Table 2_Loss plus adversity: posttraumatic stress and prolonged grief three years after the 2023 Türkiye earthquakes.docx

Among bereaved participants, those reporting additional earthquake-related adversity had substantially higher posttraumatic stress than those without additional adversity (43.0 vs. 16.7; Hedges g = 1.43, 95% CI [0.93, 1.94]) and greater grief severity (30.5 vs. 18.4; g = 0.97, 95% CI [0.45, 1.48]). Additional adversity remained associated with grief severity after adjustment for posttraumatic stress and depression. By contrast, posttraumatic stress was only modestly higher among participants with bereavement alone than among those with neither bereavement nor additional adversity, and the difference was not statistically significant (g = 0.30, 95% CI [−0.10, 0.69]); however, the confidence interval did not exclude a moderate effect.

In secondary analyses, the association between brooding and posttraumatic stress was weaker among bereaved participants, and meaninglessness showed an incremental association with grief beyond posttraumatic stress and depression. Both findings varied across sensitivity analyses and should be regarded as preliminary. Three years after the earthquakes, symptom burden was substantial and was highest when bereavement co-occurred with additional disaster-related adversity.</p>