Type-D Personality and Secondary Traumatic Stress: The Mediating Role of Difficulties in Emotion Regulation

Year 2024, Volume: 12 Issue: 24, 239 - 261, 15.10.2024

Melisa Sevi Koç , Aliye Ateş

https://doi.org/10.20304/humanitas.1466242

Abstract

The objective of this study was to explore the associations among Type-D personality, secondary traumatic stress, and emotion regulation challenges in adult users of social media. Additionally, the study aimed to investigate whether emotion regulation difficulties mediate the relationship between Type-D personality and secondary traumatic stress. The sample comprised 331 active social media users aged 18 to 65, who confirmed no direct exposure to the 2023 Kahramanmaraş earthquake. Utilizing the Personal Information Form, Type-D Personality Scale, Secondary Traumatic Stress Scale for Social Media Users, and Difficulty in Emotion Regulation Scale - Short Form, data were collected through an online survey. Pearson correlation analysis was used to examine the associations among variables. Hayes' PROCESS macro-based hierarchical regression method was used to assess the mediation hypothesis. Independent samples t-tests and one-way ANOVA was used to explore potential variations in reported secondary traumatic stress based on gender, psychiatric history, frequency of exposure to earthquake-related content on social media, and presence of Type-D personality. The results indicated significant positive correlations between Type-D personality traits, secondary traumatic stress, and emotion dysregulation. Emotion dysregulation emerged as a complete mediator in the association between Type-D personality traits and secondary traumatic stress. Moreover, individuals exhibiting Type-D personality traits demonstrated elevated levels of secondary traumatic stress compared to their non-Type-D counterparts. Additionally, individuals who reported constant exposure to earthquake-related news and messages exhibited higher levels of secondary traumatic stress compared to those reporting occasional or no exposure. Likewise, individuals with Type-D personality reported greater difficulties in emotion regulation compared to their counterparts. In conclusion, this study revealed that difficulty with emotion regulation is one of the underlying factors that may explain the relationship between Type D personality and secondary traumatic stress.

Keywords

Type D personality, secondary traumatic stress, emotion regulation difficulties

D TİPİ KİŞİLİK ÖZELLİKLERİ VE İKİNCİL TRAVMATİK STRES: DUYGU DÜZENLEME GÜÇLÜĞÜNÜN ARACI ROLÜ

Abstract

Bu çalışmanın amacı yetişkin sosyal medya kullanıcılarında D tipi kişilik özellikleri, ikincil travmatik stres ve duygu düzenleme güçlüğü arasındaki ilişkilerin incelenmesi ve D tipi kişilik özelliği ile ikincil travmatik stres ilişkisinde duygu düzenleme güçlüğünün aracı rolünün olup olmadığının ortaya koyulmasıdır. Araştırmanın katılımcılarını 2023 Kahramanmaraş depremine doğrudan maruz kalmadığını beyan eden 18-65 yaş arası toplam 331 aktif sosyal medya kullanıcısı birey oluşturmaktadır. Verilerin toplanmasında Kişisel Bilgi Formu, D Tipi Kişilik Ölçeği (DS14), Sosyal Medya Kullanıcıları İçin İkincil Travmatik Stres Ölçeği (SM-İTSÖ) ve Duygu Düzenleme Güçlüğü Ölçeği – Kısa Form (DDGÖ-16) kullanılmıştır. Veriler, çevrimiçi olarak toplanmıştır. Değişkenler arası ilişkilerin incelenmesi için Pearson korelasyon analizi, aracılık hipotezinin test edilmesi için Hayes (2022) tarafından geliştirilen Process Macro 4.3.1 eklentisi kullanılarak veriden 5000 örneklem ile Bootstrap yöntemi ile bir dizi regresyon tabanlı yol analizi gerçekleştirilmiştir. Katılımcıların bildirdiği ikincil travmatik stres düzeyinin cinsiyet, psikiyatrik öykü, sosyal medya üzerinden depreme ilişkin haberlere/gönderilere maruz kalma sıklığı ve D tipi kişiliğe sahip olup olmamalarına bağlı olarak değişip değişmediğini tespit etmek için bağımsız örneklemler t-testi ve tek yönlü ANOVA analizleri kullanılmıştır. Bulgular, D tipi kişilik özellikleri, ikincil travmatik stres ve duygu düzenleme güçlüğü değişkenleri arasında pozitif yönlü ve istatistiksel olarak anlamlı ilişkiler olduğunu; D tipi kişilik özelliği ile ikincil travmatik stres ilişkisinde duygu düzenleme güçlüğünün tam aracı rol oynadığını ve D tipi kişiliğe sahip olanların olmayanlara oranla ve depreme ilişkin haberlere/gönderilere her zaman maruz kaldığını bildirenlerin hiçbir zaman ya da ara sıra maruz kaldığını bildirenlere oranla daha yüksek ikincil travmatik stres düzeyine sahip olduklarını ortaya koymuştur. Benzer şekilde, D tipi kişiliğe sahip olanların duygu düzenleme güçlüğü ortalama puanlarının D tipi kişiliğe sahip olmayanlara oranla daha yüksek olduğu görülmüştür. Sonuç olarak, bu çalışmada D tipi kişilik ile ikincil travmatik stres arasındaki ilişkiyi açıklayabilecek altta yatan faktörlerden birinin duygu düzenleme güçlüğü olduğu ortaya koyulmuştur.

Keywords

D tipi kişilik, ikincl travmatik stres, duygu düzenleme güçlüğü

Ethical Statement

Bu çalışma için etik kurul izni İstanbul Aydın Üniversitesi Sosyal ve Beşeri Bilimler Etik Komisyonu'nun 07/07/2023 tarihli ve 2023/6 numaralı kararı ile alınmıştır. Çalışma boyunca Yükseköğretim Kurumları Bilimsel Araştırma ve Yayın Etiği Yönergesi kapsamında belirtilen tüm kurallara uyulmuştur. Katkı Oranları: 1. yazar %70 oranında, 2. yazar %30 oranında katkı sağlamıştır.

References

• Aker, T. (2006). 1999 Marmara depremi: Epidemiyolojik bulgular ve toplum ruh sağlığı uygulamaları üzerine bir gözden geçirme. Türk Psikiyatri Dergisi, 17 (3), 204-212.
• Aldao, A., Nolen-Hoeksema, S., & Schweizer, S. (2010). Emotion-regulation strategies across psychopathology: A meta-analytic review. Clinical Psychology Review, 30(2), 217–237. https://doi.org/10.1016/j.cpr.2009.11.004
• Altındağ, A., Özen, S. & Sır, A. (2005). One-year follow-up study of postraumatic stress disorder among earthquake survivors in Turkey. Comprehensive Psychiatry, 46(5), 328-333. https://doi.org/10.1016/j.comppsych.2005.01.005
• Amerikan Psikiyatri Birliği. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.). https://doi.org/10.1176/appi.books.9780890425787.
• Amstadter, A. B., & Vernon, L. L. (2008). Emotional reactions during and after trauma: A comparison of trauma types. Journal of Aggression, Maltreatment & Trauma, 16(4), 391–408. https://doi.org/10.1080/10926770801926492
• Aquarius, A. E., Denollet, J., Hamming, J. F., Van Berge Henegouwen, D. P., & De Vries, J. (2007). Type-D personality and ankle-brachial index as predictors of impaired quality of life and depressive symptoms in peripheral arterial disease. Archives of Surgery (Chicago, Ill.: 1960), 142(7), 662–667. https://doi.org/10.1001/archsurg.142.7.662 Argın, Y. (2023). Doğal afetlerde sosyal medya kullanımı: 2023 Kahramanmaraş depremi özelinde Twitter örneği. İnsanat Sanat Tasarım ve Mimarlık Araştırmaları Dergisi, 3(1), 140-165.
• Balzarotti, S., Biassoni, F., Villani, D., Prunas, A., & Velotti, P. (2016). Individual differences in cognitive emotion regulation: Implications for subjective and psychological well-being. Journal of Happiness Studies: An Interdisciplinary Forum on Subjective Well-Being, 17(1), 125–143. https://doi.org/10.1007/s10902-014-9587-3
• Bjureberg, J., Ljótsson, B., Tull, M. T., Hedman, E., Sahlin, H., Lundh, L. G., Bjärehed, J., DiLillo, D., Messman-Moore, T., Gumpert, C. H., & Gratz, K. L. (2016). Development and validation of a brief version of the Difficulties in Emotion Regulation Scale: The DERS-16. Journal of Psychopathology and Behavioral Assessment, 38(2), 284–296. https://doi.org/10.1007/s10862-015-9514-x
• Brans, K., Koval, P., Verduyn, P., Lim, Y. L., & Kuppens, P. (2013). The regulation of negative and positive affect in daily life. Emotion 13(5), 926–939. https://doi.org/10.1037/a0032400
• Cénat, J. M., McIntee, S. E., & Blais-Rochette, C. (2020). Symptoms of posttraumatic stress disorder, depression, anxiety and other mental health problems following the 2010 earthquake in Haiti: A systematic review and meta-analysis. Journal of Affective Disorders, 273, 55–85. https://doi.org/10.1016/j.jad.2020.04.046
• Cho, G., & Kang, J. (2017). Type D personality and post-traumatic stress disorder symptoms among intensive care unit nurses: The mediating effect of resilience. PLoS ONE, 12. https://doi.org/10.1371/journal.pone.0175067.
• Connally, D. (2012). The relationship between clinician sex, ethnicity, sexual identity and secondary traumatic stress. Journal of Gay & Lesbian Mental Health, 16(4), 306–321. https://doi.org/10.1080/19359705.2012.697002. Çelik Balcı, S. & Altınışık, M. S. (2021). Adaptation of Secondary Traumatic Stress Scale to Turkish for social media users: Reliability and validity study. Türk Psikolojik Danışma ve Rehberlik Dergisi, 11(60), 1-12.
• Dan-Glauser, E. S., & Gross, J. J. (2013). Emotion regulation and emotion coherence: Evidence for strategy-specific effects. Emotion, 13(5), 832–842. https://doi.org/10.1037/a0032672
• De Fruyt, F., & Denollet, J. (2002). Type D personality: A five-factor model perspective. Psychology & Health, 17(5), 671–683. https://psycnet.apa.org/doi/10.1080/08870440290025858
• Demir, M. (2023). 06 Şubat Kahramanmaraş merkezli depremler sonrasında sosyal medya kullanımının yansımaları. Türk Deprem Araştırma Dergisi, 5(2), 248-269. https://doi.org/10.46464/tdad.1334129
• Denollet J. (2005). DS14: standard assessment of negative affectivity, social inhibition, and Type D personality. Psychosomatic Medicine, 67(1), 89–97. https://doi.org/10.1097/01.psy.0000149256.81953.49
• Denollet, J., & Conraads, V. M. (2011). Type D personality and vulnerability to adverse outcomes in heart disease. Cleveland Clinic Journal of Medicine, 78 Suppl 1, S13–S19. https://doi.org/10.3949/ccjm.78.s1.02
• Denollet, J., Sys, S. U., & Brutsaert, D. L. (1995). Personality and mortality after myocardial infarction. Psychosomatic Medicine 57(6), 582–591. https://doi.org/10.1097/00006842-199511000-00011
• Doré, B. P., Silvers, J. A., & Ochsner, K. N. (2016). Toward a personalized science of emotion regulation. Social and Personality Psychology Compass, 10(4), 171–187. https://doi.org/10.1111/spc3.12240
• Dünya Sağlık Örgütü (DSÖ). (2023). Statement – Türkiye/Syria earthquakes. https://www.who.int/europe/news/item/14-02-2023-statement-turkiye-and-syria-earthquakes.
• Ehring, T., &, D. (2010). Emotion regulation difficulties in trauma survivors: the role of trauma type and PTSD symptom severity. Behavior Therapy, 41(4), 587-98. https://doi.org/10.1016/j.beth.2010.04.004.
• Figley, C. R. (1999). Compassion fatigue: Toward a new understanding of the costs of caring. In B. H. Stamm (Ed.) Secondary traumatic stress: Self-care issues for clinicians, researchers, and educators (2nd ed., pp. 3-28). Sidran.
• Figley, C. R. (Ed.). (1995). Compassion fatigue: Coping with secondary traumatic stress disorder in those who treat the traumatized. Brunner/Mazel.
• Garnefski, N., & Kraaij, V. (2007). The Cognitive Emotion Regulation Questionnaire: Psychometric features and prospective relationships with depression and anxiety in adults. European Journal of Psychological Assessment, 23(3), 141–149. https://doi.org/10.1027/1015-5759.23.3.141
• Gratz, K. L., & Roemer, L. (2004). Multidimensional assessment of emotion regulation and dysregulation: Development, factor structure, and initial validation of the difficulties in emotion regulation scale. Journal of Psychopathology and Behavioral Assessment, 26(1), 41–54. https://psycnet.apa.org/doi/10.1023/B:JOBA.0000007455.08539.94
• Gross, J. J. (1998). The emerging field of emotion regulation: an integrative review. Review of General Psychology, 2(3), 271-299.
• Gross, J. J. (2002). Emotion regulation: Affective, cognitive, and social consequences. Psychophysiology, 39(3), 281–291. https://doi.org/10.1017/s0048577201393198
• Gross, J. J. (2015). Emotion regulation: Current status and future prospects. Psychological Inquiry, 26(1), 1–26. https://psycnet.apa.org/doi/10.1080/1047840X.2014.940781
• Gross, J. J., & Levenson, R. W. (1993). Emotional suppression: Physiology, self-report, and expressive behavior. Journal of Personality and Social Psychology, 64(6), 970–986. https://doi.org/10.1037//0022-3514.64.6.970
• Gross, J. J., & Levenson, R. W. (1997). Hiding feelings: the acute effects of inhibiting positive and negative emotions. Journal of Abnormal Psychology,. 106(1), 95–103. https://doi.org/10.1037//0021-843x.106.1.95
• Gündüz, B. (2020). Meslek elemanlarının yaşadıkları ikincil travmatik stres. İstanbul Kent Üniversitesi İnsan ve Toplum Bilimleri Dergisi, 1(1), 1-14.
• Habibović, M., van den Broek, K. C., Alings, M., Van der Voort, P. H., & Denollet, J. (2012). Posttraumatic stress 18 months following cardioverter defibrillator implantation: shocks, anxiety, and personality. Health Psychology, 31(2), 186–193. https://doi.org/10.1037/a0024701
• Hayes, A., F. (2022). Introduction to mediation, moderation, and conditional process analysis: A regression based approach (3rd. Ed.). Guilford Press.
• Hayes, J. P., Morey, R. A., Petty, C. M., Seth, S., Smoski, M. J., McCarthy, G., & Labar, K. S. (2010). Staying cool when things get hot: emotion regulation modulates neural mechanisms of memory encoding. Frontiers In Human Neuroscience, 4, 230. https://doi.org/10.3389/fnhum.2010.00230
• Karasar, N. (2023). Bilimsel araştırma yöntemi: Kavramlar, ilkeler, teknikler (38. Baskı). Nobel Akademik Yayıncılık.
• Kavak, G., Karaköse, Ş., & Koçak, O. (2023). Psikolojik sağlamlık ve ikincil travmatik stres ilişkisi: Sosyal medya kullanımının aracı rolü. Sosyal Çalışma Dergisi, 7(2), 92-111.
• Kılıç, M. , Üstündağ Öcal, N. & Uslukılıç, G. (2021). Sağlık çalışanlarının D tipi kişilik yapısı ve yaşam doyumunun ekip çalışması tutumu üzerine etkisi. Sağlık Bilimleri Dergisi, 30(3), 326-336.
• Kıvrak, Y., & İnaltekin, A. (2023). Covid-19 salgınında sağlık çalışanlarında depresyon, anksiyete, stres, travma düzeyi ve D tipi kişilik: Vaka-kontrol çalışması. Kocatepe Tıp Dergisi, 24(1), 62-68.
• Kunst, M., Bogaerts, S., & Winkel, F. (2011). Type D personality and posttraumatic stress disorder in victims of violence: a cross-sectional exploration.. Clinical Psychology & Psychotherapy, 18(1), 13-22. https://doi.org/10.1002/cpp.698.
• Kurt, E., & Gülbahçe, A. (2019). Van depremini yaşayan öğrencilerin travma sonrası stres bozukluğu düzeylerinin incelenmesi. Atatürk Üniversitesi Sosyal Bilimler Enstitüsü Dergisi, 23(3), 957-972.
• Kwon, H. R., Eoh, Y., & Park, S. H. (2020). The mediating role of catastrophizing in the relationship between emotional clarity and posttraumatic stress symptoms among earthquake survivors in Korea: A cross-sectional study. Frontiers in Psychology, 11, 1114. https://doi.org/10.3389/fpsyg.2020.01114
• Mancini, M. N. (2019). Development and validation of the Secondary Traumatic Stress Scale in a sample of social media users [Doktora tezi]. Cleveland State University.
• Mauss, I. B., Levenson, R. W., McCarter, L., Wilhelm, F. H., & Gross, J. J. (2005). The tie that binds? Coherence among emotion experience, behavior, and physiology. Emotion, 5(2), 175–190. https://doi.org/10.1037/1528-3542.5.2.175 Mavi, E. E. (2020). Afet kriz yönetiminde medya: 30 Ekim 2020 İzmir Depremi. Karadeniz Teknik Üniversitesi İletişim Araştırmaları Dergisi, 10(2), 31-53.
• Mennin, D. S. (2005). Emotion and the acceptance-based approaches to the anxiety disorders. In S. M. Orsillo & L. Roemer (Eds.) Acceptance and Mindfulness-Based Approaches to Anxiety (pp. 37-68). Springer.
• Messerli-Bürgy, N., Barth, J., von Känel, R., Schmid, J.-P., Saner, H., & Znoj, H. (2012). Maladaptive emotion regulation is related to distressed personalities in cardiac patients. Stress and Health, 28(4), 347–352. https://doi.org/10.1002/smi.2420
• Michal, M., Wiltink, J., Grande, G., Beutel, M., & Brähler, E. (2011). Type D personality is independently associated with major psychosocial stressors and increased health care utilization in the general population.. Journal of Affective Disorders, 134(1-3), 396-403. https://doi.org/10.1016/j.jad.2011.05.033.
• Mols, F., & Denollet, J. (2010). Type D personality in the general population: a systematic review of health status, mechanisms of disease, and work-related problems. Health and Quality of Life Outcomes, 8(9). https://doi.org/10.1186/1477-7525-8-9.
• Ogińska-Bulik N. (2006). Occupational stress and its consequences in healthcare professionals: the role of type D personality. International Journal of Occupational Medicine and Environmental Health, 19(2), 113–122. https://doi.org/10.2478/v10001-006-0016-7
• Öncü, E., & Köksoy Vayısoğlu, S. (2018). The validity and reliability of type D personality scale in the Turkish population. Ankara Medical Journal, 18(4), 646-656. https://doi.org/10.17098/amj.497485
• Palen, L., & Hughes, A. L. (2018). Social Media in Disaster Communication. In H. Rodríguez, W. Donner, & J. E. Trainor (Eds.), Handbook of Disaster Research (pp. 497– 518). Springer.
• Parslow, R. A., Jorm, A. F., & Christensen, H. (2006). Associations of pre-trauma attributes and trauma exposure with screening positive for PTSD: analysis of a community-based study of 2,085 young adults. Psychological Medicine, 36(3), 387–395. https://doi.org/10.1017/S0033291705006306
• Pedersen, S. S., & Denollet, J. (2004). Validity of the Type D personality construct in Danish post-MI patients and healthy controls. Journal of Psychosomatic Research, 57(3), 265–272. https://doi.org/10.1016/S0022-3999(03)00614-7
• Pedersen, S. S., van Domburg, R. T., Theuns, D. A., Jordaens, L., & Erdman, R. A. (2004). Type D personality is associated with increased anxiety and depressive symptoms in patients with an implantable cardioverter defibrillator and their partners. Psychosomatic Medicine, 66(5), 714–719. https://doi.org/10.1097/01.psy.0000132874.52202.21
• Pedersen, S. S., Yagensky, A., Smith, O. R., Yagenska, O., Shpak, V., & Denollet, J. (2009). Preliminary evidence for the cross-cultural utility of the type D personality construct in Ukraine. International Journal of Behavioral Medicine, 16(2), 108–115. https://doi.org/10.1007/s12529-008-9022-4
• Pedersen, S.S. & Denollet, J. (2006) Is type D personality here to stay? Emerging evidence across cardiovascular disease patient groups. Current Cardiology Reviews, 2(3), 205-213. http://dx.doi.org/10.2174/157340306778019441
• Pekdemir N. H. (2018). Akademisyenlerde D tipi kişilik yapısı ile iş doyumu arasındaki ilişkinin incelenmesi [Yüksek lisans tezi, Haliç Üniversitesi]. https://tez.yok.gov.tr/UlusalTezMerkezi/
• Polman, R., Borkoles, E., & Nicholls, A. R. (2010). Type D personality, stress, and symptoms of burnout: the influence of avoidance coping and social support. British Journal of Health Psychology, 15(Pt 3), 681–696. https://doi.org/10.1348/135910709X479069
• Rademaker, A. R., van Zuiden, M., Vermetten, E., & Geuze, E. (2011). Type D personality and the development of PTSD symptoms: A prospective study. Journal of Abnormal Psychology, 120(2), 299–307. https://doi.org/10.1037/a0021806
• Schiffer, A. A., Pedersen, S. S., Widdershoven, J. W., Hendriks, E. H., Winter, J. B., & Denollet, J. (2005). The distressed (type D) personality is independently associated with impaired health status and increased depressive symptoms in chronic heart failure. European Journal of Cardiovascular Prevention and Rehabilitation, 12(4), 341–346. https://doi.org/10.1097/01.hjr.0000173107.76109.6c
• Selby, E. A., Anestis, M. D., & Joiner, T. E. (2008). Understanding the relationship between emotional and behavioral dysregulation: Emotional cascades. Behaviour Research and Therapy, 46(5), 593–611. https://doi.org/10.1016/j.brat.2008.02.002
• Seligowski, A., Lee, D., Bardeen, J., & Orcutt, H. (2015). Emotion Regulation and Posttraumatic Stress Symptoms: A Meta-Analysis. Cognitive Behaviour Therapy, 44, 87-102. https://doi.org/10.1080/16506073.2014.980753.
• Shapinsky, A. C., Rapport, L. J., Henderson, M. J. & Axelrod, B. N. (2005). Civilian PTSD scales: Relationships with trait characteristics and everyday stress. Assessment, 12, 220-230. https://doi.org/10.1177/1073191104273130
• Shepherd, L., & Wild, J. (2014). Emotion regulation, physiological arousal and PTSD symptoms in trauma-exposed individuals. Journal of Behavior Therapy and Experimental Psychiatry, 45, 360- 367. https://doi.org/10.1016/j.jbtep.2014.03.002.
• Sher, L. (2005). Type D personality: the heart, stress, and cortisol. QJM: An International Journal of Medicine, 98(5), 323–329. https://doi.org/10.1093/qjmed/hci064.
• Spindler, H., Pedersen, S. S., Serruys, P. W., Erdman, R. A., & van Domburg, R. T. (2007). Type-D personality predicts chronic anxiety following percutaneous coronary intervention in the drug-eluting stent era. Journal of Affective Disorders, 99(1-3), 173–179. https://doi.org/10.1016/j.jad.2006.09.009
• Şahinsoy, K. (2017). Kriz yönetimi açısından geleneksel ve sosyal medya. İstanbul Aydın Üniversitesi Dergisi, 9(4), 1-19. https://doi.org/10.17932/IAU.IAUD.13091352.2017.9/36.1-19
• Tabachnick, B. G., & Fidell, L. S. (2013). Using multivariate statistics (6th ed.), Allyn and Bacon.
• T.C Cumhurbaşkanlığı Strateji ve Bütçe Başkanlığı (SBB). (2024). Kahramanmaraş ve Hatay depremleri yeniden imar ve gelişme raporu. https://www.sbb.gov.tr/wp-content/uploads/2024/02/Kahramanmaras-ve-Hatay-Depremleri-Yeniden-Imar-ve-Gelisme-Raporu-1.pdf
• Tull, M. T., Barrett, H. M., McMillan, E. S., & Roemer, L. (2007). A preliminary investigation of the relationship between emotion regulation difficulties and posttraumatic stress symptoms. Behavior Therapy, 38(3), 303–313. https://doi.org/10.1016/j.beth.2006.10.001
• Tull, M. T., Vidaña, A. G., & Betts, J. E. (2020). Emotion regulation difficulties in PTSD. In M. T. Tull & N. A. Kimbrel (Eds.), Emotion in posttraumatic stress disorder: Etiology, assessment, neurobiology, and treatment (pp. 295–310). Elsevier Academic Press.
• Usta, E. & Yükeler, M. (2021). Afetlerde sosyal medya kullanımı ve etik ikilemler: İzmir Seferihisar depremi örneği. Afet ve Risk Dergisi, 4(2), 249-269. https://doi.org/10.35341/afet.981246
• van den Broek, K. C., Nyklícek, I., & Denollet, J. (2009). Anxiety predicts poor perceived health in patients with an implantable defibrillator. Psychosomatics, 50(5), 483–492. https://doi.org/10.1176/appi.psy.50.5.483
• Wikman, A., Bhattacharyya, M., Perkins-Porras, L., & Steptoe, A. (2008). Persistence of posttraumatic stress symptoms 12 and 36 months after acute coronary syndrome. Psychosomatic Medicine, 70(7), 764–772. https://doi.org/10.1097/PSY.0b013e3181835c07
• Williams, L., O’Connor, R. C., Howard, S., Hughes, B. M., Johnston, D. W., Hay, J. L., O’Connor, D. B., Lewis, C. A., Ferguson, E., Sheehy, N., Grealy, M. A., & O’Carroll, R. E. (2008). Type-D personality mechanisms of effect: The role of health-related behavior and social support. Journal of Psychosomatic Research, 64(1), 63–69. https://doi.org/10.1016/j.jpsychores.2007.06.008
• Yates, D., & Paquette, S. (2011). Emergency knowledge management and social media technologies: A case study of the 2010 Haitian Earthquake. International Journal of Information Management, 31(1), 6–13. https://doi.org/10.1016/j.ijinfomgt.2010.10.001
• Yeşil, A. (2010) 112 acil sağlık hizmetlerinde çalışan sağlık çalışanlarında ruhsal travma ve ilişkili sorunların yaygınlığı [Yüksek lisans tezi, Kocaeli Üniversitesi]. https://tez.yok.gov.tr/UlusalTezMerkezi/
• Yiğit, İ., & Guzey Yiğit, M. (2017). Psychometric properties of the Turkish version of difficulties in emotion regulation scale-brief form (DERS-16). Current Psychology, 38(6), 1503–1511. https://doi.org/10.1007/s12144-017-9712-7
• Yurtlu, F. B., Öztürk, B., Güven, E., Eren, T. (2024). Afet sonrası ilk 72 saatte yapılacak faaliyetlere ilişkin stratejiler: Türkiye. Doğal Afetler ve Çevre Dergisi, 10(2), 504-522. https://doi.org/10.21324/dacd.1429668.
• Zeytinoğlu-Saydam, S., Yumbul, Ç., Yumbul, C., Akarca, G., Özgün, S., & Egeci, S. (2020). Terör: Ne yaşıyoruz? Nasıl baş ediyoruz? Elektronik Sosyal Bilimler Dergisi, 19(75), 1534-1545. https://doi.org/10.17755/esosder.653489.
• Zhang, Y., & Ho, S. M. (2011). Risk factors of posttraumatic stress disorder among survivors after the 512 Wenchuan earthquake in China. PloS one, 6(7), e22371. https://doi.org/10.1371/journal.pone.0022371.