Network comparison of post-traumatic stress, anxiety, and mood symptoms in local Turkish and Syrian refugee youth following the 2023 Kahramanmaraş earthquakes

Abstract Previous studies conducted with youth experiencing natural disaster trauma have shown that post-traumatic stress disorder, anxiety, and mood symptoms can follow a complex course; the varying associations between clusters of internalization symptoms may change over time or in a context-specific manner. However, the paucity of studies evaluating relevant symptoms to distinguish between immigrant and local youth necessitates eliminating uncertainty. This study aims to comparatively examine the internalization symptom networks related to natural disaster trauma among Syrian refugee youths with a heavier traumatic burden and Turkish host community youths residing within the same earthquake-affected region. This network analysis study was conducted with a community sample of 3,071 youths aged 14 to 22 years (Turkish: n = 1,845; Syrian: n = 1,226), approximately 1.5 to 2 years after the disaster. The Network Comparison Test (NCT) indicated that the two groups differed in overall network structure. Global strength was significantly greater in the Syrian network, indicating a more densely interconnected symptom network. The Turkish sample showed a strong association between trauma and PTSD symptoms, with mood symptoms such as loneliness, depression, or affective PTSD symptoms being more prominent bridges. In the Syrian sample, a strong association was observed between trauma and symptoms of social anxiety, with the prominent bridge role of depression and anxiety symptom clusters like hyperarousal, social anxiety, and panic/somatic. While trauma is organized in a more typical pattern of PTSD symptoms among Turkish, it is organized in a more complex structure involving a broader network of anxiety symptoms among Syrian.