Background: The psychological impact of disasters extends beyond directly exposed populations to those indirectly affected through close social networks. Sex is a critical factor of post-trauma outcomes, yet its role in shaping the mental health of indirectly exposed individuals remains underexplored.
Objective: This study investigates sex-based disparities in psychosocial distress among a cohort remotely exposed to a major earthquake.
Methods: Approximately 3 months after the 2023 Kahramanmaras earthquakes, 129 Turkish medical students with indirect exposure (e.g. via affected relatives or close social circles) took part in this cross-sectional study, completing a structured anxiety survey and a self-report form. The self-report form assessed academic stress, health behaviors (smoking, alcohol use, exercise, and nutrition status), and lifestyle factors.
Results: After Bonferroni correction, no variable remained statistically significant. However, using the Benjamini-Hochberg false discovery rate procedure, peer bullying was associated with sex (χ2(3) = 13.581, p_FDR = .046, Cramer's V = 0.324). All other chi-square tests were nonsignificant under both correction methods.
Conclusion: After rigorous correction, sex differences were largely attenuated. Peer bullying showed a possible association under FDR, but not under Bonferroni, suggesting the need for larger confirmatory studies.
Keywords: Anxiety; earthquake psychology; earthquake risk factors; post-disaster health; sex differences.
Main findings: After Benjamini–Hochberg correction (but not Bonferroni), peer bullying was associated with sex among indirectly exposed medical students; all other variables showed no robust sex differences under either correction.Added knowledge: This study demonstrates that indirect disaster exposure through social networks can produce measurable psychological distress, but sex-specific patterns are subtle and largely attenuated after multiplicity adjustment. The most reliable sex-related marker was peer bullying, though this finding did not survive the most stringent (Bonferroni) correction.Global health impact for policy and action: Post-disaster mental health frameworks should extend screening and support to remotely affected healthcare trainees. While sex-sensitive approaches remain important, they should prioritize interpersonal stressors such as peer bullying and be applied cautiously, as many initially observed sex disparities may not be robust; larger confirmatory studies are needed to guide resource allocation and targeted interventions.