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Author Spotlight: Unveiling Mechanisms of Stress Resilience - Significant Findings, Advancements, and Future Research
Published on: December 15, 2023
A vulnerability paradox in the cross-national prevalence of post-traumatic stress disorder
Michel L A Dückers1, Eva Alisic2, Chris R Brewin2
1Michel L. A. Dückers, PhD, Impact - National Knowledge and Advice Centre for Psychosocial Care Concerning Critical Incidents, Arq Psychotrauma Expert Group, Diemen, and NIVEL- Netherlands Institute for Health Services Research, Utrecht, The Netherlands; Eva Alisic, PhD, Monash University Accident Research Centre, Monash University, Melbourne, Australia; Chris R. Brewin, PhD, Department of Clinical, Educational and Health Psychology, University College London, London, UK m.duckers@nivel.nl.
Background:
Determinants of cross-national differences in the prevalence of mental illness are poorly understood.
Aims:
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.
Method:
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.
Results:
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.
Conclusions:
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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