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

OBJECTIVE: This study aimed to examine the determinants of mental health among adult earthquake survivors by testing conceptual models of post-traumatic stress disorder (PTSD) and complex post-traumatic stress disorder (CPTSD). Specifically, the study investigated how trauma memories, post-traumatic cognitions, trauma identity and safety-seeking behaviours interact to influence mental health outcomes. METHODS: A cross-sectional design was employed with a sample of 285 adults (65.3% female) who experienced the 2023 Kahramanmaraş earthquakes in Türkiye. Participants completed self-report measures assessing trauma memories, post-traumatic cognitions, safety-seeking behaviours, trauma identity, PTSD and CPTSD symptoms, and overall mental health. Two structural equation models-one for PTSD and one for CPTSD-were tested to evaluate the pathways linking trauma-related variables to mental health. RESULTS: Structural equation modelling indicated that trauma memories significantly and positively predicted post-traumatic cognitions, which in turn predicted both trauma identity and safety-seeking behaviours. These mediators were positively associated with PTSD and CPTSD symptoms, which negatively predicted mental health. In the PTSD model, trauma identity had a stronger effect, whereas in the CPTSD model, safety-seeking behaviours were more influential. Both models demonstrated good fit indices, confirming the hypothesized pathways. CONCLUSIONS: The findings underscore the pivotal role of trauma memories and post-traumatic cognitions in shaping trauma-related behavioural and identity processes that contribute to PTSD and CPTSD symptoms. Targeting these mechanisms in clinical interventions may enhance mental health outcomes in individuals exposed to large-scale natural disasters.