Post-traumatic cognitions, death anxiety, and coping mechanisms in patients with major depression disorder affected by a natural disaster: A mediatory model study

Background: In this study, it was focused not on mental disorders that arise after a natural disaster, but on how psychiatric patients diagnosed with mental disorders were affected by the earthquake. Objective: This study was aimed at investigating the relationship between death anxiety, one of the subheadings of Terror Management Theory, and post-traumatic cognitions and coping strategies in individuals diagnosed with Major Depressive Disorder (MDD) after a natural disaster. Method: This cross-sectional, descriptive, and correlational study was conducted in the psychiatry outpatient clinic of a tertiary hospital in Adıyaman, one of the provinces affected by the February 6, 2023 earthquake in Turkey between February 2024 and May 2024. The study sample consisted of 75 patients diagnosed with Major Depressive Disorder who were affected by the earthquake. The data of the study were collected with the Posttraumatic Cognitions Inventory, Thorson-Powell’s Death Anxiety Scale, and Strategies of Coping with Earthquake Stress Scale using the face-to-face intervention technique. Results: In the study, while a negative and significant correlation was determined between the positive reappraisal levels of the patients with Major Depressive Disorder and their negative cognitions about themselves ( r = −.321, p = .005), a significant and negative correlation was determined between their positive reappraisal coping mechanism and post-traumatic cognitions ( r = −.329, p = .001). In the mediation model analysis, it was concluded that death anxiety played a mediating role in the relationship between post-traumatic cognitions and coping with earthquake stress (β = −.0442, p = .0061). Conclusion: It was determined that as the positive reappraisal levels of the patients with Major Depressive Disorder decreased after the trauma they experienced, their negative cognitions about themselves and their post-traumatic negative cognitions increased. It was also determined that post-traumatic cognitions increased death anxiety, which negatively affected individuals’ ability to cope with the earthquake stress.