Psychological Distress, Resilience, and Well-Being Among Survivors of the 2023 1 Kahramanmaraş Earthquakes: A Multi-Site Cross-Sectional Study

Eda Yılmazer^*

• Beykoz University, Istanbul, Türkiye

Background: The 2023 Kahramanmaraş earthquakes were among the most devastating disasters in modern Türkiye, 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 two 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 = .45) and resilience (R² = .32). Logistic regression revealed that female gender (OR = 1.80, p = .024) and depression severity (OR = 1.10, p = .001) significantly increased the likelihood of probable PTSD. Conclusions: Nearly two 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.