INTRODUCTION
According to Tiemey (1989), disasters are events that occur relatively suddenly in a certain geographical region, create collective stress, cause a certain amount of loss and disrupt the life of the society. Ergünay (1996) disasters; causes physical, economic and social losses for people, affects communities by stopping or interrupting normal life and human activities; It defines events as events that can originate from natural, technological and human factors. According to Karancı (2007), earthquakes, which are among disasters, are actually natural events. For this natural event to turn into a disaster, it must cause losses and disrupt life (cited in Öztürk, 2013). In their study, Çakır et al. (2006) examined disasters; They defined disasters as natural events that cause loss of life and property and harm people in a broad sense, and they stated that the characteristics of the disaster are that it is natural, causes loss of life and property, occurs in a very short time, and cannot be prevented by people after it starts.
Earthquakes are one of the leading natural disasters that remain in the consciousness of societies and still threaten them. Atalay (1998) defines earthquakes as ground or crustal movements, the duration of which is expressed in seconds, as tremors caused by the breaking of the crust or the energy accumulated in magma coming to the surface from weak areas of the earth, and divides earthquakes into three according to their causes. These; tectonic earthquakes, volcanic earthquakes and depression earthquakes. 90% of the earthquakes seen in the world are of tectonic origin. Turkey is located on the Alpine-Himalayan (Mediterranean) Seismic Zone, which is one of the world's three important seismic zones (Pacific Ocean Seismic Zone, Alpine-Himalayan Seismic Zone and Atlantic Ocean Seismic Zone). Almost all of the earthquakes that occur in Turkey are concentrated in three main zones. These are the Northern Anatolian Fault Line, the Southeastern Anatolian Fault Line and the Western Anatolian Fault Line, which includes the depression areas in the Aegean region (cited in Karakuş, 2013).
There are other studies that define earthquake differently. ''Earthquake is a natural disaster that causes physical destruction and death and can create serious psychological problems for survivors'' (cited in Nakajima, 2012), ''Earthquakes affect living and non-living things. some on assets It may cause harmful effects (Şahin and Sipahioğlu, 2002). While Watt (2002) defines these damages as damage to elements that have direct material value, Köknel (1987) defines them as "short and long-term psychological disorders due to the earthquake phenomenon settling into people's subconscious" (Öztürk, 2013).
Earthquakes are life-threatening, previously unknown and uncontrollable natural disasters. They cause large-scale destruction in the lives of thousands of people by causing them to be injured, suddenly lose their loved ones and property, become homeless and displaced (cited in Önsüz et al., 2009). In line with this information, it becomes clear that earthquakes have short and long-term effects on human life (Öztürk, 2013). Natural disasters such as earthquakes, which cause great harm to people, remain in the memory of societies not only at the time they occurred, but also afterwards. Research shows that people who are exposed to such natural disasters cannot recover from the effects of the event even years later and experience psychological problems (cited in Karakuş, 2013).
Studies indicate that the characteristics of the disaster are also related to the psychological consequences. Not expecting the disaster, being unprepared, the area and intensity of the disaster (its spread to the geographical society in general) are all positively related to the difficulties experienced by the victims (cited in Erkan, 2010).
TRAUMA
'' Trauma according to DSM-IV diagnostic criteria; It is defined as the individual experiencing or witnessing a life-threatening event or the danger of actual death, serious injury, or loss of physical integrity, and the person reacts to this situation with extreme fear, helplessness, and terror (cited in Bilici et al., 2013).
According to Herman (1992), psychological trauma is a pain of powerlessness. At the time of trauma, the individual feels helpless and in such situations, the normal behavioral system that provides control, connection and a sense of meaning is disrupted (Tanhan and Kardaş, 2014).
Events that cause trauma and the psychological consequences of these events are a matter of great importance. Many researchers include these issues in their studies. ir. Issues such as earthquakes, war, accidents, sexual abuse are issues that create traumatic effects on people. It is of great importance to determine people's reactions to these traumatic events and to develop appropriate intervention programs. “Traumatic experiences are extraordinary and disrupt the individual's normal adaptation to life. “Unlike ordinary misfortunes, traumatic events generally involve threats to life or physical integrity or are closely related to violence and death” (cited in Tanhan and Kardaş, 2014). Although the changes in attitude and behavior that natural disasters cause in people are shaped according to personal characteristics, they are also affected by the current conditions. Research in the field of social psychology emphasizes that an individual's attitudes and behaviors can be two-dimensional. The first is the idea that behavior develops based on personal characteristics, and the second is the idea that attitudes and behavior are formed based on environmental conditions (as cited in Yılmaz and Işıtan, 2012).
According to Gershuny and Thayer (1999), a traumatic situation is a personal experience. Two people may have experienced the same event, but one of them may find the event traumatic while the other may not find it traumatic. According to Everstine and Everstine (1993), the cause of trauma may be injury due to earthquake experience, however, factors that are involved in the event and complicate the situation can be considered as the secondary cause of trauma. These causes may not cause trauma on their own. For example, if a person injured in an earthquake is kept waiting in the emergency room, the waiting itself is not a traumatic cause. But this situation may cause some negative emotions (cited in İşmen, 2006).
Trauma that occurs after a natural disaster differs from other traumas in three ways:
1. After a natural disaster, consequences that cause stress occur (destruction of the house and neighborhood, loss of life or disability, etc.).
2.The effects of trauma occurring after a natural disaster can be long-term.
3. The psychological and physical trauma that occurs after a natural disaster has the characteristics of "mass victimization". Applications made to hospitals in the acute period after the disaster are naturally mostly related to physical conditions. It tastes. Bar-Doyan et al., (2000) ; Holpern et al.,
(2003). It is seen that the psychological part of the experiences gains more importance after physical recovery begins (İşmen, 2006).
As mentioned above, disasters; These are events that create both physical and psychological trauma on individuals. There is no one who has seen a disaster but has not been affected. Even if the individual survives the disaster with minimal physical damage, the psychological trauma he or she experiences is not to be underestimated, and the resulting symptoms may appear even years later (cited in Çakmak et al., 2010).
Post-Traumatic Stress Disorder (PTSD)
“Actual death or threat of death, serious injury, encountering a situation that threatens the individual's physical integrity, such may occur after severe traumatic events such as witnessing a situation; Symptoms such as re-experiencing the event, unwanted thoughts and images coming to mind, avoidance and excessive physiological arousal are diagnosed as post-traumatic stress disorder (PTSD) (cited in Tanhan and Kardaş, 2014).
PTSD is a condition of characteristic symptoms that develop after exposure to natural disasters such as earthquakes, storms, hurricanes, tornadoes and floods, and other distressing traumatic events. PTSD describes psychiatric symptoms that include emotional, cognitive, behavioral and social disorders that develop after an event that is outside of normal experience and can be a source of distress for anyone who goes through this experience. PTSD begins upon encountering the trauma or within the next few years, and symptoms increase and plateau over the next few years. Symptoms may fluctuate over time and intensify during stressful periods. Approximately 30% of patients show complete recovery, 60% have mild-moderate symptoms, and 10% have symptoms that remain unchanged or worsen. It is common for those who benefit from treatment to have symptoms reappear years later if they encounter a serious stressor (Önsüz et al. 2009).
İşmen (2006), psychological effects of earthquake experience:
1. Anger and suppression of emotions
2. Separation anxiety
3. Detachment and passivity
4. Don't hide the truth from children
5. Feeling guilty for being alive
6. Helplessness and great pain
7. Alcohol use
8. Suicide
9. Jealousy/Hostility
10. Distortions are listed as follows.
Most of the studies on conditions accompanying PTSD have found that depression and anxiety are seen at serious rates. Studies have shown that PTSD continues years later. As examples of these studies; In a study by Shore et al. (1986), depression and anxiety symptoms decreased 3 years after the Helen volcanic eruption, while PTSD symptoms continued for many years. Kessler et al. (1995) also stated that 1/3 of people who developed PTSD did not see a decrease in their symptoms even 10 years after the event. In the study of Goenjian et al. (2000), it was determined that people who experienced traumas such as major earthquakes or violence did not experience any relief in their PTSD symptoms even after a period of 1.5 to 4.5 years. In a study conducted after the Armenia earthquake, Goenjian et al. (1994) stated that the impact of the earthquake on people doubled after the earthquake, and therefore, PTSD symptoms continued for many years (Önsüz et al. 2009).
When we look at the reasons for the long-lasting psychological effects of the earthquake; Önsüz et al. (2009), in their study conducted 6 years after the Marmara earthquake, found that the high rate of PTSD was caused by the severity of the Marmara earthquake, the high loss of life and property, the difficulty in living conditions after the earthquake, the frequency of aftershocks, and especially through media outlets. They said that the frequent statements that such a severe earthquake would occur again in the Marmara region may have been effective. At the same time, Armenian et al. (2000-2002) reported that family members, relatives, friends
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