Secondary traumatic stress and psychological distress among responders to the 2023 Kahramanmaraş earthquakes: a systematic review and meta-analysis
- 1Psychology Department, Faculty of Administrative, Business and Social Sciences, İstanbul Nişantaşı University
- 2Psychology Department, Faculty of Arts and Sciences, Haliç University
Abstract
Background: The Kahramanmaraş earthquakes on February 6, 2023 prompted one of the largest disaster response operations on record. Responders faced repeated exposure to death and distress, and locally recruited personnel were often disaster-affected themselves. Existing syntheses of this event excluded responders.
Methods: Following PRISMA 2020 (PROSPERO-registered), seven Turkish and English sources were searched for studies on psychological outcomes among responders to these earthquakes. The primary outcome was secondary traumatic stress. Outcomes were pooled in random-effects models (restricted maximum likelihood, Hartung–Knapp–Sidik–Jonkman adjustment); prevalence after Freeman–Tukey transformation. Personal exposure was a pre-specified moderator.
Results: Twenty-one studies were included; 13 quantitative studies contributed data on 2,894 responders. The pooled Secondary Traumatic Stress Scale total across four studies was 44.37 (95% CI 32.25–56.50; I ² = 99.2%). Heterogeneity appeared partly attributable to personal exposure: personnel resident in or affected by the disaster zone scored 48.80 against 38.40 among deployed personnel, an imprecisely estimated difference of 10.40 points (95% CI 1.57–19.23), with τ ² falling from 46.96 to 8.22 among deployed personnel. Pooled prevalence of probable post-traumatic stress disorder across three studies was 14.5% (8.5–21.5). Within the largest sample, personal exposure predicted secondary traumatic stress in graded fashion: physical injury Hedges’ g = 0.99, home destruction g = 0.70, bereavement g = 0.41.
Conclusion: Whether the responder was also a victim was the most consistent modifier of outcome. Its direction was consistent, but its magnitude was imprecise and possibly small. Task allocation and post-deployment monitoring should be organized around personal exposure rather than professional role alone.
Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD420261289019 , identifier CRD420261289019.
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BibTeX
@article{cınaroglu2026secondary,
title = {{Secondary traumatic stress and psychological distress among responders to the 2023 Kahramanmaraş earthquakes: a systematic review and meta-analysis}},
author = {Metin Çınaroğlu and Eda Yılmazer},
journal = {Frontiers in Public Health},
year = {2026},
month = oct,
doi = {10.3389/fpubh.2026.1967067},
url = {https://www.frontiersin.org/articles/10.3389/fpubh.2026.1967067/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Secondary traumatic stress and psychological distress among responders to the 2023 Kahramanmaraş earthquakes: a systematic review and meta-analysis
AU - Metin Çınaroğlu
AU - Eda Yılmazer
PY - 2026
DA - 2026/10/08
JO - Frontiers in Public Health
DO - 10.3389/fpubh.2026.1967067
UR - https://www.frontiersin.org/articles/10.3389/fpubh.2026.1967067/full
AB - Background: The Kahramanmaraş earthquakes on February 6, 2023 prompted one of the largest disaster response operations on record. Responders faced repeated exposure to death and distress, and locally recruited personnel were often disaster-affected themselves. Existing syntheses of this event excluded responders. Methods: Following PRISMA 2020 (PROSPERO-registered), seven Turkish and English sources were searched for studies on psychological outcomes among responders to these earthquakes. The primary outcome was secondary traumatic stress. Outcomes were pooled in random-effects models (restricted maximum likelihood, Hartung–Knapp–Sidik–Jonkman adjustment); prevalence after Freeman–Tukey transformation. Personal exposure was a pre-specified moderator. Results: Twenty-one studies were included; 13 quantitative studies contributed data on 2,894 responders. The pooled Secondary Traumatic Stress Scale total across four studies was 44.37 (95% CI 32.25–56.50; I ² = 99.2%). Heterogeneity appeared partly attributable to personal exposure: personnel resident in or affected by the disaster zone scored 48.80 against 38.40 among deployed personnel, an imprecisely estimated difference of 10.40 points (95% CI 1.57–19.23), with τ ² falling from 46.96 to 8.22 among deployed personnel. Pooled prevalence of probable post-traumatic stress disorder across three studies was 14.5% (8.5–21.5). Within the largest sample, personal exposure predicted secondary traumatic stress in graded fashion: physical injury Hedges’ g = 0.99, home destruction g = 0.70, bereavement g = 0.41. Conclusion: Whether the responder was also a victim was the most consistent modifier of outcome. Its direction was consistent, but its magnitude was imprecise and possibly small. Task allocation and post-deployment monitoring should be organized around personal exposure rather than professional role alone. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD420261289019 , identifier CRD420261289019.
SN - 2296-2565
ER -