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Is there a vulnerability paradox in PTSD? Pitfalls in cross-national comparison of epidemiological data - Authors' reply.

Dückers, M.L.A., Alisic, E., Brewin, C.R. Is there a vulnerability paradox in PTSD? Pitfalls in cross-national comparison of epidemiological data - Authors' reply. British Journal of Psychiatry: 2016, 209(6), p. 527-528.
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In this publication Dückers et al analyse the relationship between prevalence estimates of trauma exposure and post-traumatic stress disorder (PTSD) in published data-sets from 24 countries, and between PTSD and vulnerability (based on a country vulnerability index developed in the 2013 World Risk report). The findings are substantially counterintuitive; countries with low vulnerability have higher lifetime rates of PTSD, meaning that countries with low vulnerability and high trauma exposure have the highest rates of lifetime PTSD.

The authors do emphasise a number of limitations of their work, and yet they conclude that a ‘vulnerability paradox’ exists for both PTSD and depression, with rates higher in countries with more resources and better healthcare systems.