en تخصصي Special پژوهشي Research <div style="text-align: justify;"><strong>Background</strong>: Post-traumatic stress disorder (PTSD) is frequently observed in individuals who have experienced earthquakes and may result in prolonged psychological challenges. Personal capacities, including psychological resilience and spiritual health, could serve as mitigating elements; however, their role in forecasting PTSD severity has not been sufficiently investigated within disaster-affected communities in Iran. The present research sought to determine whether resilience and spiritual well-being can predict the intensity of PTSD symptoms in survivors of the 2023 Khoy earthquake, after accounting for demographic and trauma-related factors<br> <strong>Materials and Methods</strong>: This investigation utilized a cross-sectional methodology to examine associations among variables. The study cohort consisted of 164 adult survivors, selected through a two-stage cluster sampling approach from public health clinics in Khoy, Iran. Over a three-month data collection period, participants provided responses to standardized assessment tools, which included the 10-item Connor-Davidson resilience scale (CD-RISC-10), the Spiritual Well-Being Questionnaire, and the PTSD Checklist aligned with DSM-5 criteria. Data were processed using bivariate correlation analysis and sequential regression modeling to evaluate the relationships.<br> <strong>Results</strong>: Resilience (Mean&plusmn;SD, 23.14&plusmn;6.39) and spiritual well-being (Mean&plusmn;SD, 36.50&plusmn;3.40) were significantly negatively associated with PTSD symptoms. In the regression analysis, resilience alone explained 33% of the variance (R&sup2;=0.33, P<0.001). Adding spiritual well-being increased the explained variance to 39% (&Delta;R&sup2;=0.06, P=0.027). Both variables remained significant unique predictors (&beta;=&ndash;0.61 and &beta;=&ndash;0.26, respectively).<br> <strong>Conclusion</strong>: Resilience and spiritual well-being are key protective factors against PTSD among earthquake survivors in Khoy, Iran, 2023, highlighting their potential utility in culturally informed, post-disaster mental health interventions.</div> Earthquake, Post-traumatic stress disorder (PTSD) Resilience, Spiritual well-being, Iran 71 78 http://hdq.uswr.ac.ir/browse.php?a_code=A-10-701-1&slc_lang=en&sid=1 Vahid Sabri vahidsabri87@gmail.com 0000-0003-1542-7325 No Department of Clinical Psychology, Khoy University of Medical Sciences, Khoy, Iran. Roghieh Sodeify sodeifi_r@gmail.com 0000-0002-1422-8829 No Department of Nursing, Khoy University of Medical Sciences, Khoy, Iran. Leila Mokhtari mokhtari_l@gmail.com 0000-0002-8527-9703 No Department of Nursing, Khoy University of Medical Sciences, Khoy, Iran. Zeinab Habibpour habibpoor_z@khoyums.ac.ir Yes Department of Nursing, Khoy University of Medical Sciences, Khoy, Iran.