Differences in prevalence rates of PTSD in various European countries explained by war exposure, other trauma and cultural value orientation

Abstract

Background: Guided by previous explorations of historical and cultural influences on the occurrence of PTSD, the aim of the present study was to investigate the contributions of war victimisation (in particular, World War II) and other civil trauma on the prevalence of PTSD, as mediated by cultural value orientation. Secondary data analysis was performed for 12 European countries using data, including PTSD prevalence and number of war victims, crime victims, and natural disaster victims, from different sources. Ten single value orientations, as well as value aggregates for traditional and modern factors, were investigated.

Results: Whilst differences in PTSD prevalence were strongly associated with war victim rates, associations, albeit weaker, were also found between crime victims and PTSD. When cultural value orientations, such as stimulation and conformity as representatives of modern and traditional values, were included in the multivariate predictions of PTSD prevalence, an average of approximately 80% of PTSD variance could be explained by the model, independent of the type of trauma exposure.

Conclusion: The results suggest that the aftermath of war contributes to current PTSD prevalence, which may be explained by the high proportion of the older population who directly or indirectly experienced traumatic war experiences. Additional findings for other types of civil trauma point towards an interaction between value orientation and country-specific trauma rates. Particularly, being personally oriented towards stimulation appears to interact with differences in trauma prevalence. Thus, cultural value orientation might be viewed not only as an individual intrinsic process but also as a compensatory strategy after trauma exposure.

Figure 1

Model illustrating the relations among the ten motivational types of value as proposed by Schwartz (2006) (Illustration taken from Schwartz, Basic Human Values: Theory, Measurement, and Applications, 2006 with permission from the author).

Figure 2

AB Interaction effects in predicting PTSD. A) Interaction effects between crime rates and the individual value of ‘stimulation’. B) Interaction effects between road fatality rates and the individual value of ‘stimulation’.