Separate Roles for State and Trait Anxiety in the Formation of SHU Syndrome: Testing a Moderated Mediation Hypothesis

• Author: Glenn D. Walters
• Date: 01 January 2022
• DOI: 10.1177/00328855211069142
• Published date: 01 January 2022
• Subject Matter: Articles

Separate Roles for State

and Trait Anxiety in the

Formation of SHU

Syndrome: Testing a

Moderated Mediation

Hypothesis

Glenn D. Walters

1

Abstract

It has been proposed that state anxiety, aroused when an inmate is initially

placed in restrictive housing, interacts with the sequestering Special Housing

Unit (SHU) environment to overtax the individual’s already limited coping

resources, and promotes later emotional problems and psychological deteriora-

tion. This study tested a SHU syndrome hypothesis with a moderated mediation

path analysis of 69 male inmates. Results revealed that group status (general

population vs. restrictive housing) interacted with state anxiety to increase

trait anxiety and ineffective coping, which then gave rise to higher staff ratings

of psychological disturbance in inmates with no prior history of mental illness.

Keywords

SHU syndrome, coping skills, state and trait anxiety

Introduction

The use of special housing to manage correctional populations presents both

opportunities and problems. Special housing is frequently employed as

1

Kutztown University, Kutztown, PA, USA

Corresponding Author:

Glenn D. Walters, Kutztown University Department of Criminal Justice, 15200 Kutztown Rd.,

Kutztown, PA 19530, USA.

Email: walters@kutztown.edu

Article

The Prison Journal

2022, Vol. 102(1) 25–46

© 2022 SAGE Publications

Article reuse guidelines:

sagepub.com/journals-permissions

DOI: 10.1177/00328855211069142

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punishment for institutional rule violations and as a way of managing the

more violent inmates in the prison population while protecting the more

vulnerable ones. As a general rule, special or restrictive housing has

been found to be effective in reducing prisoner misconduct, particularly

when hard-to-manage inmates like gang members are targeted (Fischer,

2002; Ralph & Marquart, 1991). There are concerns, however, that

special housing may be overused and that keeping an inmate in segrega-

tion over an extended period of time may create serious psychological

problems and issues, even in inmates without a history of prior mental

health disorder (Grassian, 1983). One such problem is a constellation of

behaviors, abnormalities, and symptoms known as SHU (Special

Housing Unit) syndrome. The purpose of the current investigation was

to test a conceptual model of SHU syndrome with a moderated mediation

research design in a group of inmates with no apparent mental health

needs.

SHU Syndrome

Grassian (1983, p. 2006) developed the concept of SHU syndrome from

interviews held with 15 male inmates living in a restrictive housing unit

at the Massachusetts Correctional Institution-Walpole. All 15 were plain-

tiffs in a class action suit alleging Eighth Amendment violations emanating

from their exposure to long-term solitary conf‌inement. The symptoms of

this syndrome, as outlined by Grassian, were generalized hyperresponsivity

to external stimuli, perceptual distortions and hallucinations, affective dis-

turbances, concentration and memory diff‌iculties, disturbances of thought

content, and problems with impulse control. Of particular note, these symp-

toms were said to remit or signif‌icantly diminish within hours of the

inmate’s removal from isolation. This led Grassian to conclude that restric-

tive or segregation housing was the cause of these symptoms. Early cross-

sectional studies comparing inmates in restrictive housing to inmates in

general population produced mixed and inconclusive results (Hodgins &

Côté, 1991; Suedfeld et al., 1982), and exposed the existence of large indi-

vidual differences between prisoners in restrictive housing and prisoners in

general population in terms of their premorbid mental status (Motiuk &

Blanchette, 2001). Researchers soon realized that longitudinal investiga-

tions were required to properly evaluate the validity and prevalence of

SHU syndrome.

The f‌irst longitudinal study conducted on psychological adjustment in

restrictive housing was performed by Zinger et al. (2001). Using a sample

of 60 Canadian prisoners evaluated at three points in time, with 30 days

26 The Prison Journal 102(1)