Disaster education: empowering resilience and mitigating PTSD in disaster-prone areas of China

The people of disaster-affected communities are suffering from post-traumatic stress disorder (PTSD) due to the adverse effects of natural disasters. Education about disasters has become a possible strategy for fostering resilience and easing PTSD symptoms. This study intends to investigate the moderating roles of social support and disaster experiences on the relationships between disaster education, psychological resilience, and PTSD in disaster-prone regions of Southwest China. This study used Disaster Education Evaluation Scale, Psychological Resilience Scale (CD-RISC), Social Support Rating Scale (SRSS), event intensity Scale and Post Traumatic Stress Disorder Self-Rating Scale (PTSD-SS), surveyed 712 residents in Yunnan, Guizhou, Sichuan and other areas where natural disasters frequently occur in Southwest China. The research findings indicate that there is a negative association between disaster education and PTSD. The association is influenced by the presence of improved psychological resilience, which acts as a mediator. Additionally, it was discovered that disaster events positively moderated the relationship between psychological resilience and PTSD while social support negatively moderated it. Resilience has a noteworthy role as a substantial mediator, highlighting its crucial function in mitigating the detrimental consequences of catastrophes and amplifying the beneficial outcomes of disaster education. These results imply that building psychological resilience, which might reduce PTSD symptoms in people living in disaster-prone regions, is a critical part of disaster education. The strength of the catastrophic event and social support are other factors that affect how psychological resilience and PTSD are related. The research argues that disaster education is crucial for strengthening community resilience and reducing PTSD symptoms in at-risk areas. To increase psychological resilience and lessen PTSD in high-risk locations, policymakers and disaster management organizations should emphasize disaster education initiatives and strengthen social support network.


Introduction
Disaster education has potential to improve community preparation and response, decrease susceptibility, and boost psychological well-being in disaster-prone locations [1].Disaster education was characterized as education on disaster risk, vulnerability, mitigation, and preparation, which was intended to lessen the negative effects of catastrophes [2].Disaster education was incorporated and recombined into the whole catastrophe cycle as one of the unified and inclusive approaches for avoiding and decreasing disaster-related risk in the Sendai Framework for Disaster Risk Reduction 2015-2030 [3].Education enables people and communities to take preventative action to safeguard themselves and their communities by sharing information about catastrophe risks, warning systems, evacuation methods, and psychological coping mechanisms [4,5].Additionally, disaster education promotes societal cohesiveness and a feeling of shared responsibility, both of which are essential for successful disaster management [6].It serves as a catalyst for building resilience and reducing the detrimental psychological repercussions of disasters, such PTSD [7][8][9].
Numerous research have examined how disaster education might increase resilience [10][11][12][13] and lessen post-traumatic stress disorder (PTSD) symptoms [14][15][16].In order to investigate the impact of disaster education on disaster preparation and PTSD symptoms, North et al [17] results showed that disaster education programs substantially reduced participant PTSD symptoms and disaster readiness.This research emphasizes how education helps people be more resilient to catastrophes on an individual and a communal level.Sakurai et al [5] stressed the value of educational interventions in boosting community preparation, social capital, and adaptive ability in disaster-affected areas.In order to investigate the impact of disaster education on disaster resilience and mental health, Tang et al [18] carried out a systematic review, and found a strong correlation between enhanced disaster resilience and better mental health outcomes and disaster education.The results highlighted the potential of education in reducing the negative psychological consequences of catastrophes and boosting general well-being among impacted communities.The effects of disaster education on community resilience and disaster response were investigated by Zhou et al [8] and found that one risk factor was a lower level of schooling.Women with lower levels of education were more likely to belong to profile groups with higher levels of PTSD than women with higher levels of education.With regard to fostering resilience and reducing PTSD symptoms in disaster-affected communities, these studies emphasized the value of disaster education.The precise moderating functions of social support and disaster experiences are, however, not well understood in the context of China's disaster-prone areas.
Southwest China, which includes the three provinces of Sichuan, Yunnan, and Guizhou, is situated between latitude 21°08′ to 34°19′ north and longitude 97°13′ to 110°12′ east.For example, the 2008 Wenchuan earthquake and the 2013 Lushan earthquake occurred inside the geographical confines of the Longmen Mountain fault zone.The two seismic events resulted in 446,600 and 13,200 fatalities, respectively [19].These areas are located at the connection of the riverside disaster belt and the mountainous disaster belt, making it one of the three major disaster zones in China [19].The natural environment and complex geological structure in this area give rise to various types of natural disasters, including drought and early floods, earthquakes, landslides, torrential rain and floods, forest fires, hail, and winds [20,21].
To accurately assess the relationship between disaster education and post-disaster traumatic stress disorder, this study focuses on the three provinces of Yunnan, Guizhou, and Sichuan in southwest China, which frequently experience natural disasters.By investigating the current state of disaster education among the local population, we aim to understand how disaster education influences the degree of PTSD through psychological resilience.Based on these findings, we will propose feasible suggestions and countermeasures to benefit the public.Despite the rising volume of research on disaster education and its effects on PTSD and resilience, little is known about the precise moderating effects of social support and disaster experiences in China's disaster-prone areas.Few research has assessed the complex relationships between disaster education, psychological resilience, and PTSD in particular geographical settings [14], despite the fact that earlier studies have looked at the general efficacy of disaster education programs.It is essential to comprehend how social support and catastrophic experiences affect the linkages between these factors in order to design efficient treatments that address the particular problems faced by communities in disaster-prone areas.
This study seeks to fill this knowledge vacuum by examining the moderating effects of social support and catastrophic experiences on the associations between disaster education, psychological resilience, and PTSD in disaster-prone areas in Southwest China.The following are the research inquiries driving this investigation: This study's main goal is to investigate the moderating effects of social support and disaster experiences on the connections between disaster education, psychological resilience, and PTSD in disaster-prone areas in Southwest China.This study explores the complex relationship between disaster education, resilience, and posttraumatic stress disorder (PTSD), with a particular focus on the sometimes neglected moderating influences of social support and catastrophic events.The distinctiveness of this research is emphasised by its use of data obtained from certain regions in China that are prone to disasters.Each of these regions is distinguished by its unique cultural, social, and geographical attributes.Numerous scholarly investigations have been conducted to examine the effects of disaster education on mental health outcomes on a worldwide scale.However, the present study brings a novel viewpoint by concentrating specifically on Southwest China.The primary objective of this study is to contribute to the current understanding of the effectiveness of disaster education.The intention is to provide valuable insights that may inform decision-makers, disaster management organisations, and educational institutions in their efforts to enhance community resilience and reduce post-traumatic stress disorder (PTSD) symptoms in places that are particularly vulnerable to disasters.

2.
Literature review and research hypotheses 2.1.Disaster education and its impact on resilience Disaster education, as a vital component of quality education, focuses on enhancing disaster literacy, including knowledge, response skills, and psychological preparedness [5].Existing research has provided various understandings of disaster education, with three key perspectives highlighted in its definition.Firstly, it aims to improve the public's ability to respond to disasters [22].Secondly, it encompasses education related to disasters or comprehensive education utilizing disaster-related materials [23].Thirdly, Kitagawa [1] synthesized relevant literature and classified disaster education into different types based on their attributes.In terms of the timing of disaster education, it can be categorized into two types: conventional [1] and unconventional [24].Chinese scholars predominantly interpret it based on the content of disaster education, which includes sections on disaster knowledge, disaster psychology, disaster response, and disaster experience [25][26][27].Irrespective of the specific definition, all these concepts agree that disaster education aims to enhance people's awareness and ability to cope with disasters [11,28,29].By disseminating knowledge and developing necessary skills, disaster education seeks to minimize the potential negative impact of disasters on individuals and communities [18].Given the uncertainty, diversity, and prolonged nature of disasters, accurate prediction of their occurrence is challenging [30].However, we can minimize the physical and psychological damage inflicted on individuals by improving their coping abilities, both physically and psychologically.
Psychological resilience, which refers to an individual's ability to maintain or quickly restore normal psychological functioning after experiencing adversity, trauma, or significant stress, plays a crucial role in coping [31].The concept of psychological resilience was initially proposed by American psychologist Anthony in the 1987 and is considered a successful response of the 'self-adjustment mechanism' [32].It is influenced by a combination of innate biological traits and external factors acquired throughout life [33].Protective factors play a key role in the development of psychological resilience [34].These factors, such as individual internal intellectual functions, self-efficacy, and beliefs [35,36], as well as external factors like social relationships, living environment, and education, help reduce the negative impact of adverse situations on the general population [37,38].
As the frequency of disasters increases, more scholars have delved into the relationship between education and psychological resilience.Some researchers have highlighted that disaster education is linked to individuals' inherent qualities and their ability to remain calm and composed in the face of disasters [5].For example, Oktari et al [39] demonstrated a significant and sustainable improvement in children's psychological resilience through their engagement in disaster education activities like psychological cultural practices.
Based on previous research, this study posits that disaster education primarily encompasses three aspects: disaster knowledge, disaster psychology, and disaster response.It asserts a positive correlation between disaster education and psychological resilience.Therefore, the study proposes hypothesis 1: H1: Disaster education significantly and positively affects psychological resilience.H1A: Disaster knowledge positively affects psychological resilience.H1B: Disaster psychology positively affects psychological resilience.H1C: Disaster response positively affects resilience.

The relationship between resilience and PTSD
Resilience can be categorized into three main definitions.The consequential definition views resilience as representing well-adapted or well-developed outcomes even in the face of severe threats [38].The competency definition emphasizes the individual trait of mental resilience, indicating the ability to withstand high levels of destructive change while exhibiting minimal negative behaviors [40].The process definition, widely accepted, recognizes psychological resilience as a dynamic development involving individuals' successful adaptation to crises [33].Psychological resilience typically comprises two defining elements: experiencing adversity and effective coping strategies.PTSD refers to the sustained or delayed psychological reactions following exposure to extraordinary stimuli [41].PTSD is a psychological condition that involves intrusion, avoidance, and hyperarousal after a disaster exposure [41].It is a common psychological problem among individuals who have experienced disasters [42].The occurrence and progression of PTSD are influenced by various physical, physiological, and psychosocial factors [16].
Several factors are responsible for the development of PTSD.Basic personal information, such as age and gender, contributes to its likelihood [7].Middle-aged individuals are more prone to developing PTSD, and women have a higher incidence compared to men [43].Personality traits also affect susceptibility, as introverted, neurotic, and impulsive individuals are more susceptible to PTSD [44,45].Education level is another factor, with higher-educated individuals often possessing effective coping strategies, leading to lower PTSD rates.Conversely, lower-educated individuals tend to have negative perceptions of emergencies.Additionally, religious beliefs, the size of the stressor, traumatic experiences, loss of loved ones, physical impairment, biological factors, sociocultural influences, and support systems all impact the development of PTSD [46].
Regarding the connection between psychological resilience and PTSD, extensive research indicates that psychological resilience has a significant negative predictive effect on PTSD [47][48][49].Studies demonstrate that individuals with high psychological resilience hold plentiful psychological resources like life satisfaction, optimism, and tranquility [14,50,51].These individuals can effectively utilize their psychological resources in stressful environments, cope with difficulties, and achieve positive adaptation outcomes [27].Adolescents with good psychological resilience exhibit fewer symptoms of anxiety and depression.Highly resilient individuals are also less likely to develop severe psychological disorders like PTSD following traumatic experiences [52].Furthermore, lacking effective psychological coping styles doubles the risk of developing psychological problems in high-stress situations [53].Building upon previous research, this study proposes hypothesis 2.
H2: Psychological resilience significantly and negatively affects PTSD.

Relationship between disaster education and PTSD
Disaster education plays a crucial role in mitigating the physical and mental damage experienced by individuals.Numerous studies have highlighted the significance of disaster education in restoring the psychological wellbeing of disaster victims [8,14,54,55].The cognition and understanding of traumatic events by individuals act as mediators and direct determinants of stress responses.The occurrence of PTSD in disaster victims is often closely linked to these factors.Therefore, it is essential to strengthen disaster education for disaster victims, correct distorted thinking patterns, and engage in cognitive reconstruction.Practical results from various contexts, such as post-disaster psychoeducation and intervention in the United States, continuous post-disaster psychoeducational support in Taiwan [50], Japan [56], and educational interventions in different disaster events in China [57], have effectively demonstrated that disaster education can ease the adverse psychological impact of traumatic experiences and reduce the incidence of PTSD.
Based on these considerations, this study posits that disaster education can reduce the severity of PTSD symptoms among individuals affected by disasters.Therefore, hypothesis 3 is proposed as follows.
H3: Disaster education significantly and negatively affects PTSD.

The mediating effect of psychological resilience
Psychological resilience means an individual's capacity to adapt well in the face of adversity, trauma, tragedy, threat, or other major stressors.The Resilience Scale (CD-RISC), developed by Connor and Davidson [58], is widely regarded as the best tool for measuring psychological resilience due to its reliability, validity, and ease of use.After its introduction to China, psychologists conducted numerous studies and experiments, establishing a good match with the Chinese norm.Yu and Zhang [58] further divided the original scale into three dimensions: toughness, strength, and optimism.Psychological resilience and adaptability exhibit a positive correlation, indicating that greater resilience enhances an individual's ability to regulate the external environment and achieve higher levels of adaptability [59].This, in turn, effectively alleviates symptoms of PTSD.Disaster education can mitigate the physical and mental damage caused by disasters, including the relief of PTSD symptoms.Based on these perspectives, this study posits that psychological resilience is primarily manifested in three aspects: resilience, strength, and optimism.Additionally, disaster education affects the severity of PTSD symptoms through its impact on psychological resilience.Therefore, hypothesis 4 is proposed as follows.
H4: Psychological resilience mediates the relationship between disaster education and PTSD.

The moderating effect of social support
Social support means the provision of psychological or material assistance and support from various social aspects, such as parents, relatives, and friends.It encompasses the benefits derived from social connections, which can help alleviate psychological stress responses, reduce mental tension, and enhance social adaptability.An analysis of 153 relevant studies conducted by Cui Ke et al [60] confirmed the correlation between social support and the mental health of disaster victims.This study demonstrated direct effects, indirect effects, or interaction effects.Overall, the level of social support has either positive or negative impacts on various dimensions of mental health, and the influence of different forms and sources of social support on the mental health outcomes of disaster victims varies.Furthermore, multiple studies show that strong social support acts as a protective factor against PTSD [61][62][63][64].Adequate social support is beneficial for physical and mental health, providing individuals with protection in stressful conditions and acting as a buffer to reduce the severity of PTSD symptoms.A supportive system facilitates the development of psychological resilience, thereby improving individuals' ability to overcome adversity.Furthermore, the previous discussion on the correlation between psychological resilience and PTSD confirms their negative association.Based on these findings, this study proposes Hypothesis 5, H5: Social support negatively moderates the impact of psychological resilience on PTSD.

The moderating effect of disaster events
In recent years, event studies examining the correlation between disaster events and psychological resilience have gained momentum.Scholars have highlighted that the impact on college students and their psychological recovery following major disasters varies depending on factors such as the severity of the disaster, post-disaster life recovery, and the level of psychological support received [65,66].People face significant psychological challenges due to major disasters.Normal stress responses to such events include feelings of fear, sadness, and anger.However, some individuals may also experience intense fear, helplessness, and exhibit symptoms like numbness, recurrent thoughts of the disaster, excessive vigilance, and avoidance.Moreover, the affected population may develop PTSD, and the severity of exposure to disaster events can predict delayed or persistent treatment-resistant PTSD [14,67,68].Considering the context, this study proposes Hypothesis 6, H6: Disaster events positively moderates the impact of psychological resilience on PTSD.Overall, disaster education, psychological resilience, and PTSD are interconnected variables.Disaster education can influence changes in an individual's psychological resilience, which subsequently impacts the severity of PTSD symptoms.Social support and disaster events may act as catalytic factors within this process.Previous studies have primarily focused on investigating psychological resilience [31,69], social support [66,70], and PTSD [45,46] separately in the aftermath of earthquakes, floods, and violent incidents, without exploring the interaction among these five variables.Therefore, this study aims to construct a theoretical model (see figure 1) to examine the relationships among these five variables.

Criteria and selection of respondents
The study focuses on the regions of Yunnan, Guizhou, and Sichuan in southwestern China, which are prone to frequent natural disasters.The determination of the sample size was conducted using a power analysis method.This approach guarantees that there is an adequate degree of statistical power to detect the effects of interest.To ascertain the appropriate sample size for this investigation, a power analysis was undertaken to guarantee that the study has enough statistical power to detect significant effects.The G * Power software was used to determine the desired statistical power of 0.80, a medium effect size, and an alpha level of 0.05.The optimal sample size was calculated based on the given criteria.In the context of our research, 886 questionnaires were disseminated.A total of 780 questionnaires were gathered from the given options.Following a comprehensive evaluation aimed at verifying the quality and comprehensiveness of the replies, 712 questionnaires were deemed valid and included in the analysis.Consequently, the questionnaire validity rate was determined to be 80.4%.The size of the sample used in this study surpassed the recommended value determined by our power analysis, so assuring that our research had sufficient statistical power to identify significant effects and correlations between the variables under investigation.Additionally, the power analysis considers factors such as the predicted effect size, the desired level of significance, and the intended power of the test [71].The observed effects were witnessed in a population of considerable size, and our chosen sample is representative, thus providing the capacity to draw generalizable and statistically sound conclusions.The selection of controls was conducted with great attention to detail, taking into consideration characteristics such as age, socioeconomic position, and amount of exposure to the event.This rigorous approach was employed to ensure that any observed effects could be confidently assigned to the variables of interest, rather than being influenced by external confounding factors.The chosen sampling mechanism employed in this study was stratified random sampling, wherein the population was divided into distinct and non-overlapping sub-groups [72].Participants were picked at random within each subgroup, ensuring that each individual had an equal opportunity for selection and reducing the likelihood of any potential biases.The provision of these specific facts is intended to enhance the level of transparency in our research approach and strengthen the credibility of our results.

Design of the questionnaire, response rate, and pretesting
The questionnaire was carefully designed, taking into account the study objectives and the reliability of the measurement tools.To obtain a full understanding of the study's factors, a combination of open-ended and Likert scale questions was utilized to gather feedback and quantitative data.Acknowledging the significance of achieving a high response rate to ensure the credibility and reliability of our research outcomes, we implemented several strategies such as sending repeated reminders and follow-up messages.As a consequence, we were able to attain a commendable response rate of 80.4%.Prior to administering the questionnaire to our primary sample, a pretest was conducted using a smaller subset (50 respondents) of the intended population.The initial stage of this study was of utmost importance as it allowed us to detect any uncertainties, enhance the clarity of the questions, and guarantee that the questionnaire effectively captures the desired data.In an effort to enhance transparency and bolster confidence in our data gathering methodology, we want to elucidate the details of our research process.

Data collection
During the first stage of our investigation, our goal was to collect a diverse array of replies in order to get a full comprehension of the topic at hand.To this end, data were obtained from 712 respondents.
To ensure the representativeness of the samples, the selection of representative areas (counties) followed specific criteria.Firstly, areas that have experienced typical natural disaster events, such as Qujing, Yuxi, and Baoshan in Yunnan; Anshun, Liupanshui, and Zunyi in Guizhou; and Dujiangyan, Luzhou, and Wenchuan in Sichuan, were included due to their vulnerability to natural disasters.Secondly, areas that have implemented disaster education initiatives after the disaster events were selected.Thirdly, a geographically balanced distribution was ensured through random sampling.Below are the basic characteristics of the sample subjects (table 1).

Measuring tools
For ensuring the reliability and validity of the measurement tools, this study selected and modified wellestablished scales from domestic and international literature, aligning them with the research objectives and seeking expert opinions.The dimensions and specific topics of each factor were improved through a thorough review of authoritative research.[68] and Caifeng et al [73].Additionally, the viewpoints of Yang Ting [74] and specific research needs were considered in designing and compiling the disaster education measurement scale.The scale comprises a total of 12 questions across three dimensions: 'disaster knowledge,' 'disaster response,' and 'disaster psychology.'Each dimension consists of four questions.A 5-level scoring system is used, with higher scores indicating a higher level of disaster education.

Psychological resilience
Psychological resilience was assessed using the Connor-Davidson Resilience Scale (CD-RISC) proposed by Connor and Davidson [58].The scale was reclassified into three dimensions by Yu and Zhang [50], resulting in a total of 25 questions.The dimensions include 'resilience' (13 items), 'strength' (8 items), and 'optimism' (4 items).A 5-level scoring system is employed, with higher overall scores indicating a higher level of mental resilience.

PTSD
Measurement of PTSD was performed using the Post-Traumatic Stress Disorder Self-Assessment Form (PCL-C).PCL-C provides focused evaluation of the emotional experiences of people in their everyday lives following trauma [25].In light of the delicate subject matter, a number of preventative measures were implemented to safeguard the emotional and psychological welfare of the individuals included in our study.Prior to the dissemination of the questionnaires, the participants were provided with information on the survey's content and the possibility of encountering emotional stimuli.The participants were provided with the assurance that their involvement in the study was completely voluntary, and they had the option to resign from the study at any time without facing any negative consequences.Furthermore, we furnished all participants with supplementary materials, encompassing contact details for mental health practitioners and counselling facilities in the vicinity, in the event that they have a want to engage in conversations or engage in emotional processing subsequent to their involvement.Additionally, we took measures to ensure that the survey setting was conducive to participant comfort, and we made sure that qualified specialists were present on-site to provide prompt assistance in case of any required support.Based on how much the symptoms the participants had been dealing with during the previous month, they were given ratings.PCL-C had 17 questions under 3 dimensions, such as repeated experience, emotional numbness, and hyperarousal.The scoring scale ranges from 17 to 85 points overall, with a 5-level scoring structure.

Social support
Social Support Scale (QFSSS) was applied to evaluate social support in several dimensions such as partner, family, friend, and community.QFSSS was developed by Garcia-Martin et al [75].Each dimension had 3 questions.A 5-level scoring method was employed, with higher total scores indicating a higher level of social support.

Disaster events
Based on Morgeson's work [76], event intensity is determined by three factors: novelty, disruption, and criticality.This study synthesized the three-factor event intensity scale from Morgeson [77], and Morgeson and DeRue [78] to design and compile a questionnaire specific to the research needs.The scale consists of 10 questions across three dimensions: 'novelty' (4 items), 'criticality' (3 items), and 'disruption' (3 items).A 5-point rating method is used, with higher total scores indicating a higher intensity of the disaster event.

Justification of the scales used for psychological measurements
The scales used in this study is widely accepted and utilized in many prior studies [48,58,79,80].The instruments have repeatedly demonstrated excellent levels of reliability, as seen by their internal consistency (Cronbach's alpha >0.82) and test-retest reliability.This indicates that they are among the most reliable and robust assessment tools currently available.Due to their widespread utilization, these scales also provide more effective comparison with other research endeavors.
Cultural sensitivity is a significant factor in shaping psychological constructs, since they are subject to substantial impact from cultural norms and settings [10].The scales that were chosen have exhibited a high degree of cross-cultural applicability, since they have been successfully utilized in a wide range of situations and have displayed a keen awareness and sensitivity to cultural distinctions [81].This characteristic rendered them very appropriate for our research sample, which encompassed a wide range of demographic groups.
In terms of comprehensiveness and precision, our selection of tools was guided by the extent and accuracy with which they assessed the constructs under consideration, while it is acknowledged that alternative scales exist for similar purposes [67].The selected scales facilitated a comprehensive and intricate comprehension of the psychological processes being examined, encompassing several aspects and dimensions that alternative scales may have failed to include.
In terms of operational feasibility, the scales chosen for our study were deemed appropriate.They struck a balance between being concise enough to not discourage people from participating, while yet being comprehensive enough to effectively capture the underlying components.This approach effectively maintained an equilibrium between the level of effort required from participants and the depth and quality of the data collected.
In line with the objective of maintaining consistency and facilitating comparisons, our study sought to reproduce some findings from prior research [18,50,68].The utilization of scales that were utilized in previous investigations facilitated a direct comparison, hence augmenting the strength and applicability of our findings.

Data analysis
The collected samples were coded according to the standard requirements of social statistical analysis, and statistical analysis software such as SPSS 20.0 and AMOS 24.0 were used for hierarchical and multidimensional analysis of the data.Relevant research hypotheses, including disaster education, psychological resilience, social support, disaster events, and PTSD, were tested and analyzed.The verification results of the research hypotheses and their implications were proposed.Before hypothesis testing, it was necessary to check for common method bias in the variables and samples used in the study.To address this, Harman's one-way detection method was employed.This method, while simple and easy to use, only diagnoses the severity of common method bias and does not prove its absence in the measurement.Furthermore, exploratory factor analysis and confirmatory factor analysis were performed to observe the structural consistency, reliability, and validity of the indicators used.

Ethics approval and consent to participate
The research was conducted in accordance with the Declaration of Helsinki.All methods were carried out in accordance with relevant guidelines and regulations.This study has been approved by the Ethics Committee of the College of Teachers, Chengdu University, China.The ethical number is CDDXSFXY20230006.The research ethics committee, namely the Ethics Committee of the College of Teachers at Chengdu University, China, has approved the use of verbal consent for face-to-face interviews with respondents in this study.Ethical considerations were strictly adhered to throughout the study.Participants were provided with detailed and objective explanations of the survey's purpose before their selection.Verbal consent was obtained from the participant before each face-to-face interview.They were assured that the research results and data would be used solely for this study.Strict confidentiality was maintained to safeguard any personal information that should not be disclosed publicly.

Analysis of common method bias
Due to the data being derived from post-disaster questionnaires of residents in Yunnan-Guichuan, there was a possibility of common method bias, which could affect the validity of the study.To test for common method bias, Harman's univariate test was conducted based on the research by Podsakoff et al [82].Harman's univariate test examines whether a single factor emerges during factor analysis or if one factor explains a majority of the covariance between variables.In this study, exploratory factor analysis was performed using the data from 712 questionnaires.The variance interpretation rate of the first principal component was only 21.42%, far below 50%, indicating that there was no significant common method bias in the analyzed data.This suggests that no individual factor or set of factors in the study exhibited excessive explanatory power, and the common method bias remained within the normal range, thereby not affecting the accuracy of the research results [83].
Additionally, an exploratory factor analysis (EFA) was performed to ascertain the latent component structure of the questionnaire questions.The EFA was conducted using the principle component analysis (PCA) extraction approach, followed by a varimax rotation.The Kaiser-Meyer-Olkin (KMO) measure of sample adequacy yielded a value of 0.931, indicating a substantial level of appropriateness of the dataset for conducting factor analysis [84].Furthermore, the Bartlett's test of sphericity yielded a statistically significant result (p < .001),providing additional support for the suitability of doing the component analysis [85].The findings presented a strong basis for the factor structure we have proposed.

Fit of the factor model
To test the fit of the structural equation model, AMOS 24.0 software was used.The results indicated that X 2 /df = 1.388,RMSEA = 0.023, GFI = 0.915, NFI = 0.921, RFI = 0.916, IFI = 0.977, TLI = 0.956.The chi-square and degrees of freedom (X 2 /df) of the model should fall between 1 and 3, the root mean square error of approximation (RMSEA) should be less than 0.05, and other fit indices (GFI, etc) should be above 0.9 [86].Based on these criteria, the confirmatory factor analysis model in this study demonstrated good model fit (table 2).

Descriptive statistics and reliability and validity
Table 3 presents the mean, standard deviation, correlation matrix, reliability, and validity of the variables.Each variable demonstrated good reliability with values above 0.7, and the average variance extracted (AVE) values were above 0.5, indicating satisfactory reliability and convergent validity.The correlation coefficients between all variables are provided, with the diagonal values representing the square root of each variable's AVE which was larger than the absolute value of the correlation coefficient with other variables.It indicates good discriminant validity and construct validity.
The factor loadings in our structural equation model provide insight into the magnitude and direction of the associations between each variable and the latent constructs they represent [87].For example, the variable 'Disaster knowledge' demonstrates a strong and positive relationship with its underlying factor, as evidenced by its mean of 3.484 and a reliability coefficient (α) of 0.891.This is further supported by its high AVE value of 0.673.The variables 'Disaster psychology' and 'Disaster response' have averages of 3.626 and 3.514, respectively.These variables also have reliability coefficients of 0.859 and 0.878, indicating their significant contributions to the model.This is further supported by their AVE values of 0.605 and 0.643.The variable labelled 'Resilience' demonstrates its significance through many statistical measures.It has a mean value of 3.610 and a reliability coefficient of 0.914, indicating its consistency.Additionally, its AVE value of 0.555 further highlights its central role in the study.The variables 'Social support' and 'Disaster events' report mean values of 3.405 and 3.428, respectively.These variables also exhibit good reliability, with coefficients of 0.887 and 0.884.Furthermore, their AVE values of 0.656 and 0.645 indicate their important contributions in the study.Finally, the variable labelled 'PTSD' has a mean value of 3.633 and a reliability coefficient of 0.900.These statistics offer valuable information on the relationship between the variable and its underlying construct, as indicated by its AVE of 0.593.

Hierarchical regression test for main and moderating effects
To account for the influence of participants' basic information on the study hypotheses, hierarchical regression analysis was conducted, incorporating gender, age, and education as control variables.Table 4 presents the results of the regression models.Model 2 added the independent variables to model 1, showing that disaster  Model 6 incorporated the moderator variables (social support and disaster events) into Model 5.The regression results indicated that social support (β = −0.167,p < 0.001) and the interaction term of social support * psychological resilience (β = −0.194,p < 0.001) had a significant negative moderating effect on PTSD.This suggests that the negative impact of psychological resilience on PTSD is strengthened under conditions of high social support.Additionally, disaster events (β = 0.188, p < 0.001) and the interaction term of disaster events * psychological resilience (β = 0.126, p < 0.001) had a significant positive moderating effect on PTSD.This indicates that under conditions of a high degree of positive impact from disaster events, the negative impact of psychological resilience on PTSD is weakened (table 4).
Slope tests were conducted to further demonstrate the moderating effects of social support and disaster events.Figures 2 and 3 illustrate the adjustment effects.In the social support and psychological resilience adjustment chart, the negative influence effect is greater in the high group compared to the low group, with the slope lines of the two groups intersecting, indicating the presence of a moderating effect.The results of our study are consistent with other research, providing further evidence that social support has a beneficial role in mitigating the adverse impact of resilience on PTSD.Moreover, in accordance with existing scholarly sources, it was seen that catastrophe occurrences functioned as a detrimental moderator, lessening the mitigating effect of resilience on PTSD [61][62][63][64].In the adjustment diagram of disaster events and psychological resilience, the  negative influence effect is smaller in the high group compared to the low group, and the slope lines of the two groups intersect, confirming the presence of a moderating effect.

Mediation effect test
This study aims to examine whether psychological resilience mediates the relationship between disaster education and PTSD symptoms in the post-disaster population.The mediation effects were tested using the Bootstrap Bias Corrected method.
Firstly, table 5 presents the mediation effect coefficient for the mediation path 'disaster education → psychological resilience → PTSD,' which is −0.291.The confidence interval does not include 0, and the p-value is less than 0.001, indicating a significant negative mediation effect.After including psychological resilience, the total effect coefficient for 'disaster education → PTSD' is −0.657, with a confidence interval of −0.706 to −0.609, which does not include 0, and the p-value is significant.Additionally, the direct effect coefficient is −0.366, with a confidence interval of −0.425 to −0.306, also not including 0, and the p-value is significant.These results demonstrate that the total effect, direct effect, and indirect effect are all significant, indicating a partially negative mediation effect of 'disaster education → psychological resilience → PTSD.' Secondly, the corresponding mediation paths for each dimension of disaster education were examined, including 'disaster knowledge → psychological resilience → PTSD,' 'disaster psychology → psychological resilience → PTSD,' and 'disaster coping → psychological resilience → PTSD.'For 'disaster knowledge → psychological resilience → PTSD,' the mediation effect coefficient is −0.200, with a confidence interval that does not include 0, and a p-value less than 0.001.After including psychological resilience, the total effect coefficient for 'disaster knowledge → PTSD' is −0.330, with a confidence interval of −0.373 to −0.289, and the p-value is significant.The direct effect coefficient is −0.130, with a confidence interval of −0.168 to −0.092, and the p-value is significant.These results indicate a partially negative mediation effect of 'disaster knowledge → psychological resilience → PTSD.' Similarly, for 'disaster psychology → psychological resilience → PTSD,' the mediation effect coefficient is −0.231, with a confidence interval that does not include 0, and a p-value less than 0.001.After including psychological resilience, the total effect coefficient for 'disaster psychology → PTSD' is −0.405, with a confidence interval of −0.449 to −0.361, and the p-value is significant.The direct effect coefficient is −0.174, with a confidence interval of −0.251 to −0.132, and the p-value is significant.These findings indicate a partially negative mediation effect of 'disaster psychology → psychological resilience → PTSD.' Furthermore, for 'disaster coping → psychological resilience → PTSD,' the mediation effect coefficient is −0.203, with a confidence interval that does not include 0, and a p-value less than 0.001.After including psychological resilience, the total effect coefficient for 'disaster coping → PTSD' is −0.309, with a confidence interval of −0.351 to −0.268, and the p-value is significant.The direct effect coefficient is −0.107, with a confidence interval of −0.143 to −0.070, and the p-value is significant.These results indicate a partially negative mediation effect of 'disaster coping → psychological resilience → PTSD.
Furthermore, the indirect effect coefficients of resilience dimensions, including toughness, strength, and optimism, are shown in table 5 for the influence of disaster education on PTSD and the influence of the dimensions of disaster knowledge, disaster psychology, and disaster coping on PTSD.The confidence intervals for these coefficients include 0, and the p-values are significant.
Based on the results of this paper, the path hypothesis test results of the study model are shown in figure 4.

Effect of disaster education on psychological resilience
Disaster education has a favorable and substantial impact on the resilience of disaster victims.Previous studies have examined psychological resilience's affecting elements from a variety of angles, including both internal and external environmental influences for each person [23].This research examined the effects of several catastrophe knowledge, psychology, and reaction characteristics on psychological resilience with an emphasis on disaster education.The findings indicated that disaster education is substantially and favorably linked with psychological resilience, with disaster psychology having the highest influence and disaster information having the least influence.This finding experimentally supports the link between disaster education and psychological resilience, highlighting the value of disaster education in strengthening catastrophe victims' capacity for psychological response [4].

Effect of disaster education on PTSD
Disaster education is a significant factor impacting PTSD in those who are impacted, according to the hierarchical regression analysis.The path coefficient data demonstrated a substantial negative link between disaster education and PTSD, with disaster psychology having the most influence among the major contributing elements.This result is consistent with other research showing that traumatic experience education may lessen the negative psychological impacts [55].Through the investigation and analysis of post-disaster individuals in the Yunnan-Guichuan area, it was observed that disaster psychology, disaster response, and disaster knowledge in disaster education had a significant negative impact on PTSD, with disaster psychology having the greatest impact and disaster response having the smallest impact.All dimensions of disaster education were significantly negatively correlated with PTSD, indicating that disaster education significantly negatively impacts PTSD.This result highlights the positive effect of disaster education in alleviating the severity of PTSD symptoms in affected individuals.Zhou et al [8] reported that one of the risk indicators was a lack of schooling.Women with lesser levels of education were more likely to fall into profile groups where PTSD was prevalent.

Effect of psychological resilience on PTSD
The psychological resilience of affected individuals has a significant negative impact on their own response to PTSD.With the frequent occurrence of disaster events, it is important to consider not only the external education and intervention for PTSD but also explore the correlation between PTSD and 'protective factors' such as the psychological adaptation level of individuals.Studies have indicated that higher levels of psychological resilience are associated with more effective alleviation of PTSD symptoms, based on the correlation between psychological resilience and the individual's ability to regulate their internal world [27,66].Table 4 demonstrates that the findings of this study are consistent with this perspective.As an independent variable, psychological resilience significantly and negatively affects PTSD, thus highlighting its importance as another influential factor alongside disaster education.A child's psychological resilience is an innate trait, although Niazi et al [31] claimed that it is neither fixed or solely dependent upon intrinsic elements.It may be muted by different life circumstances and strengthened with efficient psychological catastrophe preparation, allowing kids to adjust successfully to new perceived realities of life.

Mediating role of psychological resilience in the impact of disaster education on PTSD
This study discovered that part of the impact of disaster education on PTSD is achieved through the mediating effect of individuals' psychological resilience after experiencing disasters.To gain a deeper understanding of the impact mechanism between disaster education and PTSD, it is insufficient to solely examine the relationship between various dimensions of disaster education and PTSD symptoms.The results indicate that psychological resilience plays a significant role in the influence mechanism of PTSD, as observed through disaster education alleviating PTSD symptoms by enhancing psychological resilience.The mediation effect test's path coefficients demonstrate the establishment of a mediation path in the PTSD pathway from disaster education to psychological resilience, exerting a significant negative influence on the effect of disaster education on PTSD.These findings are in line with Wang et al [88].They argued that resilience mediated the associations between exposure to earthquakes and the symptoms of PTSD and the associations between insomnia and the symptoms of PTSD.Particularly, only teenagers with a lower degree of resilience showed a significant correlation between earthquake exposure and PTSD symptoms.Furthermore, in the mediation relationship model, the mediating effect of disaster knowledge, disaster psychology, and disaster response from the independent variable of disaster education aligns with the resilience, strength, and optimism contained in the intermediary variable of psychological resilience.The mediation effect is confirmed, revealing that each path exhibits some mediating effect.The link between depression, anxiety, and PTSD symptoms in catastrophe victims and quality of life was examined by Park and Bae [16] for the moderating influence of community resilience.They found that whereas community resilience was favorably correlated with quality of life in disaster victims, depression, anxiety, and PTSD symptoms were adversely correlated with quality of life in disaster victims.Among the path coefficients corresponding to each dimension of disaster education, the disaster psychology → psychological resilience → PTSD path has the greatest negative mediation effect, while the disaster knowledge → psychological resilience → PTSD path has the smallest negative mediating effect.Among the path coefficients corresponding to each dimension of psychological resilience, the disaster education → strength → PTSD path exhibits the greatest negative mediating effect, while the disaster education → optimism → PTSD path has the smallest negative mediating effect.When considering the corresponding path coefficients of the independent and intermediary variables, the largest negative mediation effect is observed in the disaster psychology → strength → PTSD path, while the smallest negative mediation effect occurs in the disaster knowledge → psychological resilience → PTSD path.
These research findings suggest that disaster education, encompassing disaster knowledge, disaster psychology, and disaster response, should be strengthened to enhance individuals' psychological resilience, particularly focusing on improving resilience, strength, and optimism.This, in turn, can enhance individuals' functional coping abilities and effectively alleviate symptoms associated with PTSD reactions.

Moderating effect of social support on the impact of psychological resilience on PTSD
This study reveals that social support and disaster events moderate the impact of psychological resilience on PTSD.Specifically, social support demonstrates a significant negative moderating effect, while disaster events exhibit a positive moderating effect.Previous research has generally indicated that psychological resilience has a direct negative predictive effect on PTSD, and some scholars have suggested that social support positively regulates the impact of psychological resilience on PTSD.However, this study uncovers a different finding.It reveals that under high social support conditions, the negative effect of psychological resilience on PTSD is strengthened, establishing a negative moderating effect of social support.Xi et al [26] argued that both resilience and social support have a direct impact on PTSD as well as a secondary impact through anxiety and depression.5.6.Moderating effect of disaster events on the impact of psychological resilience on PTSD Disaster events themselves also play a role in influencing the impact of resilience on PTSD.As the event system theory gains increasing empirical support across various levels of research, some scholars argue that the different attributes of event intensity, such as novelty, subversiveness, and criticality, are related to different outcome variables or have varying effects on the same outcome variable [46,88].Considering natural disasters as typical events, the intensity of these events is closely linked to the PTSD symptoms experienced by affected individuals.The results of this study demonstrate that high-intensity disaster events have a positive influence, which weakens the negative impact of psychological resilience on PTSD, thereby establishing a moderating effect.

Conclusion
This study shows how psychological resilience mediates the link between PTSD and disaster education.Disaster education significantly reduces the severity of PTSD symptoms by boosting psychological resilience.This mediation effect emphasizes the need to consider individuals' psychological adaption level as a 'protective factor' in addition to external education and intervention for PTSD.
This research provides more evidence of the complex interconnections among disaster education, psychological resilience, PTSD, and the moderating influences of social support and catastrophe occurrences.It also reveals the moderating effects of social support and catastrophic experiences on the influence of psychological resilience on PTSD.Disaster occurrences have a positive moderating impact, but social support shows a substantial negative moderating effect.These results provide important new understandings into the intricate interactions between different variables and outcomes in the context of PTSD and disaster education.This study highlights the need to improve disaster education initiatives, including topics like catastrophe knowledge, disaster psychology, and disaster response.Disaster education may strengthen people's functional coping skills and successfully reduce symptoms related to PTSD responses by emphasizing on enhancing resilience, strength, and optimism.The research also emphasizes the significance of considering the moderating effects of social support and catastrophic occurrences, further highlighting the varied character of PTSD therapies.
The results of this research add to the body of evidence already available on disaster education and its effects on PTSD and psychological resilience.They help academics, policymakers, and practitioners who operate in disaster-prone regions by providing insightful information that directs the creation of evidence-based treatments and educational initiatives.Future studies should continue to investigate and improve the processes behind the link between disaster education, psychological resilience, and PTSD, taking into consideration a variety of demographics and cultural circumstances.We can successfully create resilience and lessen the burdens of PTSD by using the power of disaster education, promoting the wellbeing and rehabilitation of those who have been touched by disasters.

Policy recommendations
7.1.Community-driven digital platforms for empowering disaster education Community-based disaster literacy campaigns and education should be implemented.It involves assigning tasks, freezing work execution, conducting scheduled disaster knowledge lectures, disaster response training, and activities focused on disaster psychological well-being.Additionally, daily community work should emphasize the popularization and dissemination of common-sense disaster first aid.Moreover, it is essential to enhance the knowledge and response capabilities of key personnel such as police officers, firefighters, urban management team members, security personnel, taxi drivers, teachers, and service industry practitioners.It is also recommended to strengthen the development of disaster education content on public digital education platforms.These platforms should encourage self-education and educate the public on topics such as social responsibility, awareness of responsibilities, basic disaster knowledge, prevention, and control abilities.Simultaneously, leveraging the district media center's role, it is vital to widely disseminate people's disaster knowledge and first aid skills through public service advertisements, websites, and popular online platforms such as WeChat, Douyin, Kuaishou, which are easily accessible to the public.

Promoting psychological resilience for strengthening support systems and channels
The government should take the lead and increase financial investment.Collaborating with social enterprises, democratic groups, and communities, a psychological assistance system should be established.This system should include a chain of psychological management centers that integrate consultation, assessment, follow-up, and intervention services.Additionally, there is a need to improve psychological management channels.Utilizing various platforms and media, such as telephone hotlines, the internet, psychological counseling columns, and counseling activities, efforts should be made to strengthen psychological counseling services.This includes disseminating mental health knowledge, promoting healthy lifestyles, enhancing the mental health literacy of the general population, cultivating a positive social mentality, and fostering a healthy and progressive psychological atmosphere.

Unifying resources for enhanced social support for strengthening comprehensive assistance
The government should actively encourage all relevant departments to leverage social resources to meet the public's material needs.This includes increasing investment in the production of protective materials to ensure adequate material support.Additionally, taking advantage of the digital age, accurate and reliable information should be disseminated to the public through mass media, avoiding misinformation or speculation, and ensuring a balanced and healthy public discourse that provides the necessary emotional support.Communities, businesses, and families should offer comprehensive emotional, instrumental, and informational support.Actively monitoring their own and others' psychological well-being, it is important to shift excessive attention away from negative news and foster a sense of resilience, confidence, and determination to overcome challenges.This collective support from the community, businesses, and families will establish a strong network of support.

Developing crisis plans, strengthening disaster response capabilities, and mitigating the impact of disasters
This study recommends to enhance the precision of natural disaster prediction and forecasting systems.It can minimize the severity of the effects of natural hazards.An effective plan can ensure easily communication between various stakeholders.Besides, early warning systems should be graded properly to convey the message regarding severity of the natural hazards.Adjustments to the level of early warnings or their removal should be made based on real-time conditions, with notifications sent to emergency management and other relevant departments at each level.

Research limitations and future research directions
While this study collected a large sample of nationwide data, it is important to acknowledge some limitations.Firstly, it is a cross-sectional survey that utilized self-assessment questionnaires.Future studies could consider incorporating structured interview questionnaires to assess stress levels, thus enhancing the accuracy of the study.Additionally, this study focused on the relationship between disaster education and post-disaster PTSD in disaster-affected areas.To further advance the research, it would be beneficial to explore different aspects of disaster education and the timing of post-disaster PTSD, investigating how the timing of disaster education interventions impacts the mitigation of PTSD at different stages.

( a )
How can disaster education affect PTSD and psychological resilience in those living in disaster-prone areas?(b) What are the moderating effects of social support on the association between PTSD, psychological resilience, and disaster education?(c) What moderating effects can catastrophic experiences have on the connections between PTSD, psychological resilience, and disaster education?(d) How does psychological resilience mediate the relationship between disaster education and PTSD symptoms in the post-disaster population?

Figure 1 .
Figure 1.Conceptual model diagram of this study.

Figure 2 .
Figure 2. Social support and resilience relationship.

Figure 3 .
Figure 3. Disaster events and resilience relationship.

Table 1 .
Sample descriptive statistics.Drawing on the Chinese Health Literacy Scale, this study adapted the disaster literacy maturity scale developed by Brown et al

Table 3 .
Descriptive statistics and reliability of variables.

Table 4 .
Hierarchy regression tests for main effects and moderating effects.