Secondary traumatic stress and psychological distress among responders to the 2023 Kahramanmaraş earthquakes: a systematic review and meta-analysis

BackgroundThe Kahramanmaraş earthquakes on February 6, 2023 prompted one of the largest disaster response operations on record. Responders faced repeated exposure to death and distress, and locally recruited personnel were often disaster-affected themselves. Existing syntheses of this event excluded responders.MethodsFollowing PRISMA 2020 (PROSPERO-registered), seven Turkish and English sources were searched for studies on psychological outcomes among responders to these earthquakes. The primary outcome was secondary traumatic stress. Outcomes were pooled in random-effects models (restricted maximum likelihood, Hartung–Knapp–Sidik–Jonkman adjustment); prevalence after Freeman–Tukey transformation. Personal exposure was a pre-specified moderator.ResultsTwenty-one studies were included; 13 quantitative studies contributed data on 2,894 responders. The pooled Secondary Traumatic Stress Scale total across four studies was 44.37 (95% CI 32.25–56.50; I2 = 99.2%). Heterogeneity appeared partly attributable to personal exposure: personnel resident in or affected by the disaster zone scored 48.80 against 38.40 among deployed personnel, an imprecisely estimated difference of 10.40 points (95% CI 1.57–19.23), with τ2 falling from 46.96 to 8.22 among deployed personnel. Pooled prevalence of probable post-traumatic stress disorder across three studies was 14.5% (8.5–21.5). Within the largest sample, personal exposure predicted secondary traumatic stress in graded fashion: physical injury Hedges’ g = 0.99, home destruction g = 0.70, bereavement g = 0.41.ConclusionWhether the responder was also a victim was the most consistent modifier of outcome. Its direction was consistent, but its magnitude was imprecise and possibly small. Task allocation and post-deployment monitoring should be organized around personal exposure rather than professional role alone.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/view/CRD420261289019, identifier CRD420261289019.