Publication date

Paradoxes and parallels in the global distribution of trauma-related mental health problems.

Dückers, M.L.A., Brewin, C.R. Paradoxes and parallels in the global distribution of trauma-related mental health problems. In: A. Maercker; E. Heim; L.J. Kirmayer. Cultural clinical psychology and PTSD. Göttingen: Hogrefe, 2019 147-158
One can hardly overestimate the value of a healthy mind or underestimate the sacrifices people are willing to make in the pursuit of health and happiness. Yet, during the course of their lives people are likely to be confronted with well-established factors connected to poor health.

Aim and Methods
In this chapter, we focus on mental health, although we are aware of the multifaceted relation between physical and mental health issues. Among the risk and protective factors that are linked to developing mental health problems are female gender, lack of social support, existing mental health problems, lower socioeconomic status, and above all, exposure to adversity and stress (Brewin, Andrews, & Valentine, 2000; Ozer, Best, Lipsey, & Weiss, 2003; Bonanno, Brewin, Kaniasty, & La Greca, 2010; Yehuda et al., 2015). The negative health effect of exposure to external events such as disasters, accidents, severe illness, and loss of close family or a friend has been confirmed in many studies (Bonde et al., 2016; Galea, Nandi, & Vlahov, 2005; Kessler et al., 2017; Neria, Nandi, & Galea, 2008; Reifels, Mills, Dückers, & O’Donnell, 2017; Scott et al., 2013; Yzermans, Van Der Berg, & Dirkzwager, 2009).

What the chapters of this book have in common is that they explore cultural aspects of posttraumatic stress disorder (PTSD); however the current chapter is slightly different because of its emphasis on cross-national patterns and the relevance of country-level factors that turn out to be risk and protective factors themselves. Understanding prevalence and predictive factors at the individual and group level is important to design and implement promising prevention, detection, mitigation, and amelioration strategies. On the other hand, cross-national differences in the prevalence of mental illness are important for promoting global mental health, but their determinants are poorly understood. Mental disorders specifically associated with trauma and stress are exceptional in needing external events to have caused psychiatric symptoms for a diagnosis to be made (Maercker et al., 2013). In this chapter, we will present differences in prevalence of trauma-related mental health problems across countries. Also, we will describe how exposure to trauma in national populations, together with cultural and socioeconomic country characteristics, can explain differences in prevalence between countries. By taking interactions between a number of factors into account, we illustrate how national receptive contexts for trauma vary across the world. After having presented findings from recent studies, we will discuss some implications for research and practice. (aut. ref.)