Post-traumatic stress disorder and prolonged grief disorder among adolescents after the cianjur earthquake: prevalence and mental health implications

Abstract

The Cianjur earthquake on November 21, 2022, caused severe psychological impacts, particularly among adolescents who experienced significant loss or direct exposure to the disaster. This study aimed to analyze the prevalence of Post-Traumatic Stress Disorder (PTSD) and Prolonged Grief Disorder (PGD), and to examine their respective effects on the mental health of adolescent disaster survivors. The research employed a descriptive and correlational quantitative design using a survey approach. A total of 551 adolescents aged 13–17 were selected through purposive sampling based on their exposure to the disaster’s impact. Three instruments were used to collect data: the PTSD Checklist for DSM-5 (PCL-5) to assess post-disaster trauma symptoms; the PGD-13-R to measure prolonged grief severity; and the Mental Health Continuum-Short Form (MHC-SF) to evaluate emotional, psychological, and social well-being. Data were analyzed using descriptive statistics, t-tests, ANOVA, Pearson correlations, and multiple linear regression. Results showed that 18.5% of respondents met the criteria for PTSD and 6.9% for PGD. Regression analysis indicated that PTSD had a significant negative impact on mental health (β = –0.250; p < 0.001), while PGD was not a significant predictor (β = 0.046; p = 0.312). These findings suggest that post-disaster trauma contributes more substantially to mental health deterioration than prolonged grief. Therefore, evidence-based interventions such as Ego State Therapy are recommended to address PTSD symptoms effectively among adolescents affected by the earthquake.

Keywords
  • Post-Traumatic Stress Disorder (PTSD)
  • Prolonged Grief Disorder (PGD)
  • mental health
  • adolescents
  • Cianjur earthquake
References
  1. Alves, A. C., Leitão, M., Sani, A. I., & Moreira, D. (2024). Impact of sexual abuse on post-traumatic stress disorder in children and adolescents: A systematic review. Social Sciences, 13(4), 189. https://doi.org/10.3390/socsci13040189
  2. Asyraf, M. Q., Isti'adah, F. N. L., & Sugara, G. S. (2024). Ego state counseling to increase gender awareness in LGBT adolescents. Jurnal Konseling dan Pendidikan, 12(4), 165-185. https://doi.org/10.29210/1128600
  3. Azizah, M. A. N., Sugara, G. S., & Rahimsyah, A. P. (2024). Counseling for Victims of Dating Violence with Emotional Freedom Technique: Single Case Research Design. Jurnal Konseling dan Pendidikan, 12(4), 68-84. https://doi.org/10.29210/1127100
  4. Badan Nasional Penanggulangan Bencana. (2022, Desember 4). Update Korban Meninggal Dunia Pasca Gempabumi Cianjur 321 Orang. BNPB. https://www.bnpb.go.id/berita/-update-korban-meninggal-dunia-pasca-gempabumi-cianjur-321-orang-
  5. Barboza, J., Seedall, R., Hooghe, A., Kaplow, J., & Bradshaw, S. (2025). Forming our grief rhythm: The relational window of tolerance for bereaved parents. Family Process, 64(1), e13048. https://doi.org/10.1111/famp.13048
  6. Bartlett, J. D., & Smith, S. (2019). The role of early care and education in addressing early childhood trauma. American journal of community psychology, 64(3-4), 359-372. https://doi.org/10.1002/ajcp.12380
  7. Boelen, P. A., & Smid, G. E. (2017). Disturbed grief: Prolonged grief disorder and persistent complex bereavement disorder. BMJ, 357, j2016. https://doi.org/10.1136/bmj.j2016
  8. Bonanno, G. A., & Malgaroli, M. (2020). Trajectories of grief: Comparing symptoms from the DSM-5 and ICD-11 diagnoses. Depression and Anxiety, 36(6), 564–572. https://doi.org/10.1002/da.22902
  9. Bonanno, G. A., Chen, S., Bagrodia, R., & Galatzer-Levy, I. R. (2024). Resilience and disaster: flexible adaptation in the face of uncertain threat. Annual review of psychology, 75(1), 573-599. https://doi.org/10.1146/annurev-psych-011123-024224
  10. Cacciatore, J., Thieleman, K., Fretts, R., & Jackson, L. B. (2021). What is good grief support? Exploring the actors and actions in social support after traumatic grief. PLOS ONE, 16(5), e0252324. https://doi.org/10.1371/journal.pone.0252324
  11. Cacciatore, J., Thieleman, K., Fretts, R., & Jackson, L. B. (2021). What is good grief support? Exploring the actors and actions in social support after traumatic grief. PloS one, 16(5), e0252324. https://doi.org/10.1371/journal.pone.0252324
  12. Claxton, J., Vibhakar, V., Allen, L., Finn, J., Gee, B., & Meiser-Stedman, R. (2021). Risk factors for depression in trauma-exposed children and adolescents: A systematic review and meta-analysis. Journal of affective disorders reports, 5, 100150. https://doi.org/10.1016/j.jadr.2021.100150
  13. Comtesse, H., Ertl, V., Hengst, S. M., Rosner, R., & Smid, G. E. (2021). Ecological grief as a response to environmental change: a mental health risk or functional response?. International journal of environmental research and public health, 18(2), 734. https://doi.org/10.3390/ijerph18020734
  14. Cruz, D., Lichten, M., Berg, K., & George, P. (2022). Developmental trauma: Conceptual framework, associated risks and comorbidities, and evaluation and treatment. Frontiers in psychiatry, 13, 800687. https://doi.org/10.3389/fpsyt.2022.800687
  15. Cunningham, J., Shevlin, M., Cerda, C., & McElroy, E. (2025). ICD-11 Prolonged Grief Disorder, Physical Health, and Somatic Problems: A Systematic Review. Clinical Psychology in Europe, 7(1), e14351. https://doi.org/10.32872/cpe.14351
  16. Deperrois, R., & Combalbert, N. (2022). Links between cognitive distortions and cognitive emotion regulation strategies in non-clinical young adulthood. Cognitive Processing, 23(1), 69-77. https://doi.org/10.1007/s10339-021-01057-y
  17. Diaz, K., Staffileno, B. A., & Hamilton, R. (2021). Nursing student experiences in turmoil: A year of the pandemic and social strife during final clinical rotations. Journal of Professional Nursing, 37(5), 978-984. https://doi.org/10.1016/j.profnurs.2021.07.019
  18. Doba, K., Saloppé, X., Choukri, F., & Nandrino, J. L. (2022). Childhood trauma and posttraumatic stress symptoms in adolescents and young adults: The mediating role of mentalizing and emotion regulation strategies. Child Abuse & Neglect, 132, 105815. https://doi.org/10.1016/j.chiabu.2022.105815
  19. Eisma, M. C., Janshen, A., & de Haan, N. (2025). Rumination, Hopelessness, Behavioural Avoidance and Psychopathology Symptoms After Bereavement: Serial Mediation Analyses. Clinical Psychology & Psychotherapy, 32(2), e70053. https://doi.org/10.1002/cpp.70053
  20. Fatimah, S. D. D., Isti'adah, F. N., & Sulistiana, D. (2025). Adaptasi Alat Ukur Mental Health Continuum-Short Form (MHC-SF) Untuk Siswa SMA Sederajat. Jurnal Bimbingan Konseling dan Psikologi, 5(1), 11-26. https://doi.org/10.56185/jubikops.v5i1.904
  21. Glawing, C., Karlsson, I., Kylin, C., & Nilsson, J. (2024). Work‐related stress, stress reactions and coping strategies in ambulance nurses: A qualitative interview study. Journal of advanced nursing, 80(2), 538-549. https://doi.org/10.1111/jan.15819
  22. Gomis-Pomares, A., Lacomba-Trejo, L., & Villanueva, L. (2025). Using Avoidant Emotion-Focused Coping and being a Woman with Adverse Childhood Experiences as the Worst-Case Scenario for Internalising Problems. Journal of Child & Adolescent Trauma, 1-11. https://doi.org/10.1007/s40653-025-00688-z
  23. Guldin, M. B., & Leget, C. (2024). The integrated process model of loss and grief-An interprofessional understanding. Death Studies, 48(7), 738-752. https://doi.org/10.1080/07481187.2023.2272960
  24. Hardt, M. M., Williams, J. L., & Jobe‐Shields, L. (2022). The role of experiential avoidance in the relationship between traumatic distress and yearning in sudden and unexpected bereavement. Journal of Clinical Psychology, 78(4), 559-569. https://doi.org/10.1002/jclp.23261
  25. Herzog, P., Barth, C., Rief, W., Brakemeier, E. L., & Kube, T. (2022). How expectations shape the formation of intrusive memories: An experimental study using the trauma film paradigm. Cognitive Therapy and Research, 46(4), 809-826. https://doi.org/10.1007/s10608-022-10290-4
  26. Howie, J. H. (2022). Determinants of Perceived Social Support in Individuals with Serious Mental Illness: A Secondary Analysis. University of Missouri-Kansas City.
  27. Hunafa, S., Sugara, G. S., & Muhajirin, M. (2024). Enhancing resilience in sexual harassment victims using narrative exposure therapy: a single case research. Jurnal Konseling dan Pendidikan, 12(3), 139-155. https://doi.org/10.29210/1121000
  28. Jellestad, L., Vital, N. A., Malamud, J., Taeymans, J., & Mueller-Pfeiffer, C. (2021). Functional impairment in posttraumatic stress disorder: A systematic review and meta-analysis. Journal of psychiatric research, 136, 14-22. https://doi.org/10.1016/j.jpsychires.2021.01.039
  29. Johnson, K. F., Ieva, K., & Byrd, J. (2022). Introduction to the Special Issue on School Counselors Addressing Education, Health, Wellness, and Trauma Disparities. Professional School Counseling, 26(1b). https://doi.org/10.1177/2156759X221105451
  30. Kataoka, S., Langley, A., Wong, M., Baweja, S., & Stein, B. (2012). Responding to students with PTSD in schools. Child and adolescent psychiatric clinics of North America, 21(1), 119. https://doi.org/10.1016/j.chc.2011.08.009
  31. Keyes, C. L. (2002). From languishing to flourishing in life. Journal of Health and Social Research, 43, 207-222. https://doi.org/10.2307/3090197
  32. Lehner, M., Skórzewska, A., & Wisłowska-Stanek, A. (2021). Sex-related predisposition to post-traumatic stress disorder development—the role of neuropeptides. International journal of environmental research and public health, 19(1), 314. https://doi.org/10.3390/ijerph19010314
  33. Makwana, N. (2019). Disaster and Its Impact on Mental Health: A Narrative Review. Journal of Family Medicine and Primary Care, 8(10), 3090. https://doi.org/10.4103/jfmpc.jfmpc_893_19
  34. McKay, M. T., Cannon, M., Chambers, D., Conroy, R. M., Coughlan, H., Dodd, P., ... & Clarke, M. C. (2021). Childhood trauma and adult mental disorder: A systematic review and meta‐analysis of longitudinal cohort studies. Acta Psychiatrica Scandinavica, 143(3), 189-205. https://doi.org/10.1111/acps.13268
  35. Merino, M., Tornero-Aguilera, J. F., Rubio-Zarapuz, A., Villanueva-Tobaldo, C. V., Martín-Rodríguez, A., & Clemente-Suárez, V. J. (2024). Body Perceptions and Psychological Well-Being: A Review of the Impact of Social Media and Physical Measurements on Self-Esteem and Mental Health with a Focus on Body Image Satisfaction and Its Relationship with Cultural and Gender Factors. Healthcare, 12(14), 1396. https://doi.org/10.3390/healthcare12141396
  36. Mikulincer, M., & Shaver, P. R. (2022). An attachment perspective on loss and grief. Current opinion in psychology, 45, 101283. https://doi.org/10.1016/j.copsyc.2021.11.003
  37. Mortazavi, S. S., Assari, S., Alimohamadi, A., Rafiee, M., & Shati, M. (2020). Fear, loss, social isolation, and incomplete grief due to COVID-19: a recipe for a psychiatric pandemic. Basic and clinical neuroscience, 11(2), 225. https://doi.org/10.32598/bcn.11.covid19.2549.1
  38. Muhtadi, H. F., & Ahman, A. (2024). Adaptation of the PG-13-R Instrument to Measure Prolonged Grief Disorder in Adolescents. Buletin Konseling Inovatif, 4(2), 85-90. https://doi.org/10.17977/um059v4i22024p85-90
  39. Mukherjee, U., Sehar, U., Brownell, M., & Reddy, P. H. (2024). Mechanisms, consequences and role of interventions for sleep deprivation: Focus on mild cognitive impairment and Alzheimer’s disease in elderly. Ageing Research Reviews, 100, 102457. https://doi.org/10.1016/j.arr.2024.102457
  40. Nawangsih, E. (2014). Play Therapy Untuk Anak-Anak Korban Bencana Alam yang Mengalami Trauma (Post Traumatic Stress Disorder/PTSD). Psympathic: Jurnal Ilmiah Psikologi, 1(2), 164-178. https://doi.org/10.15575/psy.v1i2.475
  41. Neuner, F., Schauer, M., Karunakara, U., Klaschik, C., Robert, C., & Elbert, T. (2015). Psychological trauma and evidence for enhanced vulnerability for posttraumatic stress disorder through previous trauma among West Nile refugees. BMC Psychiatry, 4, 34. https://doi.org/10.1186/1471-244X-4-34
  42. Pinquart, M. (2020). Posttraumatic stress symptoms and disorders in children and adolescents with chronic physical illnesses: a meta-analysis. Journal of Child & Adolescent Trauma, 13(1), 1-10. https://doi.org/10.1007/s40653-018-0222-z
  43. Pinto, R. J., Morgado, D., Reis, S., Monteiro, R., Levendosky, A., & Jongenelen, I. (2017). When social support is not enough: Trauma and PTSD symptoms in a risk-sample of adolescents. Child abuse & neglect, 72, 110-119. https://doi.org/10.1016/j.chiabu.2017.07.017
  44. Prigerson, H. G., Boelen, P. A., Xu, J., Smith, K. V., & Maciejewski, P. K. (2021). Validation of the new DSM-5-TR criteria for prolonged grief disorder and the PG-13-Revised (PG-13-R) scale. World Psychiatry, 20(1), 96–106. https://doi.org/10.1002/wps.20823
  45. Punski‐Hoogervorst, J. L., Engel‐Yeger, B., & Avital, A. (2023). Attention deficits as a key player in the symptomatology of posttraumatic stress disorder: A review. Journal of neuroscience research, 101(7), 1068-1085. https://doi.org/10.1002/jnr.25177
  46. Rachma, H., & Febrianti, T. (2021). Social Determinants of Risk Post Traumatic Stress Disorder (PTSD) after The Sunda Strait Tsunami Disaster. Jurnal Kesehatan, 12(2), 280–286. https://doi.org/10.26630/jk.v12i2.2148
  47. Rahma, A. (2018). Implementasi program pengurangan risiko bencana (PRB) melalui pendidikan formal. Jurnal Varidika, 30(1), 1-11. https://doi.org/10.23917/varidika.v30i1.6537
  48. Rahmadian, A. A., LN, S., Rusmana, N., & Downs, L. L. (2016). Prevalensi PTSD dan Karakteristik Gejala Stres Pascatrauma pada Anak dan Remaja Korban Bencana Alam. Edusentris, 3(1), 1-17
  49. Reed, G. M., First, M. B., Billieux, J., Cloitre, M., Briken, P., Achab, S., ... & Bryant, R. A. (2022). Emerging experience with selected new categories in the ICD‐11: Complex PTSD, prolonged grief disorder, gaming disorder, and compulsive sexual behaviour disorder. World Psychiatry, 21(2), 189-213. http://dx.doi.org/10.1002/wps.20960
  50. Regel, S., & Joseph, S. (2017). Post-traumatic stress. Oxford University Press.
  51. Rønning, L., Shor, R., Anyan, F., Hjemdal, O., Jakob Bøe, H., Dempsey, C. L., & Espetvedt Nordstrand, A. (2025). The prevalence of sexual harassment and bullying among Norwegian Afghanistan veterans: does workplace harassment disproportionately impact the mental health and life satisfaction of female soldiers?. Journal of interpersonal violence, 40(1-2), 465-488. https://doi.org/10.1177/08862605241248432
  52. Salma, S., & Hidayat, R. (2016). Pengembangan Instrumen Asesmen untuk Mendeteksi Pengalaman Traumatis Penyintas Erupsi Gunung Berapi. Jurnal Psikologi, 15(1), 1-10. https://doi.org/10.14710/jpu.15.1.1-10
  53. Shear, M. K., Simon, N., Wall, M., Zisook, S., Neimeyer, R., Duan, N., ... & Keshaviah, A. (2011). Complicated grief and related bereavement issues for DSM-5. Depression and Anxiety, 28(2), 103–117. https://doi.org/10.1002/da.20780
  54. Sirrine, E. H., Kliner, O., & Gollery, T. J. (2023). College student experiences of grief and loss amid the COVID-19 global pandemic. OMEGA-Journal of Death and Dying, 87(3), 745-764. https://doi.org/10.1177/00302228211027461
  55. Smith, K. V., Wild, J., & Ehlers, A. (2024). From loss to disorder: The influence of maladaptive coping on prolonged grief. Psychiatry research, 339, 116060. https://doi.org/10.1016/j.psychres.2024.116060
  56. Stroebe, M., Schut, H., & Stroebe, W. (2017). Attachment in coping with bereavement: A theoretical integration. Review of general psychology, 9(1), 48-66. https://doi.org/10.1037/1089-2680.9.1.48
  57. Sugara, G. S. (2017). Konseling Traumatik Menggunakan Ego State Therapy (Traumatic Counseling Using Ego State Therapy). PROCEEDING IAIN Batusangkar, 1(1), 160-170.
  58. Sugara, G. S., Yulianingsih, Y., Isti’adah, F. N., Adiputra, S., Muhajirin, M., Fadli, R. P., & Ifdil, I. (2021). Ego state therapy for the treatment of grief and loss after death. Addictive Disorders & Their Treatment, 20(3), 151-158. https://doi.org/10.1097/ADT.0000000000000215
  59. Sugara, G. S., Muhajirin, M., & Rahimsyah, A.P. (2024). Manual adaptasi PCL-5 Indonesia version. [Manual]. Department of Guidance and Counseling. Universitas Muhammadiyah Tasikmalaya
  60. Sugara, G. S., Masfufah, D. D., Arumsari, C., Muhajirin, M., & Rahimsyah, A. P. (2025). Effect of Dialectical Behavior Therapy on Psychological Well-Being with Adolescent Body Image Dissatisfaction. Journal of Contemporary Psychotherapy, 1-11. https://doi.org/10.1007/s10879-025-09673-x
  61. Tamir, T. T., Yimer, B., Gezahgn, S. A., Mekonnen, F. A., Teshome, D. F., & Angaw, D. A. (2024). Prevalence and associated factors of post-traumatic stress disorder in pediatric populations in Africa: a systematic review and meta-analysis. BMC psychiatry, 24(1), 643. https://doi.org/10.1186/s12888-024-06106-2
  62. Weathers, F.W., Litz, B.T., Keane, T.M., Palmieri, P.A., Marx, B.P., & Schnurr, P.P. (2013). The PTSD Checklist for DSM-5 (PCL-5). Scale available from the National Center for PTSD at www.ptsd.va.gov.
  63. Williamson, V., Creswell, C., Butler, I., Christie, H., & Halligan, S. L. (2019). Parental experiences of supporting children with clinically significant post-traumatic distress: A qualitative study of families accessing psychological services. Journal of Child & Adolescent Trauma, 12, 61-72. https://doi.org/10.1007/s40653-017-0158-8
  64. Worden, J. W. (2018). Grief counseling and grief therapy: A handbook for the mental health practitioner. springer publishing Company.