The Interplay of Post-Traumatic Stress Symptoms, Psychological Resilience, and Mother–Infant Attachment in Predicting Postpartum Depression After Earthquakes

Abstract

This study investigates the complex predictors of postpartum depression (PPD) among women affected by the 2023 Kahramanmaraş earthquakes, focusing on the roles of post-traumatic stress symptoms (PTSS), psychological resilience, and mother–infant attachment. A cross-sectional study of 270 postpartum women utilized measures of PTSS (Impact of Event Scale–Revised [IES-R]), PPD (Edinburgh Postnatal Depression Scale [EPDS]), psychological resilience (Brief Psychological Resilience Scale [BPRS]), and mother–infant attachment (Mother-Infant Attachment Scale [MIAS]). Initial analyses showed that disaster-related exposure (e.g., following news and losing relatives) was significantly associated with PTSS severity. Hierarchical regression analyses demonstrated that PTSS was a significant positive predictor of PPD. Crucially, psychological resilience was found not only to be a direct negative predictor of PPD but also a significant moderator, weakening the positive relationship between PTSS and PPD. Furthermore, mother–infant attachment was a significant independent negative predictor of PPD, contributing to the variance beyond trauma and resilience. The findings confirm that in a post-disaster context, PTSS is a major risk factor for PPD, while psychological resilience serves a critical buffering function, and a strong mother–infant bond offers unique protection. These results underscore the necessity for integrated interventions that address trauma, foster resilience, and support the mother–infant relationship to mitigate PPD in vulnerable populations.