Dückers Michel L A, Olff Miranda
NIVEL-Netherlands Institute for Health Services Research, Utrecht, The Netherlands.
Impact-National Knowledge and Advice Centre for Psychosocial Care Concerning Critical Incidents, Diemen, The Netherlands.
J Trauma Stress. 2017 Apr;30(2):200-204. doi: 10.1002/jts.22173. Epub 2017 Mar 22.
Recent research suggests that greater country vulnerability is associated with a decreased, rather than increased, risk of mental health problems. Because societal parameters may have gender-specific implications, our objective was to explore whether the "vulnerability paradox" equally applies to women and men. Lifetime posttraumatic stress disorder (PTSD) prevalence data for women and men were retrieved from 11 population studies (N = 57,031): conducted in Australia, Brazil, Canada, France, Lebanon, Mexico, Netherlands, Portugal, Sweden, Switzerland, and the United States. We tested statistical models with vulnerability, gender, and their interaction as predictors. The average lifetime PTSD prevalence in women was at least twice as high as it was in men and the vulnerability paradox existed in the prevalence data for women and men (R = .70). We could not confirm the possibility that gender effects are modified by socioeconomic and cultural country characteristics. Issues of methodology, language, and cultural validity complicate international comparisons. Nevertheless, this international sample points at a parallel paradox: The vulnerability paradox was confirmed for both women and men. The absence of a significant interaction between gender and country vulnerability implies that possible explanations for the paradox at the country-level do not necessarily require gender-driven distinction.
近期研究表明,国家脆弱性越高,心理健康问题的风险越低,而非越高。由于社会参数可能具有性别特异性影响,我们的目标是探讨“脆弱性悖论”是否同样适用于男性和女性。从11项针对澳大利亚、巴西、加拿大、法国、黎巴嫩、墨西哥、荷兰、葡萄牙、瑞典、瑞士和美国的人群研究(N = 57,031)中获取了男性和女性创伤后应激障碍(PTSD)终生患病率数据。我们以脆弱性、性别及其相互作用作为预测因素,测试了统计模型。女性创伤后应激障碍终生患病率的平均值至少是男性的两倍,且男性和女性的患病率数据中均存在脆弱性悖论(R = 0.70)。我们无法证实社会经济和文化国家特征会改变性别效应这一可能性。方法学、语言和文化有效性问题使国际比较变得复杂。尽管如此,这个国际样本表明了一个类似的悖论:男性和女性均证实了脆弱性悖论。性别与国家脆弱性之间不存在显著的相互作用,这意味着在国家层面上对该悖论的可能解释不一定需要性别驱动的区分。