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UDC 159.923.2

Psychological prevention of the negative impact of war on Ukrainian
students’ attitudes towards health

Tetiana Tytarenko
Doctor of Psychological Sciences, Professor, Full Member of the National Academy of Educational
Sciences of Ukraine
Institute of Social and Political Psychology of the National Academy of Educational Sciences of
Ukraine
04070, 15 Andriivska Str., Kyiv, Ukraine
https://orcid.org/0000-0001-8522-0894

Abstract. The relevance of this study is determined by the need to examine opportunities for reducing
the negative impact of war on the civilian population of Ukraine, their health, and well-being. The
aim of the research was to identify directions for the psychological prevention of the negative
influence of wartime threats on young people and their attitudes towards health. The empirical
research methods included an author-designed questionnaire, methods of mathematical statistics and
data analysis using the Jamovi programme, and the Kruskal-Wallis test to identify relationships with
the socio-demographic characteristics of students. Based on changes in students’ attitudes towards
health and the resources available to them, three groups were identified: the resource-stabilisation
group (43.8%), the resource-accumulation group (34.9%), and the resource-depletion group (21.3%).
The threats that students considered significant in the context of their attitudes towards health
included the risk of shelling, danger to loved ones, lack of conditions for rest and work, loss, injury,
or death of relatives and close persons, environmental and epidemic risks, relationship breakdowns,
forced displacement, and the threat of mobilisation. Among the methods of health restoration,
students most frequently chose passive and active forms of rest, communication with loved ones,
humour and entertainment, hobbies and creative activities, self-regulation practices, and assistance
from doctors and psychologists. Individuals who were in long-term relationships or marriage
perceived the threat of shelling more acutely and experienced a stronger fear of relationship
breakdown. Prevention of the impact of wartime threats on young people’s attitudes towards health
relied on non-institutional recovery resources (sleep, rest, communication, search for meaning,
hobbies), and the combined effect of these practices enhanced their effectiveness. Effective
preventive measures included encouraging the regularity of basic recovery methods, fostering an
internal permission to rest and function imperfectly, and integrating recovery practices into daily
study and work routines. For the resource-stabilisation group, greater support for horizontal
connections within networks of mutual assistance and joint activities was recommended. For the
resource-accumulation group, the development of communicative competence skills and the
prevention of relationship breakdowns were recommended. For the resource-depletion group, it was
considered desirable to develop group-based formats for discussing wartime experiences, which
reduce the sense of uniqueness of such experiences and prevent isolation. The practical value of the
study lies in the development of targeted configurations of preventive measures according to available
resources, their use, and changes in attitudes towards health

Keywords: threats; psychological health of young people; resource-stabilisation, resource-
accumulation, and resource-depletion groups; methods of recovery; socio-demographic differences

Introduction
Extreme life circumstances associated with the active phase of the war in Ukraine, its duration, and
the aggressor’s brutality have given rise to a specific attitude among civilians towards themselves and
their own safety. Life in the rear, sometimes even far from the frontline, nevertheless did not exclude
the possibility of daily unpredictable and dangerous developments. The psychological health of
Ukraine’s civilian population deteriorated as a result of years of shelling, intensified attacks on energy
and water supply infrastructure, widespread destruction, losses, and uncertainty about the future. The
number of complaints concerning mental health increased, alongside the growing need for recovery.
Under the extreme conditions of wartime, young people gradually began to recognise in a new way
the dependence of their ability to study, form close relationships, and derive satisfaction from life on
their routine well-being and on their capacity to overcome numerous fears, depression, exhaustion,
and hopelessness. Thus, the study of the psychological aspects of preventing a deterioration in young
people’s attitudes towards their own health has become an increasingly relevant scientific task.
The negative impact of wartime conditions on an individual’s attitude towards health
manifested itself as the experience of daily life-threatening circumstances. Six years after the end of
the war in northern Sri Lanka, R. Jayasuriya et al. (2025) identified the following types of potentially
traumatic war-related events: extreme violence, traumatic losses, the impact of conflict, and the
effects of constant stressors. As demonstrated by E. Zalli’s (2024) study, the modal response to
threats, grief and other potentially traumatic circumstances was resilience, which facilitated more
flexible self-regulation. Z. Kostova et al. (2025) investigated how assistance provided to the
Ukrainian population by mental health professionals strengthened an aspect of resilience known as
compassion satisfaction. In 2025, M. Bradshaw et al. (2025), having conducted a cross-national meta-
analysis of data collected in 22 geographically, economically and culturally diverse countries,
demonstrated the influence of numerous factors on self-rated health, including country, age, gender,
marital status, employment, education, attendance at religious services and immigration status.
Accordingly, the Ukrainian sample also has its own specific characteristics regarding self-rated
health, and the threatening conditions of war have become a significant factor in changes to this self-
assessment. Psychological prevention of the impact of prolonged uncertainty and threats on self-rated
health involves identifying core resources for resilience. A large group of experts, as presented in the
work by S. Hobfoll et al. (2021), which examined the principles of assisting victims of natural
disasters and mass violence, investigated the effectiveness of various models for preserving resources
in conditions of mass traumatisation. According to the World Health Organization (2023), the key
tools of socio-psychological prevention are considered to be the development of self-regulation skills,
psychological education aimed at addressing the impact of prolonged stress on physical and mental
health, as well as the legitimisation of rest and self-care as a necessary condition for adaptation during
wartime.
In working with veterans, improving the capacity for emotional self-regulation has become
increasingly important. As shown by the study by N. Malek et al. (2024), specialised mobile
applications can be effective tools for anger management. In Ukraine, rehabilitation centres are being
actively established and programmes for the psychological recovery of military personnel following
combat deployment are being developed. Among the tasks faced by staff at such rehabilitation
centres, as shown by data from the study by I. Prykhodko et al. (2023), are not only the elimination
of the negative impact of combat stress on mental health, but also the strengthening of mental health
and the mobilisation of psychological resources. There are also studies of the civilian population of
Ukraine affected by the war. A comparison of Israeli and Ukrainian communities has shown that in
Ukrainian society, people have significantly higher levels of hope and social resilience compared to
Israelis, and also demonstrate greater individual and community resilience (Kimhi et al. 2023). Based
on these indicators, effective methods of recovery can be developed. It should be noted that restorative
work with young people has its own specific characteristics. A study conducted by O. Kokun & O.
Bezverkhyi (2026) on Ukrainian students during a full-scale war revealed an increase in symptoms
of post-traumatic stress disorder and somatic complaints over the course of a year, indicating a greater
need for psychological support.
It is important to examine which preventive measures are used to reduce stress and promote
health among Ukrainian students. The aim of the study was to identify approaches to psychological
prevention of the negative impact of military threats on young people and their attitudes towards
health. To achieve this aim, the following steps were undertaken: changes in young people’s attitudes
towards their own health during the war were identified; young people’s attitudes towards threatening
life circumstances and the use of recovery practices were examined; and preventive measures aimed
at strengthening the recovery process were identified.

Materials and Methods
The empirical research methods included an author-designed questionnaire, methods of mathematical
statistics, and data analysis using the Jamovi software package (version 2.3.28.0). The obtained data
were coded and analysed using non-parametric statistical procedures. In particular, the Kruskal–
Wallis test was applied to examine differences between three groups of respondents with different
types of attitudes towards health in terms of the prevalence of recovery practices, as well as to identify
relationships between these groups and socio-demographic variables. The use of this criterion was
determined by the ordinal nature of the data and the absence of a normal distribution.
For one of the survey sections analysed in the article, a series of health-related questions was
developed. The response options were based on detailed narratives about wartime life provided by
participants in a previously conducted qualitative study (Tytarenko, 2024). The questions were as
follows: (1) “How has your attitude towards health changed during the war?” (response options: I pay
less attention to health; I pay more attention to health; nothing has changed in my attitude towards
health); (2) “Which life circumstances are threatening to your health?” (response options: lack of
adequate conditions for sleep, rest, and work; risk of missile, bomb, or drone attacks; the frontline
approaching; danger to relatives and loved ones, separation from them; environmental deterioration
and epidemic risks; forced displacement and lifestyle changes; threat of mobilisation; losses, injuries,
or death of loved ones; divorce, infidelity, or relationship breakdowns); (3) “Who or what helps you
most in restoring your health?” (response options: rest, sleep, sport, walks; communication with
relatives, loved ones, and friends; hobbies, travel, creativity, books; humour, entertainment, computer
games, television series; religion, meditation, yoga, breathing practices; work or academic workload;
psychotherapy, psychological counselling, sanatorium treatment; self-help: self-care, self-regulation
practices, self-improvement).
The indicators according to which respondents were divided into three groups (resource-
stabilisation, resource-accumulation, and resource-depletion) included three types of attitudes
towards health and eight methods of recovery. The resource-stabilisation group included respondents
whose attitudes towards health and recovery methods had not changed during the war; the resource-
accumulation group included respondents whose attention to health had increased and whose
recovery methods had expanded and been renewed; the resource-depletion group included
respondents whose attention to health had decreased and whose recovery methods had diminished
and acquired a destructive character.
Sample characteristics: the sample consisted of 502 respondents aged between 17 and 44 years;
of these, 80.9% were individuals under the age of 22. In terms of gender, the sample was feminised
(403 women and 91 men). All respondents were participants in the educational process: 419 (83.5%)
were pursuing a Bachelor’s degree, 78 (15.5%) a Master’s degree, and 5 (1%) education at the third
(educational and scientific) PhD level. The majority of respondents lived in Ukraine in the same
region where they had resided before the beginning of the full-scale invasion (74.5%); however, one
quarter of the sample had experienced a change of residence, indicating direct experience of
adaptation to wartime conditions.
The sample was formed through the distribution of links to the online platform Google Forms.
Participation in the study was anonymous and voluntary. All respondents provided informed consent
for the use of their responses for scientific purposes. The study was conducted between April and
October 2025. The research was carried out in accordance with current national and international
ethical requirements. The author-designed questionnaire for data collection (one section of which is
analysed in the article) was approved by the Research Ethics Commission of the Institute for Social
and Political Psychology of the National Academy of Educational Sciences of Ukraine in accordance
with the ICC/ESOMAR International Code on Market, Opinion and Social Research and Data
Analytics (2025).
 Results and Discussion
Indicators of the dynamics of young people’s attitudes towards their own health during the war
demonstrate the heterogeneity of changes observed since the beginning of the full-scale phase of the
war. A polarisation in attitudes towards personal health can be observed. According to the direction
of changes in the assessment of their own health and well-being from the beginning of the aggression
in 2022 until autumn 2025, respondents were divided into three groups. For some individuals, the
war prompted greater self-care, and they began to accumulate resources. For others, the war distracted
them from their own health and from analysing their routine well-being, and they instead began
actively depleting their personal resources. For a certain category of young people, the war had the
effect of leaving them indifferent towards changes in their own health. Each group – the resource-
accumulation group (34.9%), the resource-depletion group (21.3%), and the resource-stabilisation
group (43.8%) – demonstrated a specific need for targeted preventive work aimed at increasing
attention to health, improving awareness of its value, and developing the ability to recover effectively.
According to the obtained results, respondents perceived the war as a multidimensional threat
to health extending far beyond immediate physical danger. The most widespread threat was
considered to be the risk of shelling and the approach of the frontline (71.3%), which created a state
of constant tension and expectation of danger. The high percentage of responses concerning danger
to loved ones and forced separation from them (63.9%) indicated the predominance of existential
fears. More than half of the respondents (53.2%) reported the absence of adequate conditions for
sleep, rest, and work, indicating disruption of basic physiological needs. Almost half of the
respondents (49.4%) identified the loss, injury, or death of loved ones as a significant threat to health.
Other threats – deterioration of the environmental situation and epidemic risks (45%), relationship
breakdowns (29.1%), forced displacement (25.5%), and the threat of mobilisation (16.3%) – created
an additional background of cumulative stress.
Analysis of responses concerning methods of health recovery demonstrated respondents’
orientation towards accessible, routine, and socially mediated resources. The most frequently selected
methods were rest, sleep, physical activity, and walks (78.3%), indicating awareness of the
importance of basic recovery mechanisms. Communication with relatives, loved ones, and friends
(75.3%) also played an important role, serving the function of emotional stabilisation and
psychological support. A significant proportion of respondents used humour, entertainment,
computer games, and television series (62.2%) as a means of psychological relief. Hobbies, creativity,
travel, and reading (61.4%) contributed to preserving a sense of identity and inner resilience. Self-
help and self-regulation practices were used by 41.6% of respondents. Professional assistance and
spiritual practices remained less widespread, which may have been related to limited accessibility or
prevailing social attitudes.
Such methods of self-recovery as turning to entertainment content did not demonstrate
significant associations with changes in attitudes towards health. Although the majority of young
people used humour, entertainment, games, and television series, the relieving effect of such practices
proved short-lived, and long-term recovery did not occur. Seeking professional assistance from
doctors, psychologists, and psychotherapists (21.7%) was also not very common among young
people. This may indicate limited accessibility of medical and psychological assistance in different
regions. Spiritual practices and meditation were used by 19.3% of respondents. Evidently, among
recovery methods, preference was given to self-regulatory and communicative practices, that is, those
oriented towards social support.
According to a number of socio-demographic characteristics, the Kruskal-Wallis test identified
the following statistically significant differences between particular groups of young people. An age-
specific pattern in the experience of war was revealed. Older respondents (22-44 years) significantly
more often experienced such a threat as the possibility of mobilisation (H = 51.1; p < 0.001) than
younger respondents (17-21 years). Among methods of recovery, younger participants more
frequently used humour, games, and television series as coping strategies (H = 10.015; p = 0.002),
whereas older respondents resorted to this means of self-preservation and recovery significantly less
often.
 Individuals who were in long-term relationships or marriage perceived the threat of shelling
more acutely (H = 12.141; p = 0.033). They experienced fears of infidelity, divorce, and relationship
breakdown (H = 22.745; p < 0.001) and more actively used communication with close individuals as
a resource than students who did not have a permanent partner at the time of the study. This
corresponds well with the logic of emotional involvement and responsibility for others. A person’s
financial situation, as it turned out, was associated both with the assessment of threats and with
methods of recovery (rest and communication). A better financial situation provided greater access
to recovery resources and reduced the significance of threats for respondents. Students who lived and
studied in more dangerous regions were more fearful of shelling and the approach of the frontline (H
= 11.28; p = 0.004). The threat of relationship breakdown was experienced more strongly by those
students who had been forced to change their place of residence since the beginning of the war (H =
30.139; p < 0.001). No other significant differences by place of residence were identified. Likewise,
no statistically significant gender differences were found.
In such a field as health psychology, especially under wartime conditions, the need for the
prevention of health deterioration increases substantially, creating an urgent social and scientific
demand for the legitimisation of such disciplines as preventive psychology or preventive health
psychology. This is evidenced both by the results of the author’s study and by the findings of the
scientific investigations of N. Byshevets et al. (2023) and S. Kimhi et al. (2023). Prevention of health
problems is a global priority, and psychiatrists are increasingly raising the issue of the potential of
preventive psychiatry, although the level of its implementation remains low because resources are
limited. In order to meet the enormous mental health needs of the population, new forms of
intervention are being used more actively, including mobile and internet-based interventions, as well
as blended and stepped-care models (Singh et al., 2022). The present study did not include obtaining
data regarding the popularity among young people of online consultations with specialists. The choice
of young people as the research group in this study was justified both by the author’s previous
investigations into attitudes towards health among people of different age groups (Tytarenko, 2024)
and by the scientific work of other authors (Kałwak et al., 2024). Young people proved to be more
vulnerable to the negative impact on health of both the war and the contemporary polycrisis, which
in recent years has come to include COVID-19, the war in Ukraine, climate change, and the economic
crisis.
The focus of contemporary research aimed at identifying the role of widespread social
determinants in health problems and developing preventive measures usually concerns vulnerable
population groups with an increased risk of health disorders, particularly refugees and migrants. Such
groups are precisely those that require preventive intervention strategies, including universal,
selective, and indicated approaches. Preventive assistance is primarily focused on young people, and
prevention is delivered through various innovative methods, including digital formats, within
educational institutions, workplaces, communities, and clinical settings. Different types of
psychosocial interventions contribute to the development of resilience, improvement of mental health
literacy, and enhancement of social support. These include training young people to recognise and
understand their own emotions, suicide prevention programmes, interventions aimed at combating
loneliness, and trauma-informed interventions within an interdisciplinary approach (Kirkbride et al.,
2024). The author’s study confirmed the urgent need for comprehensive education of young people
regarding various forms of professional assistance available in cases of health-related problems,
involving psychologists, educators, doctors, and social workers.
Given the prevalence of existential and cumulative threats (the risk of shelling, danger to loved
ones, loss), the key focus of prevention is the search for strategies of self-preservation and recovery.
Prevention approaches should concentrate on identifying and strengthening the basic resources of
resilience. This approach is consistent with contemporary understandings of resilience as flexible
adaptation to conditions of prolonged uncertainty and threat, as substantiated in the study by I.R.
Galatzer-Levy et al. (2018), as well as with the resource conservation models of S.E. Hobfoll et al.
(2021), which emphasise the importance of timely prevention of burnout in situations of mass trauma.
 An important area of prevention is the strengthening of everyday and socially mediated
resources for recovery – primarily interpersonal communication, social support and engagement in
activities that sustain a sense of control and identity. These resources constitute social capital, which
influences human health in stressful situations, where support from family and friends, as well as the
social network, alleviates stress and promotes recovery (Ta et al., 2025). Among the effective means
of psychological prevention of health deterioration, non-institutional resources stand out, on which
young people predominantly rely in their daily lives. This involves targeted changes to the work
(study) – rest routine, with an emphasis on enhancing various forms of active and passive leisure.
Equally effective are preventive measures focused on intensifying communication with significant
others and engaging in joint activities, which strengthen the sense of community, control and identity.
Significant preventive measures also include psychological education on the importance of mental
health and ways to maintain it; the development of self-regulatory personality traits; and the
promotion of self-care.
Given the identified polarisation of attitudes towards health, preventive measures must be
differentiated and aimed both at supporting a responsible attitude towards health and at preventing its
devaluation in the context of dwindling resources. A study by colleagues, conducted on a sample of
students in Ukraine, found that the psycho-emotional status and physical condition of students at
higher education institutions, as well as their emotional well-being, are directly dependent on their
level of physical activity and lifestyle. It has been demonstrated that a more active lifestyle and
systematic health-promoting recreational physical activity allow for a confident prediction of the
maintenance of emotional well-being during the hostilities in Ukraine (Byshevets et al., 2023).
The results obtained in the study make it possible to move towards the development of specific
means of socio-psychological prevention of the negative impact of war on Ukrainian students’
attitudes towards health. The proposed measures are grounded in the identified threats, available
recovery resources, and socio-demographic differences. What follows is a comparison of youth
groups according to three types of attitudes towards health. Representatives of the resource-
stabilisation group, which included almost half of the respondents (43.8%), stated that their attitude
towards health had not changed significantly during the years of the full-scale war. Such data indicate
the relative stability of their habitual lifestyle, previously formed habits, and established self-care
strategies even under threatening wartime conditions. Young people in …