Determinants of mental health in earthquake survivors: Trauma memories, cognitions, identity and safety‐seeking behaviours in PTSD and CPTSD models

AbstractObjective: This study aimed to examine the determinantsof mental health among adult earthquake survivors bytesting conceptual models of post-traumatic stress disorder(PTSD) and complex post-traumatic stress disorder(CPTSD). Specifically, the study investigated how traumamemories, post-traumatic cognitions, trauma identity andsafety-seeking behaviours interact to influence mentalhealth outcomes.Methods: A cross-sectional design was employed with asample of 285 adults (65.3% female) who experienced the2023 Kahramanmaraş earthquakes in Türkiye. Participantscompleted self-report measures assessing trauma memories,post-traumatic cognitions, safety-seeking behaviours,trauma identity, PTSD and CPTSD symptoms, and overallmental health. Two structural equation models—one forPTSD and one for CPTSD—were tested to evaluate thepathways linking trauma-related variables to mental health.Results: Structural equation modelling indicated thattrauma memories significantly and positively predicted post-traumatic cognitions, which in turn predicted both traumaidentity and safety-seeking behaviours. These mediatorswere positively associated with PTSD and CPTSDsymptoms, which negatively predicted mental health. In thePTSD model, trauma identity had a stronger effect, whereas in the CPTSD model, safety-seeking behaviours were moreinfluential. Both models demonstrated good fit indices,confirming the hypothesized pathways.Conclusions: The findings underscore the pivotal role oftrauma memories and post-traumatic cognitions in shapingtrauma-related behavioural and identity processes thatcontribute to PTSD and CPTSD symptoms. Targetingthese mechanisms in clinical interventions may enhancemental health outcomes in individuals exposed to large-scale natural disasters.