Toplu Kayıpların Ardından Ruminasyon ve Suçluluk Duygusunun İkincil Travmatik Stres Üzerindeki Etkisi

Öz

Amaç: Deprem, fiziksel hasara ve can kaybına yol açan büyük ölçekli bir felakettir ve deprem sonrası travma sonrası stres bozukluğu sıklıkla görülmektedir. Travmatik olayı doğrudan deneyimlemese de sosyal medya aracılığıyla travmatik haber içeriklerine maruz kalan bireyler, ikincil travmatik stresi açığa çıkarmaktadır. İkincil travmatik stres, şiddetli stres, kaygı, öfke, depresyon ve diğer duygusal bozukluklara yol açarak afetten doğrudan etkilenmeyen bireylerin genel iyilik halini olumsuz etkilemektedir. Bu çalışma, ikincil travmatik strese katkıda bulunduğu düşünülen ruminatif düşünce ve suçluluğun incelenmesini amaçlamaktadır. Yöntem: Kesitsel tipteki bu çalışmaya Kahramanmaraş depremi sonrası 20 Nisan-20 Haziran 2023 tarihleri arasında internet üzerinden ulaşılabilen 18 yaş ve üzeri 152 gönüllü dahil edilmiştir. Araştırmanın güç analizi G*POWER 3.1.9.7 (Güç analizi istatistik yazılımı) ile yapılmıştır. Etki büyüklüğü 0,50 ve alfa 0,05 olduğunda örneklem büyüklüğünün gücü 0,92 olarak bulunmuştur. Veri toplama araçları, Kişisel Bilgi Formu, Sosyal Medya Kullanıcıları İçin İkincil Travmatik Stres Ölçeği, Sürekli Utanç ve Suçluluk Ölçeği ve Kısa Form-Ruminasyon Ölçeğinden oluşmaktadır. Bulgular: Katılımcıların % 17.8'i (n=27) psikiyatrik tanı almıştır ve % 47.4'ü geçmişte en az bir deprem geçirmiştir. Örneklemin % 57.2'si Kahramanmaraş merkezli depremden kendilerinin veya sevdiklerinin etkilendiğini bildirmiştir. Geçmişinde en az bir depremden etkilenen, Kahramanmaraş merkezli depremde sevdiği birinin veya kendisinin etkilendiğini bildiren, psikiyatrik tanısı olan ve sosyal medyada geçirdiği süre fazla olan katılımcıların daha yüksek düzeyde ikincil travmatik stres gösterdiği bulunmuştur. Ortak değişkenler kontrol edildikten (geçmiş deprem travması, depremden etkilenme, psikiyatrik tanı, sosyal medyada geçirilen süre) sonra bile ruminatif düşünce ve suçluluğun, ikincil travmatik stresi yordadığını göstermiştir. Sonuç: Sosyal medya kullanımından ruh sağlığına giden yolu keşfedilmesi, travma önleme ve müdahale stratejilerinin geliştirilmesinde rehberlik sağlamaktadır. Sosyal medya aracılığıyla dolaylı travmaya maruz kalanlarda sosyal medya içeriklerinin tüketiminin sınırlandırılması ve olumsuz duyguların azaltılması için duygu düzenleme yöntemlerinin öğrenilmesi için stratejiler geliştirilmelidir.

Anahtar Kelimeler

• Travma sonrası stres bozuklukları
• suç
• depremler
• sosyal medya

Proje Numarası

None

The Effect of Rumination and Guilt on Secondary Traumatic Stress Following Mass Disappearances

Öz

Objective: An earthquake is a large-scale disaster that causes physical damage and loss of life, and post-traumatic stress disorder is frequently observed after an earthquake. Although individuals do not directly experience the traumatic event, individuals exposed to traumatic news content through social media reveal secondary traumatic stress. Secondary traumatic stress leads to severe stress, anxiety, anger, depression, and other emotional disorders and negatively affects the general well-being of individuals who are not directly affected by the disaster. This study aims to examine ruminative thinking and guilt, which are thought to contribute to secondary traumatic stress. Methods: This cross-sectional study included 152 volunteers aged 18 years and over who could be reached via the Internet between 20 April and 5 May 2023 after the Kahramanmaraş earthquake. The power analysis of the study was performed with G*POWER 3.1.9.7 (Power analysis statistical software). When the effect size was 0.50 and alpha was 0.05, the power of the sample size was found to be 0.92. Data collection tools consisted of Personal Information Form, Secondary Traumatic Stress Scale for Social Media Users, Trait Shame and Guilt Scale, and Short Form Rumination Scale. Results: 17.8% (n=27) of the participants had a psychiatric diagnosis and 47.4% had experienced at least one earthquake in the past. 57.2% of the sample reported that they or their loved ones were affected by the Kahramanmaraş earthquake. It was found that participants who were affected by at least one earthquake in the past reported that they or their loved ones were affected by the Kahramanmaraş earthquake, had a psychiatric diagnosis, spent more time on social media showed higher levels of secondary traumatic stress. Even after controlling for covariates (past earthquake trauma, being affected by the earthquake, psychiatric diagnosis, time spent on social media), ruminative thinking and guilt predicted secondary traumatic stress. Conclusion: Exploring the pathway from social media use to mental health guides the development of trauma prevention and intervention strategies. Strategies should be developed to limit the consumption of social media content and learn emotion regulation methods to reduce negative emotions in those exposed to vicarious trauma through social media.

Anahtar Kelimeler

• Posttraumatic stress disorders
• guilt
• earthquakes
• social media

Destekleyen Kurum

None

Proje Numarası

None

Teşekkür

None

Kaynakça

1. Ayhan, C., Aydar, R., & Aktaş, M. (2024). Trauma-informed care and its use in psychiatric nursing: a review. Journal of Nursing Care Research, 1(3), 79-84. doi: 10.51271/jncr-0014
2. Balcı Çelik, S., Altınışık, M. S. (2021). Adaptation of secondary traumatic stress scale to Turkish for social media users: Reliability and validity study. Turkish Psychological Counseling and Guidance Journal, 11(60), 1-12. Retrieved October 23, 2023, from https://dergipark.org.tr/en/download/article-file/1671897
3. Baum, N. (2015). Secondary traumatization in mental health professionals. Trauma, Violence, & Abuse, 17(2), 221–235. doi: 10.1177/1524838015584357
4. Bemak, F., Chung, R. C-Y. (2017). Refugee trauma: Culturally responsive counseling interventions. Journal of Counseling & Development, 95, 299-308. doi: 10.1002/jcad.12144
5. Bistas, K., Grewal, R. (2023). The intricacies of survivor's guilt: exploring ıts phenomenon across contexts. Cureus, 15(9), e45703. doi: 10.7759/cureus.45703
6. Bub, K., Lommen, M. J. (2017). The role of guilt in posttraumatic stress disorder. European Journal of Psychotraumatology, 8(1), 1407202. doi: 10.1080/20008198.2017.1407202
7. Bugay, A., Demir, A. (2011). Psychometric properties of the Turkish Version of Trait Shame and Guilt Scale. The Eurasian Journal of Educational Research, 11(45), 17-30. Retrieved March 3, 2023, from https://ejer.com.tr/wp-content/uploads/2021/01/ejer.2011.45.2.pdf
8. Cinar, E. N., Abbara, A., Yilmaz, E. (2023). Earthquakes in Turkey and Syria-collaboration is needed to mitigate longer terms risks to health. BMJ (Clinical research ed.), 380, p559. doi: 10.1136/bmj.p559

9. Çınaroğlu, M., Yılmazer, E. Sayar, G.H. (2025). Psychological impact of the 2023 Kahramanmaraş earthquakes on non-victims: a cross-sectional study. BMC Public Health, 25, 597. doi: 10.1186/s12889-025-21901-6
10. Crowe, L. (2009). Social support in later life : the influence of retirement and marital status : a thesis presented in partial fulfilment for the requirements for the degree of Master of Science in Psychology at Massey University, Palmerston North, New Zealand.
11. Ehring, T., Razik, S., Emmelkamp, P. M. (2011). Prevalence and predictors of posttraumatic stress disorder, anxiety, depression, and burnout in Pakistani earthquake recovery workers. Psychiatry Research, 185(1-2), 161–166. doi: 10.1016/j.psychres.2009.10.018
12. Erdur-Baker, O., Bugay, A. (2012). The Turkish version of the Ruminative Response Scale: An examination of its reliability and validity. The International Journal of Educational and Psychological Assessment, 10(2), 1-16. Retrieved October 20, 2023, from https://hdl.handle.net/11511/74901
13. Erkoyun, E. (2023, 4 March). Turkey's earthquake death toll rose to 45,968 -interior minister. Reuters. https://www.reuters.com/world/middle-east/turkeys-earthquake-death-toll-rose-45968-interior-minister-2023-03-04/
14. Fan, F., Zhang, Y., Yang, Y., Mo, L., Liu, X. (2011). Symptoms of posttraumatic stress disorder, depression, and anxiety among adolescents following the 2008 Wenchuan earthquake in China. Journal of Traumatic Stress, 24(1), 44–53. doi: 10.1002/jts.20599
15. Fu, Y., Chen, Y., Wang, J., Tang, X., He, J., Jiao, M., Yu, C., You, G., Li, J. (2013). Analysis of prevalence of PTSD and its influencing factors among college students after the Wenchuan earthquake. Child and Adolescent Psychiatry and Mental Health, 7, 1–6. doi: 10.1186/1753-2000-7-1
16. Fullerton, C. S., Ursano, R. J., Wang, L. (2004). Acute stress disorder, posttraumatic stress disorder, and depression in disaster or rescue workers. The American Journal of Psychiatry, 161(8), 1370–1376. doi: 10.1176/appi.ajp.161.8.1370
17. Grubaugh, A. L., Zinzow, H. M., Paul, L., Egede, L. E., Frueh, B. C. (2011). Trauma exposure and posttraumatic stress disorder in adults with severe mental illness: A critical review. Clinical Psychology Review, 31(6), 883–899. doi: 10.1016/j.cpr.2011.04.003
18. Güler, K., Uzun, S., & Emirza, E. (2024). Secondary traumatic stress and coping experiences in psychiatric nurses caring for trauma victims: A phenomenological study. Journal of Psychiatric and Mental Health Nursing, 32(2), 402–413. doi: 10.1111/jpm.13121
19. Johansen, A. B., Kristiansen, E., Bjelland, I., Tavakoli, S. (2019). Secondary traumatic stress in Norwegian SUD-therapists: Symptoms and related factors. Nordisk Alkohol & Narkotikatidskrift: NAT, 36(6), 522–531. doi: 10.1177/1455072519847014
20. Hartman, J. J. (2014). Anna Freud and the Holocaust: Mourning and survival guilt. The International Journal of Psychoanalysis, 95(6), 1183-1210. doi: 10.1111/1745-8315.12250
21. Hu, E., Koucky, E. M., Brown, W. J., Bruce, S. E., Sheline, Y. I. (2014). The role of rumination in elevating perceived stress in posttraumatic stress disorder. Journal of Interpersonal Violence, 29(10), 1953–1962. doi: 10.1177/0886260513511697
22. Hull, A. M., Alexander, D. A., Klein, S. (2002). Survivors of the Piper Alpha oil platform disaster: long-term follow-up study. The British Journal of Psychiatry, 181(5), 433–438. doi: 10.1192/bjp.181.5.433
23. Kahil, A., Palabıyıkoğlu, N. R. (2018). İkincil travmatik stres. Psikiyatride Güncel Yaklaşımlar, 10(1), 59-70. doi: 10.18863/pgy.336495
24. Kalaycıoğlu, O., Akhanlı, S. E. (2020). Sağlık araştırmalarında güç analizinin önemi ve temel prensipleri: Tıbbi çalışmalar üzerinde uygulamalı örnekler. Turkish Journal of Public Health,18(1), 103-112. doi: 10.20518/tjph.602400
25. 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. Retrieved October 24, 2023, from https://dergipark.org.tr/tr/pub/scd/issue/82328/1312463
26. Lachlan, K. A., Spence, P. R., Seeger, M. (2009). Terrorist attacks and uncertainty reduction: Media use after September 11. Behavioral Sciences of Terrorism and Political Aggression, 1(2), 101–110. doi: 10.1080/19434470902771683
27. Liang, Y., Cheng, J., Ruzek, J. I., Liu, Z. (2019). Posttraumatic stress disorder following the 2008 Wenchuan earthquake: A 10-year systematic review among highly exposed populations in China. Journal of Affective Disorders, 243, 327–339. doi: 10.1016/j.jad.2018.09.047
28. LoSavio, S. T., Dillon, K. H., Resick, P. A. (2017). Cognitive factors in the development, maintenance, and treatment of post-traumatic stress disorder. Current Opinion in Psychology, 14, 18–22. doi: 10.1016/j.copsyc.2016.09.006
29. Murray, H., Pethania, Y., Medin, E. (2021). Survivor guilt: A cognitive approach. Cognitive Behaviour Therapist, 14, e28. doi: 10.1017/S1754470X21000246
30. Ogińska-Bulik, N., Gurowiec, P. J., Michalska, P., Kędra, E. (2021). Prevalence and predictors of secondary traumatic stress symptoms in health care professionals working with trauma victims: A cross-sectional study. PloS One, 16(2), e0247596. doi: 10.1371/journal.pone.0247596
31. Pugh, L. R., Taylor, P. J., Berry, K. (2015). The role of guilt in the development of post-traumatic stress disorder: A systematic review. Journal of Affective Disorders, 182, 138–150. doi: 10.1016/j.jad.2015.04.026
32. Rackham, L. A., Lau-Zhu, A. (2021). Taxing working memory to modulate mental imagery of the 9/11 terrorist attacks following media exposure during childhood: A pilot study in young adult UK residents. Anxiety, Stress, and Coping, 34(4), 423–436. doi: 10.1080/10615806.2020.1870107
33. Szabo, Y. Z., Warnecke, A. J., Newton, T. L., Valentine, J. C. (2017). Rumination and posttraumatic stress symptoms in trauma-exposed adults: a systematic review and meta-analysis. Anxiety, Stress, and Coping, 30(4), 396–414. doi: 10.1080/10615806.2017.1313835
34. Tang, B., Deng, Q., Glik, D., Dong, J., Zhang, L. (2017). A meta-analysis of risk factors for post-traumatic stress disorder (PTSD) in adults and children after earthquakes. International Journal of Environmental Research and Public Health, 14(12), 1537. doi: 10.3390/ijerph14121537
35. Turliuc, M. N., Măirean, C., Turliuc, M. D. (2015). Rumination and suppression as mediators of the relationship between dysfunctional beliefs and traumatic stress. International Journal of Stress Management, 22(3), 306–322. doi: 10.1037/a0039272
36. Von Rueden, K. T., Hinderer, K. A., McQuillan, K. A., Murray, M., Logan, T., Kramer, B., Gilmore, R., Friedmann, E. (2010). Secondary traumatic stress in trauma nurses: prevalence and exposure, coping, and personal/environmental characteristics. Journal of Trauma Nursing : The Official Journal of the Society of Trauma Nurses, 17(4), 191–200. doi: 10.1097/JTN.0b013e3181ff2607
37. Wampole, D., & Bressi, S. (2019). Exploring strategies for promoting trauma-informed care and reducing burnout in acute care psychiatric nursing. Journal of Nursing Education and Practice, 9(5), 110-117. doi: 10.5430/JNEP.V9N5P110
38. Wang, W., Wu, X., Lan, X. (2020). Rumination mediates the relationships of fear and guilt to posttraumatic stress disorder and posttraumatic growth among adolescents after the Ya’an earthquake, European Journal of Psychotraumatology, 11(1), 1704993. doi: 10.1080/20008198.2019.1704993
39. Wang, W., Wu, X., Tian, Y. (2018). Mediating roles of gratitude and social support in the relation between survivor guilt and posttraumatic stress disorder, posttraumatic growth among adolescents after the Ya'an earthquake. Frontiers in Psychology, 9, 2131. doi: 10.3389/fpsyg.2018.02131
40. Vaingankar, J., Abdin, E., Chong, S., Shafie, S., Sambasivam, R., Zhang, Y., Chang, S., Chua, B., Shahwan, S., Jeyagurunathan, A., Kwok, K., Subramaniam, M. (2020). The association of mental disorders with perceived social support, and the role of marital status: results from a national cross-sectional survey. Archives of Public Health=Archives Belges de Sante Publique, 78, 108. doi: 10.1186/s13690-020-00476-1
41. Yıldırım, M., Seyrek, E., Çelik, İ., Aziz, I., Gómez-Salgado, J. (2025). The mediating roles of perceived social support and resilience in the relationship between earthquake anxiety and traumatic experiences among earthquake survivors in Turkey. Acta Psychologica, 253, 104714. doi: 10.1016/j.actpsy.2025.104714.
42. Zhao, N., Zhou, G. (2020). Social media use and mental health during the COVID-19 pandemic: Moderator role of disaster stressor and mediator role of negative affect. Applied Psychology. Health and Well-being, 12(4), 1019–1038. doi: 10.1111/aphw.12226