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Peer-reviewedCC BYEuropean journal of investigation in health, psychology and education

The Sequential Roles of Psychological Flexibility and Positivity in the Association Between Post-Traumatic Stress Symptoms and Depressive Symptoms Among Earthquake Survivors in Türkiye.

  • Adem Peker1
  • Serkan Cengiz2
  • Yüksel Eroğlu3
  • Carlos Laranjeira4,5,6
  • Murat Yıldırım2,7,8
8 affiliations
  1. 1Department of Counseling and Guidance, Faculty of Education, Ataturk University, 25240 Erzurum, Türkiye.
  2. 2Department of Psychology, Faculty of Science and Letters, Agri Ibrahim Cecen University, Fırat Mahallesi Yeni Üniversite Caddesi No: 2 AE/1, 04100 Merkez, Agri, Türkiye.
  3. 3Department of Counseling and Guidance, Faculty of Education, Afyon Kocatepe University, 03200 Afyon, Türkiye.
  4. 4University of Leiria and Oeste, Rua General Norton de Matos, 2411-901 Leiria, Portugal.
  5. 5Centre for Innovative Care and Health Technology (ciTechCare), Campus 5, Rua das Olhalvas, 2414-016 Leiria, Portugal.
  6. 6Comprehensive Health Research Centre (CHRC), University of Évora, 7000-801 Évora, Portugal.
  7. 7Department of Psychology, Faculty of Arts and Sciences, Haliç University, 34060 Istanbul, Türkiye.
  8. 8Psychology Research Center, Khazar University, AZ1096 Baku, Azerbaijan.
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Abstract

Earthquakes can have substantial consequences for psychological well-being, including post-traumatic stress and depressive symptoms. Drawing on Acceptance and Commitment Therapy (ACT), which conceptualizes psychological flexibility as a central process in adaptive psychological functioning, this study examined the sequential mediating roles of psychological flexibility and positivity in the association between post-traumatic stress symptoms and depressive symptoms among survivors of the two major earthquakes that struck Türkiye on 6 February 2023. This cross-sectional study included 834 earthquake survivors (Mage = 26.7; 71.1% female) who were assessed approximately three months after the earthquakes. Participants completed validated self-report measures of post-traumatic stress symptoms, psychological flexibility, positivity, and depressive symptoms. Depressive symptoms were assessed using the 12-item depression subscale of the Brief Symptom Inventory and were analyzed as a continuous variable. Correlation and sequential mediation analyses were conducted, with indirect effects evaluated using bootstrapping. Post-traumatic stress symptoms were positively associated with depressive symptoms and negatively associated with psychological flexibility and positivity. Psychological flexibility was positively associated with positivity and negatively associated with depressive symptoms, while positivity was negatively associated with depressive symptoms. Sequential mediation analysis indicated that psychological flexibility and positivity mediated the association between post-traumatic stress symptoms and depressive symptoms. These findings suggest that psychological flexibility and positivity may represent relevant psychological processes in the association between post-traumatic stress and depressive symptoms among earthquake survivors and may inform post-disaster psychological support.

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Cite

BibTeXRIS
BibTeX
@article{peker2026sequential,
  title = {{The Sequential Roles of Psychological Flexibility and Positivity in the Association Between Post-Traumatic Stress Symptoms and Depressive Symptoms Among Earthquake Survivors in Türkiye.}},
  author = {Adem Peker and Serkan Cengiz and Yüksel Eroğlu and Carlos Laranjeira and Murat Yıldırım},
  journal = {European journal of investigation in health, psychology and education},
  year = {2026},
  month = oct,
  doi = {10.3390/ejihpe16100158},
  url = {https://europepmc.org/article/MED/42930221},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - The Sequential Roles of Psychological Flexibility and Positivity in the Association Between Post-Traumatic Stress Symptoms and Depressive Symptoms Among Earthquake Survivors in Türkiye.
AU  - Adem Peker
AU  - Serkan Cengiz
AU  - Yüksel Eroğlu
AU  - Carlos Laranjeira
AU  - Murat Yıldırım
PY  - 2026
DA  - 2026/10/07
JO  - European journal of investigation in health, psychology and education
DO  - 10.3390/ejihpe16100158
UR  - https://europepmc.org/article/MED/42930221
AB  - Earthquakes can have substantial consequences for psychological well-being, including post-traumatic stress and depressive symptoms. Drawing on Acceptance and Commitment Therapy (ACT), which conceptualizes psychological flexibility as a central process in adaptive psychological functioning, this study examined the sequential mediating roles of psychological flexibility and positivity in the association between post-traumatic stress symptoms and depressive symptoms among survivors of the two major earthquakes that struck Türkiye on 6 February 2023. This cross-sectional study included 834 earthquake survivors (Mage = 26.7; 71.1% female) who were assessed approximately three months after the earthquakes. Participants completed validated self-report measures of post-traumatic stress symptoms, psychological flexibility, positivity, and depressive symptoms. Depressive symptoms were assessed using the 12-item depression subscale of the Brief Symptom Inventory and were analyzed as a continuous variable. Correlation and sequential mediation analyses were conducted, with indirect effects evaluated using bootstrapping. Post-traumatic stress symptoms were positively associated with depressive symptoms and negatively associated with psychological flexibility and positivity. Psychological flexibility was positively associated with positivity and negatively associated with depressive symptoms, while positivity was negatively associated with depressive symptoms. Sequential mediation analysis indicated that psychological flexibility and positivity mediated the association between post-traumatic stress symptoms and depressive symptoms. These findings suggest that psychological flexibility and positivity may represent relevant psychological processes in the association between post-traumatic stress and depressive symptoms among earthquake survivors and may inform post-disaster psychological support.
SN  - 2174-8144
SN  - 2254-9625
ER  -