Dear Editor,

We are writing to express our appreciation for the recent publication of the study titled “PTSD, FOMO and fake news beliefs: a cross-sectional study of Wenchuan earthquake survivors” [1]. This study offers valuable insights into the intricate connections among posttraumatic stress disorder (PTSD), fear of missing out (FOMO), and beliefs in fake news. The authors have selected individuals who were affected by the earthquake as a sample to investigate the correlation between FOMO and belief in fake news, which presents a unique and innovative situation. The term "deepfake" is derived from the combination of "deep learning" and "fake". It refers to the creation of highly realistic yet artificial images, sounds, and videos using artificial intelligence techniques [2]. Deepfakes rely on neural networks that analyze extensive datasets to learn and imitate a person's facial expressions, mannerisms, voice, and inflections [3]. According to Saifuddin et al. [4], for example, focus on the causes of sharing behavior related to purposeful deepfakes. Regarding the relationship between citizens' usage of news and their sharing of deepfakes, FOMO also acts as a competent mediator.

Post-traumatic stress disorder (PTSD) is a mental health condition triggered by experiencing or witnessing a terrifying event [5].  In Chen’s [1] research, they concentrated their investigation on a population that was affected by PTSD as a result of the earthquake, which was a public health emergency. “Fear of missing out” (FOMO) is a psychological construct defined by an apprehension of being absent from other people's rewarding experiences and the desire to stay connected with others’ experiences constantly [6]. Chen’s [1] research is pertinent and significant for further investigations into the correlation between PTSD/FOMO and beliefs in fake news in the context of various natural catastrophes. Some recent studies found that during times of social isolation, individuals may frequently experience FOMO when they are separated from their social milieu, as they are unable to interact with their friends or family members [7-9]. In addition, FOMO usually plays as a mediator variable to expand PTSD and the domain of psychopathology-related constructs [10,11].

Over the past 20 years, there has been a general increase in the occurrence of catastrophic earthquakes. In 2021, there were 26 catastrophic earthquakes, which is higher than the average of 19.6 earthquakes over the past two decades. The frequency of these earthquakes has been consistently strengthening year after year [12]. In considering natural catastrophes, earthquakes represent an exemplary model for future study due to their frequent occurrence in modern society. Regarding earthquakes, when subsequently validating the rate of gender belief in fake news, the inclusion of 180 males and 176 women is a suitable sample size. Moreover, considering the likelihood that individuals in seismically impacted areas will experience trauma again after obtaining the questionnaire, a completion rate of less than 50% is acceptable. The article is well-formatted with clear tables and diagrams of the moderating effects of each variable. Some positive suggestions are provided for further progress.

The general populace, except for professionals in specific relevant domains (such as journalists and government organizations), may not possess the same level of sensitivity and discernment towards news as these experts do. Typically, the substance of the material would get greater interest than the identity of the publisher. Sometimes this might be due to the publisher intentionally creating a deceptive situation [13,14].

For the frequency of the questionnaire collection, collecting surveys over intervals of 3, 5, and 10 years for the same set of individuals may enhance the objectivity and credibility of the results. There was a significant delay between the occurrence of the earthquake and the gathering of the questionnaire.

The level of education is a crucial component that should be considered. Individuals' propensity to believe fake news may differ based on their level of education [15,16].

The questionnaire was targeted towards individuals aged 20-47 years old (as of 2023). It may be worth considering eliminating the upper age limit. The minimum age in the questionnaire was five years old during the earthquake. From an ethical standpoint, it would be advisable to increase this age regarding the participant’s ability to provide informed consent. By combining these two criteria, we may restrict the participants in the questionnaire to individuals aged 24-60, i.e. those who were between the ages of 10 and 45 at the time of the earthquake.

For H7 Gender moderates the FOMO–fake news pathway, a basic slope analysis revealed that FOMO had a significant and positive impact on the belief in fake news among women, but no such effect was observed among men. However, conducting additional research may yield different results when age and gender are combined. Additionally, Tantau et al.'s [17] study highlights the important roles that gender and age play in the acceptance and dissemination of fake news. Young women are unlikely to disseminate misleading information online in this scenario. Meanwhile, Warner-Søderholm et al. [18], demonstrate that women and young users possess greater expectations for honesty and trust in comparison to others.

The main techniques employed are the collection of questionnaires and the analysis of data. To augment the sample size for the upcoming research, it is advisable to incorporate a comparative examination of the statements and comments found in interconnected posts across several public social media platforms such as Weibo, Zhihu, Tiktok, etc. To examine the susceptibility of individuals to believing fake news, the research can include a control group consisting of persons who were not affected by the Wenchuan earthquake. According to Tobias et al. [19], people with good mental health are more likely to believe news that promises to improve their lives in the future, whereas those suffering from mental illnesses tend to be more pessimistic about the future and will interpret news reports with a negative outlook. Moreover, results can vary for different mental disorders. Individuals with autism are vulnerable to higher updating of beliefs when they are given information with an excessively low degree of accuracy.” Similar explanations for why persons with post-traumatic stress disorder (PTSD) flashbacks have been put forth by Linson et al. [20] and Wilkinson et al. [21].

The causal relationship between PTSD and FOMO needs further exploration. FOMO caused by the Wenchuan earthquake is positively associated with PTSD; believing fake news is positively associated with FOMO; believing fake news is positively associated with PTSD; PTSD mediates the association between FOMO and believing fake news etc.

In terms of the disaster, our task is not only to reconstruct and repair the facilities of the city's infrastructure, but also to prioritize the development of post-disaster psychology. Psychological professionals with relevant expertise can be employed to offer prompt psychological counseling to individuals and leading cadres in the disaster-stricken region. News media practitioners should exhibit heightened awareness of their professional ethics and morals and refrain from deliberately fabricating fake news for the purpose of attracting attention. Overall, “PTSD, FOMO and fake news beliefs: a cross-sectional study of Wenchuan earthquake survivors” offers significant goals and instructions for future endeavors regarding PSTD, FOMO, and fake news”.