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The Mediating Role of Difficulties in Emotion Regulation and Earthquake Stress Coping in the Relationship Between Posttraumatic Cognitive Attribution and Posttraumatic Stress Disorder in Türkiye 2023 Earthquake Survivors

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Çağlar, Azmi·2025·Psychiatric Quarterly
DOI 10.1007/s11126-025-10118-wPMC PMC11929673
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Abstract

Natural disasters such as earthquakes leave deep psychological effects on individuals that can lead to posttraumatic stress disorder, and understanding these effects is vital to support psychological recovery processes after trauma. In this context, the aim of this study was to examine the mediating role of emotion regulation difficulties, religious coping, positive reappraisal and seeking social support in the relationship between posttraumatic cognitive attributions and posttraumatic stress disorder in 2023 Kahramanmaraş Pazarcık, Elbistan and Hatay Yayladağı earthquake survivors (N = 408). The findings from the multiple mediation analysis showed the indirect effect of posttraumatic cognitive attribution on PTSD through difficulties in emotion regulation, religious coping, positive reappraisal, and seeking social support. Therefore, difficulties in emotion regulation may be a risk factor for PTSD, while religious coping, positive reappraisal and seeking social support may be protective factors. Strategies to reduce difficulties in emotion regulation and to improve religious coping, positive reappraisal and social support seeking in earthquake survivors may be necessary to reduce PTSD that may be caused by the earthquake.

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  • Another study found that positive reappraisal was inversely associated with PTSD-related symptoms in the presence of adaptive posttraumatic cognitions.

    “Another study found that positive reappraisal was inversely associated with PTSD-related symptoms in the presence of adaptive posttraumatic cognitions (34).”

    From Coping strategies and psychological outcomes following the 2023 Kahramanmaraş earthquakes: a systematic review with meta-analytic synthesis (2026) · cites this paper as [34]

    The Conclusion reports that PTSD was significantly negatively associated with positive reappraisal, and the Results (Mediational Analyses) report a significant negative effect of positive reappraisal on PTSD. But the Introduction defines the posttraumatic cognitive attributions studied as non-adaptive, not adaptive; the paper does not establish the claimed association in the presence of adaptive posttraumatic cognitions. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

  • There is a consistent association observed between perceived social support and lower trauma-related distress in the reviewed studies.

    “These implications align with the consistent association observed between perceived social support and lower trauma-related distress in the reviewed studies [e.g., (31, 34)].”

    From Coping strategies and psychological outcomes following the 2023 Kahramanmaraş earthquakes: a systematic review with meta-analytic synthesis (2026) · cites this paper as [34]

    The Results (Table 1) show that seeking social support was negatively correlated with PTSD symptoms among earthquake survivors, and the Discussion cites low social support as a PTSD risk factor. But this study measured seeking support, not perceived support; the Discussion links higher perceived support to positive emotions, not directly to lower trauma-related distress. It does not establish a consistent perceived-support finding across reviewed studies. (LLM, conf=0.85)

    Experimental — accuracy not yet measured

  • The reviewed studies included diverse survivor groups, ranging from young adults and university students to general community samples and individuals residing in temporary shelter settings after extensive loss.

    “The reviewed studies included diverse survivor groups, ranging from young adults and university students [e.g., (31, 36)] to general community samples and individuals residing in temporary shelter settings after extensive loss (34).”

    From Coping strategies and psychological outcomes following the 2023 Kahramanmaraş earthquakes: a systematic review with meta-analytic synthesis (2026) · cites this paper as [34]

  • Evidence from individual studies indicates that difficulties in emotion regulation may mediate the relationship between maladaptive cognitions and PTSD-related symptoms.

    “Notably, evidence from individual studies indicating that difficulties in emotion regulation may mediate the relationship between maladaptive cognitions and PTSD-related symptoms [e.g., (34)] suggests that targeting cognitive–emotional processes may be especially relevant in post-disaster interventions.”

    From Coping strategies and psychological outcomes following the 2023 Kahramanmaraş earthquakes: a systematic review with meta-analytic synthesis (2026) · cites this paper as [34]

  • The present review explored subgroup patterns descriptively (e.g., stronger effects in more severely affected samples), but these observations remain provisional.

    “While the present review explored subgroup patterns descriptively (e.g., stronger effects in more severely affected samples), these observations remain provisional and should be tested more rigorously in future studies [cf. (33, 34)].”

    From Coping strategies and psychological outcomes following the 2023 Kahramanmaraş earthquakes: a systematic review with meta-analytic synthesis (2026) · cites this paper as [34]

    The Results report correlations and mediation analyses, not subgroup patterns or stronger effects in more severely affected samples. The Limitations and Future Research section recommends further studies of this paper’s cross-sectional findings, but does not address the citing review’s descriptive subgroup observations (no page numbers supplied). (LLM, conf=0.74)

    Experimental — accuracy not yet measured

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Cited by

Sorted by citations

Authors
Çağlar, A.
Affiliations
Bolu Abant İzzet Baysal University (TR)
Corresponding author
Çağlar, Azmi
ORCID
Çağlar, Azmi
Venue
Psychiatric Quarterly
Publisher
Springer Science and Business Media LLC
Published
2025-01-29
Volume
96
Issue
1
Pages
201-212
ISSN
  • 0033-2720 (ISSN-L)
  • 1573-6709
DOI
10.1007/s11126-025-10118-w
PMC
PMC11929673
OpenAlex
W4406937423
Cited by
7
References
4
Citations by year
2026: 4 · 2025: 3
FWCI
8.27
Type
journal article
Language
en
Open access
Licence
Locations
  • Psychiatric Quarterly (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed (publishedVersion)
Funders
Abant Izzet Baysal University
Topics
  • Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
  • Social Sciences › Psychology › Clinical Psychology › Grief, Bereavement, and Mental Health
  • Social Sciences › Psychology › Clinical Psychology › Resilience and Mental Health
Keywords
post-traumatic stress disorder, 2023 Kahramanmaraş earthquakes, earthquake survivors, emotional dysregulation, religious coping, positive reappraisal, social support seeking, natural disasters, protective factors, risk factors, mediation
MeSH terms
Emotional Regulation, Adaptation, Psychological, Adult, Aged, Female, Humans, Male, Middle Aged, Social Support, Stress Disorders, Post-Traumatic, Stress, Psychological, Turkey, Survivors, Young Adult, Earthquakes

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