DOI: 10.26650/iujhsr2026-1913115 ISSN: 3149-9724

A Longitudinal Study of Acute Stress Symptoms, Sleep Quality, and Subsequent PTSD Symptom Severity in Adolescents in Residential Care after an Earthquake

Muhammed Erbay, Pınar Karan, Ali Karayağmurlu, Nusret Soylu
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Background: Earthquakes are among the most destructive natural disasters and may lead to substantial psychologic consequences in children and adolescents. Although acute stress symptoms have traditionally been considered potential indicators of later posttraumatic stress responses, evidence regarding their association with subsequent PTSD symptoms remains inconsistent. In addition, sleep disturbances have increasingly been recognized as an important factor in trauma-related psychopathology. This study aimed to examine the associations of acute stress symptoms and sleep quality with subsequent PTSD symptom severity among adolescents in residential care following a natural disaster.Methods: The study included 41 adolescents aged 10-17 years diagnosed with ASD in residential care. Assessments were conducted within one month following the earthquake, with follow-ups at one and three months. Measures included the National Stressful Events Survey Acute Stress Disorder Short Scale (NESSS), the Children’s PTSD Reaction Index (CPTSD-RI), the Sleep Quality Scale (SQS), and the Schedule for Affective Disorders and Schizophrenia for School-Age Children. Statistical analyses were conducted using complete-case data from participants who completed all relevant assessments (n = 33).Results: ASD symptom severity was not significantly associated with PTSD symptom severity at either the 1-month follow-up (r = .22, p = .225) or 3-month follow-up (r = .12, p = .489). In contrast, sleep quality showed a strong negative correlation with PTSD symptoms at both time points (r =.64, p < .001; r =.57, p = .001, respectively). Regression analyses demonstrated that sleep quality was significantly associated with PTSD symptom severity at both the one-month (B = 4.40 p < .001) and three-month follow-ups (B = 3.20, p < .001), whereas ASD symptom severity and the ASD × sleep quality interaction were not significantly associated with PTSD symptom severity. All correlation and regression analyses were conducted on participants with complete data for the relevant variables.Conclusion: Acute stress symptom severity was not associated with subsequent PTSD symptom severity in this sample of adolescents in residential care following a natural disaster. In contrast, poorer sleep quality was consistently associated with greater PTSD symptom severity across follow-up assessments. These findings indicate that sleep quality may represent a clinically relevant marker of posttraumatic stress responses and a potential target for early intervention among trauma-exposed youth in residential care.

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