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To date, cultural clinical research has primarily focused on differences between ethnic groups when investigating causal beliefs about mental disorders. While individual as well as contextual factors are considered important for gaining a better understanding of cultural influences, research on causal beliefs about post-traumatic stress disorder (PTSD) and cultural correlates in laypersons is scarce. This study aimed at gaining a better understanding of the association between causal beliefs about PTSD and cultural aspects, as well as other contextual and individual correlates of causal beliefs. We conducted a cross-sectional, vignette-based online survey with 737 laypersons from Mexico, Ecuador, Germany, Greece, and Russia. Participants completed the revised Illness Perception Questionnaire (IPQ-R) and reported several cultural and sociodemographic (e.g. country of residence, gender, personal values) as well as mental health–related variables (e.g. PTSD symptoms, previous seeking of help). Latent class analysis (LCA) was performed to identify subgroups of individuals expressing similar causal beliefs for PTSD. Multinomial logistic regression was used to analyse covariates of class membership. LCA resulted in a three-class solution of casual beliefs: a traumatic event–focused class (41.1%); an intrapersonal causes class (40.1%); and a multiple causes class (18.0%). Multinomial logistic regression analysis revealed country of residence, gender, personal value of security, PTSD symptoms, and mental health literacy as significant covariates of class membership. Integrating a more diverse concept of culture into cultural clinical research can be a valuable addition to group comparisons based on nationality or ethnicity. Cultural clinical research needs to move towards a more integrated approach that accounts for the complexity of culture. Including additional contextual and sociodemographic factors can help to reach a more accurate understanding of the cultural influences on the development of causal beliefs and mental health. We found three types of causal beliefs about post-traumatic stress disorder. Causal beliefs were related to country of residence, gender, mental health, knowledge, and personal values. Cultural clinical research should include contextual and sociodemographic characteristics. [ABSTRACT FROM AUTHOR]

Laypersons' causal beliefs about mental disorders can differ considerably from medical or psychosocial clinicians' models as they are shaped by social and cultural context and by personal experiences. This study aimed at identifying differences in causal beliefs about post-traumatic stress disorder (PTSD) by country and gender. A cross-sectional, vignette-based online survey was conducted with 737 participants from Germany, Greece, Ecuador, Mexico, and Russia. Participants were presented with a short unlabeled case vignette describing a person with symptoms of PTSD. Causal beliefs were assessed using an open-ended question asking for the three most likely causes. Answers were analyzed using thematic analysis. Afterwards, themes were transformed into categorical variables to analyze differences by country and by gender. Qualitative analyses revealed a wide range of different causal beliefs. Themes differed by gender, with women tending to mention more external causal beliefs. Themes also differed between the five countries but the differences between countries were more pronounced for women than for men. In conclusion, causal beliefs were multifaceted among laypersons and shared basic characteristics with empirically derived risk factors. The more pronounced differences for women suggest that potential gender effects should be considered in cross-cultural research., Competing Interests: The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data, in the writing of the manuscript, or in the decision to publish the results.