International Journal of Science Annals, Vol. 7, No. 1, 2024 рrint ISSN: 2617-2682; online ISSN: 2707-3637; DOI:10.26697/ijsa SOCIAL AND BEHAVIORAL SCIENCES. Psychology ORIGINAL RESEARCH Psychological Stress among University Students in Wartime: A Longitudinal Study Authors’ Contribution: A – Study design; Mykhaylyshyn U. B. 1,2 AB , Stadnik A. V. 1,3 ABDE , B – Data collection; Melnyk Yu. B. 4,5 ADEF , Vveinhardt J. 6,7 EF , C – Statistical analysis; Oliveira M. S. 8,9 EF , Pypenko I. S. 4,5 ACDEF D – Data interpretation; 1 E – Manuscript preparation; Uzhhorod National University, Ukraine 2 F – Literature search; Transcarpathian Research Expert Forensic Center of the MIAU, Ukraine 3 G – Funds collection Kharkiv National University of Internal Affairs, Ukraine 4 Kharkiv Regional Public Organization “Culture of Health”, Ukraine 5 Scientific Research Institute KRPOCH, Ukraine 6 Institute of Sport Science and Innovations, Lithuania 7 Lithuanian Sports University, Lithuania 8 Higher Institute of Social Work of Porto, Portugal 9 University Institute of Health Sciences-CESPU, Portugal Received: 05.04.2024; Accepted: 28.06.2024; Published: 30.06.2024 Abstract Background and War has an extremely negative effect on people’s psyches. This is especially true Aim of Study: for student youth. They have to build personal lives and continue their studies in these difficult and traumatic conditions. The aim of the study: to identify the peculiarities of the dynamics of psychological trauma, and the manifestations of depression, anxiety and stress among students in wartime. Material and Methods: The study involved university students from Ukraine and European Union countries in 2022-2024. Respondents aged 20-50 years were divided into 4 groups. Group 1 consisted of 107 students, including 64 (59.8%) males and 43 (40.2%) females, living in areas where there was no hostilities or shelling (November 2022). Group 2 consisted of 103 students, including 52 (50.5%) males and 51 (49.5%) females, living in the area of active hostilities (November 2022). Group 3 consisted of 112 students, including 41 (36.6%) males and 71 (63.4%) females, living in areas where there was no hostilities or shelling (March 2024). Group 4 consisted of 115 students, including 30 (26.1%) males and 85 (73.9%) females, living in the area of active hostilities (March 2024). The study involved the development of the author’s questionnaire and the adapted psychological test on the DASS-21, which is available on the Google Forms platform. The technique was found to have adequate internal consistency. Cronbach’s alpha was 0.807. Results: Longitudinal studies have shown that university students in wartime are characterised by a tendency to increase psychogenics related to martial law, communication and safety. A closer look at the dynamics of psychopathological symptoms revealed a trend towards increased depression and anxiety, as well as a stabilisation of acute stress indicators in all groups. This indicates a serious deterioration in the mental health of the students and a further chronicisation of their neurotic disorders. Conclusions: The negative impact of the war in Ukraine on the mental health of student youth requires the active implementation of psychological support measures and psychoprophylaxis in accordance with individual psychodiagnostic findings. Keywords: mental health, psychotraumatic impact, anxiety, depression, stress, students, war Copyright: © 2024 Mykhaylyshyn U. B., Stadnik A. V., Melnyk Yu. B., Vveinhardt J., Oliveira M. S., Pypenko I. S. Published by Archives of International Journal of Science Annals DOI: https://doi.org/10.26697/ijsa.2024.1.6 Conflict of interests: The authors declare that there is no conflict of interests Peer review: Double-blind review Source of support: This research did not receive any outside funding or support 27 International Journal of Science Annals, Vol. 7, No. 1, 2024 рrint ISSN: 2617-2682; online ISSN: 2707-3637; DOI:10.26697/ijsa Information about Mykhaylyshyn Ulyana Bohdanivna – https://orcid.org/0000-0002-0225-8115; the authors: Doctor of Psychological Sciences, Full Professor; Head of the Department of Psychology, Uzhhorod National University, Uzhhorod, Transcarpathian Research Expert Forensic Center of the Ministry of Internal Affairs of Ukraine, Ukraine. Stadnik Anatoliy Volodymyrovych – https://orcid.org/0000-0002-1472-4224; Doctor of Philosophy in Medicine, Affiliated Associate Professor, Kharkiv National University of Internal Affairs; Uzhhorod National University, Ukraine. Melnyk Yuriy Borysovych – https://orcid.org/0000-0002-8527-4638; Doctor of Philosophy in Pedagogy, Affiliated Associate Professor; Chairman of Board, Kharkiv Regional Public Organization “Culture of Health” (KRPOCH); Director, Scientific Research Institute KRPOCH, Ukraine. Vveinhardt Jolita – https://orcid.org/0000-0001-6231-9402; Doctor of Social Sciences, Full Professor, Chief Researcher, Institute of Sport Science and Innovations, Lithuanian Sports University, Lithuania. Oliveira Madalena Sofia – https://orcid.org/0000-0002-1764-1475; Doctor of Philosophy in Psychology, Professor, Higher Institute of Social Work of Porto; Guest Lecturer, University Institute of Health Sciences-CESPU, Portugal. Pypenko Iryna Sergiivna (Corresponding Author) – https://orcid.org/0000-0001- 5083-540X; iryna.pipenko@gmail.com; Doctor of Philosophy in Economics, Affiliated Associate Professor, Secretary of Board, Kharkiv Regional Public Organization “Culture of Health”; Co-Director, Scientific Research Institute KRPOCH, Ukraine. Introduction Materials and Methods More than two years of war have changed the lives of Two phases of the study have been conducted: Ukrainians. Living in difficult socioeconomic and November 2022 (Phase 1) and March 2024 (Phase 2) psychological conditions of war leads to psychological during the war in Ukraine. The survey respondents were trauma and mental health problems. Recent students from Ukraine and European Union countries. psychological studies have shown that the vast majority The respondents were aged between 20 and 50 years. of the population (75.0%), including 92.5% of men and All respondents were divided into 4 groups. 57.5% of women, are in a state of moderate to severe Group 1 – students living in areas where there was no stress during the full-scale war in Ukraine. The intensity hostilities or shelling (the Transcarpathian region of of general stress for men and women does not differ Ukraine and EU countries) consisted of 107 people, significantly and is in the zone of marked tension including 64 (59.8%) males and 43 (40.2%) females (Kurova, 2022). (November 2022). University students are no exception. Today’s young Group 2 – students living in the area of active hostilities people face new challenges: worrying about their own (Kharkiv region, Ukraine) consisted of 103 people, safety and the safety of others, studying under martial including 52 (50.5%) males and 51 (49.5%) females law (underground adapted premises, online learning, (November 2022). disruption of timetables and quality of teaching during Group 3 – students living in areas where there was no rocket attacks), electricity, heating and water cuts, lack hostilities or shelling (the Transcarpathian region of of internet and mobile communications, etc. Despite the Ukraine and EU countries) consisted of 112 people, inhumane conditions, some students continue to study including 41 (36.6%) males and 71 (63.4%) females and live in frontline areas. Other students try to stay (March 2024). away from the war. They live in places where there are Group 4 – students living in the area of active hostilities no active hostilities. Current research shows that (Kharkiv region, Ukraine) consisted of 115 people, students’ adaptation to stress in the context of prolonged including 30 (26.1%) males and 85 (73.9%) females war is characterised by a certain complexity, stages, (March 2024). duration, nature and purposefulness (Stadnik et al., Due to the war in Ukraine, the study was conducted by 2022). This is why we believe that longitudinal studies posting the author’s questionnaire and the DASS-21 need more attention. This allows us to identify certain psychological test on the Google Forms platform for features of the psychological dynamics of the potential participants personality of students in conditions of war and https://forms.gle/1JXiLsLraBKnzAcW9. In addition, all prolonged insecurity. groups were monitored during remote and face-to-face The aim of the study. To identify the peculiarities of the teaching. Individual interviews were conducted when psycho-traumatic effects of the war in Ukraine on necessary. university students in 2022-2024, and to describe the To investigate the extent and nature of the psychological dynamics of their depression, anxiety and stress to trauma experienced by university students in the context develop further psychological support and of war and martial law, we used a questionnaire psychoprophylaxis. developed in collaboration with the Scientific Research 28 International Journal of Science Annals, Vol. 7, No. 1, 2024 рrint ISSN: 2617-2682; online ISSN: 2707-3637; DOI:10.26697/ijsa Institute KRPOCH minor manifestations (5-6/4-5/8-9 points), moderate https://forms.gle/sAaDRx4zcYF1inSz9. The manifestations (7-10/6-7/10-12 points), severe questionnaire is anonymous and consists of 14 questions manifestations (11-13/8-9/13-16 points), and extremely relating to place of study, gender, age, region of severe manifestations (14+/10+/17+ points). The residence and factors of psychological trauma in the average score on the scales is calculated as an arithmetic war. mean. Data on stress levels and content were collected using SPSS 29.0.2 software was used for the statistical the Depression Anxiety Stress Scales (DASS-21). analysis. The data were analysed by means of The DASS-21 (21 items) is a short form of the DASS- descriptive statistics. The internal consistency was 42, a self-report scale designed to measure the negative assessed by means of Cronbach’s alpha. emotional states of depression, anxiety and stress. The depression/anxiety/stress scales were scored according Results to the methodology (Henry & Crawford, 2005; This research is part of a comprehensive study of mental Lovibond & Lovibond, 1995). This technique is suitable health in the extreme conditions of martial law and full- for both clinical and nonclinical settings. For Ukrainian scale war in Ukraine, which has been ongoing since students, the Ukrainian version of the DASS-21 February 2022. questionnaire was used (Melnyk & Stadnik, 2023). The dynamics of the level and type of psychological The number of students with normal, minor, moderate, trauma experienced by university students during the severe or very severe manifestations was assessed. On war are shown in Table 1. the depression/anxiety/stress scales, the scores were as Figure 1 shows the dynamics of the overall level of follows: normal manifestations (0-3/0-4/0-7 points), psychological trauma by groups of students in wartime. Table 1 Dynamics of the Level and Type of Psychological Trauma of University Students in the Conditions of War in 2022-2024 29 International Journal of Science Annals, Vol. 7, No. 1, 2024 рrint ISSN: 2617-2682; online ISSN: 2707-3637; DOI:10.26697/ijsa Figure 1 Dynamics of the Total Level of Psychological Trauma by Groups of Students in Wartime in 2022-2024 Based on the results of the online survey, for Group 1 in of income (37.1%), fear of death and risk of losing 2022, the main factors of psychological trauma were property (37.9%). This is due to difficult military and problems adapting to a new place of residence (42.1%), humanitarian situations (daily rocket attacks, frequent separation from relatives and family (28.0%) and displacement, power, water and heat cuts). problems communicating with friends/relatives At the same time, in 2024, the trends among Group 4 (25.2%). They were least concerned about romantic students changed slightly. The main psychogeneses relationships (2.8%), the coronavirus pandemic (5.6%), were the risk of death of relatives/family (75.7%), lack fear of death (8.4%), problems communicating with of work or other sources of income (64.4%) and friends/relatives (8.4%) and problems related to martial problems related to martial law (59.1%). This can be law (8.4%). explained by the further deterioration of the socio- At the same time, in 2024 (Group 3), the following psychological situation due to the prolongation of the psychogenic factors came to the fore: risk of death of war and the significant damage to civilian infrastructure. relatives/family (75.0%), problems related to martial The coronavirus pandemic (6.1%) and problems at the law (73.2%), problems in communicating with new place of residence (12.2%) were the least common friends/relatives (67.9%) and separation from traumatic factors for students in Group 4. relatives/family (60.7%). The following factors of It should be noted that in 2022-2024, we recorded a psychological trauma had the lowest rates: risk of significant increase (more than three times) in the personal safety (2.7%), fear of injury (4.5%), and risk of following psychogeneses among university students in loss of property (8.0%). the Kharkiv region: problems with communication with It should be noted that between 2022 and 2024, we friends/relatives, problems related to martial law, and recorded a more than threefold decrease in the following problems in romantic relationships (more than twice). psychogenes: risk of personal safety, fear of injury and There has also been an increase in the following risk of property loss. This indicates that these problems psychological traumas: risk of losing housing, risk of are being addressed among this group of students. At the death of relatives and problems communicating with same time, there has been a sharp increase in problems friends and family. In our view, this is due to unresolved with romantic relationships, problems related to martial mobilisation issues, frequent rocket and drone attacks on law (more than eight times), problems communicating frontline areas, intensified enemy information and with friends/relatives and the risk of death of psychological operations, and the escalation of the relatives/family (more than three times). situation on the frontline. At the same time, the risk to Gender-specific characteristics of students living in the personal safety is reduced by 1/3. This can be explained Transcarpathian region of Ukraine and EU countries by a certain adaptation of the students to the conditions include a significant excess (two times) of psychogenic of the frontline region during this period. factors such as separation from relatives/family among Gender peculiarities of students in the Kharkiv region in males and personal safety risk among females. 2022-2024 include a significant excess (more than two For respondents in Group 2 in 2022, the most important times) of the following psychogenes among men: vital indicators of psychological trauma were risk of problems in romantic relationships, problems in a new personal safety (61.9%), lack of work or other sources place of residence, separation from relatives/family, and 30 International Journal of Science Annals, Vol. 7, No. 1, 2024 рrint ISSN: 2617-2682; online ISSN: 2707-3637; DOI:10.26697/ijsa for women – risk to personal safety, fear of death, risk The comparative characteristics of depression, anxiety of death of relatives/family. The symptoms of and stress manifestations by respondent group in 2022- psychological trauma were further evaluated using the 2024 are shown in Table 2-4. DASS-21. Table 2 Comparative Characteristics of Depression Manifestations by Respondent Group in 2022-2024 Table 3 Comparative Characteristics of Anxiety Manifestations by Respondent Group in 2022-2024 Table 4 Comparative Characteristics of Stress Manifestations by Respondent Group in 2022-2024 31 International Journal of Science Annals, Vol. 7, No. 1, 2024 рrint ISSN: 2617-2682; online ISSN: 2707-3637; DOI:10.26697/ijsa The dynamics of minor, moderate, severe and extremely for minor (15.2%), moderate (24.1%), severe (9.8%) severe depression manifestations among university and extremely severe (9.8%) manifestations of students during the war are shown in Figure 2. depression among Group 3 students in 2024 increased The dynamics of the Depression Scale revealed an more than 2-fold. This indicates a serious deterioration almost 2-fold decrease in the absence of depressive in their mental health. This was usually manifested by symptoms among students in the Transcarpathian region complaints of frequent headaches, stomach pain, rapid and the EU in 2022-2024 (from 86.9% of students in heartbeats or breathing, sweating, dizziness and Group 1 to 46.4% of students in Group 3). The scores unexplained panic. Figure 2 Dynamics of Depression Manifestations among University Students in Wartime in 2022-2024 The gender specificity of students is that depression is and extremely severe (6.7%) manifestations of more pronounced among women in Group 3 than among depression were less common among men in Group 4 all groups of students studying in the Transcarpathian than among women (3.5%, 41.2%, 22.4% and 10.6% region and in the EU. The scores of moderate (26.8%), respectively). severe (11.3%) and extremely severe (4.2%) The dynamics of minor, moderate, severe and extremely manifestations of depression among women in 2024 severe anxiety manifestations among university students increased more than 2-fold compared to the same data in during the war are shown in Figure 3. 2022 (4.7%, 2.3% and 2.3% respectively) and more than We analysed the dynamics of the Anxiety Scale score that among men in Group 3 (19.5% and 7.3% based on a study of students using the DASS-21. Among respectively). students living in the Transcarpathian region and the EU The dynamics of the Depression Scale among students in 2022, 86.9% had no anxiety symptoms (normal in the Kharkiv region (Groups 2 and 4) were revealed as manifestations), 6.5% had minor symptoms, 3.7% had follows. Over the period 2022-2024, there was a moderate symptoms, 1.9% had severe symptoms, and decrease (more than 3-fold) in the absence of depressive 0.9% had critical anxiety. In 2024, 52.7% of the students symptoms from 78.6% (students in Group 2) to 22.4% had no anxiety symptoms (normal manifestations), (students in Group 4). The scores for moderate (40.0%), 14.3% had minor symptoms, 3.7% had moderate severe (20.9) and extremely severe (9.6%) symptoms, 8.0% had severe symptoms, and 2.7% had manifestations of depression among students in Group 4 extremely severe anxiety. The increase in particularly in 2024 increased more than 5-fold. These scores are the severe and extremely severe manifestations of anxiety highest of all the groups studied. This indicates a among students indicates a sharp deterioration in their significant deterioration in the mental health of students psychological state, the presence of neurotic disorders in the Kharkiv region in 2022-2024. and maladjustment in the third year of the war. The gender differences in depression manifestations It should be noted that, according to the results of the among students in the Kharkiv region are the greatest 2022 gender survey, anxiety is more pronounced among among women in Group 4 (2024). This suggests that women. Minor anxiety symptoms were observed in these women have significant mental health problems. 11.6% of women, moderate in 7.0%, severe and In 2024, the percentages of women with moderate extremely severe in 2.3%, these percentages were (26.7%), severe (11.3%), and extremely severe (4.2%) significantly greater than those for men (3.1%, 1.6%, depression increased more than 2-fold compared to 1.6% and 0.0%, respectively). In 2024, there is no those in 2022 (4.7%, 2.3% and 2.3% respectively). Men statistically significant difference between the anxiety in Group 4 had lower levels of depression than women scores of women and men in the Transcarpathian region did. Minor (6.7%), moderate (36.7%), severe (16.7%) and the EU. 32 International Journal of Science Annals, Vol. 7, No. 1, 2024 рrint ISSN: 2617-2682; online ISSN: 2707-3637; DOI:10.26697/ijsa Figure 3 Dynamics of Anxiety Manifestations among University Students in Wartime in 2022-2024 The dynamics of the Anxiety Scale among students in indicating significant mental disorders among these the Kharkiv region showed that moderate (24.4%), respondents. severe (12.2%) and extremely severe (8.7%) The scores of moderate (25.9%), severe (12.9%) and manifestations of anxiety among students in Group 4 in extremely severe (4.7%) anxiety among women in 2024 2024 increased more than 3 times and were the highest increased by 1.5-2 times compared to those in 2022 among all study groups. This indicates a significant (9.8%, 5.9% and 3.9% respectively). deterioration in the mental health of the students, The anxiety scores of the men in Group 4 (20.0%, 10.0% manifested by complaints of palpitations, pain behind and 3.3%, respectively) were also lower than those of the breastbone, rapid breathing, excessive sweating, the women. trembling, weakness, fatigue, dizziness, frequent The dynamics of minor, moderate, severe and extremely urination and sleep problems. severe stress manifestations among university students Among all gender groups in the Kharkiv region, anxiety during the war are shown in Figure 4. is most pronounced among women in Group 4 (2024), Figure 4 Dynamics of Stress Manifestations among University Students in Wartime in 2022-2024 The dynamics of the Stress Scale among students in the minor manifestations of stress; 1.7% experienced Transcarpathian region and the EU (Groups 1 and 3) are moderate manifestations; 0.9% of the students in Group as follows. In 2022, 8.4% of the students experienced 1 had severe and extremely severe manifestations. In 33 International Journal of Science Annals, Vol. 7, No. 1, 2024 рrint ISSN: 2617-2682; online ISSN: 2707-3637; DOI:10.26697/ijsa 2024, 9.8% of students experienced minor stress among students in the Kharkiv region remained manifestations of stress; 4.5% experienced moderate virtually unchanged in 2022-2024, indicating an manifestations; 0.9% of the students in Group 3 insufficient level of adaptation to stress among students experienced severe or extremely severe manifestations. in the third year of the war. The lack of dynamics indicates a certain stabilisation of Gender differences among students studying in the acute stress among students in the Transcarpathian Kharkiv region are that among all gender groups, stress region and the EU during the war. is most pronounced among males in Group 4 (2024). The gender peculiarities of stress manifestations among This indicates significant psychological disturbance in students in the Transcarpathian region and the EU are these respondents, manifested by heart palpitations, that moderate, severe and extremely severe breathing difficulties and insomnia. Male students were manifestations were observed in 2.4% of the students, more likely to have diarrhoea (or, conversely, which is greater than the same percentages among constipation), acute respiratory diseases, skin diseases women (5.6%, 0.0% and 0.0%, respectively). This (neurodermatitis), allergies, tremors and sticky hands. indicates that male students are less able to adapt to The scores of men with minor (23.3%), moderate stress. (13.3%), severe (3.3%) and extremely severe (3.3%) By analysing the dynamics of the Stress Scale among stress in 2024 are significantly greater than those of students in the Kharkiv region (Group 2 and Group 4), women (16.5%, 4.7%, 2.4% and 1.2% respectively). we noted a slight increase in minor (18.3%) and The dynamics of the total manifestations of depression, moderate (7.0%) manifestations of stress in 2024. At the anxiety and stress among university students during the same time, the scores of severe and extremely severe war are shown in Figure 5. Figure 5 Dynamics of Total Manifestations of Depression, Anxiety and Stress among University Students in Wartime During the 2022-2024 war in Ukraine, we observed the significantly greater than those in 2022 for Group 1 (2.5 following changes in the psychological well-being of points) and Group 2 (3.0 points). We believe this is due university students. to the continued uncertainty of the military and The average scores on the Depression Scale for students humanitarian situation in Ukraine as a result of the war. in Groups 1 and 2 (2022) were 2.7 and 3.2 points This took the form of increased helplessness, insecurity, respectively, which are more than twice as high as those powerlessness, powerlessness, insecurity, loneliness, a for students in Group 3 (5.1 points) and Group 4 (7.2 sense of failure and an inability to make decisions. It points) in 2024. This upwards trend in depression should be noted that the average score on the Anxiety indicates a certain tendency toward chronic neurotic Scale for female students was greater than that for male disorders among university students against the students in all study groups. background of the protracted war in Ukraine, which The average scores on the Stress Scale for students in manifests itself in increased complaints of low mood, low Groups 1 and 3 living in the Transcarpathian region and self-esteem, pessimism, apathy, lethargy, fatigue, the EU remained virtually unchanged over the period constant dissatisfaction and hopelessness. In terms of 2022-2024 (4.8 and 4.9 points respectively) and were gender differences in the Depression Scale, the average lower than those for students in Groups 2 and 4 living in score of female students was greater than that of male the Kharkiv region (5.5 and 5.7 points respectively). This students in all study groups. indicates a much worse military and humanitarian We also see an upwards trend on the Anxiety Scale. The situation in the Kharkiv region, which is close to the front average scores for students in Group 3 and Group 4 in line, as well as a certain adaptation of students to acute 2024 were 3.9 and 4.8 points, respectively, which are psychogenic conditions in the context of the 2022-2024 34 International Journal of Science Annals, Vol. 7, No. 1, 2024 рrint ISSN: 2617-2682; online ISSN: 2707-3637; DOI:10.26697/ijsa war. It should be noted that the average score of the male to combat psychological trauma depends on the impact students on the Stress Scale was greater than that of the of extreme conditions (participation in combat female students in all study groups. operations). Even with a low level of exposure to extreme Cronbach’s alpha coefficients were calculated for each of conditions (lack of combat experience), there is a high the three scales of the DASS-21 as an estimate of internal probability of mental disorders, a tendency toward consistency reliability. Acceptable levels of reliability personality disorders, and behavioural and activity were found for all scales: Depression scale α=0.712, disorders. Anxiety scale α=0.783, Stress scale α=0.733. Cronbach’s The COVID-19 pandemic has added extreme conditions alpha for the total scale was α=0.807. These scores are an to the existing conditions of low-intensity warfare in our indication of the homogeneity of the items in each study of the mental health of military personnel and dimension of the scale. students. These new conditions made it possible to determine that military men with combat experience Discussion were significantly less likely to suffer from anxiety, Since the end of the Second World War, Europe has not depression, stress and sleep disorders than military men seen a war of scale and intensity that is currently taking without such experience (Melnyk et al., 2020; Melnyk & place in Ukraine. This war has affected the lives of more Stadnik, 2020). We assumed that the mental health of than 40 million Ukrainians, including hundreds of students in low-intensity wars and under extreme thousands of students. pandemic conditions would be significantly different Most students continue their studies at university. Some from the mental health of trained military personnel. students (a small number, mostly women) have been Therefore, we only looked at students who were involved forced to become refugees and continue their studies in sports. Most students had a moderate level of mental remotely in EU countries. It must be borne in mind that health, approximately one-third had a high level of in the globalised modern world, the effects of a war in mental health, and less than 10.0% had a low level of one country will inevitably have repercussions in other mental health (Melnyk et al., 2022). Similar findings of countries. War affects international politics, economics, the positive impact of physical activity and sport on population migration, health care, etc., to varying respondents’ mental health during this period have been degrees. reported by other researchers (Lange et al., 2023; Watson This study is an integral part of a longitudinal study that et al., 2023). These studies confirm that systematic includes a comprehensive examination of the mental physical activity has a positive effect on mental health, health of Ukrainian students continuing their studies even in the extreme conditions of a pandemic and/or low- under extreme conditions: low-intensity war (2014- intensity war. The positive effect of physical activity on 2022), the COVID-19 pandemic (2020-2022), and students’ mental health has been demonstrated in martial law and full-scale war in Ukraine (from 2022 to numerous studies (Mahindru et al., 2023; Melnyk, 2019; the present). This study explored stressors that may affect Yao et al., 2023), including under the extreme conditions the academic performance and well-being of young of the COVID-19 pandemic (Huang et al., 2023; Precht people in a military environment. Such risk factors et al., 2023). include mental, emotional and behavioural problems. Studies of student youth in a full-scale war show that the For a specific study, the dynamics of depression, anxiety greatest psychogenics are: risk of death of relatives, and stress indicators were examined among students at family separation from relatives, family, lack of work or state universities in Ukraine who studied in 2022-2024 in other source of income, fear of death and risk of loss of significantly different regions. The study also included property (Stadnik et al., 2022). students who continued their studies at a distance in EU There is also a link between psychological distress and countries. This choice was necessitated by the need to chronic fatigue and sleep problems. This relationship is study the effects of warfare on students under different bidirectional, as symptoms can be both a source and a conditions of stress: Group 1 (students living in areas consequence of psychological distress. In addition, the where there was no hostilities or shelling, dependence of the mental state of the students on the Transcarpathian region of Ukraine and EU countries, degree of their physical proximity to the combat zone November 2022); Group 2 (students living in the area of was revealed. The negative impact on students’ mental active hostilities, Kharkiv region, Ukraine, November health increases with proximity to the combat zone 2022); Group 3 (students living in areas where there was (Stadnik et al., 2023). The analysis of the psychological no hostilities or shelling, Transcarpathian region of well-being of university students and their choice of Ukraine and EU countries, March 2024); and Group 4 coping strategies to overcome life crises in the context of (students living in the area of active hostilities, Kharkiv the war in Ukraine shows that the level of negative region, Ukraine, March 2024). impact was greater the closer the students were to the Recent scientific publications in the social and zone of active hostilities. University students use behavioural sciences, as well as the authors’ own different coping strategies in stressful war situations in experience, allowed us to build the methodological basis Ukraine. However, the coping strategy of cognitive for our research. restructuring is more commonly used. Coping strategies Previous studies have examined the effects of extreme of social support and self-criticism are typical for conditions of low-intensity warfare on military personnel students living in the area of active military operations (Melnyk et al., 2019). The level of resistance of soldiers (Pypenko et al., 2023). 35 International Journal of Science Annals, Vol. 7, No. 1, 2024 рrint ISSN: 2617-2682; online ISSN: 2707-3637; DOI:10.26697/ijsa Personal resources that might support the resilience of a influence of their proximity to the combat zone. Similar sample of Ukrainian students to the stress of war were results have been found in a number of studies: explored. Emotional stability and resilience were found manifestations of depression were more common in to be the resources most strongly associated with fewer women than in men. At the same time, severe and posttraumatic stress disorder symptoms and fewer extremely severe manifestations of anxiety (2-3 times physical complaints, while benevolence and integrity higher than similar indicators in respondents) were also played a role (Kokun & Bezverkhyi, 2024). observed among students who were not in the vicinity of The problems of Ukrainian refugee students pursuing the combat zone (Stadnik et al., 2022; 2023). There was higher education in Europe have been studied by Pentón evidence of a strong dose-response relationship between Herrera and Byndas (2023), and Regnoli et al. (2023). war-related stressors and meeting criteria for Refugees have been found to experience psychological posttraumatic stress disorder (PTSD) and complex PTSD stress that can lead to mental health problems. War- (CPTSD). Participants who had the highest exposure to related population movements have a negative impact on war-related stressors were significantly more likely to mental health, which is regularly confirmed by numerous meet the requirements for PTSD (OR=4.20; 95% studies (Fino et al., 2020; Radhouane, 2023). CI=2.96-5.95) and CPTSD (OR=8.12; 95% CI=5.11- The unprecedented scale of Russian aggression against 12.91) compared to the least exposed (Karatzias et al., Ukraine has caused the largest mass displacement of 2023). people in modern history (Patel & Erickson, 2022). Similar trends, albeit at slightly different rates, have been Studies show that asylum seekers and refugees are reported by other researchers. People living in a war-torn particularly vulnerable to traumatic experiences that are region of Ukraine also had a significantly increased risk threefold in nature: pre-migration, peri-migration, and of PTSD (OR=4.11, 95% CI=2.37-7.13), severe anxiety post-migration (Chen et al., 2017). According to (OR=3.10, 95% CI=1.83-5.27), and moderate/severe researchers (Marchi et al., 2022), the experience of war depression (OR=2.65, 95% CI=1.79-3.92) (Osokina et and displacement can have profound effects on children’s al., 2023). affective development and mental health. However, the Thus, the use of different techniques to study this mechanisms underlying these effects remain unknown. problem shows similar results – the war had a significant In addition, refugees are exposed to war through the negative impact on the mental state of students, and the media coverage of war-related violence. This leads to closer they were to the war zone, the greater the impact. stress and overstimulation (Chudzicka-Czupała et al., In line with previous research on the impact of the 2023). Russian-Ukrainian War on the mental health of students’ The relevance of certain psychological symptoms youth in Ukraine, predictors are described that determine (anxiety, depression, insomnia, and poor health) among the impact of features of interpersonal style on the index civilians and especially young people during war is of perceived stress, index of coping resources, positive widely recognised (Baroud & Dirani, 2023; Zaid et al., attitude towards others, autonomy, environmental 2023). management, personal development, life goals, self- Contemporary research during the Russian-Ukrainian perception, psychological well-being, inclusion, control, War has shown high prevalence rates of symptoms of risk acceptance, and resilience (Lunov et al., 2023). psychological distress, anxiety, depression and insomnia Effects can also be characterised as stages of mental among Ukrainians aged 18 and over. In addition, health impact: acute reactions – acute disorder – chronic researchers stress the need for further research and the stress/disorder at both personal and societal levels (Vus need to develop effective survival strategies for & Esterlis, 2022). Gilreath et al. (2022) studied stressors Ukrainians during the war (Długosz, 2023; Khraban, that can affect the academic performance and well-being 2022; Pavlova & Rogowska, 2023). of youth during wartime. The choice of the subject of research and techniques was This study has several limitations. First, it should be determined by the real needs and problems identified in noted that the study was conducted under active war the scientific literature. The Depression Anxiety Stress conditions, which may have contributed to the high Scales are widely used in modern research as a reliable scores. Second, our study is limited by the small number screening tool for studying the impact of war on of participants in each group. It was not possible to carry individuals’ mental health (Çelebi & Durmuş Sarıkahya, out a more comprehensive assessment of the students 2023; Chudzicka-Czupała et al., 2023; El-Ghitany et al., under these conditions. 2024). It must be considered that the participants were young The application of this technique made it possible to students. This may have influenced the results. Some identify psychogenic factors affecting students in war researchers argue that young people are more interested and martial law conditions, as well as to detail in contemporary social dilemmas than other age groups, psychopathological symptoms according to the Anxiety, and that this affects their mental health and psychological Depression and Stress Scales. well-being (Barchielli et al. 2022; Bezzi 2022; Galliano We analysed the data from the DASS-21 study and 2020). compared it with other research techniques, namely, the It should also be noted that in the study of Ukrainian General Health Questionnaire (GHQ-28), and the Social students, we used only the Ukrainian versions of the Support Questionnaire (F-SozU K-22), in the context of author’s questionnaire and the DASS-21 questionnaire dividing students into groups according to the level of (Melnyk & Stadnik, 2023). This approach avoided any 36 International Journal of Science Annals, Vol. 7, No. 1, 2024 рrint ISSN: 2617-2682; online ISSN: 2707-3637; DOI:10.26697/ijsa possible misinterpretation of the questions and optimised sweating, dizziness and occasional panic. The gender the response time. peculiarity of depression is its prevalence among women Nevertheless, this has provided important information in all groups, with the highest levels of depression among that provides an insight into the mental health status of women in Group 4 (Kharkiv region) in 2024. the sample and allows conclusions to be drawn about the The studied dynamics of anxiety among students showed dynamics of this process over the last two years, which an increase in moderate, severe and extremely severe can help to take early action to improve the mental health manifestations of anxiety both among students in Group status of students. 3 (the Transcarpathian region and the EU) and among students in Group 4 (the Kharkiv region). At the same Conclusions time, the anxiety scores of Group 4 students increased In conclusion, the ongoing war in Ukraine has had a more than 3-fold in 2024 and were the highest of the all negative impact on the mental health of university groups. The symptoms included palpitations, pain behind students. the breastbone, rapid breathing, excessive sweating, Our longitudinal studies conducted in 2022-2024 showed trembling, weakness, fatigue, dizziness, and frequent that university students in the Transcarpathian region of urination and sleep problems. Gender peculiarities: the Ukraine and EU countries are characterised by a anxiety scores of women and men in the Transcarpathian significant decrease (by 3 to 4 times) in the following region and the EU are not significantly different, and psychogenes: risk of personal safety, fear of injury, and among all gender groups, anxiety is most pronounced risk of property loss. This indicates a reduction in their among women in Group 4 in 2024. role in the psychological trauma of students. At the same The recorded dynamics of stress among university time, there was a significant increase in problems with students during the war showed a certain stabilisation and romantic relationships, problems related to martial law (8 the absence of acute stress among students in the times), problems communicating with friends/relatives Transcarpathian region and the EU, as well as an increase and the risk of death of relatives/family (3 times). in minor and moderate stress among students in the Among university students who did not change their Kharkiv region. Symptoms included palpitations, place of permanent residence and stayed in the frontline difficulty breathing, insomnia, frequent diarrhoea (or, area of the Kharkiv region in 2022-2024, we recorded a conversely, constipation), acute respiratory problems, significant increase in the following psychogenes: skin problems (neurodermatitis), allergies, tremors and problems communicating with friends/relatives, sticky hands. The gender specificity of stress problems related to martial law, problems in romantic manifestations among students is the prevalence of stress relationships (more than 3 times), the risk of losing among males in all groups studied. In 2024, men in housing, the risk of death of relatives, and problems Group 4 (Kharkiv region) had the highest level of stress, communicating with friends/relatives (more than 2 indicating that these respondents had acute mental times). In our opinion, this is due to the problems of disorders. mobilisation, frequent rocket and drone attacks on the The dynamics of general depression, anxiety and stress frontline areas, the intensification of the enemy’s scores among university students during the war showed information and psychological operations and the a trend towards an increase in depression and anxiety and escalation of the situation on the frontline. At the same a stabilisation of stress scores. This indicates the time, there is a decrease in the risk to personal safety (by chronicity of neurotic disorders among students in the 1/3), which can be explained by a certain adaptation of context of the protracted war in Ukraine. Symptoms the students to the conditions of the frontline region included increasing complaints of low mood, low self- during this period. esteem, pessimism, apathy, lethargy, fatigue, constant Gender dynamics are characterised by a significant dissatisfaction and hopelessness. prevalence of psychogenic factors such as separation In our view, the prospect of further research lies in the from relatives and family (Groups 1 and 3) and problems development of effective measures of psychological with romantic relationships and new residences (Groups support and psychoprophylaxis among students. 2 and 4). For women, the greatest risks are personal Acknowledgments safety (in the Transcarpathian region and the EU), fear of The authors would like to express their gratitude to all the death, and the risk of death for relatives and family (in participants who completed the questionnaire and all who the Kharkiv region). helped us in distributing and gathering the questionnaires A more detailed study of the dynamics of required for the data collection. psychopathological symptoms, carried out using the DASS-21 technique, showed that in 2022-2024 among Ethical Approval students in the Transcarpathian region and the EU, the The study protocol was consistent with the ethical scores of minor, moderate, severe and extremely severe guidelines of the 1975 Declaration of Helsinki, as manifestations of depression increased more than 2-fold. reflected in prior approval by the Institution’s Human Among students living in the Kharkiv region, it increased Research Committee. Permission for this research was more than 5-fold and was the highest of all student received from the Research Committee of Virtue and groups. This indicates a serious deterioration in students’ Ethics Scientific Research Institute KRPOCH (protocol mental health and is usually manifested by frequent no. 023-3/SRIKRPOCH dated 10.08.2023). Informed headaches, stomach aches, rapid heartbeat or breathing, consent was sought from all the participants. 37 International Journal of Science Annals, Vol. 7, No. 1, 2024 рrint ISSN: 2617-2682; online ISSN: 2707-3637; DOI:10.26697/ijsa Funding Source Fino, E., Mema, D., & Russo, P. M. (2020). War trauma This research did not receive any outside funding or exposed refugees and posttraumatic stress support. disorder: The moderating role of trait resilience. Journal of Psychosomatic Research, 129, Article References 109905. Barchielli, B., Cricenti, C., Gallè, F., Sabella, E. 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International Journal of Science Annals, 7(1), 27–40. https://doi.org/10.26697/ijsa.2024.1.6 The electronic version of this article is complete. It can be found online in the IJSA Archive https://ijsa.culturehealth.org/en/arhiv This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (http://creativecommons.org/licenses/by/4.0/deed.en). 40