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

Dückers, ML; Alisic, E; Brewin, CR; (2016) A vulnerability paradox in the cross-national prevalence of post-traumatic stress disorder. British Journal of Psychiatry , 209 (4) pp. 300-305. 10.1192/bjp.bp.115.176628. Green open access

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Abstract

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.

Type: Article
Title: A vulnerability paradox in the cross-national prevalence of post-traumatic stress disorder.
Open access status: An open access version is available from UCL Discovery
DOI: 10.1192/bjp.bp.115.176628
Publisher version: http://dx.doi.org/10.1192/bjp.bp.115.176628
Language: English
Additional information: Copyright © The Royal College of Psychiatrists 2016. This is an author-produced electronic version of an article accepted for publication in the British Journal of Psychiatry. The definitive publisher-authenticated version is available online at http://bjp.rcpsych.org.
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences > Clinical, Edu and Hlth Psychology
URI: https://discovery.ucl.ac.uk/id/eprint/1508274
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