We investigated the association between PTSD symptom levels and sociodemographic characteristics, earthquake survival, and related losses, and post-earthquake life events 4 years after two major earthquakes in Turkey in a sample of children and adolescents who emigrated from the devastated area. The study subjects consisted of 1999 earthquake survivors who moved to Ankara, Turkey, at the time of the study. The inclusion criteria included age ranging from 8 to 18 years and the absence of a serious cognitive or mental disorder that would interfere with response to self-report questionnaires. Regarding the earthquake experiences, unexpectedly, the findings indicate a significant association between posttraumatic stress, depression, fear and avoidance symptoms and only one of five subscales of Earthquake Experiences Scale. namely Functionality, even after controlling for the post-earthquake life events. Impact of earthquake was not found to predict psychological symptoms. Children and adolescents' subjective perception of the earthquake was ail associated factor with higher posttraumatic stress and depression scores. Impact of earthquake was not found to predict psychological symptoms. We conclude that the level of PTSD symptoms in children and adolescents who survived a major earthquake is determined by the negative impact of the trauma on functionality and the degree of subjective negative perception about earthquake. Additional Studies of PTSD in survivors of other types of major trauma are required to provide the interventions most effective for those individuals. (C) 2008 Published by Elsevier Ltd.