Earthquake exposure, cognitive integration, and psychiatric symptoms in bereavement: A moderated mediation with fulfilling daily activities

Introduction: Bereaved individuals experiencing losses tend to experience better psychological well-being if they experience higher levels of cognitive integration. This study aims to investigate the everyday life context where this process could take place, given that bereaved individuals also experience disruptions to fulfilling daily activities. 

Methods: Among a nationally representative sample of 1588 bereaved Turkish people 7 months after the 2023 Turkey–Syria Earthquake (September–October 2023), we conducted moderated mediation analyses to investigate whether (1) cognitive integration mediated the links between the levels of earthquake exposure and psychiatric (grief, PTSD, anxiety, depressive) symptoms, and (2) disruptions to fulfilling daily activities moderated the mediation. 

Results: The two components of integration, namely comprehensibility and footing in the world, fully mediated the positive links between earthquake exposure and all four psychiatric symptoms (βs =.02–.03; βs =.06–.08). Direct and indirect paths were stronger under higher levels of disruptions to fulfilling daily activities: the indirect exposure-comprehensibility-symptoms were only significant under high (βs =.03–.04, 95% CI [.01–.02,.05–.06]) and medium (βs =.02–.03, 95% CI [.01–.02,.03–.04]) levels, and the direct exposure-grief links were only significant under high levels of disruptions (β =.09, 95% CI [.03,.16]). 

Conclusions: The current findings were in line with classic psychological theories on coping with stress, trauma, and loss and highlighted the importance of considering the behavioural context for engagement in fulfilling daily activities in the aftermath of natural disasters among bereaved individuals. Copyright © 2025 The Author(s).