Abstract
This study aimed to investigate the effectiveness of Ellis’s rational-emotional approach on criminal thinking and law-evasion in male prisoners. A quasi-experimental design utilizing pretest, post-test, and follow-up test and waiting-list control groups was conducted. Thirty male prisoners were selected by purposeful sampling and randomized into experimental and waiting list control groups. Participants of experimental group received 12 sessions of Ellis’s rational-emotional approach intervention; and all participants answered to PICTS-L-SF and ABAWS as dependent variables at 3 time points (pretest, post-test, and 1 month follow-up). A repeated measures analysis of variance was used to analyze the data. Results showed criminal thinking and law-evasion in experimental group, as compared to control, at post-test phase was significantly decreased (p < .05); and improvement of dependent variables in the follow-up phase has also been continued (p < .05). Therefore, REBT can be beneficial for reducing criminal and illegal thoughts and behaviors among prisoners.
Introduction
Psychological and criminological researchers have continuously wanted to comprehend the countless interacting biological, psychological, and social factors to clarify why some people tend to involve in criminal and antisocial behavior (Moreira et al., 2022). Accordingly, numerous theories attribute the basis of these behaviors to factors such as personality (Mansoor et al., 2022), temperament (Moreira et al., 2022), mental disorders, genetic problems (Liu et al., 2021), economic problems (Link & Oser, 2018), ineffective parenting (Sana et al., 2021), cognitive factors (Meterko & Cooper, 2022), ethnicity (Walters, 2018), and social factors (Smith et al., 2019). Likewise, numerous studies reveal that men are more prone to criminal and anti-social behaviors (Benson & Harbinson, 2020; Gottschalk, 2022) and though these behaviors start from adolescence and reach their peak during this period, a major part of these behaviors delinquency occurred in adulthood (Carlsson & Sivertsson, 2021).
Based on what has been said, one of the factors affecting the tendency to criminal and antisocial behavior is cognitive factors (Meterko & Cooper, 2022). In this regard, error patterns in thinking (as one of the cognitive problems) are the factors that are raised regarding criminal behavior (Garvin & Goldstein, 1990). This concept was introduced as criminal thinking and expanded by many researchers, especially Walters (2021). According to the definition, criminal thinking is a distinctive thought pattern used by criminals to deal with or eliminate negative emotions such as guilt and shame caused by illegal behaviors so that they can continue to commit crimes without psychological burden (Walters, 2021). Criminal thinking comprises numerous mindsets, including cognitive defensive aggressive mechanisms such as excusing criminal activity, justifying criminal behavior, suppressing or resisting the authorities, and denying their original malice (Cornish & Clarke, 2014), and helps criminals to use the two mechanisms of moral disengagement (Bandura, 2014) and neutralization techniques (Sykes & Matza, 1957), to reduce the guilt associated with criminal behavior and includes mechanisms and techniques that emphasize denial and ignore responsibility (Walters, 2021).
Criminal thinking can take one of two forms: the content of criminal thinking (what an offender thinks) and the process of criminal thinking (how an offender thinks; Morgan et al., 2012). In an attempt to explain the persistence of crime within the framework of the criminal lifestyle theory, Walters (2012) stressed the process of criminal thinking and divided this process into two dimensions, commonly known as proactive and reactive criminal thinking. Proactive criminal thinking represents the planned, calculated, and neutralizing aspects of the criminal thinking process, while reactive criminal thinking involves impulsive, reckless, and emotional aspects (Walters, 2007). The previous studies have emphasized that active and reactive criminal thinking can play a significant role in initiating and maintaining criminal behavior (Butt et al., 2019; Megreya et al., 2015; Walters, 2016, 2019). Therefore, paying attention to this factor is of great importance.
One of the variables that have a lot to do with criminal thinking is law-evasion (Walters, 2019). An inordinate propensity to law-evasion can also facilitate criminal and anti-social behavior. Law-evasion is synonymous with order-avoidance, the consequences of which are a person not being satisfied with his or her rights, violating the rights of others, not doing their homework, escaping responsibility, and attaining the goal by any likely means (Mirfardi & Faraji, 2016). Law-evasion individuals do not respect norms and might try to violate the law (Holtmann, 2008). Since in law-evasion, not following the rules is not considered as a negative behavior, these people engage in antisocial behavior more easily than normal people (Walters, 2020). The subject of law-evasioning in prisons is similarly one of the significant issues that have always been taken into consideration. Law-evasion offers the context for returning to prison, and this issue can conflict with one of the important purposes of prison, which is to reform and educate prisoners. Though, law-evasion is still one of the difficulties faced by prisons (Mofid et al., 2017), and reducing law-evasion is a significant objective in prisons (Kiamini et al., 2014). The costs associated with law-evasion and re-offending can vary depending on the severity and frequency of the crime, but the impact can be significant on both individuals and society as a whole. For example based on FY 2020 data, the average annual COIF (Annual Determination of Average Cost of Incarceration Fee) for a Federal inmate in a Federal facility in FY 2020 was $39,158 (Bureau, 2021). Therefore intervention, and decrease are of great prominence.
While many researchers emphasize the criminology factors of criminal behaviors, many others have focused on the psychological dimensions of these behaviors (Liu et al., 2021; Walters, 2019). For example the risk-need-responsivity (RNR) model has received widespread recognition as the leading model for guiding offender assessment and treatment (Andrews et al., 2011). Some consider RNR to be the foremost evidence-based model for rehabilitative programming in youth and adult corrections (McGuire, 2004), providing a relatively powerful model of crime and crime prevention. The model elucidates the key questions of who should be treated (i.e., risk), what treatment should be focused on (i.e., needs), and how those individuals should be treated (i.e., responsivity; Andrews et al., 2011). The RNR model posits that individuals who engage in criminal behavior have deficits in various domains, including but not limited to, antisocial attitudes, negative personality traits, low self-control, poor social ties, and substance abuse. Additionally, Ellis’s Rational-Emotional Approach or Rational Emotive Behavior Therapy (REBT) is among the most effective methods for improving cognitive factors, representing one of the most essential and long-standing cognitive-behavioral approaches (Liu et al., 2021) and can address specific factors identified by the RNR model, such as antisocial cognition.
This therapy aims to alter and recover irrational thoughts that are dependent on maladaptive behaviors and emotional responses (Neamtu & David, 2016). REBT declares that there is a biological tendency in humans to think in a destructive and irrational, yet rational and healthy way (Şahin et al., 2022). A factor that (due to being unreal, pessimistic, and irrational) can impede performing efficient behaviors (Almomani et al., 2021). Consequently, the key objective of REBT is to correct irrational thinking; this factor will decrease dysfunctional behaviors and negative emotions, and physical changes (Liu et al., 2021). In his rational-emotional approach, Ellis indicates that irrational thinking leads to intense emotions, which will result in disorganization, failure to attain goals, and a reduction in satisfaction. In fact, in this view, it is supposed that behavioral, mental, and emotional disorders are the consequence of ineffective thinking methods and faults in behaviors and thoughts (El-Nahhas, 2020). Then, in REBT, antisocial behaviors can also be influenced via errors in habits and thoughts. The result of the study by Meterko and Cooper (2022) also depicts that cognitive bias is one of the causes of people’s tendency toward criminal and anti-social behavior. A systematic review conducted between 1995 and 2007 has also demonstrated the effectiveness of Rational Emotive Behavior Therapy (REBT) in reducing repeated offenses (Debidin & Dryden, 2011).
The effectiveness of REBT in improving cognitive and behavioral problems has been shown in numerous studies (Bardak-Ćurko, 2020; Kazem, 2022; Liu et al., 2021; Mobashery et al., 2022; Nafisi, 2020), which shows the effectiveness of this cognitive-behavioral intervention. Likewise, the conducted studies reveal that generally, cognitive behavioral therapies are effective interventions in improving criminal thinking (Lindblom et al., 2018; Nyazmand et al., 2022; Rezapour-Mirsaleh et al., 2021; Walters, 2017) and law-evasion (Hollin, 2019; Hornsveld et al., 2019; Sharma, 2020). Although these studies are inconsistent with the research methods and tools of the present study, their findings demonstrate the effectiveness of cognitive and behavioral therapies on criminal thinking and law-evasion. Given what has been said, criminal thinking is important in the occurrence of antisocial behaviors and related factors. Despite the effectiveness of REBT in reducing criminal behaviors (e.g., Debidin & Dryden, 2011), this cognitive-behavioral intervention has received less attention in the Iranian penal community, and no research has fully considered the goals of this study. Accordingly, the present study was conducted with the aim of examining the effectiveness of REBT on criminal thinking and law-evasion in male prisoners.
Method
Design and Participants
In this quasi-experimental study, a Pretest-posttest follow-up experimental design with control group was used. Thirty male prisoners from Ardakan prison, Iran, in 2023 participated in the study. Participants selected by Convenience sampling and randomly assigned in experimental and waiting-list groups. Although 15 participants in each group is a small sample size for a quasi-experimental study and may result in a decrease in the generalizability of the findings and effect size, a larger sample in group therapy may also reduce group cohesion. Specifically, in present study, interactions between participants about criminal behaviors and thinking (which considered undesirable in society) could contribute to greater effectiveness of treatment, and a larger sample may have reduced group cohesion, increased confidentiality, and quality of challenge between participants (Burlingame et al., 2011). For this, up to 15 prisoners were selected to participate in each group to maintain the quality of the therapy and the intergroup interaction (Hornsveld et al., 2019). The presence of a large sample size in experimental research may reduce the quality of instructional sessions, which is also ethically incorrect (Burlingame et al., 2011). Finally, because in the REBT’s group, the participants had to feel satisfied with the addition or decrease of the participants (Germer & Neff, 2019), the participants in this study disagreed with the increasing number of group members.
Criteria for inclusion in the study were as follows: 1. Inclination to participate in the research, 2. individuals who passed at least 1 year from the imprisonment, 3. previously arrested for criminal behaviors, 4. the age range of 25 to 50 years old. Criteria for exclusion were included having a specific mental disorder and receiving other psychological treatments. These criteria were chosen because they may affect criminal thinking and related variables. All participants did not have score above t = 70 in the Minnesota multiphasic personality inventory (MMPI-2) subscales, indicating no specific mental disorder (Hosseinchari et al., 2011). Also, the mean criminal thinking score of all participants was higher than the average of the attainable scores, indicating high criminal thinking (Walters, 2006). To assess the criteria, interviews and psychiatric record files also were used. Before the intervention, the study objectives were explained to the participants and they completed the consent form. Ethical consent was obtained from the research committee of Islamic Azad University of Isfahan (Ethics code: IR.IAU.KHUISF.REC.1401.355) and registered in Iranian Registry of Clinical Trials (IRCT code: IRCT20230218057442N1).
Procedure
After the call of the research, a total of 57 prisoners volunteered to participate in the study. They were told that if they did not receive the intervention during the study, after the completion of the study, similar interventions would be carried out for them. Considering inclusion and exclusion criteria, 30 prisoners remained in the study. Participants were informed that their answers to the questionnaires would remain completely confidential; and they were asked to respond honestly to each question and participate actively in group discussions. Intervention flowchart is presented in Figure 1.

Intervention flow-chart.
The waiting group did not receive any intervention and informed that they were put on a waiting list. Participants of both groups answer to the psychological inventories of Criminal Thinking Styles-Layperson Edition-Short Form (PICTS-L-SF) and Antisocial Behavior at Workplace Scale (ABAWS), before the intervention as pre-test. Immediately after the intervention in the experimental group, participants in both groups answered the PICTS-L-SFm and ABAWS as post-test. Finally, 1 month after the intervention, in the follow-up phase, the participants answered the questionnaires again. During the 1 month follow-up, prisoners were not receiving any kind of intervention in both groups. Data were analyzed by Multivariate Repeated Measure MANOVA (groups × times).
The participants of experimental received REBT (Ellis & Jaffe, 1974) in 12 ninety-minute sessions (twice per week). The intervention was conducted by the lead author, who was trained in REBT (Primary Certificate) under supervision of the second author, who was also trained REBT (Advanced Practicum). In order to manage potential conflicts of interest, in addition to using a control group, two independent assessors monitored the intervention stages and an independent assessor, who was blind to the study group’s assignment or results, was also used to reduce the risk of bias. Content of sessions is presented in Table 1. It may seem that in the REBT offered to the participants, other concepts such as self-control and impulsivity are also presented. But this is a misunderstanding. Some concepts such as self-control, impulsivity, emotions, and problem solving are part of the important tasks of the participants in Ellis’ rational emotional intervention. Thus, focusing on issues such as self-control and impulsivity in intervention sessions did not mean that Ellis’ rational emotional intervention included self-control and impulsivity, but merely because of the generalization of Efficient and rational thoughts and behaviors to Prisoners’ daily activities.
Content of Sessions.
Finally data were analyzed by Multivariate Repeated Measure MANCOVA (groups × times). Effect sizes (Cohen’s d) were estimated by dividing mean of change scores by standard deviation of the change scores (Feingold, 2009).
Instruments
Criminal Thinking
The PICTS-L-SF (Walters, 2011) is a 35-item, self-report measure. Like all versions of the PICTS, the PICTS-L-SF is designed to assess thought patterns that are associated with criminal behavior (Walters, 2006). A layperson version of the PICTS, the PICTS-L, was developed by James Kaufman for the purpose of measuring criminal thinking in non-offender populations (Walters, 2011). This was done by altering the wording of the questions so that a history of criminal behavior was not assumed. For example, the question on the PICTS reading “I have used alcohol or drugs to eliminate fear or apprehension before committing a crime” is changed on the PICTS-L to read “I have used alcohol or drugs to eliminate fear or apprehension before doing something risky.” Additionally, a Short Form version of the PICTS (Walters, 2006), the PICTS-SF, was developed to create an abbreviated version, 35 versus 80 test items, that requires less time to complete. The PICTS-L-SF was developed by the researchers for the purposes of this study. This was done by selecting the test items on the 80-item PICTS–L that corresponded to the 35 items on the PICTS—SF (PICTS-SF) (Walters, 2012). Response options to items on the PICTS-L-SF are provided using a 4-point Likert Scale (1 = disagree, 4 = strongly agree; Walters, 2006). The scales on the original PICTS were created utilizing exploratory and confirmatory factor analysis (Walters, 1995, 2002; Walters et al., 1998) and these scales were utilized based on the items of each scales that were retained in the PICTS-L-SF. The PICTS-L-SF produces two content scales (i.e., Current Crim Thinking and Historical Criminal Thinking), two composite scales (i.e., Proactive Criminal Thinking and Reactive Criminal Thinking), seven thinking pattern scales (i.e., Mollification, Cutoff, Entitlement, Sentimentality, Superoptimism, Cognitive Indolence, and Discontinuity), and four Factor and Special Scales (i.e., Problem Avoidance, Interpersonal Hostility, Self-Assertion, and Denial of Harm; Walters, 2012). Despite the scales yielded, Walters identifies General Criminal Thinking and the composite scales as the “most important scores on the inventory” (Walters, 2012). The current research calculated the scale’s exam’s reliability using Cronbach’s alpha, resulting in a value of 0.897.
Law-Evasion
To examine law-evasion, the questionnaire on anti-social behavior in prison (9-question form) was used. This questionnaire is an adaptation of the Antisocial Behavior at Workplace Scale (ABAWS), which has nine questions and was introduced and presented by (Robinson & O’Leary-Kelly, 1998). The response scale of the questionnaire is based on the Likert spectrum from never do it (1) to do it every day (7) and a higher score indicates more antisocial behaviors. In the preparation of this questionnaire, (Robinson & O’Leary-Kelly, 1998; Conducted with 70 Master of Business Administration (M.B.A.) students) precisely investigated the face validity (using 70 tuition-paying M.B.A) students, with a ratio of 71% to 100% have been agreed with the harmfulness of each of the behaviors reported in the scale of antisocial behaviors. Convergent and divergent construct validities (based on the correlation between scores in the antisocial behaviors questionnaire with confrontational behaviors, behaviors based on neglect, willingness to leave the service, and behaviors based on conscientiousness and loyalty), retest reliability (with a time interval of 2 weeks) equal to 0.87, and reliability based on internal consistency (Cronbach’s alpha in two measurements) equal to 0.75 and 0.81, respectively, and they were reported favorable. From the individual level to the group level, it can also be used for group antisocial behaviors (Robinson & O’Leary-Kelly, 1998). Elçi et al. (2013) also used this questionnaire in a study in addition to exploratory factor analysis (component analysis original with varimax rotation) with factor loadings of 0.48 to 0.79. Cronbach’s alpha equal to 0.85 have been reported for this scale. In the present study, the questionnaire items for use in prison were rewritten and their face validity was also approved by five university experts (PhD in Psychology). The current research calculated the scale’s exam’s reliability using Cronbach’s alpha, resulting in a value of 0.871.
Results
The mean ages of the participants were approximately similar in both groups (35.33 ± 7.92 in experimental and 37.40 ± 8.04 in waiting-list control group respectively). T tests showed there was no significant difference between groups regard age (t = −0.709, p > .05). The frequencies of some demographic characteristics of the participant are presented in Table 2.
Frequencies of Marital Status, Education, Number of Prior Convictions, and Length of the Conviction in Participant.
Participants of both groups were approximately similar in frequency of marital status, education, number of prior convictions, and length of the conviction. Normality of scores distribution for experimental group by Shapiro-Wilk test were assumed (p < .05). Levene’s Test for equality of variances was not significant (p < .05) that is show assumption of equality of variances for all variables verified. There were no differences between two groups regard pre-tests (p < .05). The criminal thinking and law-evasion mean in the three measurements of pre-test, post-test, and follow-up are presented in Table 3.
Criminal Thinking and Law-Evasion Mean in the Three Measurements of Pre-Test, Post-Test, and Follow-Up.
There were no differences between two groups regard pre-tests (p < .05). The repeated measures analysis of variance to compare criminal thinking and law-evasion among the three groups in the three measurements are presented in Table 4 and Bonferroni post-hoc to compare groups in pre-test, post-test, and follow-up are presented in Table 5.
Repeated Measures Analysis of Variance to Compare Criminal Thinking and Law-Evasion Among the Three Groups in the Three Measurements.
Bonferroni Post-Hoc to Compare Groups in Pre-Test, Post-Test, and Follow-Up.
The results showed (Tables 4 and 5) after the REBT intervention, the mean criminal thinking scores decreased (p < .05), the mean law-evasion scores decreased also (p < .05) and in both dependent variables, the durability of the improvement created for the members of the experimental group was statistically significant (p < .05).
Discussion
The current study was done with the aim of the effectiveness of REBT on criminal thinking and law-evasion in male prisoners. The results revealed that REBT was effective on criminal thinking and law-evasion in male prisoners and the durability of the improvement created for the members of the experimental group was statistically significant. The results of the test of the first research hypothesis revealed that after REBT the average scores of criminal thinking in the participants of the experimental group decreased significantly compared to the control group, and the persistence created during the follow-up period was statistically significant. The result in this part is consistent with the results obtained from preceding research (Lindblom et al., 2018; Nyazmand et al., 2022; Rezapour-Mirsaleh et al., 2021; Walters, 2017). Walters indicated that a brief cognitive behavioral intervention is effective on the criminal thinking of male prisoners (Walters, 2017). To explain this part of the research findings, it can be supposed that using educational packages that facilitate the cognitive, behavioral, and emotional skills of prisoners (as what was used in this research) can lead to the adjustment of criminal thinking. This can exist since REBT stresses correcting irrational thoughts. In this regard, Ellis and Jaffe (1974) revealed that it is not external events (A) that cause people’s dysfunctional reactions (such as criminal behavior) (C), but rather their irrational beliefs (B) that create these situations. This feature of REBT can also be extended to crime conditions. In the criminal thinking model, it is also supposed that prisoners, due to their criminal thinking (B), when put in a certain situation; not having enough money to live on (A), tend to engage in criminal behavior (C) (Walters, 2017). Consequently, in training sessions, prisoners learned how to classify their ineffective thoughts and then challenge these thoughts using the ABC model and substitute them with more efficient thinking. This issue started with generating self-awareness and recognizing the feelings that simplify criminal behavior in prisoners and continued with training on how to form criminal behavior (through criminal thinking) and challenging exercises regarding irrational thoughts. The prisoners, in the training sessions, strengthened their skills by doing individual and group exercises so that they can change their criminal thoughts with more rational and efficient ones, which will ultimately lead to more effective behavioral consequences for them.
The results of the test of the second research hypothesis revealed that after REBT the law-evasion in the participants of the experimental group decreased significantly compared to the control group, and the persistence created during the follow-up period was statistically significant. The result in this part is consistent with the results obtained from preceding research (Hollin, 2019; Hornsveld et al., 2019; Sharma, 2020).
For example, Sharma (2020) indicated that cognitive-behavioral therapy is effective in reducing recidivism. In another study, Hollin (2019) indicated that cognitive behavioral therapy is effective in decreasing criminal behaviors by improving interpersonal interactions, social perception, and social cognition. In illuminating this part of the research findings, it is likely to indicate that lawlessness happens when a person strengthens the irrational belief that he is greater than the law (entitlement), considers all people to be law evaders, or imagines that laws are cruel and made to harm people. Instead, a group of prisoners described law evasion as brave behavior and a good advantage. Consequently, what exists in law evasion to a large extent are inflexible, extreme, and irrational beliefs. Criminals may experience numerous negative emotions when they find themselves in front of the law (e.g., they may resent having to take a certain dose of methadone or psychiatric drugs in prison only on doctor’s orders). These emotions, which often include Unhealthy Negative Emotions (UNEs), call for maladaptive behaviors (such as law-evasion) that arise from irrational beliefs. Instead, unhealthy negative emotions (UNEs) are associated with very unpleasant (chronic and severe) physical symptoms, and for this reason, people in these circumstances regularly select behaviors that temporarily free them from the negative consequences of physical symptoms and unhealthy negative emotions. Though these behaviors are essentially in conflict with efficient and legal behaviors. For instance, a prisoner who is faced with the doctor’s prohibition to take more methadone or medicine may decide to steal some methadone or medicine to get rid of his physical symptoms and unhealthy negative emotions (the perception of failure in front of the doctor). In another instance, when in group meetings, prisoners were asked what they would do to meet their financial needs if they found out that their wallets and mobile phones were stolen in another city; they said that the only way to get rid of anger and despair is to steal or beg. Accordingly, irrational beliefs besides unhealthy negative emotions make criminals desire to evade the law. In the REBT sessions, the prisoners were able to adjust their beliefs more effectively. In REBT sessions, prisoners learned to develop their skills in problem-solving, assertiveness, decision-making, and conflict, which play a significant role in evasion, by using three types of techniques, namely, problem-solving, cognitive restructuring, and coping (Godard et al., 2017). Consequently, via cognitive restructuring, prisoners experienced and practiced situations in which they could choose more effective behaviors instead of illegal behaviors. This factor ultimately reduced the amount of Law-Evasion among prisoners.
Conclusion
This study aimed to investigate the impact of Rational Emotive Behavior Therapy (REBT) on criminal thinking and Law-Evasion in male prisoners. The study found that REBT helped in reducing irrational beliefs and minimizing criminal thinking and law-evasion among prisoners. These results have important practical implications for practitioners in the fields of criminal justice, rehabilitation, and education. REBT can be incorporated into rehabilitation programs to address the irrational beliefs of prisoners, which may help reduce their risk of reoffending after release. Policy changes could include incorporating REBT into prison rehabilitation programs or prioritizing the use of REBT in crime prevention and post-release support centers. The Risk-Need-Responsivity model suggests that interventions should be tailored to an individual’s specific risk factors and needs, making REBT a useful and tailored intervention for reducing criminal thinking and impulsivity. Additionally, school counselors may use REBT as a crime prevention strategy in schools. These findings highlight the importance of addressing irrational beliefs in preventing criminal behavior and highlight the significance of using REBT to reduce criminal thinking and law-evasion in prisoners and those with a tendency toward criminal behavior. By prioritizing the provision of effective and targeted treatment to offenders, practitioners can improve their long-term outcomes. Ultimately, this study provides a better understanding of the relationship between irrational beliefs and criminal behavior and stresses the need to address these beliefs as part of any intervention seeking to reduce recidivism rates.
Limitations and Future Research
This study has limitations that should be taken into account in the generalization of the finding. Small sample size may affect generalizability of the findings and intervention effect size. Other limitations of the present research comprise the impossibility of controlling disturbing variables, the limitation of the research population to male prisoners, and the use of a questionnaire as the lone research evaluation tool, which shows the need for caution in generalizing the results. We supposed, as it was concluded from the literature review, that a decrease in criminal thinking may lead to a decrease in criminal behaviors and consequently prevent recidivism; but because the length of imprisonment was different for the participants and we were unable to track their future after imprisonment, the impact of the intervention on returning to prison was not investigated. In the present study, duration of the imprisonment, the level of education, and the age of the participants were controlled, however, it is suggested that future studies compare the effectiveness of REBT on the basis of these demographic variables.
Footnotes
Acknowledgements
We thank all the prisoners who participated in the study.
Declaration of Conflicting Interests
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding
The author(s) received no financial support for the research, authorship, and/or publication of this article.
Availability of Data and Materials
All data generated or analyzed during this study are included in their entirety in this published article itself.
