Psychological Distress, Resilience, and Well-Being Among Survivors of the 2023 Kahramanmaraş Earthquakes: A Multi-Site Cross-Sectional Study

Abstract

Background The 2023 Kahramanmara & scedil; earthquakes were among the most devastating disasters in modern T & uuml;rkiye, with severe consequences for survivors' mental health. While post-disaster psychopathology has been widely studied, less is known about positive psychological outcomes such as resilience and well-being in this context.Objective This study examined levels of depression, anxiety, post-traumatic stress symptoms, well-being, and resilience among earthquake survivors, explored group differences, and identified predictors of key psychological outcomes.Methods A cross-sectional survey was conducted with 642 adult survivors across 11 heavily affected cities, nearly 2 years after the earthquakes. Data were collected between September 2024 and January 2025, corresponding to 19-22 months after the earthquakes. Participants completed validated self-report measures: BDI-II, BAI, PCL-5, WEMWBS, and CD-RISC. Analyses included group comparisons, correlations, hierarchical regressions predicting well-being and resilience, and logistic regression predicting probable PTSD (PCL-5 >= 47).Results Survivors reported moderate depression (M = 22.1), mild-moderate anxiety (M = 19.4), and near-threshold PTSD symptoms (M = 40.0). Overall, 31.0% of participants exceeded the PCL-5 cut-off for probable PTSD (95% CI: 27.4-34.8%). Well-being (M = 35.6) and resilience (M = 56.0) were below normative values. Women reported higher depression than men, while trauma-exposed participants had significantly worse outcomes across all measures. Bivariate correlations showed strong associations between distress, reduced well-being, and diminished resilience. Hierarchical regressions indicated that depression and PTSD symptoms were the primary predictors of both lower well-being (R2 = 0.45) and resilience (R2 = 0.32). Logistic regression revealed that female gender (OR = 1.80, p = 0.024) and depression severity (OR = 1.10, p = 0.001) significantly increased the likelihood of probable PTSD.Conclusion Nearly 2 years after the earthquakes, survivors experienced substantial psychological distress alongside reduced well-being and resilience. Clinical symptoms, particularly depression and PTSD, more strongly associated with outcomes than sociodemographic or exposure variables. These findings highlight the need for interventions that both alleviate trauma-related psychopathology and strengthen resilience and well-being as part of long-term disaster recovery.