Overall quality of life and emotional regulation among inmates: A narrative review

Abstract

Although there is a plethora of studies related to quality of life (QoL), little is known about QoL in prison settings. Emotions and difficulties in emotional regulation in incarcerated individuals may affect inmates' QoL and also their ability to reintegrate into society. The purpose of this review was to compile the empirical evidence and identify knowledge gaps to make suggestions for enhancing QoL in correctional environments. This narrative review includes research published between 2014 and 2024 in PubMed, Google Scholar, EBSCO, and Embase on inmates' QoL, emotion regulation, and mental health. Research on forensic patients as well as non‐English articles was excluded. Emotions and emotion regulation were interlinked with mental health issues, while social support was the most eminent feature promoting overall QoL in prisoners, along with other systemic and environmental aspects. Our narrative review suggests that the research to date is limited, focused on male and young inmates, and based on self‐reported cross‐sectional data. From a public health perspective, identifying the impact of emotions and mental health in the prison population could help improve the QoL of prisoners and inform research, rehabilitation programs, and correctional policy.

Through the years, concepts of overall quality of life (QoL) and emotional control among populations of people who are incarcerated have changed dramatically. In the past, prisons were largely built as punishment and deterrent facilities, with little thought given to the mental health of the inmates. ¹ The 18th and 19th century's early correctional programs, which placed a strong emphasis on labor, seclusion, and rigorous discipline, frequently made psychological suffering worse rather than better. However, a turn toward human rights and rehabilitation by the middle of the 20th century progressively brought more attention to the mental health requirements of convicts. The significant impact of incarceration on emotional functioning was first documented by research in the 1970s and 1980s, which focused on problems including anxiety, depression, and the disintegration of adaptive coping strategies. ¹

Primarily used in the medical and social sciences, the notion of QoL was later expanded to include prison populations in order to evaluate not only the material conditions of confinement but also its psychological and social aspects. In this environment, emotional regulation became a crucial concept that connected resilience, adjustment, and rehabilitation results to the capacity to control emotions. These two concepts' confluence today highlights a wider understanding that prison conditions have a significant impact on mental health and that reintegrating offenders into society and enhancing their QoL depend heavily on managing emotional regulation.

The World Health Organization defines QoL as the person's view of their place in life in relation to their objectives, standards, expectations, and worries, as well as the culture and value systems in which they live. ² Research has shown that prison settings evoke sensory, social, and cognitive deprivation, resulting in reduced QoL and mental health. ³ , ⁴ QoL and well‐being have consistently been demonstrated as important objectives to be accomplished in a plethora of contexts such as justice and health. ⁵ , ⁶

Approaching the matter from a rehabilitative perspective, imprisonment should help individuals assimilate again into society without reducing their QoL. ⁷ It is argued that offenses stem from the inability to live a fulfilling life in ways that are considered functional, healthy, and acceptable by society. ⁸ Poor QoL during imprisonment may indicate the absence of well‐being that contributed to criminal activity; thus, high QoL upon discharge may be an indication of a decreased likelihood of committing future offenses and a sign of effective rehabilitation. ⁹

Approximately 11 million people are currently incarcerated globally. ¹⁰ Since 2000, the international incarcerated population has increased by approximately 20%, with Oceanea and the Americas holding the greatest escalations at approximately 59% and 41%, respectively. ¹¹ Africa and Asia together have 62% of incarcerated individuals worldwide. ¹² , ¹³ When individuals are incarcerated, they lose their liberty and the chance to make decisions about their lives. ¹⁴

Studies have shown that while people are imprisoned, they experience difficulties in achieving independence and individuality, which results in losing their motive to pursue their interests and personal goals and not living at peace with themselves. ¹⁴ , ¹⁵ QoL has been defined in micro (i.e., subjective and individual) and macro (i.e., objective and societal) terms; and there are different models that are not consistent with each other. ¹⁶ Pinto et al. ⁶ identified QoL as an outcome of comfort and well‐being, while Straś‐Romanowska ¹⁷ viewed QoL as the content that individuals acquire through their cognitive and emotional experiences. The latter identified four dimensions in these life experiences: the personal, the psychosocial, the psychophysical, and the metaphysical.

Personal QoL is achieved when individuals are able to take responsibility for their own lives and their decisions, something that contrasts with the lives of incarcerated individuals. ¹⁴ In prison, personal QoL is related to autonomy; the latter is a main aspect of the social climate in prison. ¹⁸ Although imprisonment conflicts with autonomy, it has been found that inmates maintain to a degree the option of making their own decisions. ¹⁹ Personal QoL is also related to meaningful activities, which is another main aspect of the social climate in prison settings. ¹⁸ Meaningful activities provide the motivation prisoners need in order to remain active and achieve personal growth, which also results in coping with imprisonment. ¹⁹

Research has shown that factors that have been found to predict higher levels of overall QoL are self‐efficacy, ²⁰ ego‐resilience, emotions, and social support. ¹⁴ Incarcerated individuals with high levels of self‐efficacy have been found to be engaged in behaviors that promote health, report higher rates of overall health since their imprisonment, and perceive their levels of overall health to be higher. ²¹ Other researchers have found that low levels of self‐efficacy are correlated with criminal thinking; thus, increases in levels of self‐efficacy might reduce recidivism behaviors. ²² , ²³

Resilience is the ability to adjust positively in the face of severe hardship, ¹⁴ thus individuals with high levels of ego‐resilience exhibit greater psychological adjustment. ²⁴ On the other hand, low levels of ego‐resilience are correlated with problematic coping and passive responding, which results in maladaptive behaviors. ²⁵ Although some research has been conducted on ego‐resilience in incarcerated individuals, ²⁶ , ²⁷ , ²⁸ there has been no empirical evidence on the relationships between prisoners' ego‐resiliency and QoL.

Studies have demonstrated a relationship between ego‐resilience and emotionality where resilient individuals use their positive emotions to effectively and quickly recover from adverse experiences. ²⁹ The latter can be explained by the Affect Infusion Model where it is theorized that the way in which individuals react toward a distinct emotion they experience is linked to how they evaluate their emotion based on their affective state. ³⁰

Emotions

Incarcerated individuals confront a plethora of adverse emotions as an outcome of the stressors of imprisonment such as loss of autonomy, living in a harsh environment, and being detached from their families. Despair, anxiety, anger, fear, and depression are some of the commonly reported emotions that are frequently intensified by lack of privacy, overcrowding, and the ongoing worry of violence. ³¹ Also, difficulties in regulating emotions have been associated with interpersonal issues, ³² which are prevalent in inmates.

Emotions are inward experiences of short duration that can bring intense physiological arousal and have the ability to cause and/or reinforce distinct behaviors. An emotion is the immediate instinctive feeling that is difficult for individuals to control and is experienced when someone is triggered by an event. ³³ Emotion is also interlinked to mood, yet there are distinct differences. Mood is an experience that has a long duration with low intensity in comparison to emotions. Mood is also a phenomenon triggered by a multitude of combinations of events. ³³ Although emotion and mood are two different phenomena, they both interact with each other. Emotions can impact mood, which in turn can add to mood by impacting the emotions, ³⁴ thus it would be important to consider this while examining emotional regulation.

Mood is argued to have a crucial role in psychological well‐being. ³⁵ It has also been found that mood can have an infiltrating effect on cognitive functioning and behaviors and that the former can be slowly altered by the social environment and other internal factors. ³⁶ Simply stated, an individual's mood is the outcome of their late actions and has a pivotal role in their future behaviors. The latter interaction is of high importance for the individual's mental health. ³⁷ , ³⁸

Emotional regulation is a combination of a plethora of skills that includes one's ability to identify and comprehend emotions, the capability to choose and apply techniques to control the experienced emotion in order to accomplish a desired outcome, the willingness to endure a plethora of emotions, and the competency to regulate impulsive behavior and respond in accordance with morality. ³⁹ Emotion dysregulation is commonly associated with traumatic experiences and may link interpersonal violence to risky behaviors. ⁴⁰ Symptoms of emotional dysregulation comprise elevated emotional intensity, negative responsiveness to emotional states, insufficient emotional comprehension, maladaptive emotion control techniques intended to modify the length and/or degree of emotional experiences, and an inability to manage behaviors throughout emotional turmoil. ⁴¹

Relevance of Review

Based on all the above mentioned, overall QoL is an important factor to be examined. Although there is a plethora of research in the literature among variables related to QoL, there is little research on the topic in prison settings. ³ , ⁹ , ¹⁴ , ⁴²

Prisoners' emotional states are also an important and frequently disregarded aspect of the justice system. Emotions and difficulties in emotional regulation in incarcerated individuals may affect their QoL and also their behavior, their ability to reintegrate into society, and their overall chances of rehabilitation. From a public health perspective, identifying the impact of emotions, emotional regulation, and mental health in the prison population could help improve the current and future QoL of prisoners. A supportive environment and access to quality services may alleviate the deterioration of prisoners' QoL, emotional regulation, and mental health that may result in adverse effects on personal, physical, and social issues in prison settings.

Method

A narrative review of the background literature was undertaken. Articles were pursued in PubMed, Google Scholar, EBSCO, and Embase search engines. The search was conducted on published articles within the time frame 2014–2024, in the English language, concerning female and male incarcerated individuals, including adolescents and the elderly. Key terms for searching were prisoner(s), inmate(s), prison, incarceration, correction facility, combined with QoL, emotion(s), negative emotion(s), positive emotion(s), emotion regulation, mental health, and prevalence.

Preference was given to articles published in the last 5 years. Additional articles relevant to the current review were searched on the websites of organizations such as the World Health Organization (WHO) and the United Nations Office on Drugs and Crime (UNDOC). Unpublished, gray literature, and articles in languages other than English, as well as those involving forensic patients or forensic psychiatric settings, were excluded.

Criteria for inclusion

Publication Period: Articles from 2014 to 2024, with a focus on research from the most recent 5 years (2019–2024). We chose English‐language publications. Population: Research including both male and female inmates, including young people and senior inmates. Setting: Studies carried out in correctional facilities, jails, or other confinement settings. Study Focus: Papers covering at least one of the following topics: QoL, emotions (both positive and negative), control of emotions, and mental well‐being. The frequency of emotional or mental health problems in groups that are incarcerated. Source Databases: Reports from WHO and the United Nations Office on Drugs and Crime (UNODC), as well as articles obtained from PubMed, Google Scholar, EBSCO, and Embase.

Results

Inmates' QoL compared to the general population

QoL is an umbrella term under which a plethora of aspects are included such as nutrition, overall health (i.e., both physical and psychological), safety, resiliency, connectedness, and support. ⁴³ In France, it was found that the QoL of incarcerated individuals is lower in comparison to the general population, mainly in four domains of mental health, physical health, environment, and social interaction. ³ Similar findings were found in prison populations in previous studies in Thailand and Ireland. ⁴⁴ , ⁴⁵ In three categories (i.e., physical health, environment, and social interaction) female convicts in Belgium rated their QoL similarly to the general population; however, they rated their psychological health lower than the general population. ⁴⁶

The overall QoL of elderly French prisoners was found to be worse in comparison to the general population; factors that contribute to this fact were found to be personal aspects such as stressful life experiences, mental disorders and somatic ailments, as well as interpersonal and environmental elements such as prison conditions, diminished privacy, relationships with prison staff and aggressive behavior. ⁴⁷ Young incarcerated individuals were found to have higher levels of impaired QoL in comparison to older incarcerated individuals. ⁴⁸ They also had 3 times higher levels of mental health‐related issues compared to youth in the general population, ⁴⁹ including adversities in childhood such as homelessness, poverty, health problems, and substance abuse ⁵⁰ , ⁵¹ as well as childhood trauma (e.g., sexual abuse). ⁵² Adolescents in residential care with similar risk patterns to offenders were observed to have poor QoL due to childhood maltreatment. ⁵³ Overall, the incarcerated population is considered to be at higher risk of developing physical and mental health issues in comparison to the general population. ⁵⁴ , ⁵⁵ , ⁵⁶ , ⁵⁷

Personal aspects

Ego‐resiliency was found to be a positive significant predictor of psychophysical QoL (PQoL) and also facilitated the appropriate adaptability needed in prison settings, ⁵⁸ , ⁵⁹ in which incarcerated individuals have limited control over their daily routine since it is foisted upon them. However, it has been indicated that when incarcerated individuals perceive that they are capable of making choices on their own, they report higher levels of overall QoL. ⁶⁰ Self‐efficacy has also been found to be a significant positive predictor of PQoL and has also been related to active coping and future planning, which may result in increasing PQoL. ⁵⁸ , ⁵⁹

Religion, as a resource of coping in stressful times, ⁶¹ was found to be related to prisoners' overall QoL. ⁶² Inmates in Poland who frequently used religious strategies had higher levels of overall QoL in comparison to prisoners who used these strategies less frequently; inmates who did not use religious strategies had the lowest levels of QoL. ⁶² More specifically, it was shown that inmates with a higher QoL who experienced difficult social situations perceived them as an opportunity to learn, had a sense of direction, found new meaning, and got closer to God; prisoners with a high QoL were also willing to provide spiritual support to fellow prisoners and exhibited behaviors of forgiveness. On the other hand, inmates with a low QoL showed passive problem‐solving behaviors where they believed that only God had control over their lives and not themselves. ⁶² Religion also affected PQoL where inmates with low PQoL perceived it as a punishment from God for their sins and frequently expressed their dissatisfaction toward God and the church; in contrast, those with higher levels of PQoL used positive religious strategies such as praying for a miracle. ⁶²

Interpersonal and social aspects

It has been indicated that interpersonal and social factors were found to be related to high overall QoL among inmates. ⁴² A study that examined QoL and psychopathology in Nigerian adolescents in correctional facilities found that inmates who have positive and helpful behaviors that promote social relationships had higher levels of QoL; on the other hand, those with higher levels of overall psychopathology had low levels of QoL. ⁶³

Similarly, social relationships and psychological factors in older convicts were negatively correlated with isolation and a reduction in visits. ⁴² In Polish prisoners, it was found that their psychosocial QoL levels were very low since inmates were annoyed by the lack of belonging, bonding, and closeness, particularly with their closest relatives from whom they had been separated. ⁶² The findings of a qualitative study, which explored how young Cambodian prisoners perceive their QoL and mental health, showed that some incarcerated individuals had higher levels of QoL than others due to the fact that they received socioeconomic support outside of prison, mainly from their parents and/or relatives; yet the majority of participants reported experiencing negative mental health. ⁶⁴ In the aforementioned study, it was also found that social and emotional support played a key aspect in the development of prisoners' coping mechanisms. In a study conducted on Malaysian prisoners, it was found that having relationships with their families contributed positively to the inmates' QoL. ⁶⁵

QoL has been found to be positively influenced by social relationships inside prison, too. When prison staff have a positive stance and provide support to inmates, the latter's QoL increases. ¹⁵ , ⁶⁶ , ⁶⁷ , ⁶⁸ Barquín et al. ⁶⁹ , in their study of five different Andalusian prisons, had similar findings to the aforementioned; however, it was indicated that when prison staff knew every detail about the inmates, the prison environment felt somewhat strict and patronizing. Findings indicated that all kinds of social support (e.g., emotional, informative) played a crucial role in inmates' PQoL; thus, respect, acceptance, and positive feedback, both from fellow prisoners and staff, were of high value. ¹⁴ In a previous study by Skowroński and Talik ⁷⁰ , it was indicated that informational support was correlated with overall QoL; however, emotional support was not correlated with any domain of QoL.

Findings from female Polish prisoners showed that social support not only promotes but also protects overall QoL; more specifically, one of the most crucial components is appraisal support, which helps others comprehend that they have the ability and skills to be in a particular social group. In other words, an inmate's psychosocial and subjective QoL satisfaction increases when their needs for security and belonging in the prison culture are met, which leads to the pursuit of their goals. Incarcerated individuals who had poor social support were indicated to be three times more prone to develop depression in comparison to those with good social support. ⁷¹ These findings are similar to those in the research conducted by Abdu et al. ⁷²

Social support from mental health professionals inside prison has been found to be associated with increases in prisoners' PQoL. The sense of being supported by a therapist and participating in meaningful activities was shown to be related to higher QoL across all domains. ⁷³ A study in a sample of young female offenders showed greater treatment engagement when they perceived their QoL in the domains of environmental, psychological, and physical health as satisfactory. ⁷⁴

Environmental aspects

While individual‐level emotional regulation is important, the review could better address the role of systemic issues such as overcrowding, staff‐inmate relations, and institutional policies in shaping inmates' QoL. For instance, overcrowding frequently leads to restricted access to resources, elevated conflict, and stress among prisoners—all of which can worsen depressive symptoms and make coping mechanisms more difficult. In a similar vein, relationships between staff and inmates are crucial in determining emotional health. While combative or punitive connections may exacerbate stress, anxiety, and emotional dysregulation, positive interactions with correctional officials can promote a sense of safety and stability. The psychological results and general QoL of prisoners are also greatly impacted by institutional regulations, such as those controlling visitation, access to mental health services, and rehabilitative activity.

Other factors such as past convictions and reduced ward security were correlated with prisoners' QoL. Particularly, it was found that individuals who had experienced imprisonment in the past perceived their QoL with greater differences than those who are incarcerated for the first time. The former reported lower levels of QoL in three categories of well‐being and professionalism, harmony, and development; however, in terms of overall QoL, it was indicated that there were no significant differences between the two groups. ⁷⁵

Correctional systems in different countries

USA: Reduced ward security was found to be related to higher overall QoL ⁷³ , ⁷⁶ ; however, Trizna and Adamowski ⁷⁷ found no relationship between overall QoL and ward security. In a medium‐security prison in Kentucky with older participants, it was found that environmental QoL was low, which was related to the enhanced programming that prison settings provided; on the other hand, social QoL and social relationships had the highest scores, especially among the middle‐aged participants. ⁷⁸

Holland: In the Dutch prison population, it was found that reduced security in jail settings may bring adverse effects; more specifically, it was indicated that levels of misconduct and victimization were high, and this may have a detrimental effect on the well‐being of incarcerated individuals and prison staff. ⁷⁶

Other findings showed that young prisoners were frequently subjected to violence, bullying, abuse, trauma, isolation, and lack of privacy, social networks, and the ability to set future goals, which may result in the absence of well‐being and the development of mental health issues. ⁷² , ⁷⁹ It has also been found that inmates who experienced verbal and/or physical abuse had higher rates of developing depression in comparison to other prisoners who had not experienced abuse. ⁷¹ In the research of Atilola et al., ⁶³ the most eminent characteristic that hindered social QoL (in school and/or vocational function) was problems in peer relationships, such as experiencing bullying, verbal abuse, and being ostracized.

Malaysia: Along these lines, feeling physically safe was shown to be related to higher social and environmental QoL in elderly prisoners as well, while obtaining pleasure from activities was correlated with psychological and physical QoL. ⁴² Feeling safe was found to be correlated with QoL in Malaysian prisoners; more specifically, safety was correlated with domains of QoL, such as lineage, mind, and property. ⁶⁵

Overcrowded prison settings have been found to have adverse effects on the QoL. ⁶⁷ , ⁶⁹ Overcrowded cells without any emotional attachment among cellmates were also found to result in mental health issues and feelings of loneliness ⁶⁴ and were correlated with reduced social and environmental QoL in prison. ⁸⁰ Overcrowding has been found to worsen relationships between prisoners and prison staff, resulting in an unpleasant environment that hinders the adjustment of inmates. ⁶⁹

Nigeria: Finally, in the qualitative study by Orjiakor et al., ⁸¹ it was found that Nigerian prisoners awaiting trial tended to have a lower QoL than inmates who were already serving their sentences. Prisoners awaiting their trial undergo poor diets, stricter rules, and no compensation after acquittal, resulting in a violation of their human rights. The feeling of alienation from culture and society contributes to the increase of anxiety levels that may lead to episodes of depression.

Romania: In situations of prolonged periods without conviction, inmates tend to lose their connection with confinement and begin to perceive it as an outcome of their powerlessness and the brutality of the criminal justice system. The latter impacts the prisoners' sense of self and social comparisons, which in turn result in feelings of shame and poor overall QoL. ⁸¹ The aforementioned was also indicated in the study of van Ginneken et al. ⁷⁶ conducted with Dutch prisoners and Mindrescu's ⁸² study with inmates from Romania.

The concepts of retributive justice, which place an emphasis on punishment, deterrence, and incapacitation, have fundamentally influenced correctional systems all over the world. According to this concept, the primary response to crime is jail, which is seen as a violation of the law and state authority. However, restorative justice, which reframes crime as a violation of people and relationships rather than as an offense against the state, has been increasingly popular throughout the world in recent decades. In order to mend harm via communication, mediation, and community involvement, restorative justice places a strong emphasis on accountability, healing, and reintegration. This strategy has gained popularity in a variety of settings, such as community‐based corrections, youth justice systems, and even prisons, where programs now emphasize rapprochement between victims, offenders, and society.

Restorative methods have been pioneered by nations like Canada, Norway, and New Zealand, who have included them into their national rehabilitation and penitentiary policies. The United Nations and other international organizations have also supported restorative justice as a more effective and compassionate strategy for fostering social cohesion and lowering recidivism. The worldwide trend shows an increasing understanding that encouraging accountability and emotional regulation through restorative methods can enhance both inmate outcomes and community safety, even though expanding these techniques is still difficult.

Emotions

Depression and loneliness

Research has indicated that feeling lonely, being disconnected from loved ones, and loss of autonomy are the main causes of depression in prison settings; depression is frequently associated with hopelessness in prison, with individuals serving long sentences and/or life in prison having even higher levels of hopelessness. ⁸³ It has been found that internalized feelings such as anxiety, depression, and hopelessness are more frequently reported by female prisoners; in addition, female inmates are more likely to express their emotions by seeking assistance and/or by crying than male prisoners. ⁸⁴ Green et al. ⁸⁴ also found that a great percentage of female offenders had past experiences of trauma, especially sexual and physical abuse. The latter finding is also supported by the study of Chen and Gueta ⁸⁵ among Israeli prisoners. Emotional states, such as feelings of loneliness and guilt that emerge by recalling former illegal behaviors among prisoners, are another risk factor for developing depression. ⁸⁶

Fear

Fear is frequently reported by incarcerated individuals and is associated with the repressive nature of imprisonment and the potential for violence among inmates; this kind of fear, which stems from the unpredictable and risky environment of the prison setting, is also related to and/or may lead to anxiety. ³¹

Anger

Anger is another commonly observed response to unjust practices and hardships encountered while serving time; the emotion of anger might manifest as aggression toward self and/or others, which may lead to (i) violence toward inmates and/or staff; and/or (ii) self‐harming behaviors. ⁸⁷ In the Italian incarcerated population, it has been found that anger levels and emotion regulation can be influenced by conditions in the prison setting. ⁸⁸ Anger in prisoners has been negatively related to interpersonal forgiveness and gratitude and hinders psychological well‐being. ⁸⁹ It has also been found that prisoners who reported higher levels of experiencing inward anger were found to have high levels of alexithymia (i.e., recognizing and labelling their emotions), while those reporting high levels of experiencing outward anger were linked to having difficulties in controlling impulsive behaviors while emotionally aroused. ⁸⁸ Anger is negatively correlated with prisoner's metaphysical QoL and is also associated with low levels of PQoL. ⁷⁰

Positive emotions

Interpersonal forgiveness and gratitude have been found to decrease aggression and promote the psychological well‐being in Indonesian and Chinese incarcerated individuals. ⁹⁰ , ⁹¹ , ⁹² A study of an incarcerated population in Italy also showed that interpersonal forgiveness and gratitude might decrease antisocial intent and violence in prisoners. ⁸⁹

Another study conducted in Polish prisons showed that resilience also plays a crucial role in overall QoL. ⁶⁸ , ⁷⁰ Similar findings were shown in Afra et al.' ⁹³ study of female prisoners in Isfahan, where it was found that tolerance of negative emotions had a significant relationship with prison life satisfaction. Resilience was found to have a crucial role in Nigerian prisoners serving life sentences, where most of the inmates were found to have low levels of resilience and were associated with decreased social relationships, environmental QoL, and health. ⁹⁴

Interestingly, education was indicated to impact on how prisoners feel. French prisoners with high educational levels reported greater and more positive emotional states in comparison to fellow prisoners with lower educational status; it was also found that those with a high level of education experienced less psychological distress and symptoms of depression. ⁴⁷

Personality disorders

In their research, Yang et al. ⁹⁵ found that antisocial personality disorder (ASPD) and borderline personality disorder (BPD) were two of the most common disorders among incarcerated individuals; the study also showed that emotional regulation had a significant role in developing ASPD and BPD. Research has indicated that prisoners with ASPD and BPD who had difficulties with regulating their emotions had increased chances of exhibiting suicidal behaviors. ⁹⁵ However, there was evidence indicating that when dialectical behavioral therapy strategies are used, difficulties in emotional regulation might be decreased and ASPD and BPD symptoms can be reduced, resulting in a decrease in suicidal behaviors. ⁹⁶

Discussion

QoL

Personal aspects

Ego‐resiliency and self‐efficacy were two personal characteristics that were strongly related to high levels of psychophysical QoL. When prisoners are able to adapt and believe in their abilities to achieve their goals, it helps them in using active coping strategies and future planning, which is very useful in the prison environment that provides limited control over everything. Personal aspects that hindered overall QoL in prisoners were stressful life experiences, mental disorders, and physical diseases. ⁴⁷ , ⁵⁸ , ⁵⁹ , ⁶⁰ The findings indicated that religion impacts overall QoL, and when prisoners frequently use religious strategies, they report higher levels of QoL, especially in the psychophysical domain. Those with a higher QoL tend to perceive difficult social situations more positively and as opportunities to learn and connect with God. ⁶²

Interpersonal, social, and environmental aspects

Factors that contributed to poor QoL in prisoners were interpersonal aspects such as violent behaviors and bad relationships with prison staff, and environmental aspects such as unhealthy prison conditions and lack of privacy. Social QoL in inmates can be increased when helpful and positive behaviors are adopted by them. ⁴⁷ , ⁶³ Prison overcrowding was one of the most commonly observed features that negatively impacted the interpersonal, social, and environmental QoL of prisoners. Not having enough room, lack of bonding with cellmates, being separated from loved ones, and lack of belonging hinder social relationships with both fellow inmates and prison staff and impedes inmates' adjustment. ⁴² , ⁶⁴ , ⁶⁷ , ⁶⁹ , ⁸⁰ , ⁹⁷

The most eminent feature that promotes—in some cases protects ⁷⁰ —overall QoL in prisoners is social support in all its forms; social support also helps inmates to develop active coping strategies. Emotional, appraisal, informative, socioeconomic support inside and outside prison, support from prison staff (including health care professionals), and fellow prisoners were indicated to be of high importance during imprisonment, since inmates feel that they have abilities and skills to pull through; also feeling safe, accepted and respected, they are more engaged in activities, especially when they receive positive feedback. ¹⁴ , ¹⁵ , ⁶⁴ , ⁶⁵ , ⁶⁶ , ⁶⁷ , ⁶⁸ , ⁷³ , ⁷⁴ Poor social support in prison has been correlated with depression and feelings of isolation, which results in poor emotion regulation and mental health issues. ⁷¹ , ⁷² Similar findings were found in the study of Mohammed et al. ⁹⁸ among HIV patients, which is a common health condition in prisoners.

Prisoners awaiting trial found themselves in an unfavorable situation, with poor QoL reported in all domains. ⁷⁶ , ⁸¹ , ⁸² Whether ward security has a part in inmates' QoL remains under debate, with the study by O'Flynn et al. ⁷³ finding that reduced ward security was linked to higher levels of QoL, compared to the study by Trizna and Adamowski ⁷⁷ who found no relationship; on the other hand, it was indicated that reduced security may lead to misconduct and abuse affecting the QoL of inmates. ⁷⁶ All forms of abuse are another aspect that negatively impacts the overall QoL (especially social and psychological) in prison settings and may lead to severe mental health issues. ⁶³ , ⁷¹ , ⁷² , ⁷⁹

QoL between first‐time offenders and recidivists

A crucial but frequently disregarded component in comprehending recidivism among repeat criminals is QOLin prison. According to earlier studies, more severe prison conditions—such as overcrowding, little autonomy, violence, and poor access to healthcare or education—can worsen psychological suffering and strengthen criminal identities. ¹

The QoL experienced by incarcerated individuals often differs significantly between first‐time offenders and recidivists. For first‐time offenders, imprisonment frequently represents a profound disruption of social identity, family life, and future aspirations. The shock of incarceration, coupled with the stigma of being labeled a criminal, can generate intense feelings of fear, shame, and uncertainty. These individuals may struggle with adapting to the restrictive environment, which often manifests in heightened stress, anxiety, and emotional dysregulation. These effects are frequently amplified for repeat offenders. ⁷⁵

In contrast, recidivists may see incarceration as a normalized or routinized life experience, which can make them less motivated to engage in rehabilitative processes and increase their sense of helplessness. ⁹⁹ Further lowering long‐term QoL, recurrent incarceration exacerbates obstacles to housing, work, and social reintegration. Comparing the two groups reveals significant differences: recidivists endure ongoing disadvantages that prolong a cycle of low QoL and few chances for successful reintegration, while first‐time offenders frequently experience acute distress from their initial incarceration. ¹

In contrast to first‐time offenders, repeat offenders may undergo cumulative institutionalization, in which extended exposure to harsh settings undermines social bonds, erodes coping strategies, and reduces motivation for lawful reintegration. ⁷⁵ Poor QOL can increase the likelihood of conflict and deprivation, which makes it harder to adjust after release and increases reliance on well‐known criminal networks. Crucially, the question is not whether repeat nearly regular part of life offenders are “adapted to” prison, but rather how their expectations, abilities, and sense of self are shaped by prison conditions. ⁹⁹

Recidivism cycles can be reinforced by broader institutional settings that do not support education, employment, or mental health, making repeat offenders less prepared for reintegration and more psychologically vulnerable. Corrections research is increasingly focusing on humane living conditions and improvements in prison culture as the cornerstone of rehabilitation rather than just punishment. By developing identity, skills, and hope that transcend incarceration, integrating lived experience into policy, and creating supportive prison environments may disrupt recidivism.

Current practices in several countries

As a result of a movement toward more rehabilitative correctional models, a number of nations have implemented measures in recent years to enhance the QoL for prisoners and promote emotional control (Table 1). Correctional facilities in Norway place a strong emphasis on the “normalization” approach, making sure that prison life is quite similar to life outside of it. In order to improve mental stability and get prisoners ready for reintegration, programs emphasize education, employment prospects, and therapeutic interventions. In addition to providing organized programs in cognitive‐behavioral therapy and emotion management, Canada has extended restorative justice initiatives within correctional facilities, fostering communication between victims and offenders. In order to promote mental health, prisons in the UK have been implementing mindfulness and resilience‐based programs more frequently. These interventions focus on stress reduction and emotional awareness.

Table 1.

Current practices and focus areas in several countries

Country	Recent practices	Focus areas
USA	Mental health courts, trauma‐informed care pilot projects, and specialized interventions	Reducing recidivism, addressing trauma, and enhancing access to mental health services
Canada	Cognitive‐behavioral therapy, organized emotional control techniques, and restorative justice initiatives	Responsibility, communication between victims and offenders, controlling emotions, and rehabilitation
United Kingdom	Resilience and mindfulness‐based programs were implemented in prisons.	Reduced stress, increased emotional intelligence, and better mental health
Norway	“Normalization” concept; prisons that are modeled after the outside world; a major emphasis on rehabilitation	Education, job training, counseling, mental stability, and preparedness for reintegration
New Zealand	Rehabilitation has a cultural foundation, particularly for Māori prisoners	Reintegration, emotional control, cultural customs, and identity enhancement

In the meanwhile, New Zealand incorporates culturally based rehabilitation programs, especially for Māori prisoners, combining contemporary psychiatric techniques with traditional methods to improve identification and emotional control. To lower recidivism and address underlying emotional issues, certain facilities in the US are experimenting with trauma‐informed care and mental health courts, even if the system is still mostly punitive. When taken as a whole, these approaches show a global trend toward realizing the importance of inmates' emotional control and QoL for their personal well‐being, reoffending reduction, and public safety.

Emotions

Imprisonment is associated with feelings of loneliness, hopelessness, and guilt, which are linked to social withdrawal and isolation, the latter of which was also related to developing depression while in prison. ⁸³ , ⁸⁶ Fear is another common feeling among prisoners which stems from experiencing past violent incidents. The former has correlated with causation of anxiety. ¹⁰⁰ Women have been indicated to find it easier to externalize internalized feelings of anxiety and depression and seek help. ⁸⁴ Anger was found to be the most commonly reported feeling among prisoners, especially males. Anger has been shown to lead to aggressive and/or self‐harming behaviors and impede psychological well‐being. ⁸⁷ , ⁸⁸ , ⁸⁹ , ¹⁰¹ Interpersonal forgiveness and gratitude have been found to decrease aggression, antisocial intent, and violence in prisoners and increase psychological well‐being. ⁸⁹ , ⁹⁰ , ⁹¹ , ⁹² Being resilient and tolerating negative emotions was indicated to be related with high levels of QoL in prison, social relationships, health and environmental QoL, in both sexes. ⁹³ , ⁹⁴ Also, high educational level was linked to experiencing more positive emotions. ⁴⁷

Although this article focuses on QoL of inmates, it is important to state that from a judicial standpoint, penalizing repeat offenders invariably brings up personal feelings, but these must be properly controlled. When judges deal with people who frequently go through the legal system, especially when there is significant injury or continuous noncompliance, they may get frustrated or morally exhausted. However, learning about the backgrounds of social deprivation, trauma, and institutionalization of defendants can arouse empathy and raise concerns about systemic failure. Judicial duty necessitates balancing these conflicting feelings: upholding public safety and accountability while acknowledging the negative effects of incarceration on people. Knowing the QoL in prison and how it relates to recidivism can make one wonder if tougher punishments actually serve justice or just cause more harm. Judges may apply emotional awareness to guide proportionate, well‐reasoned decisions based on evidence rather than completely repressing feeling. In this way, more compassionate sentencing procedures that recognize both personal accountability and the more general objective of social reintegration can be supported by judicial emotions when they are restrained by the law and ethics.

Conclusions

QoL of prisoners is a complex topic that is influenced by a plethora of variables such as mental and physical health, social interactions, and living conditions. In order to develop interventions that can increase the well‐being of prisoners, it is crucial to understand how these variables interact with each other. Teaching prisoners how to make plans for following their release, proper evaluation, effective counseling, and providing job opportunities, including age and gender‐specific activities, could be of great use to help promote physical and mental health and overall QoL during imprisonment.

The emotional state of incarcerated individuals is complex and multidimensional and is highly affected by the harsh environment in the prison setting as well as by individual and cultural differences. In order to comprehend the emotional state, it is crucial to develop an intervention high in efficacy that can lead to enhancing prisoners' QoL and mental health.

A plethora of existing literature is based on self‐reported information and cross‐sectional studies; thus, the outcomes might be influenced by inmates' desire to be perceived in a particular way. Therefore, there is a possibility that findings are biased and/or inadequately represent the constantly shifting nature of overall QoL across the lifespan. Additionally, a lack of follow‐up studies on the QoL and emotional states of incarcerated individuals was observed, which results in not having a recording of emotional alterations over time. To understand in which ways incarceration affects and alters the overall QoL and emotions of prisoners, future studies could include longitudinal designs and clinical interviews in order to have more solid data.

Many of the studies have used a convenience sampling method, and data were collected only from prisoners who volunteered to participate, so the data do not reflect the whole prison population. Additionally, in some studies, participants were excluded due to their inability to speak and/or understand the researchers' language; others were excluded because they were on suicide watch and/or in isolation. Thus, the data are restricted and cannot represent the whole picture, since several possible participants who were excluded were in positions where their QoL and emotions were highly affected in comparison to other prisoners who were not on suicide watch and/or in isolation.

More studies that examine the long‐term effects of incarceration on the QoL and emotions upon discharge are needed. Additionally, a lack of research was detected on the QoL and emotions of incarcerated groups such as people with disabilities and LGBTQ+. Furthermore, in comparison to studies on male and youth prisoners, there is a lack of studies that focus on female and elderly incarcerated populations. This imbalance restricts findings from being generalized and also underlines the need for inclusive research on the QoL and emotions of age and gender in imprisoned groups. A cross‐cultural comparative study could be found fruitful in the future, since every culture has different perspectives on QoL and emotions and people experience them differently.

To have an even wider picture of prisoners' QoL and emotions, longitudinal studies and studies including individual differences and personality traits from diverse populations could be useful. Also, anger seems to have a crucial role in incarcerated individuals as it relates to violent behaviors; thus, interventions that promote emotional regulation and impulse control strategies and emotional awareness may be beneficial to offenders. Another suggestion for future studies would be to include a daily routine screening for prisoners to have an in‐depth understanding of the factors that contribute to their well‐being. By collecting, identifying, and distinguishing emotional experiences across different age and gender groups, age‐ and gender‐specific individualized treatment plans could be developed to help each individual according to their needs and to facilitate appropriate handling, thereby promoting rehabilitation and a healthier life.

Furthermore, in the present paper, it was found that emotions and emotion regulation were interlinked in several cases with mental health issues, in a way that emotions and/or emotion regulation could promote and/or hinder mental health and vice versa. However, biological factors were not included in the articles included to make sure that other factors did not contribute to the development of mental health issues. Future studies could include genetic examination and screening of biological parents. In the same way, personal, interpersonal, social, environmental, and physical aspects of QoL have been found to impact emotions, emotion regulation, and mental health, and vice versa. Although mental health is one of the four main domains of QoL, it was impossible to isolate the impact that the former had on the latter. If the aforementioned covariance is not controlled for, the poor QoL found in almost all literature concerning prisoners may be a misleading finding that represents psychopathology. It is worth noting that most of the studies included in the current narrative review were cross‐sectional, and this design impedes the examination of which variables influence others. In other words, one cannot identify whether mental health and/or emotional regulation have an influence on QoL or vice versa (Table 2).

Table 2.

Summary of the included articles examining the domains of quality of life, emotions and emotional regulation. The articles are presented in alphabetical order

Authors	Study design	Number of participants/studies	Objective(s)	Measurements	Results
Abdu et al. 72	Cross‐sectional	332 prisoners	“To assess the prevalence and associated factors of depression among prisoners in Jimma town in 2017”	Structured questionnaire interview, BDI‐II and Oslo 3‐item social support scale	“Prevalence of depression among prisoners was very high. Having family history of mental illness, having chronic physical illness, having previous incarceration, lack of job in prison, lifetime alcohol use, thinking life to be difficult one after release from prison, having age between 21 and 25 years old, and having poor social support were found to have an impact on the prevalence of depression”
Afra et al. 93	Causal‐comparative study	280 women (140 prisoners and 140 normal women)	“To compare resilience and life satisfaction in normal and prisoner women”	n.a.	“Negative emotions tolerate have significant relationship with life satisfaction in prisoner women, also subscales of control and personal competence have significant relationship with life satisfaction in normal women. significant difference between the category of personal competence, negative emotions tolerate and positive change acceptance in prisoners and normal women. significant difference between the mean score of component life satisfaction between the two groups of prisoners and normal women”
Alves et al. 102	Quantitative and qualitative	103 participants from data from other studies and qualitative data from 15 female prisoners	“Investigated the health of detained women and the influence of incarceration from their perspective”	For qualitative semistructure schedule	“A positive influence of incarceration was described by patients with chronic illness, patients with drug addiction, and victims of interpersonal violence. Among women with mental illnesses or those without previous health problems, reports do not reveal benefits of imprisonment for mental health.”
Armiya’u et al. 94	Cross‐sectional descriptive	26 life‐sentenced prisoners	“To assess the relationship between quality of life and sociodemographic and mental health variables of life‐sentenced inmates.”	“Sociodemographic, forensic, and mental health variable questionnaire and WHOQoL‐BREF	“Majority of the participants rated state of prison welfare as poor (65.4%), were visited only once while in prison (57.7%), have low social support (53.8%), and have low resilience (65.4%). Participants who were visited once and those with positive family history of mental illness had poor perception to their overall quality of life on WHOQoL‐BREF.”
Atilola et al. 63	Cross‐sectional	165 adolescents mostly boys	“To test the hypothesis that higher self‐rated psychopathology would be associated with lower QoL among adolescents resident within youth correctional facilities in Lagos”	Strength and Difficulty Questionnaire (SDQ) and Pediatric Quality of Life questionnaire	“We were unable to infer direction of relationship between psychopathology and QoL among these adolescents, it is plausible to suppose that treatment of mental health problems could have a positive impact on rehabilitation and reintegration.”
Barendregt et al. 97	Longitudinal	95 adolescents	“Two assumptions were examined: whether subjective Quality of Life is related to delinquent behavior and psychosocial problems, and whether adolescents with adequate coping skills are less likely to commit delinquent behavior or show psychosocial problems.”	Lancashire Quality of Life Profile and Utrecht Coping List for Adolescents	“Adolescents who reported a lower Quality of Life on the health domain had more psychosocial problems at follow‐up. No relationship was found between Quality of Life and delinquent behavior. In addition, active and passive coping were associated with delinquent behavior and psychosocial functioning at follow‐up.”
Barquín et al. 69	Empirical	Almería: 763 (714 males, 49 females), Granada: 1416 (1237 males, 179 females), Jaén: 522 (487 males, 35 females), Málaga: 1123 (1008 males, 115 females), Melilla: 257 (248 males, nine females), Total: 4081 (3694 males, 387 females)	“To examine the perception of the quality of life in prison among centers depending on the relationships, conditions, and the different environments, that may affect reeducation and social rehabilitation” and “to analyze whether reeducation and social rehabilitation, the Spanish Constitution establishes regarding the enforcement of prison sentences, are more or less likely to be achieved in five prisons”	Measuring the Quality of Prison Life (MQPL) Questionnaire, Perception of the interaction between inmates and prison staff (IIPS index), Perception of the prison environment and its repercussions in social rehabilitation (PERS index)	“The main hypothesis that maintains that the quality of life varies from one penitentiary center to another is confirmed by the empirical study carried out in the five prisons.”, “It is also confirmed that the quality of life in prison depends on the interaction with the prison staff and on the environment.”, “The results show a notable difference between the five prisons surveyed, which is consistent with some measurable differences, as well as some others subjectively perceived by us in our visits, that actually exist among them.”, “Comparing these facts and impressions with the results of the survey, the prison of Almería is the one that presents the best results in both dimensions analyzed, whereas the prison of Granada obtains a clearly lower assessment than the rest”
Beijersbergen et al. 66	Large‐scale longitudinal	1909 Dutch prisoners followed for several years, during and after their incarceration	“To what extent are (i) background characteristics of correctional officers; (ii) work‐related attitudes of correctional officers; and (iii) the workload of correctional officers related to prisoners' perceptions of fairness, respect, humanity, and relationships with officers?”	Measurement of Quality of Prison Life Dutch Inmate Survey, Correctional Staff Survey based on Prison Staff Quality Life survey and Dutch Prison Service	“Data were used from (i) the Prison Project, a large‐scale study in which prisoners held in all Dutch remand centers were surveyed (n = 1610); and (ii) the Dutch Correctional Staff Survey 2011 (n = 690). Multilevel analyses showed that prisoners perceived their treatment in prison as more procedurally just in units where there are more female officers, where officers held more positive attitudes toward rehabilitation, and where there is a higher officer‐to‐inmate ratio.”
Butler et al. 54	n.i.	47,117 prisoners from 10 provincial prisons in British Columbia, Canada	“To examine changes in the prevalence of mental and substance use disorders among people admitted to provincial prisons in British Columbia, Canada.”	BC Correction's CORNET, Jail Screening Assessment Tool and Brief Psychiatric Rating Scale for Children	“The proportion of people with co‐occurring mental health needs and substance use disorders increased markedly per year, from 15% in 2009 to 32% in 2017. Prevalence of methamphetamine use disorder increased nearly fivefold, from 6% to 29%, and heroin use disorder increased from 11% to 26%. The proportion of people with any mental health need and/or substance use disorder increased from 61% to 75%.”
Chen and Gueta 85	Cross‐sectional	110 Israeli inmates (50 female and 60 male inmates)	“To examine the gender differences in various types of childhood abuse and family history of crime, substance abuse, and mental health problems.”	Addiction Severity Index, Childhood Trauma Questionnaire, Renard Diagnostic Interview and Sociodemographic Questionnaire	“The findings indicated a higher rate of multiple types of childhood abuse among the female inmates compared with the male inmates. The findings also revealed that female inmates reported more prevalence of parents' substance abuse, crime, and family's mental health problems than the male inmates did. Moreover, the female inmates reported higher rates of emotional, physical, and sexual abuse associated with family history variables compared with the male inmates. Furthermore, the findings indicated that female inmates whose siblings were involved in substance abuse and crime reported higher rates of sexual and emotional abuse compared with the male inmates.”
Combalbert et al. 3	n.i.	138 male prisoners (50 years or over) from French prisons and 138 males of similar age from the general population	“To examine the cognitive performance of older male prisoners and its effect on their perceived health and quality of life.”	Semistructured interview, Mini‐Mental State Examination (MMSE), Frontal Assessment Battery (FAB), e French version of the Nottingham Health Profile, scale of the subjective state of mental health and World Health Organization Quality of Life Questionnaire	“There were very significant differences between the two groups in terms of cognitive performance, perceived health and quality of life. There was, however, no significant association between cognitive impairment and perceived health or quality of life.”
Combalbert et al. 47	Cross‐sectional	138 male prisoners (50 years and over) in seven French prisons	“To assess the level of perceived health and quality of life of elderly prisoners in France, and to see whether there is a link between aging, time spent in prison and level of education and scores for perceived health and quality of life.”	French version of the NHP (Indicateur de Santé Perceptuelle) and World Health Organization Quality of Life short version	“The results revealed low levels of perceived health and quality of life among the elderly inmates. They also showed that age was not statistically associated with most of the dimensions of perceived health on the Nottingham Health Profile, with the exception of poor mobility. By contrast, age was statistically associated with most of the dimensions of quality of life on the WHOQOL‐Bref. Time spent in prison was only associated negatively with the “sleep” dimension of the NHP. Emotional reactions were perceived most positively by the inmates with the highest level of education.”
Danioni et al. 89	Cross‐sectional	104 male prison inmates in Northern Italy	“To consider the unique contribution of trait gratitude, trait forgiveness, and trait anger in predicting prisoners' psychological well‐being on the one hand and criminal attitudes on the other, thus integrating the focus of both traditional and positive criminology.”	Italian adaptation of Gratitude Questionnaire‐6, Trait Forgivingness Scale (TFS), State–Trait Anger Expression Inventory‐2, short version of the Psychological General Well‐Being Index, Measures of Criminal Attitudes and Associates	“Gratitude is a promotional factor that enhances psychological well‐being, whereas interpersonal forgiveness appears to be a protective factor against the adoption of a criminal attitude as violence or antisocial intent. Finally, anger is a risk factor toward both psychological well‐being and violent behaviors.”
De Smet et al. 42	n.i.	110 older prisoners (≥60 years) from 16 prisons in the Dutch‐speaking region of Belgium	“to explore to what extent variables that were categorized according to the main areas of the Good Lives Model (‘the self’, ‘the body’ and ‘social life’) are related to the quality‐of‐life domains of older imprisoned offenders.”	Mini International Neuropsychiatric Interview, Tilburg Frailty indicator, De Jong‐Gierveld Loneliness Scale, WHOQOL‐BREF	“Individual variables, such as satisfaction with activities, were related to the older prisoners' QoL in several domains simultaneously. Other than suicidal ideation, psychopathological symptoms had no significant relation to quality of life.”
Deng et al. 90	n.i.	96 Chinese male prisoners	“To investigate the effect of daily blessings counting in a sample of violent prisoners.”	Aggression Questionnaire, Satisfaction with Life Scale, Scale of Positive and Negative Experience Gratitude, Resentment and Appreciation Test	“Both interventions improved subjective well‐being and decreased aggression compared to controls. Additionally, the improvement in gratitude mediated the relationship between the two forms of intervention and subjective well‐being. These findings indicate that gratitude‐based interventions can be implemented among male prisoners to help further the psychological corrective function of prisons in China.”
Dirkzwager et al. 55	Matched cohort study	952 detained persons and 4760 matched non‐detained persons	“To examine the health of detainees in the year before and after their detention and to compared this with the health of matched non‐detainees.”	System of Social Statistical Datasets from Statistics Netherlands, NIVEL Primary Care Database, and Dutch National Prison Database	“Detainees and matched controls differed statistically significant in their pre‐detention health status. Compared with controls, male detainees were more likely to report psychological, social, neurological, digestive, genital system‐related, and unspecified health problems in the year before their detention. To some extent these pre‐detention health differences were related to socioeconomic differences. No statistically significant changes in prevalence rates from pre‐ to post‐detention and no differences in the levels of change across detainees and controls were observed. For female detainees a similar pattern was found.”
Fazel et al. 56	Review	734 articles related to prisoner health and 553 articles related to prisoner mental health	“To present the results of a structured search for systematic reviews on prisoner mental health, supplemented by data from large primary studies on individual psychiatric disorders, rates and risk factors for adverse outcomes, and interventions for mental health problems.”	PubMed	“Mental disorders are over‐represented in prisoners. The strongest evidence is for serious mental disorders, where surveys estimate that around one in seven prisoners are diagnosed with psychosis or depression. Substance abuse is also greatly increased in prisoners, compared with the general population, with around one in five entering prison with substance misuse. For many other disorders, the picture is complicated by self‐reported approaches to diagnosis that may overestimate rates, and meta‐analyses relying on random‐effects models that weigh small studies similarly to larger higher quality investigations. […] Individuals in prison with mental health problems are at increased risk of suicide, self‐harm, violence, and victimization. Risk factors for these outcomes are not specific and few of these factors are shared across them, limiting development of effective interventions.”
Fazel et al. 83	Updated systematic review and meta‐regression analysis	24 studies, a total of 18,388 inmates, in 10 countries	“To (i) estimate the prevalence of alcohol and drug use disorders in prisoners on reception to prison; and (ii) estimate and test sources of between study heterogeneity.”	PsycINFO, MEDLINE, Global Health, PubMed, CINAHL, National Criminal Justice Reference Service and EMBASE	“The prevalence estimate of alcohol use disorder was 24%, with very high heterogeneity. These ranged from 16% to 51% in male and 10–30% in female prisoners. For drug use disorders, there was evidence of heterogeneity by sex, and the prevalence estimate in male prisoners was 30% and, in female prisoners, was 51%. On meta‐regression, sources of heterogeneity included higher prevalence of drug use disorders in women, increasing rates of drug use disorders in recent decades, and participation rate.”
Ford et al. 101	n.i.	54 workers	To examine whether gratitude and anger will influence daily extra role behavior	Daily diaries, 421 daily reports	“Results indicate that perceived organizational support was related to chronic gratitude and anger, which is stable from day to day, and chronic gratitude was in turn related to chronic differences in organizational citizenship behavior. Episodic anger and gratitude, which vary daily, were related to daily supervisor interactional justice and helping behavior, respectively, and in turn predicted daily episodic variance in organizational citizenship and counterproductive work behavior. These findings suggest that the moral emotions of gratitude and anger toward the organization are indicators of employee affective well‐being and play a mediating role in the effects of organizational and supervisor supportiveness on employee performance.”
Fotedar et al. 103	Cross‐sectional	311 prisoners	“To assess the dental caries levels, periodontal health status, and oral health‐related quality of life.”	Clinical examination [decayed missing and filled teeth index (DMFT) and community periodontal index (CPI)], OHIP‐14 questionnaire	“Dental caries, periodontal disease, the number of missing teeth were significantly associated with oral health‐related quality of life. The population had a higher level of oral diseases, and one half of the population reported that their oral condition had negatively impacted them in some way, thereby affecting their quality of life.”
Gonçalves et al. 48	Longitudinal study	75 young (aged 17 to 22 years) Portuguese prisoners	“(i) To examine changes in young prisoners' mental health symptoms during incarceration; (ii) to identify personal factors associated with their mental health symptoms and perceptions of the correctional climate; and (iii) to test the incremental effect of perceptions of the correctional climate on mental health symptoms.”	Brief Symptom Inventory (Portuguese version) and Prison Environment Inventory (short version)	“Overall, mental health symptoms marginally declined by the sixth month in prison. Prisoners with a history of mental health treatment were more likely to have increased symptoms. Higher levels of mental health symptoms were associated with a history of mental health treatment, remand status, and a lower educational level. Better perceptions of the correctional climate were associated with Black race and participation in prison activities. A negative perception of the correctional climate was the strongest covariate of young prisoners' mental health symptoms and had incremental validity over that of personal variables.”
Green et al. 84	n.i.	464 female prisoners from 9 prison settings in 4 regions in the United States	“To examine patterns of traumatic events experienced by women in jail and explore how these patterns are associated with 4 psychiatric disorders (posttraumatic stress disorder, major depression, bipolar disorder, and substance use disorder).”	Diagnostic interview	“Three factors described the observed patterns of trauma exposure: family dysfunction (FD), interpersonal violence (IPV), and external events (EE). FD and IPV each contributed independently to the odds of having each of the 4 mental disorders studied (posttraumatic stress disorder [PTSD], major depression, bipolar disorder, and substance use disorder). All 3 factors contributed to the diagnosis of bipolar disorder. The only diagnosis to which stressful life events made a unique contribution was to the likelihood of having PTSD.”
Greger et al. 53	n.i.	400 adolescents	“(i) To compare self‐reported QoL between adolescents in residential youth care in Norway with and without maltreatment histories, and adolescents from the general population; and (ii) to study the impact of number of types of adversities on QoL.”	Child and Adolescent Psychiatric Assessment (CAPA), Childhood adversity scale, Questionnaire for Measuring Health‐Related Quality of Life in Children and Adolescents (KINDL‐R) and Child Behavior Checklist	“Exposed adolescents in residential youth care (RYC) reported poorer QoL than peers in control groups. Compared with nonexposed peers in RYC, the 95% confidence intervals for mean score differences on the KINDL‐R subdomains (0–100 scale) were 1.9–11.4 (Physical Well‐being), 2.2–11.1 (Emotional Well‐being), −0.7–10.0 (Self‐esteem), and 1.8–10.9 (Friends). Compared with the general population sample, the 95% confidence intervals for mean score differences were 9.7–17.6 (Physical Well‐being), 7.9–15.3 (Emotional Well‐being), 3.6–12.5 (Self‐esteem), and 5.3–12.8 (Friends). Number of types of adversities was associated with a poorer QoL score on all subdomains (Physical‐ and Emotional Well‐being, Self‐esteem, Friends, and School).
Haney 31	Systematic Critique	n.a.	“The psychological effects of solitary confinement”	n.a.	“Studies have identified a wide range of frequently occurring adverse psychological reactions that commonly affect prisoners in isolation units. The prevalence of psychological distress is extremely high. Nonetheless, use of solitary confinement in the United States vastly increased in recent decades. Advocates defend its use, often citing two recent studies to support claims that isolation has no significant adverse psychological effects, including even on mentally ill people. Those studies, however, are fundamentally flawed, their results are not credible, and they should be disregarded. Critically and comprehensively analyzing the numerous flaws that compromise this recent scholarship underscores the distinction between methodological form and substance, the danger of privileging quantitative data irrespective of their quality, and the importance of considering the fraught nature of the prison context in which research results are actually generated. Solitary confinement has well documented adverse effects. Its use should be eliminated entirely for some groups of prisoners and greatly reduced for others.”
Heller et al. 49	Observational longitudinal study	86 young prisoners and 169 non‐prisoned youths (12–18 years old)	“(i) To provide estimates of the prevalence rates of psychiatric disorders and comorbidities among youths in a juvenile detention center in Geneva, Switzerland; (ii) to investigate potential positive effects of intensive psychotherapeutic and educational services this center provides; and (iii) to examine psychiatric care prior to and after custody as well as the evolution of the youths' mental health during detention	Kiddie‐SADS Present and Lifetime Version, Wechsler Intelligence Scale for Children (4th French version), Youth Self‐Report (French version), Childhood Trauma Questionnaire and Youth Psychopathic Inventory	“Psychiatric disorders were prevalent in the incarcerated group, but young people also often suffered from several disorders simultaneously. Two‐thirds of the incarcerated participants had a diagnosis of two or more psychiatric disorders. Regarding health care, most incarcerated participants (79.1%) had psychiatric care prior to detention. The planned care after detention was associated with psychiatric comorbidities, care being more likely planned for those with comorbidities. Compared to the non‐incarcerated group, the incarcerated group had lower scores on cognitive functioning and higher scores on trauma and psychopathic traits. The youths' stay in the detention center was associated with a positive change of mental health, with externalized problems being significantly reduced at the end of their stay.”
Ilijić et al. 67	Literature review	n.i.	“To discuss the concept of the quality of prison life and the effects of social and moral climate on the overall and future behavior of prisoners”	n.i.	“Imprisonment has far‐reaching consequences on the behavior of convicts. Further investigations of the impact and the role of environment and environmental factors on the successfulness of their social reintegration could provide additional answers. Concerns about the nature, effects and purpose of imprisonment are justified. In pursuance of the goals of imprisonment, finding the most effective approach to an individual convict is indicated. Within that, both quality of life in prison and social and moral climate should have a central place, not only in future research but also in practical implementation.”
Jordaan et al. 79	Experimental research (Solomon four‐group design)	96 young male prisoners (21–25 years old)	“To develop, implement, and evaluate a Life Skills program for young adult male long‐term offenders with the aim of improving their life skills that, in turn, could enable them to adjust more effectively in the correctional environment.”	Coping Strategy Indicator, Melbourne Decision‐Making Questionnaire, Trait Emotional Intelligence Questionnaire and Aggression Questionnaire	“The findings indicated that the program had limited success in equipping the offenders with the necessary skills crucial to their survival in a correctional center. The program did, however, have significant effects, especially on problem‐solving and anger management in the short and medium term. These improvements were not long lived.”
Kurdyak et al. 50	Retrospective cohort study	48,917 ex‐convicts	“To determine the prevalence of mental health and addiction‐related service use in the 5 years prior to and during incarceration.”	“Linked correctional and administrative health data were collected from people released from Ontario provincial jails”	“Prior to incarceration, 6116 (12.5%) had a psychiatric hospitalization, 8837 (18.1%) had an mental health and addiction (MHA)‐related emergency department visit, and 15,866 (32.4%) had an MHA‐related outpatient visit. Of the individuals with any MHA‐related service prior to incarceration, 60.4% did not receive outpatient care from a psychiatrist prior to incarceration and 65.6% did not receive MHA‐related care during incarceration.”
Liu et al. 52	Systematic review and meta‐analysis	62 studies with 15,115 prisoners and 330 ex‐prisoners in 16 countries	“To examine associations between different forms of trauma and mental disorders among prisoners and ex‐prisoners.”	PsycINFO, PubMed, Medline and Web of Science	“A multilevel meta‐analysis found that overall trauma was positively associated with more diagnoses or symptoms of mental disorders. Stronger effect sizes were found between childhood trauma and sexual trauma and stress‐related disorders. Multilevel moderator analysis showed that effect size was stronger in imprisonment trauma, mixed trauma, and stress‐related disorders. Associations between trauma and mental disorders were mediated by social support but not coping.”
Massoglia and Pridemore 57	Comparative review	n.i.	“To examine the impact of incarceration on health outcomes.”	n.a.	“Despite the wealth of articles published in recent years, research in the area is still at its nascent stages, as is—from a historical context—our understanding of the penal system and its effects on society. As the number of individuals released from prison grows, and as they advance in age, research on the relationship between incarceration and health will continue to speak to a host of critical academic, social, and policy issues.”
McCauley et al. 96	Randomized clinical trial	173 (163 female) adolescents	“To evaluate the efficacy of dialectical behavior therapy (DBT) compared with individual and group supportive therapy (IGST) for reducing suicide attempts, non‐suicidal self‐injury, and overall self‐harm among high‐risk youths.”	KSADS (mood, anxiety, psychosis, and eating disorder modules), SCID‐II (borderline personality disorder module), Drug Use Screening Inventory and Child Behavior Checklist	“Significant advantages were found for DBT on all primary outcomes after treatment: suicide attempts, non‐suicidal self‐injury, and self‐harm. Rates of self‐harm decreased through 1‐year follow‐up. The advantage of DBT decreased, with no statistically significant between‐group differences from 6 to 12 months. Treatment completion rates were higher for DBT (75.6%) than for IGST (55.2%), but pattern‐mixture models indicated that this difference did not informatively affect outcomes.
Mengesha et al. 71	Facility‐based cross‐sectional	694 inmates	“To examine the prevalence and correlates of depressive symptoms among inmates in Kaliti Prison Centre, Addis Ababa, Ethiopia.”	Pretested interviewer‐administered technique, 3‐item Oslo Social Support Scale and 9‐item Patient Health Questionnaire	“The prevalence of depressive symptoms among prisoners in the current study was 56.6%. Poor social support, personal history of mental illness, physical abuse and comorbid chronic medical illness were independent correlates of depressive symptoms.”
Mindrescu 82	n.i.	200 Romanian prisoners	“To bring forward the impact that the quality of life has on the detainees of penitentiary institutions and the way they navigate their prison living throughout their sentence.”	Questionnaire‐based survey (section 1: characteristics regarding the deprivation of liberty and the punishment executed by the detainees, violent behavior and addictions of detainees; section 2: detainees' perceptions regarding the quality of life in the penitentiary	“There are significant differences in terms of detainees' assessments regarding the quality of life they have in prison depending on all 3 characteristics regarding deprivation of liberty and execution. (i) Depending on the type of deprivation of liberty, between those placed in custody and those definitively convicted; (ii) depending on the length of the current sentence served, betweenthose with a lower sentence and those with sentence of more than 2 years; and (iii) depending on the total length of time spent in prison, throughout life, between those who spent less and those who spent more than 5 years in prison. The Life Quality into the penitentiary is influenced by the real threats, but in this penitentiary more threats are transformed in opportunities and advantages.”
Mohammed et al. 98	Institutional based cross‐sectional study	740 HIV patients	“To estimate the prevalence of depression and associated factors among adult patients seeking ART treatment in Harar, east Ethiopia.”	n.i.	“From findings of this study, it emerged that depression is high among people living with HIV who participated in the study. Being male and lack of social support were statistically associated with depression. On the other hand, depressive morbidity is hence challenges to uptake of medical recommendations among PLWHA accessing care and treatment services, with potential implications for HIV treatment outcomes.”
Mooney et al. 44	Cross‐sectional	59 Irish female prisoners, 59 Irish male prisoners and 106 females from general population	“To examine mental health status and quality of life of female prisoners, the majority of whom are drug−users.”	WHOQOL‐BREF, General Health Questionnaire (short form), National Survey of Lifestyles (modified version), Attitudes and Nutrition and SLN questionnaire	“While their quality‐of‐life profile was closer to drug−using male prisoners than other comparison groups, female prisoners still had significantly poorer physical and psychological Quality of Life scores. While poorer quality of life scores may be associated with the more severe drug use patterns of female prisoners it is likely that other factors also contribute. Before resorting to drugs/crime women may have already experienced adversity. There may also be gender differences in response to the combined dimensions of environmental distress. If women are to be imprisoned appropriate comprehensive mental health promotion approaches must address their specific needs.”
Molleman and van Ginneken 80	Multilevel analysis	4046 Dutch prisoners from 45 prisons	“To fill this gap in the link between cell sharing and quality of prison life.”	Prison Environment Inventory (Dutch version; Wright, 1985)	“Findings show that cell sharing is associated with lower perceived prison quality, which is partially mediated by reduced quality of staff–prisoner relationships. Cell sharing thus undermines the Dutch penological philosophy, which considers staff–prisoner relationships to be at the heart of prisoner treatment and rehabilitation.”
Muller and Bukten 9	Cross‐sectional	1499 Norwegian prisoners	“To explore the utility of a short generic tool measuring overall QoL, the QOL5, in an incarcerated population.”	A questionnaire with a total of 116 items, generic five‐item QOL5 instrument and Hopkins Symptom Checklist 10	“The QOL5 was strongly correlated with mental health, moderately correlated with exercise frequency and weakly correlated with ward security. The QOL5 is a short measure that presents minimal burden to respondents and administrators.”
Niełaczna 15	Field research	34 Polish representatives of the Prison Administration and 90 Polish prisoners from 8 penitentiary prison settings in Poland	“To obtain a detailed and complex picture of the prison administration, its daily functioning in relation to the inmates.”	Interviews, semistructured interview questionnaire for prison administrators and officials and anonymous surveys for inmates	“Without considering human emotions, beliefs, and relationships built in a specific time and place, without understanding what prison truly is, the research results would be not just partial but false. […] Prison administration requires separate study and development. It is part of public administration, important and specific, yet almost invisible to the average citizen. Its actions and decisions affect not only over 70,000 inmates but also their families and the immediate community they will return to after serving their sentence. […] The research showed that no other public administration places such importance on the individual and everything associated with them, especially the way they manage their life in all its dimensions (personal, social, professional). […] The findings suggest that dynamic elements, which vary over time and are inherently linked to the human factor, the conditions of a given penitentiary unit, and the margin of discretion and subjectivity in the approach and evaluation of prison staff, include: (i) predictability of the prison administration's actions; (ii) trust between the administration and inmates; (iii) the way inmate matters are handled, including how refusals are justified; and (iv) penitentiary law
Norhilmi et al. 65	Quantitative study	451 prisoners	“To model quality of life (QoL) among inmates' community imprisoning in Malaysian prison.”	Semistructured interviews	“The study found QoL Maqasid al‐Sharia approach, consists of five constructs namely “religion”, “life”, “mind’, “lineage” and “property”, may be useful for strategies that could enhance QoL of these inmates' communities.”
O′Flynn et al. 73	Naturalistic cross‐sectional observational study	52 male prisoners with schizophrenia or schizoaffective disorder	“To analyze the predictors of QOL among service users within an inpatient forensic mental health hospital.”	World Health Organization QOL assessment (WHOQOL‐Bref), Essen climate evaluation schema (EssenCES), Engagement in meaningful activity survey (EMAS) and Social and occupational functioning assessment scale (SOFAS)	“Stepwise regression showed that meaningful activity, level of ward security, and therapeutic hold on the EssenCES significantly predicted QOL on a range of specific QOL domains. These variables accounted for 40% of the variance for total QOL score. Engagement in meaningful activity added the largest contribution to total QOL score accounting for 30% of the variance.”
Orjiakor et al. 81	Qualitative study	8 male prisoners (31–5 years old)	“To explore the lived experiences of awaiting trial prisoners (ATPs) detained for prolonged years in a sub‐Saharan country; examining what they make of their status and how their conditions have affected their well‐being.”	Semistructured interview	“ATPs recount disbelief and negative emotional experiences upon incarceration. Alienated and uncertain about their status, ATPs experience intensified distressful ruminations which impact well‐being. ATPs re‐rationalized incarceration and made social comparisons which breed poor perception of self. ATPs nonetheless recounted hopefulness, made favorable comparisons; and find consolation in religious beliefs.”
Pat et al. 64	Qualitative study	48 young prisoners (24 female)	“To explore young Cambodian prisoners' experiences and perceptions of mental health and well‐being, their determinants and their coping strategies.”	Six focus groups with semistructured questions	“Young prisoners reported multifaceted experiences of mental health and well‐being. The majority described adverse mental health experiences, while some revealed better well‐being, partly influenced by the socioeconomic support from outside the prisons and previous involvement or not in drug abuse. The experience of physical overcrowding without emotional attachment among the fellow prisoners was perceived as the overarching determinant of loneliness and mental health problems, while socio‐emotional support and rituals were described as the most important coping mechanisms.”
Praptomojati and Subandi 91	Pilot study, quasi‐experimental method	7 prisoners	“To investigate the influence of forgiveness therapy on improving self‐acceptance in Indonesian inmates.”	Heartland Forgiveness Scale (Indonesian version), Self‐acceptance Scale (modified; (Philips) and Expressed Acceptance of Self Scale (Berger)	“The results of the statistical analysis showed that there was a significant difference between the score of self‐acceptance before and after being given forgiveness therapy, with the score being t(6) = −2764; P = 0.033 (P < 0.05). The qualitative data also supported the quantitative analysis that forgiveness therapy could increase the self‐acceptance of the inmates. Results were expected to be used as the basis of treatment and the development of mental health programs in Indonesian correctional institutions.”
Prost et al. 78	Cross‐sectional	186 male prisoners	“(i) To describe the physical and psychological health and quality of life among older adult men incarcerated in a state prison; and (ii) to examine cohort effects between ‘emerging’, ‘middle’, and ‘late’ older adult groups.”	Older Americans Resources and Services, Multidimensional Functional Assessment Questionnaire Activities of Daily Living, Patient Health Questionnaire‐8, 20‐item PTSD Checklist for DSM‐5, World Health Organization Quality of Life BREF	“The average number of chronic health conditions for the sample was higher than those in similar samples; the proportion of older adults with four or more chronic conditions was 10% higher than the national average for adults aged 65 or older. Depression and posttraumatic stress (PTS) symptom severity scores were higher than those found in community‐based samples. Significant differences were identified between cohorts regarding physical (number of chronic conditions, F = 12.48, P < 0.01); functional impairment, F = 4.28, P < 0.05) and psychological health (PTS symptom severity, F = 3.16, P < 0.05).”
Ross et al. 43	n.i.	n.a.	“To propose a short and an expanded definition of adolescent well‐being.”	n.a.	“Maintaining and improving the well‐being of its citizens is the fundamental duty of all governments, supported by the United Nations, civil society organizations, private sector, families and communities, adolescents, among many others. This requires a clear definition and measurable indicators. Given the multidimensional nature of well‐being, spanning five domains, it will be essential that multiple sectors unite behind the common objective of improving well‐being, using a common set of definitions, concepts, and indicators. Here, focusing on adolescents, we have proposed the first two of these requirements clear definition and description of five domains that underpin a conceptual framework for adolescent well‐being, whereas work continues on the development of the common set of indicators and the policy and programming implications of this framework.”
Skowroński and Talik 104	n.i.	390 male prisoners	“To examine the differences between groups of prison inmates distinguished according to the sense of quality of life in terms of their ways of coping with stress.”	Sense of quality of life Questionnaire (SQLQ) and COPE Inventory (Polish version)	“The results of the presented research have confirmed that the ways of coping with stress used by prison inmates are related to the sense of quality of life. This conclusion applies not only to the overall sense of quality of life but also to all of its dimensions: psychophysical, psychosocial, personal, and metaphysical one. According to the assumed hypothesis, people with a high level of overall quality of life significantly more often than people with a low level of quality of life prefer active coping strategies, including strategies such as: Active coping, Planning, Searching for instrumental support, Searching for emotional support, Positive revaluation and development. A similar conclusion with minor modifications also applies to other dimensions of quality of life.”
Skowroński and Talik 68	n.i.	390 male prisoners	“To explore the correlates and predictors of metaphysical quality of life in prisoners.”	Sense of Quality of Life Questionnaire to measure metaphysical QoL (MQoL) and psychophysical, psychosocial, personal, and global QoL, Intensity of Religious Attitude Scale (SIPR), SPI/TPI Questionnaire, COPE Inventory and RCOPE Questionnaire	“The positive correlates of prison inmates' MQoL are resilience, intensity of religious attitude, and curiosity, as well as selected coping strategies (religious and nonreligious). As hypothesized, the negative correlates of inmates' metaphysical quality of life are anger, anxiety, state depression, and trait depression. A novelty of the study is the inclusion of variables that have not been analyzed before in the context of prison inmates' metaphysical quality of life or quality of life in general: intensity of religious attitude and curiosity.”
Skowroński and Talik 70	n.i.	390 Polish male prisoners	“To explore the associations between resilience and quality of life and the possible mediating influence of social support.”	Sense of Quality of Life Questionnaire, 17 Resilience Assessment Scale (SPP‐25), Social Support Scale (SWS)	“As dependent variables, we tested QoL global score and its specific components: psychosocial, psychophysical, subjective, and metaphysical. In addition, we tested global social support and its aspects—psychosocial, psychophysical, subjective, and metaphysical—as mediators. The models we constructed are acceptable and each of the predictors is significant. The study confirmed the mediating effect of social support on QoL in prisoners.”
Skowroński and Talik 58	n.i.	390 Polish male prisoners	“To identify and analyze the determinants of prison inmates' psychosocial quality of life (PQol) as a positive and negative correlates.”	Sense of Quality of Life Questionnaire, 17 Life Orientation Questionnaire (SOC‐29), General Self‐Efficacy Scale (GSES), Social Support Scale (SSS), Intensity of Religious Attitude Scale (SIPR), SPI/TPI Questionnaire and COPE Inventory	“The positive correlates for prison inmates' PQol are: sense of coherence, self‐efficacy, intensity of religious attitude, social support, and trait curiosity. Among the strategies of coping with stress, only seeking social support for emotional reasons is a significant factor that directly predicts PQol. Substance use and planning play only a mediating role in PQol prediction. The negative correlate for inmates' PQol is trait depression. Contrary to predictions, anxiety is not a negative correlate—as noted above, it is associated with a positive score on PQol.”
Skowroński and Talik 14	n.i.	390 Polish male prisoners	“To analyze the determinants of prisoners' PQoL.”	Sense of Quality of Life Questionnaire, 17 General Self‐Efficacy Scale (GSES), Social Support Scale (SSS), Life Orientation Questionnaire (SOC‐29) and Trait Personality Inventory (TPI) Questionnaire	“The positive determinants of PQoL in prisoners are coherence, self‐efficacy and social support. The negative determinant of PQoL is trait depression. […] This study has revealed a list of factors significant for improving prisoners' PQoL. Factors have also indicated which of the predictors measured are the most significant. The identified set of significant factors should be taken into account in social rehabilitation programs for prisoners as contributing to the preservation of life and health.”
Skowroński and Talik 59	n.i.	390 Polish male prisoners	“To analyze the determinants of prison inmates' personal quality of life (PQoL).”	Sense of Quality of Life Questionnaire, 17 General Self‐Efficacy Scale (GSES), Social Support Scale (SSS), Resiliency Assessment Scale (RAS) and Trait Personality Inventory (TPI) Questionnaire	“The positive correlates of PQoL are: self‐efficacy, social support, and ego‐resiliency. The negative correlate of PQoL is trait depression. The study confirmed that 2 factors affected ego‐resiliency: self‐efficacy and trait depression. All significant factors, such as self‐efficacy, social support, ego‐resiliency, or trait depression, should be taken into account in rehabilitation programs.”
Stevanović et al. 75	n.i.	578 Serbian female prisoners	“To examine whether there are differences between persons who have previously served a prison sentence and those who have not, with regards to the perception of the quality of prison life.”	MQPL questionnaire	“results show that there are significant differences regarding the assessment of the quality of prison life in the following categories: Harmony Dimensions, Professionalism Dimensions and Well‐being and Development Dimensions, and that each of those three categories is statistically significantly better rated by those who are not penological returnees. When it comes to the general assessment of the quality of prison life, the results showed that there are no significant differences between persons who have previously served a prison sentence and those who have not.”
Talik and Skowroński 62	n.i.	390 Polish male prisoners	“To analyze differences in religious strategies of coping with stress in a group of prison inmates characterized by different levels of the sense of quality of life—general, psychophysical, psychosocial, personal, and metaphysical.”	Sense of Quality of Life Questionnaire 17 and RCOPE Questionnaire (Polish version)	“Individuals with a high sense of quality of life—both general and pertaining to specific dimensions—more often chose positive religious strategies, whereas participants with a low sense of quality of life more often chose negative strategies. The exception was the metaphysical aspect of the quality of life: individuals with a high intensity of this dimension more often chose some of the positive as well as negative religious strategies.”
Trizna and Adamowski 77	n.i.	93 Polish male forensic patients	“To compare patients treated in “court psychiatric wards” of low and medium security in terms of their needs, severity of psychopathological symptoms, subjective assessment of quality of life and satisfaction with treatment.”	Camberwell Assessment of Need – Forensic Version, Brief Psychiatric Rating Scale, Client's Assessment of Treatment scale and Manchester Short Assessment of Quality of Life scale.	“Patients at the medium‐security ward reported greater overall needs and a greater number of unmet needs. The overall severity of psychopathology, including deficits and positive symptoms, was higher among patients in low security wards. Results indicate that medical care on wards with low and medium security is at a similar level. Individuals are committed to medium‐security wards based not on their mental disorder but rather on the nature of the offense they had committed, which in this case is more serious than that of individuals directed to low security wards.”
Tung et al. 86	Nationwide population‐based	82,650 Taiwanese prisoners (8520 females)	“To estimate the prevalence of mental disorders in Taiwanese prisoners.”	National Health Insurance Research Database and International Classification of Diseases 9th revision Clinical Modification	“The prevalence of mental disorders among prisoners was estimated 11.31%. Female prisons exhibited a higher prevalence than males (17.82% vs. 10.56%, P < 0.01). Among all cases that were diagnosed with the contents of mental disorder, anxiety, dissociative and somatoform disorders was the most frequent disease (total: 49.48%, female: 59.42%, male: 47.55%) followed by special symptoms or syndromes (total: 38.24%, female: 33.20%, male: 39.22%), drug dependence (total: 15.41%, female: 9.22%, male: 16.61%), episodic mood disorders (total: 13.56%, female: 26.15%, male: 11.12%), nondependent abuse of drugs (total: 11.23%, female: 2.77%, male: 12.87%) and depressive disorder (total: 11.23%, female: 11.66%, male: 11.14%).”
Turner et al. 51	Cross‐sectional	161 German adolescent and young adult offenders (27 females)	“To evaluate the prevalence of adverse childhood experiences (ACEs) and mental health problems as well as their association within a sample of male and female young offenders.”	Youth Self‐Report (YSR), Childhood Trauma Questionnaire‐Short Form (CTQ‐SF), Wender–Reimherr adult attention‐deficit disorder scale self‐report (WR‐SR), Intermittent Explosive Disorder‐Screening Questionnaire for DSM‐5)	“Considerable rates of mental health problems were found, e.g., a prevalence of 35.9% was found for intermittent explosive disorder. Furthermore, a greater proportion of the female offenders fell into the clinically significant category for somatic complaints, anxiety/depression, and attention problems than the male offenders. Female young offenders also reported more frequently about all forms of ACEs compared to the male offenders. Latent class analysis defined three subtypes of young offenders depending on their individual ACE patterns: (i) low ACEs; (ii) mainly neglectful ACEs; and (iii) multiple ACEs. ACEs were significantly associated with the occurrence of both internalizing and externalizing mental health disturbances, with the multiple‐ACE subtype being most likely to report significant mental health problems. The results of the present study point toward the relevance to routinely assess ACEs in young offenders to identify possible precursors of mental health problems and of future criminal behaviors.”
Van Damme et al. 46	Cross‐sectional	121 young female prisoners	“To examine how girls evaluate multiple domains of quality of life (QoL) and how each domain is affected by psychiatric (co)morbidity, trauma, and socioeconomic status (SES).”	WHOQOL‐BREF and Diagnostic Interview Schedule for Children‐IV (Dutch version)	“Detained girls perceived their QoL almost as good as the 12‐ to 20‐year‐olds from the WHO's international field trial on all but one domain (i.e., psychological health). They were most satisfied with their social relationships and least satisfied with their psychological health. Psychiatric disorders, trauma, and low SES were distinctively and negatively related to various domains of QoL. The girls' psychological health was most adversely affected by psychosocial and socioeconomic problems, while these variables had an almost negligible impact on their satisfaction with their social relationships.”
Van Damme et al. 74	n.i.	108 young female prisoners	“To examine to what extent psychopathology and self‐perceived quality of life (QoL) are related to treatment engagement.”	Treatment engagement questionnaires, Massachusetts Youth Screening Instrument‐second Version (MAYSI‐2; Dutch version), Diagnostic Interview Schedule for Children‐IV (DISC‐IV) and WHOQOL‐BREF	“The results showed low levels of treatment engagement and no significant changes in treatment engagement over time. Overall, detained girls with internalizing disorders reported higher treatment engagement scores, while the reverse was true for girls with externalizing disorders. Regarding QoL, the girls with greater satisfaction about their physical and psychological health and about their environment reported higher treatment engagement, while the opposite was true for the domain of social relationships. Our findings emphasize the need for strength‐based and motivational approaches and techniques in residential treatment programs for girls, in order to enable change.”
van der Kaap‐Deeder et al. 60	Cross‐sectional	156 prisoners (11.5% females) in Belgium	“To investigate the relation between choice, autonomy satisfaction, and subjective quality of life among prisoners.”	European Addiction Severity Index‐Treatment Demand Indicator (EuropASI‐TDI), autonomy subscale of the Basic Psychological Need Satisfaction and Need Frustration scale (BPNSNF), European Health Interview Survey‐Quality of Life and WHOQOL‐BREF	“Results showed that perceived afforded choice related to higher subjective quality of life within prison. This relation was partially accounted for by elevated levels of autonomy satisfaction. Supplementary analyses revealed that the benefit of choice emerged regardless of participants' valuation of choice, and that perceived afforded choice with regard to daytime activities (i.e., leisure activities, work, and education) yielded the strongest effect. Collectively, results suggest that enhancing perceived afforded choice and autonomy satisfaction may provide important avenues for promoting prisoner quality of life. These findings are discussed in light of the growing focus on strength‐based approaches and psychological well‐being within the prison context.”
van Ginneken et al. 76	n.i.	4938 Dutch prisoners (246 females) in 28 prisons in the Netherlands	“To describe Dutch prisoners' perceptions of prison climate, as well as differences across regimes.”	Prison Climate Questionnaire	“A detailed methodological approach is described that can be adopted to achieve a high response rate with survey research among prisoners. The paper alerts researchers and practitioners to a large ongoing study and first findings on prison climate in the Netherlands. The PCQ can be requested from the authors and used in future research (internationally) to gain information about the perceived quality of prison life. The paper gives insight into how different regimes are associated with differences in perceived prison climate. Collaboration on the research project can be sought with the authors.”
Velotti et al. 88	n.i.	111 male prisoners (59 Italians in Italian prisons and 52 Australians in Melbourne prisons)	“To examine the unique associations among emotion dysregulation dimensions and different aspects of anger expression and control, in both inmates and offenders on parole.”	Emotion Regulation Scale (DERS 39 ), 20‐item Toronto Alexithymia Scale‐Revised (TAS‐20) and 57‐item State–Trait Anger Expression Inventory‐2 (STAXI‐2)	“Multiple regression analyses reveal that difficulties controlling impulsive behavior when distressed are related to state anger, trait anger, and chronic anger expression. On the other hand, alexithymia predicts the maladaptive expression of anger inwardly directed. Finally, lack of emotional awareness and limited access to emotion regulation (ER) strategies are negatively related to anger control, suggesting that they may represent useful treatment targets. Interestingly, incarcerated offenders reported significantly higher levels of state anger and lower levels of anger control out (i.e., seeking support from others) than offenders living on parole in the community, highlighting the importance of contextual influences in the emotional life of offenders.”
Yang et al. 95	n.i.	1491 Chinese male prisoners	“(i) To investigate the prevalence of probable antisocial personality disorder (ASPD) and borderline personality disorder (BPD) among prisoners; and (ii) to examine the mediating effect of difficulties in emotional regulation (ER) between childhood trauma and symptoms of ASPD and BPD.”	Personality Diagnostic Questionnaire – 4 (subscales of ASPD and BPD), Childhood Trauma Questionnaire (brief version), Brief Version of Difficulties in Emotion Regulation Scale and 4 items from the Self‐Injurious Thoughts and Behaviors Interview	“Approximately, 21.2% and 11.2% of the participants were screened as ASPD and BPD, respectively. Probable ASPD and BPD were associated with higher risk of suicidal behaviors. Childhood trauma and difficulties in ER were significantly associated with suicidal behaviors in prisoners with probable ASPD and BPD. Path analyses showed that partial mediating effects of difficulties in ER were significant in the dimensions of clarity and strategies on ASPD, and in the dimensions of clarity, impulse, and strategies on BPD. ASPD and BPD are two of the common personality disorders in prisoners. Difficulties in ER are key to understanding the relationships between childhood trauma and personality disorders.”
Yang et al. 92	n.i.	144 Chinese male prisoners	“To test the effects of two typical positive psychological interventions – kindness and gratitude – on Chinese prisoners' well‐being.”	Affect Balance Scale, 5‐item Satisfaction with Life Scale, Index of Well‐Being and 6‐item scale	“Both kindness and gratitude interventions significantly increased prisoners' well‐being compared to the control group. The kindness intervention promoted higher well‐being than the gratitude intervention. Although both kindness and gratitude interventions enhanced prisoners' happiness and mitigated negative affect, the weaker effect of the gratitude condition reflects Chinese strongly communal culture, so further cross‐cultural studies would be of interest. Future research should also include longer term follow‐up and expand the work to include women in prison.”
Yiengprugsawan et al. 45	Longitudinal prospective research	711 monks, 195 prisoners and 29,713 other cohort members	To compare monks', prisoners' and other cohort members health and social well‐being.	Semistructured interviews (demographic, socioeconomic and geographic), health check, Short Form 8 Medical Outcomes instrument (4 social outcomes were measured	“For physical health, we have found certain conditions such as tuberculosis or malaria much more common among prisoners, while goiter and liver diseases were more common among monks. This could be due to prison living arrangements for the former and region of residence for the latter. For other social outcomes, lower trust, higher economic stress and lower personal well‐being was noted for prisoners compared to other groups. Findings here with regard to spirituality and religion are encouraging with almost no difference reported between prisoners and other cohort members implying that trust‐building and other social intervention for prisoners could be activated through prevalent religious beliefs and practices and with continuing support from Thai prison authorities.”

n.a., not applicable. The article does not meet the requirements to provide this information; n.i., not included. The article did not provide any information about this aspect.

To conclude with, the key findings of this narrative review indicated ego‐resilience, self‐efficacy, and religion as well as social support in all its forms to be prominent personal and interpersonal resources, respectively, in promoting inmates' QoL and mitigating mental health risks, including negative emotions (e.g., anger, fear, helplessness, depression, guilt) which are quite prevalent during imprisonment. Several environmental and systemic issues such as overcrowding, staff‐inmate relations, and institutional policies were also found to be important in shaping inmates' QoL. Although there were contradictory findings with regard to the role of ward security on inmates' QoL, all forms of abuse were consistently found to have a negative impact on mental health and the overall QoL in prison settings.

Limitations

There are various intrinsic limitations of a narrative review research study that could influence how extensive and generalizable the findings are. In the current narrative review, the language barrier imposed while searching for relevant articles was a significant restriction. The present paper solely included articles published in English, potentially resulting in the exclusion of substantial research studies published in other languages. The linguistic restriction could contribute to a skewed and/or biased understanding of the background literature since critical insights from non‐English speaking authors and nations might be overlooked. In the future, this linguistic barrier could be eliminated by collaborating with researchers from other countries and/or involving researchers who are multilingual. This approach could make feasible the inclusion of studies published in a plethora of languages and provide a more thorough international perspective. Additionally, cross‐cultural cooperation promotes an inclusive environment, which enhances the overall diversity and quality of the findings.

Finally, narrative reviews, unlike meta‐analyses and systematic reviews, often lack a systematic methodology, which might result in potential subjectivity in selecting and interpreting the findings. Lacking a standardized methodology which is used for evaluating the relevance and quality of the articles, there is an increased possibility that the author's past knowledge and/or theoretical (unknown) biases may impact the selection of articles, increasing the possibility that only studies supporting a specific viewpoint will be included. This methodological looseness not only leaves room for confirmation bias but also hinders the transparency and replicability of the review procedure. Although narrative reviews are useful for exploring a plethora of topics, their findings should be carefully interpreted, particularly (i) in relation to more systematic methodologies that seek objectivity and consistency; and (ii) when language restrictions limit the paper's range.

Author contributions

Conceptualization, K.M and E.A.; methodology, E.A.; software, E.A; validation, K.M., V.Y. and E.A.; formal analysis, V.Y.; investigation, E.A.; resources, V.Y.; data curation, K.M.; writing – original draft preparation, E.A.; writing – review and editing, K.M.; visualization, V.Y.; supervision, K.M.; project administration, K.M.; funding acquisition, V.Y. All authors have read and agreed to the published version of the manuscript.

Disclosure statement

There are no conflicts of interest.

Data availability statement

Data sharing not applicable to this article as no datasets were generated or analysed during the current study.