Gender, psychopathology, and patterns of homelessness among clients in shelter-based TCs.

UNLABELLED: Substance abuse and severe mental illness are factors that have been linked to homelessness, and the rates of mental illness have been reported to be higher among homeless women than men. Only recently have investigators begun to examine the prevalence of abuse among the homeless population and its relationship to indicators of psychopathology. This study builds on the existing literature and examines the relationship among psychiatric disturbance, abusive experiences, and homelessness among adult men and women admitted to shelter-based therapeutic community (TC) drug treatment programs.

RESULTS: The sample presents with extensive psychopathology and a history of physical and sexual abuse. Gender differences indicate that, except for antisocial personality, females yield higher rates on measures of both psychiatric disturbance and abuse. The relationship between psychopathology and abuse also appears to be much stronger for females than for males. However, the relationship between abuse and adult homelessness appears to be similar for men and women. The gender differences in the relationship between histories of abuse and manifestations of psychiatric disturbance support a hypothesis that has been proposed elsewhere: Females internalize the trauma associated with abusive experience, while males externalize it. The findings suggest that, although there may be a need for gender-specific targeted interventions, treatment providers must also recognize that the impact of abuse seems to transcend gender within this population.