Coping and PTSD symptoms in Pakistani earthquake survivors: Purpose in life, religious coping and social support

Background: High rates of posttraumatic stress disorder (PTSD) and depressive symptoms have been observed in earthquake survivors from less developed areas of the world. This study, conducted three years after the 2005 Pakistan earthquake, aimed to identify potentially protective psychosocial factors associated with lower PTSD and depressive symptom levels. Methods: Adult earthquake survivors (N=200) were recruited from affected areas in Northwestern Pakistan and completed self-report questionnaires measuring PTSD and depressive symptoms, positive and negative affect, and four psychosocial variables (purpose in life, positive and negative religious coping, and social support). Results: Sixty five percent of participants met criteria for probable PTSD. Purpose in life was associated with lower symptom levels and higher positive emotions. A form of negative religious coping (feeling punished by God for one's sins or lack of spirituality) was associated with higher symptom levels and negative emotions. Higher perceived social support was associated with higher positive emotions. Other significant relationships were also identified. Limitations: Limitations include the recruitment of a sample of convenience, a modest sample size, and the cross-sectional nature of the study. Conclusions: Findings suggest that some psychosocial factors may be protective across cultures, and that the use of negative religious coping is associated with poorer mental health outcomes in earthquake survivors. This study can inform preventive and treatment interventions for earthquake survivors in Pakistan and other less industrialized countries as they develop mental health care services.