A vulnerability paradox in the cross-national prevalence of post-traumatic stress disorder

Determinants of cross-national differences in the prevalence of mental illness are poorly understood. To test whether national post-traumatic stress disorder (PTSD) rates can be explained by (a) rates of exposure to trauma and (b) countries' overall cultural and socioeconomic vulnerability to a...

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Bibliographic Details
Published in:British journal of psychiatry Vol. 209; no. 4; pp. 300 - 305
Main Authors: Dückers, Michel L. A., Alisic, Eva, Brewin, Chris R.
Format: Journal Article
Language:English
Published: Cambridge, UK Cambridge University Press 01.10.2016
Subjects:
Adversity
Culture
Disasters
Epidemiology
Exposure to Violence - ethnology
Exposure to Violence - statistics & numerical data
Global Health - ethnology
Global Health - statistics & numerical data
Humans
International comparisons
Mental disorders
Mental health care
Polls & surveys
Population studies
Post traumatic stress disorder
Prevalence
Psychiatry
Psychological Trauma - epidemiology
Psychological Trauma - ethnology
Respondents
Risk Factors
Sex crimes
Stress Disorders, Post-Traumatic - epidemiology
Stress Disorders, Post-Traumatic - ethnology
Trauma
Vulnerability
Colombia
Netherlands
Romania
Nigeria
ISSN:0007-1250, 1472-1465
Online Access:Get full text
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Summary:Determinants of cross-national differences in the prevalence of mental illness are poorly understood. To test whether national post-traumatic stress disorder (PTSD) rates can be explained by (a) rates of exposure to trauma and (b) countries' overall cultural and socioeconomic vulnerability to adversity. We collected general population studies on lifetime PTSD and trauma exposure, measured using the WHO Composite International Diagnostic Interview (DSM-IV). PTSD prevalence was identified for 24 countries (86 687 respondents) and exposure for 16 countries (53 038 respondents). PTSD was predicted using exposure and vulnerability data. PTSD is related positively to exposure but negatively to country vulnerability. Together, exposure, vulnerability and their interaction explain approximately 75% of variance in the national prevalence of PTSD. Contrary to expectations based on individual risk factors, we identified a paradox whereby greater country vulnerability is associated with a decreased, rather than increased, risk of PTSD for its citizens.
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ISSN:0007-1250
1472-1465
DOI:10.1192/bjp.bp.115.176628