The moderating role of generalized anxiety disorder symptoms in the relationship between posttraumatic stress symptoms and depressive symptoms after the 2023 Kahramanmaraş earthquake

BACKGROUND: The 2023 Kahramanmaraş earthquake had profound psychological consequences. Symptoms of posttraumatic stress disorder (PTSD) and generalized anxiety disorder (GAD) are closely linked to depression in disaster survivors. This study aimed to examine the moderating role of GAD symptoms in the relationship between PTSD symptoms and depressive symptoms. METHODS: A descriptive, cross-sectional design was applied with 495 participants. Data were collected online approximately 21 months after the earthquake using standardized self-report measures: the PTSD Checklist for DSM-5 (PCL-5), Beck Depression Inventory, and Generalized Anxiety Disorder Scale. Data were analyzed using SPSS 26 and AMOS 23. Reliability was tested with Cronbach's alpha, confirmatory factor analysis was applied to the measurement model, and moderation analysis was conducted with Hayes' PROCESS macro (Model 1) using regression and bootstrapping. RESULTS: PTSD and GAD symptoms have a positive effect on the level of depressive symptoms. Moreover, GAD symptoms significantly moderated the relationship between PTSD symptoms and depressive symptoms, amplifying this effect. CONCLUSION: PTSD and GAD symptoms jointly increase vulnerability to depression following a major disaster, with GAD acting as a key moderating factor. These findings highlight the importance of considering comorbid anxiety in post-disaster risk assessment and intervention strategies.