Neuropsychological Insights Into Child Survival: Possible Protective Dissociation During Prolonged Entrapment After a Turkish Earthquake.

BACKGROUND Earthquakes and other catastrophic events can lead to conditions of being trapped under the rubble, which can cause minor-major health consequences. One of the most challenging issues in entrapment is the need to rescue people as fast as possible. A related issue for rescue forces is how long to continue searching survivors. Indeed, sometimes victims survive longer than expected. The cases described below led us to postulate that certain adverse psychological effects of being trapped under the rubble may be beneficial for survival in such extreme situations. CASE REPORT In this article, we report two cases of children who were rescued from under the rubble following the earthquake in Turkey in February 2023. The children were rescued approximately one week after the earthquake, exhibiting symptoms that could be understood as dissociation. We bring converging neuropsychological and neurophysiological scientific evidence which enables us to propose that dissociation-related imagination together with excessive sleep may have increased vagal nerve activity. Vagal activity in turn may have helped to reduce risk of infections and inflammation, and possibly increased the chance of survival. CONCLUSIONS Though impossible to measure and prove in such extreme contexts, we propose a plausible psychobiological mechanism for those children’s symptoms and relatively long survival under entrapment. While only a speculation, dissociation might have been protective in such conditions. We discuss the limitations of these reports and the speculative mechanisms, and provide  further implications for policy.