{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T19:51:18Z","timestamp":1769543478684,"version":"3.49.0"},"reference-count":40,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T00:00:00Z","timestamp":1769472000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychiatry"],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Earthquakes can cause substantial psychiatric morbidity including Post-Traumatic Stress Disorder (PTSD). While direct exposure effects are well known less is understood about relapse after indirect exposure. Following the 2023 Kahramanmara\u015f earthquakes clinicians observed renewed distress among survivors of the 2020 Aegean Sea earthquake. Understanding how media exposure individual factors contribute to symptom reactivation is important for post-disaster care. This study investigated factors linked to PTSD symptom relapse after repeated disaster exposure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>This prospective quantitative study (February 2023\u2013February 2024) recruited patients from a psychiatry outpatient clinic following the Kahramanmara\u015f earthquakes. Individuals with earthquake-related complaints who had also experienced the 2020 Aegean Sea earthquake were enrolled. Post-traumatic stress symptoms were assessed using the Post-Traumatic Stress Disorder Checklist for DSM-5 (PCL-5) at baseline and at 1, 3, 6, 9, and 12 months. Resilience was measured using the Resilience Scale for Adults (RSA) at baseline. Sociodemographic and clinical variables, including prior psychiatric treatment and media exposure type, were recorded. Multivariate analysis of variance was used to examine longitudinal symptom trajectories and predictors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The study included 87 participants (mean age = 48.8 \u00b1 12.5yrs), the majority were female (85%). Following the Aegean Sea earthquake, 45% of participants received psychiatric treatment, with loss experience being the only significant predictor of treatment seeking (\u03c7\u00b2 = 14.90, p &amp;lt;.001). After the Kahramanmara\u015f earthquakes, 74.7% received psychiatric treatment. A significant effect of time on PCL-5 symptom severity across the 12-month follow-up (Pillais Trace = .40, F = 7.32, p &amp;lt;.001). Age and resilience were independently associated with PTSD severity, with resilience showing the strongest effect (F = 40.24, p &amp;lt;.001). Higher PCL-5 scores among those primarily exposed to traditional media (F = 5.11, p = .027), symptom trajectories did not differ over time.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study shows that indirect exposure to large-scale disasters can shape symptom trajectories in previously affected individuals. Resilience served as a protective factor, while prior treatment indicated both vulnerability and adaptive potential. Media exposure type also influenced symptom severity. These results highlight the value of assessing resilience, treatment history, and media use in trauma-informed care after repeated disaster exposure.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpsyt.2025.1715590","type":"journal-article","created":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T06:39:28Z","timestamp":1769495968000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Psychiatric outcomes after primary and secondary earthquake exposure: effects of loss, media, and treatment"],"prefix":"10.3389","volume":"16","author":[{"given":"H\u00fcseyin Ozan","family":"Torun","sequence":"first","affiliation":[{"name":"Department of Psychiatry Izmir City Hospital","place":["Izmir, T\u00fcrkiye"]},{"name":"Ege University Institute on Drug Abuse, Toxicology and Pharmaceutical Science","place":["Izmir, T\u00fcrkiye"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Burak","family":"Akd\u00f6ner","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Near East University Faculty of Medicine","place":["Nicosia, Cyprus"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Talat","family":"Sar\u0131kavak","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Istanbul Atlas University Faculty of Medicine","place":["Istanbul, T\u00fcrkiye"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Umut","family":"Kirli","sequence":"additional","affiliation":[{"name":"Ege University Institute on Drug Abuse, Toxicology and Pharmaceutical Science","place":["Izmir, T\u00fcrkiye"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,1,27]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2020.00001","article-title":"Ecological disasters and mental health: causes, consequences, and interventions","volume":"11","author":"Morganstein","year":"2020","journal-title":"Front Psychiatry"},{"key":"B2","first-page":"191","article-title":"Posttraumatic stress disorder","volume-title":"Clinical psychology: A global perspective","author":"Mann","year":"2024"},{"key":"B3","volume-title":"Diagnostic and statistical manual of mental disorders","year":"2022"},{"key":"B4","unstructured":"\u0130\u00e7i\u015fleri Bakanl\u0131\u011f\u0131\n              TC\n            \n            \n              Afetve Acil\n              D\n            \n            \n              Ba\u015fkanl\u0131\u011f\u0131\n              Y\n            \n          \n          \u0130zmir seferihisar depremi-duyuru\n          \n          2020"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpr.2022.102203","article-title":"Long-term mental health trajectories after disasters and pandemics: a multilingual systematic review of prevalence, risk and protective factors","volume":"97","author":"Newnham","year":"2022","journal-title":"Clin Psychol Rev"},{"key":"B6","doi-asserted-by":"publisher","first-page":"55","DOI":"10.1016\/j.jad.2020.04.046","article-title":"Symptoms of posttraumatic stress disorder, depression, anxiety and other mental health problems following the 2010 earthquake in Haiti: A systematic review and meta-analysis","volume":"273","author":"C\u00e9nat","year":"2020","journal-title":"J Affect Disord"},{"key":"B7","unstructured":"\u0130\u00e7i\u015fleri Bakanl\u0131\u011f\u0131\n              TC\n            \n            \n              Afetve Acil\n              D\n            \n            \n              Ba\u015fkanl\u0131\u011f\u0131\n              Y\n            \n          \n          Kahramanmara\u015fta meydana gelen depremler hk\n          \n          2023"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1002\/c70008","article-title":"Impact of indirect trauma and disaster media exposure on psychological states and temporal processes: The case of 2023 Turkey earthquakes","volume":"31","author":"Oz","year":"2024","journal-title":"Clin Psychol Psychother"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1080\/20008198.2018.1558709","article-title":"The association between disaster exposure and media use on post-traumatic stress disorder following Typhoon Hato in Macao, China","volume":"10","author":"Hall","year":"2019","journal-title":"Eur J Psychotraumatol"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2021.674263","article-title":"Media exposure and the risk of post-traumatic stress disorder following a mass traumatic event: an in-silico experiment","volume":"12","author":"Abdalla","year":"2021","journal-title":"Front Psychiatry"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1521\/psyc.65.3.207.20173","article-title":"60, 000 disaster victims speak: Part I","volume":"65","author":"Norris","year":"2002","journal-title":"empirical Rev empirical literature 1981\u20132001. 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