (experiencing) a wish for a form or level of interaction different from the one presently experienced.
Loneliness is a distressing experience that whoever experiences it wishes it never came to him or her. Loneliness has different antecedents and various manifestations (Rokach, 2007). Loneliness is an unpleasant, even distressing experience (Peplau & Perlman, 1982). The second element is that loneliness is a subjective feeling (De Jong Gierveld et al. 2006). The desired levels of social contact are subjective and are based on comparisons to past or present relationships as well as social and cultural norms (Ponzetti, 1990; Murphy & Kupshik, 1992). Hawkley and Cacioppo (2010) asserted that loneliness stems from perceived social isolation, rather than objective isolation. Lastly, loneliness implies the perception of both quantitative and qualitative deficiencies in one’s social relationships (Peplau & Perlman 1982; Hawkley & Cacioppo, 2003; Murphy & Kupshik, 1992). A feeling of loneliness occurs when relationships do not meet one’s needs, such as the need for companionship or the need for close attachments.
Loneliness is influenced by both personal and environmental factors (Rokach & Brock, 2012; Weiss, 1989). A common element of it is the interplay of personal characteristics and environmental factors (Hawkley & Cacioppo, 2010). Personal characteristics associated with loneliness include low self-esteem, introversion, low assertiveness, and heightened sensitivity to rejection (Rokach, 2007). Loneliness is also associated with cynical attitudes toward people, a sense of alienation, minimal self-disclosure, and low levels of social risk-taking (Weeks, 2010).
Environmental factors relevant to prison inmates includes; separation from family and friends, and a culture of solitude in the prison. Conversely, lonely individuals have fewer friends and fewer close friends, their friendships are lower in quality and stability, and they see their friends as not very similar to themselves (Kingery, Erdley, & Marshall, 2011; Berndt, 2002). Researchers have stressed the importance of investigating the quality of friendships in addition to the quantity of friendships as buffers against loneliness (Parker & Asher, 1993). Indeed having reciprocal friendships protects people against feeling lonely especially when the experienced friendship quality is high (Vanhalst, Luyckx, Raes & Goossens, 2012).
There are two major types of loneliness; emotional and social loneliness. Emotional loneliness is a feeling that stems from a lack of intimate figure or emotional attachments, (a partner, a best friend) typically involving romantic partners and this feeling can be described only by the person (Weeks & Asher, 2012; Woodhouse, Dykas, & Cassidy, 2012). Social loneliness, on the other hand, refers to a feeling stemming from the absence of a social network, broader group of contacts or an engaging social network (friends, colleagues, and people in the neighborhood) with common interests. Emotional loneliness is more likely to occur with the absence of an important relationship while social loneliness tends to occur when one moves to a new social environment and can be objectively measured by an outside observer as well. (Stroebe, Stroebe, Abakoumkin, & Schut, 1996). Peplau and Perlman, (1982) posited that loneliness is a response to a discrepancy between desired and achieved levels of social contact.
Research has demonstrated between positive and a negative type of loneliness (Weeks, 2010; Jones, Rose & Russell, 1990). The positive type of loneliness is related to situations such as the voluntary withdrawal from the daily hassles of life and is oriented toward higher goals like reflections, meditations, and communication with God. Nowadays the positive type of loneliness is more frequently referred to by a separate concept “Privacy”. Privacy as a concept is voluntary and concerns a freely chosen situation of (temporary) absence of contacts with other people. The negative type of loneliness is related to an unpleasant or inadmissible lack of personal relationships and contacts with important others. This is the concept of loneliness that is nowadays used in theories and research. Moreover, it is the type of loneliness that best fits the everyday concept of loneliness.
Social bonds, social integrations and primary group relationships are sense of connectedness to one’s social group and results in feelings of well-being (Ryan & Deci, 2001). Social support is part of it. Social support refers to the experience of being valued, respected, cared about, and loved by others who are present in one’s life and are eager to help the individual to reduce the amount of stress experienced and also help the person cope better in dealing with stressful situations and enhancement of the psychological well-being. Individuals turn to people around them for assistance during troubled times they seek social support.
Zimet, Dahlem, Zimet and Farly (1988) defined social support as the degree to which one perceives that the basic social needs are meet by people around them. It is a process that can help individuals to reduce the amount of stress experienced as well as to help individual cope better in dealing with stressful situations (Lakey & Cohen, 2000). Social support according to (Yasin & Dzuikifli 2010; Sarason & Sarason, 1996) is a complex transactional process in which an active interplay between a person and his or her support network is involved in the process of providing empathy, care, love, trust(emotional support) actual aid in time, money(instrumental support) evaluative feedback(appraisal support) and information, advice, suggestions(informational support). Social support may come from family, friends, teachers, healthcare workers, community or any social groups to which one is affiliated to (Sanderson, 2004).
Shumaker and Brownel (1984) defined social support as an exchange of resources between two individuals perceived by the provider or the recipient to be intended to enhance the well-being of the recipient. It is one of the most critical dimensions that contributes to well-being and reduces stress. It serves as both a buffer against life stressors as well as an agent promoting health and well-being by creating a sense of belongingness and sense of hopefulness (Dollete, Steese, Phillips, & Matthews, 2004; Greenglass, 1993). The absence of social support may have a detrimental effect on individuals overall well-being (Dollete et al. 1993). The Deficits in social support have been shown to be related to many psychological problems such as depression and anxiety (Haney, 2002).
Social support is generally understood as help from other people in different situations in times of need. According to Sinha, Wilson and Watson (2000) social support is a stress reducer because it provides effective coping resources and helps people view events as less stressful than if they were handling the events in isolation. They pointed out that the more social support a person perceives or receives, the less likely he or she is to perceive stress.
Two separate domains of social support exist. They are structural and functional social support. Structural social support is the actual physicality of the support such as frequency of contact with friends or family, voluntary organisations, community or religious groups while functional social support includes verbal and physical appraisal, help with tasks, helpful information, guidance and social companionship (Calvete & Connor-Smith, 2006; Cohen & Wills, 1985). Social support can also be divided into two other categories: emotional support and instrumental support (Queenan, Feldman-Stewart Brundage & Groome, 2010). The conveyance of care and love is emotional support, appreciation for others, trust, and listening while instrumental support is behavior that provides tangible assistance (Uchino, Cacioppo, & Kiecolt-Glaser 1996).
Martinus NijhoffQueenan, Feldman-Stewart, Brundage and Groome (2010) suggested two categories of social support as appraisal support and informational support. While appraisal support means affirmation, feedback, and social equality, informational support refers to advice, suggestions, guidance, and information giving (Martinus et al. 2010). Evidence suggests that the perception of social support (functional) is more predictive of positive health than received or available social support (Cohen, Doyle, Turner, Alper & Skoner 2003). Social support has been shown to provide important assistance in times of adversity (Shuker & Newton, 2008; Shumaker & Brownel, 1984). In effect, it helps a stressed individual to cope with difficult life circumstances.
Organisms resist change and react to external challenges by mounting responses that maintain their equilibrium. At the psychological and behavioural levels various coping processes are involved. Coping; the ability of a person to deal effectively with a stressful or challenging situation has been a central focus in vast amount of studies when it comes to learning about stress (Lazarus & Folkman, 1984). Coping represents efforts to prevent or reduce the negative effects of stress on well-being (Lazarus & Folkman, 1984). Coping is also the efforts made to master, reduce or tolerate the demands of stress on individual’s life. It involves a decision making process in which coping strategies are selected and implemented (Zeidner & Endler, 1996). This process may range from a careful generation, evaluation, and selection of coping strategies to an intuitive or preconscious coping response (Edwards & Holden, 2003; Edworthy, 2000; Aldwin, 2000). This coincided with Lazarus and Folkman’s (1984) definition of coping as constantly changing cognitive and behavioural efforts to manage specific external or internal demands that are appraised as taxing or exceeding the resources of the person.
Coping has been referred to as strategies or results (Auerbach, Abela, Zhu, & Yao, 2010). As a strategy, coping refers to the different methods that a person may use in managing his or her circumstances while coping as a result implies the eventual outcome of the strategy for the person. Coping is moderated by personal and environmental factors. Personal factors refer to coping styles that arise from personality traits and cognitive schema that elicit scripted coping strategies (Aldwin, 2000). Environmental factors include opportunities or constraints regarding coping strategy choice and access to coping resources such as social support (Seiffge-Krenke, 2011).
Coping efforts are more likely to succeed when the demands of the chosen coping strategy are within the abilities of the person. Likewise, physical constraints and powerful others may impact coping strategy success (Edwards & Holden, 2003). Combination of coping strategies may be used to deal with any one stressor (emotion-focused and problem-focused coping) (Bombardier, D’Amico & Jordan, 1990). However, Lazarus and Folkman (1984), Sinha and Watson (2000) suggested that coping strategies that are adaptive tend to be more problem-focused (planning, active coping, seeking social support) and less emotion-focused (venting emotions or disengagement).
Many researchers categorize coping strategies as either active or passive in nature. Active coping strategies are those which involve attempts to control pain or to function in spite of distress while passive coping strategies are those relinquishing control of the distress to others or allowing the pain to negatively affect other aspects of the life. In general, previous investigations have shown that active coping strategies are often associated with better psychological adjustment, higher levels of daily functioning, and lower levels of pain intensity whereas passive coping strategies tend to be correlated with increased pain, lower levels of activity, and poorer psychological adjustment (Cattan, White, Bond & Learmouth, 2005). Coping has also been viewed as a process that changes over time and across situational contexts (Holahan & Moos, 1997). The coping type that a person uses is dependant on the persons’ appraisal of the situations’ amenability to change (Calvete & Connor-Smith, 2006).
Some studies have suggested that cognitive appraisal of a situation can be associated with coping strategies (Edmunds, Ntoumanis & Duda, 2008; Moos, 1994). This indicates that coping strategies can change according to context and can be important in determining health outcomes (Carver & Scheier, 1994). Coping targeted directly at well-being has been labeled emotion-focused coping (Lazarus & Folkman, 1984). Emotion-focused coping involves reducing the effects of stressful feelings caused by unpleasant experiences through relaxation, the use of substances (alcohol and drugs), social activities and/or defence mechanisms, including avoidance (Edwards & Holden, 2003) and other efforts to dampen symptoms without influencing their causes. Problem-focused types of coping are directed at the problem and in looking for ways to manage and solve the problem. It is thought that rather than being two discrete types of coping, emotion-focused and problem-focused coping typically co-occur (Carver & Scheier, 1994). In addition, it is argued that the ‘fit’ between one or the other and the situation is important. In this sense, problem-focused strategies are viewed as more adaptive in situations appraised as changeable and emotion-focused strategies more adaptive in irresolvable situations (Lazarus & Folkman, 1984).The social manner of emotion focused coping involves sharing feelings with others in the social network. The cognitive manner of emotion focused coping, on the other hand, involves redefining the perception of the situation (Shuker & Newton, 2008; Endler & Parker, 1990).
The tendency to conceptually separate styles of coping such as the emotion-focused and problem-focused types have lead to assumptions that there are ‘good’ and ‘bad’ ways of coping. According to Folkman and Lazarus (1985) the assumption is often that coping strategies associated with taking action and control (problem-focused methods) are thought of more favourably than those associated more with emotion. However, aside from being inaccurate, such views lead to assumptions that there is one or more ‘better’ styles of coping, irrespective of individual circumstances and situational factors. Parker and Endler (1990) however suggested an alternative view of the grouping of types of coping, proposing avoidance-coping along with problem-focused and emotion-focused coping.
Coping efforts can result in a variety of health-related, affective and behavioural outcomes. Successful coping has been related to better quality of life, mental health, and illness remission (Shuker & Newton 2008; Folkman & Lazarus, 1985). Non-coping is defined as efforts that have failed to cope, accompanied by various physical and psychosocial disturbances which results in increased stress, higher levels of depression and anxiety. Consequently, utilization of maladaptive coping strategies is associated with poorer psychological and physical functioning (Van Herreveld, Van Der Plight, Claassen & Van Dijik, 2007).
Statement of the Problem
Psychological well-being is a very important aspect for attention among prison’s inmates. Unfortunately, it has received little or no attention. In the prison custody there exists deplorable conditions such as poor medical care, congestion, over-stay and poor social services. All this may predispose prison inmates to psychological distress which seems to have a negative effect on their psychological well-being. Upon reflecting on these influences, the researcher then tries to explore ways the prison’s inmates can help themselves achieve their psychological well-being even in the presence of stress. The researcher then wish to provide answers to the following research questions:
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