Coping Strategies and Psychological Outcomes Following the 2023 Kahramanmaraş Earthquakes: A Systematic Review with Meta-Analytic Synthesis

Abstract

Background The 2023 Kahramanmara & scedil; earthquakes caused unprecedented devastation across southern T & uuml;rkiye, resulting in widespread psychological distress among survivors. Identifying coping strategies linked to better mental health outcomes is essential for guiding post-disaster support. Objective To systematically synthesize quantitative evidence on associations between coping strategies and psychological outcomes (PTSD/trauma symptoms, depression, anxiety, and posttraumatic growth [PTG]) among adult survivors of the 2023 earthquakes, and to meta-analyze associations reported in at least two independent studies. Methods Following PRISMA 2020 guidelines and a preregistered OSF protocol (osf.io/7z2pe), four databases (Web of Science, Scopus, PubMed, and DergiPark) were searched for quantitative studies published in Turkish or English. Ten cross-sectional studies (total N = 6,223) met inclusion criteria. Data were extracted using a standardized form, study quality was appraised with an adapted Newcastle-Ottawa Scale, and random-effects meta-analyses were conducted for coping-outcome pairs reported in >= 2 studies; remaining associations were summarized descriptively. Results Meta-analytic evidence indicated that resilience was consistently associated with lower psychological distress, including post-earthquake trauma severity (pooled r = -0.44), depression (r = -0.41), anxiety (r = -0.43), and overall distress across four studies (r = -0.42). Perceived social support/support-seeking coping was moderately associated with lower PTSD/trauma-related symptoms (pooled r = -0.31). Religious coping (pooled r = -0.21) and positive reappraisal (pooled r = -0.19) showed small inverse associations with PTSD symptoms but with substantial heterogeneity. In single-study analyses, meaning-centered coping and self-compassion were associated with higher PTG, suggesting potentially important pathways that require replication. Conclusion Coping processes are meaningfully linked to psychological adjustment after the Kahramanmara & scedil; earthquakes. The most robust evidence supports resilience and social support as protective correlates of lower distress. Evidence for religious coping and positive reappraisal is suggestive but heterogeneous, and PTG-related findings remain preliminary due to limited replication. Longitudinal and intervention-based research is needed to clarify causal mechanisms and inform culturally responsive disaster mental health programs.