跨国家创伤后应激障碍流行率的脆弱性悖论。
A vulnerability paradox in the cross-national prevalence of post-traumatic stress disorder.
机构信息
Michel 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
Michel 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.
出版信息
Br J Psychiatry. 2016 Oct;209(4):300-305. doi: 10.1192/bjp.bp.115.176628. Epub 2016 Jul 21.
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.
背景
精神疾病在不同国家的流行率差异的决定因素尚不清楚。
目的
检验国家创伤后应激障碍（PTSD）的发生率是否可以通过以下因素来解释：（a）暴露于创伤的发生率，以及（b）各国整体文化和社会经济对逆境的脆弱性。
方法
我们收集了使用世界卫生组织复合国际诊断访谈（DSM-IV）进行的终生 PTSD 和创伤暴露的一般人群研究。确定了 24 个国家（86687 名受访者）的 PTSD 患病率和 16 个国家（53038 名受访者）的创伤暴露率。使用暴露和脆弱性数据预测 PTSD。
结果
PTSD 与暴露呈正相关，但与国家脆弱性呈负相关。暴露、脆弱性及其相互作用共同解释了 PTSD 在全国范围内流行率的约 75%的差异。
结论
与基于个体风险因素的预期相反，我们发现了一个悖论，即一个国家的脆弱性越高，其公民患 PTSD 的风险越低，而不是越高。
Zotero 插件