The Role of Objective and Subjective Experiences, Direct and Media Exposure, Social and Organizational Support, and Educational and Gender Effects in the Prediction of Children Posttraumatic Stress Reaction One Year after Calamity.

Keywords: Predictors of PTSD in children, social support and PTSD, Age and gender effects on PTSD, degree of exposure and PTSD, Media and TV exposure and PTSD


Eighty-three students and one teacher died when a powerful earthquake hit eastern Turkey at 3:27 in the morning. The boarding school at which they were residents was destroyed. The purpose of this study was to test the direct, indirect, objective, and subjective exposure effect on the development of Post Traumatic Stress Disorder (PTSD). The impact of social and organizational support, as well as age and gender factors, were examined in relationship to the development of PTSD in this group. Participants included 270 disaster survivor elementary and secondary school students. One year after the disaster, each participant filled out a Children’s Post-Traumatic Stress Disorder Reaction Index (CPTSD), trauma exposure, trauma experiencing, social support, and organizational support scale. Contributing factors were predicted with a stepwise regression analysis. A combination of direct, indirect, objective exposure scores, subjective exposure scores, gender, age, organizational and social support variables accounted for 17% of the PTSD scores. Direct exposure accounted for 6%, subjective exposure 5.4%, age 2%, food shortage 1%, and having a friend moving away after the disaster contributed 2.6% of the total variance. Subjective exposure (fear) and direct exposure appeared to be the most significant predictors. However, inconsistent with previous research studies, media exposure, gender, and physical exposure seemed to be especially poor contributors. Neither school nor home damage, the death of relatives or friends, or gas, water, and electric shortages contributed significantly to the results. However, fear experienced during the disaster, food shortages and the loss of a friend who moved away after the earthquake were all powerful predictors. Protective factors, which can strengthen or modify the individual's ability to cope, include healthy family functioning, support from peers and family members, organizing a social network, and the utilization of civil organizations. Thus, researcher and practitioner should pay attention to those predictive and protective factors.  


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Author Biography

Sefa Bulut, Ibn Haldun University
Prof. Dr.


American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders (Rev. 4th ed.). Washington, D.C.

Bados, A., Greco, A. & Toribio, L. (2012). Traumatic experiences and posttraumatic stress disorder in Spanish university students. Anales de Psicologia, 28(2), 387-396. 387-396

Braun-Lewensohn, O., Clestin-Westreich, S., Clestin, L. P., Verté, D., & Ponjaert-Kristoffersen, I. (2009). Adolescents’ mental health outcomes according to different types of exposure to ongoing terror attacks. Journal of Youth and Adolescence, 38, 850-862.

Bulut, S. (2003). Underlying dimensions and prevalence of Post Traumatic Stress Disorder among 4th and 5th grade children who experienced the 1999 Turkish earthquakes. Doctoral dissertation, Oklahoma State University, Stillwater, OK, USA. International Dissertation Abstracts.

Bulut, S., Bulut, S., & Taylı, A. (2005). The dose of exposure and prevalence rates of Posttraumatic Stress Disorder in a sample of Turkish children eleven months after the 1999 Marmara earthquakes. School Psychology International, 26(1), 55-70.

Bulut. S. (2006) Comparing the earthquake exposed and non-exposed Turkish children’s post traumatic stress reactions. Anales de Psicologia, 22(1), 29-36.

Bulut, S. (2009a). Comparing children posttraumatic stress reactions in terms of age and gender after an earthquake. Turkish Psychological Counseling and Guidance Journal, 4(31), 43-51.

Bulut, S. (2009b). Factor analysis of posttraumatic stress disorder in children experienced earthquakes in Turkey. Contemporary Psychology, 12(2), 407-424.

Bulut, S. (2010). Children’s posttraumatic stress reactions and sub-symptoms: Three years of longitudinal investigation study after a direct exposure to an earthquake and school’s collapse. Turkish Journal of Psychology, 25(66), 87-100.

Bulut, S. (2013). Prediction of post traumatic stress Symptoms via comorbid disorders and other social and school problems in earthquake exposed Turkish adolescents. Revista Latinoamericana de Psicología, 45(1),47-61.

Cheng, Y., Wang, F., Wen, J. & Shi, Y. (2014). Risk factors of post-traumatic stress disorder (PTSD) after Wenchuan earthquakes: A case control study. PLOS ONE, 9(5), 1-7. e96644

Erden, G., Kiliç, E. Z., Uslu, R. I., & Kerimoglu, E. (1999). The validity and reliability study of the Turkish version of child post traumatic stress reaction index. Turkish Journal of Child and Adolescent Mental Health, 6(3), 143-9.

Frederick, C. J. (1985). Children traumatized by catastrophic situations. In: Eth S, Pynoos R. S, ed. Post-Traumatic Stress Disorder in children. Washington, D.C.: American Psychiatric Press.

Freedy, J. R., Saladin, M. E., Kilpatrick, D. G., Resnick, H. S., & Saunders, B. E. (1994). Understanding acute psychological distress following natural disaster. Journal of Traumatic Stress, 7(2), 257-273.

Gavriovic, J., Lecic, T. D., Knezevic, G., & Priebe, S. (2002). Predictors of post traumatic stress in civilians one year after air attacks: A study of Yugoslavian students. Journal of Nervous and Mental Disease, 190, 257-262.

Habigzang, L. F., Freitas, P. P. C., Hohendorff, J. V., & Koller, S. H., (2016). Cognitive- behavioral group therapy for girls victims of sexual violence in Brazil: Are there differences in effectiveness when applied by different groups of psychologist? Effectiveness of group therapy for girls victims of sexual violence. Anales de Psicologia, 32(2), 433-440.

Kar, N. (2009). Psychological impact of disaster on children: review of assessment and interventions. World Journal of Pediatrics, 5(1), 5-11.

Karabekiroğlu, K., Akbas, S., Taşdemir, G. N., & Karakurt, M. N. (2008). Post traumatic stress symptoms in adolescents after two murders in a school: A controlled followed-up study. International Journal of Psychiatry Medicine, 38(4), 407- 424.

Kim, B. N., Kim, J.W., Kim, H. W., Shin, M. S., Cho, N. H., & Ahn, H. et al. (2009). A six-month follow-up study of post traumatic stress and anxiety/depressive symptoms in Korean children after direct or indirect exposure to a single incident of trauma. Journal of Clinical Psychiatry, 70(80), 1148-1154.

Kun, P., Han, S., Chen, X., & Yao, L. (2009). Prevalence and risk factors for post traumatic stress disorder: a cross-sectional study among survivors of the Wenchuan 2008 earthquake in China. Depression and Anxiety, 26(12), 1134-1140.

Leiva-Bianchi, M. C. & Gallardo, I. (2013). Validation of the short posttraumatic stress disorder rating interview (SPRINT-E) in a sample of people affected by F-27 Chilean earthquake and tsunami. Anales de Psicologia, 29(2), 328-334.

Maia, L. A. C. R. (2010). Neurobiyological basis of Post-Traumatic Stress. Anales de Psicologia, 26(1), 1-10.

March, J. S., Amaya-Jackson, L., Terry, R., & Costanzo, P. (1997). Post traumatic symptomatology in children and adolescents after an industrial fire. Journal of American Academy of Child and Adolescent Psychiatry, 36(8), 1080-1088.

Martin, M., Marchand, A., Boyer, R., & Martin, N. (2009). Predictors of the development of post traumatic stress among police officers. Journal of Trauma and Dissociation, 10(4), 451-468.

Otto, M. W., Henin, A., Hirshfeld-Becker, D. R., Pollack, M. H., Biederman, J., & Rosenbaum, J. F. (2007). Post traumatic stress disorder symptoms following media exposure to tragic events: impact of 9/11 on children at risk for anxiety disorders. Journal of Anxiety Disorder, 21(7), 888-902.

Pfefferbaum, B., Seale, T. W., McDonald, N. B., Brandt, E. N., Rainwater, S. M., & Maynard, B. T. et al. (2000). Post traumatic stress two years after the Oklahoma City bombing in youths geographically distant from the explosions. Psychiatry, 63(4), 356-370.

Pfefferbaum, B., Nixon, S. J., Tivis, R. D., Doughty, D. E., Pynoos, R. S., & Gurwitch, R. H. et al. (2001). Television exposure in children after a terrorist incident. Psychiatry, 64(3), 202-211.

Pfefferbaum, B., Seale, T. W., Brandt, E. N., Pfefferbaum, R. L., Doughty, D. E., & Rainwater, S. M. (2003). Media exposure in children one hundred miles from a terrorist bombing. Annals of Clinical Psychiatry, 15(1), 1-8.

Pfeferbaum, B. J. (2005). Aspects of exposure in childhood trauma: the stressor criterion. Journal of Trauma and Dissociation, 6(2), 17-26.

Priebe, S., Matanov, A., Gavrilovic, J. J., McCrone, P., Ljubotina, D., & Knezevic, G. et al. (2009). Consequences of untreated post traumatic stress disorder following war in former Yugoslavia: Morbidity, subjective quality of life, and care costs. Croatian Medical Journal, 40, 465-475.

Pynoos, R. S. (1993). Traumatic stress and developmental psychopathology in children and adolescents. In: J. M. Oldham, MB Riba and A Tasman, Editors, Review of Psychiatry Vol. 12, Section II, American Psychiatric Press Inc., Washington, D.C., pp. 205-239.

Ruiz, S. R. S. (2006). Longitudinal evaluation of the effects of posttraumatic stress after an industrial catastrophe. A case of San Juan Ixhuatepec Community (Mexico). Anales de Psicologia, 22(1), 22-28.

Sanchez, J. I., Korbin, W. P., & Viscarra, D. M. (1995). Corporate support in the aftermath of a natural disaster. Academy of Management Journal, 38(2), 504-515.

Seino, K., Takano, T., Mashal, T., Helmat, S., & Nakamura, K. (2008). Prevalence of and factors influencing posttraumatic stress disorder among mothers of children under five in Kabul Afghanistan, after decades of armed conflicts. Health Quality Outcomes, 23, 6-29.

Terranova, A. M., Boxer, P., & Shefield-Morris, A. (2009). Factors influencing the course of post traumatic stress following a natural disaster: Children’s reactions to hurricane Katrina. Journal of Applied Developmental Psychology, 30, 344-355.

Tuicomepee, A., & Romano, J. L. (2008). Thai adolescent survivors one year after the 2004 tsunami: A mixed methods study. Journal of Counseling Psychology, 55(3), 308-318.

Vernberg, E. M., La Greca, A. M., Silverman, W. K., & Prinstein, M. J. (1996). Predication of post traumatic stress symptoms in children after hurricane Andrew. Journal of Abnormal Psychology, 105, 237-248.

Vila, G., Porche, L. M., & Mouren-Simeoni, M. C. (1999). An 18-month longitudinal study of post traumatic disorder in children who were taken hostage in their school. Psychosomatic Medicine, 61(6),746-754.

Wang, L., Zhang, Y., Wang, W., Shi, Z., Shen, J., Li, M., et al. (2009). Symptoms of posttraumatic stress disorder among adult survivors three month after the Sichuan earthquakes in China. Journal of Traumatic Stress, 22(5), 444-450. doi:10.1002/jts.20439

Wolfe, D.A., Sas, L., & Wekerle, C. (1994). Factors associated with the development of post traumatic stress disorder among child victims of sexual abuse. Child Abuse and Neglect, 18, 37-50.

Wu, C. H., Chen, S. H., Wenig, L. J., & Wu, L. C. (2009). Social relations and PTSD symptoms: A prospective study on earthquake-impacted adolescents in Taiwan. Journal of Traumatic Stress, 22(5), 451-459.

Yule, W., & Udwin, O. (1991). Screening child survivors for post traumatic stress disorders: Experiences from the “Jupiter” sinking. British Journal of Clinical Psychology, 30, 131-138.

Zhang, Z., Shi, Z., Wang, L. & Liu, M. (2011). One year later: Mental health problems among survivors in hard-hit areas of the Wenchuan earthquake. Public Health, 125, 293-300. doi:10.1016/j.puhe.2010.12.008

How to Cite
Bulut, S. (2018). The Role of Objective and Subjective Experiences, Direct and Media Exposure, Social and Organizational Support, and Educational and Gender Effects in the Prediction of Children Posttraumatic Stress Reaction One Year after Calamity. Anales De Psicología / Annals of Psychology, 34(3), 421-429.
Clinical and Health Psychology