Michel Dückers|Eva Alisic|Chris R. Brewin
A vulnerability paradox in the cross-national prevalence of post-traumatic stress disorder
Netherlands Institute for Health Services Research|Arq Psychotrauma Expert Group|Monash University|University College London
background determinants crossnational differences prevalence mental illness poorly understood aims test whether national posttraumatic stress disorder ptsd rates explained rates exposure trauma b countries overall cultural socioeconomic vulnerability adversity method collected general population studies lifetime ptsd trauma exposure measured using composite international diagnostic interview dsmiv ptsd prevalence identified 24 countries 86 687 respondents exposure 16 countries 53 038 respondents ptsd predicted using exposure vulnerability data results ptsd related positively exposure negatively country vulnerability together exposure vulnerability interaction explain approximately 75 variance national prevalence ptsd conclusions contrary expectations based individual risk factors identified paradox whereby greater country vulnerability associated decreased rather increased risk ptsd citizens