International Journal of Science Annals, Vol. 8, No. 1, 2025 рrint ISSN: 2617-2682; online ISSN: 2707-3637; DOI:10.26697/ijsa SOCIAL AND BEHAVIORAL SCIENCES. Psychology ORIGINAL RESEARCH Psychological Distress and Healthy Lifestyle among University Students in Wartime Authors’ Contribution: Stadnik A. V. 1,2 ABDEF , Mykhaylyshyn U. B. 2 BD , A – Study design; Wasilewski B.3 BF , Pypenko I. S.1,4 CDEF B – Data collection; 1 C – Statistical analysis; Kharkiv Regional Public Organization “Culture of Health”, Ukraine 2 D – Data interpretation; Uzhhorod National University, Ukraine 3 E – Manuscript preparation; Psychosomatic Institute, Poland 4 F – Literature search; Scientific Research Institute KRPOCH, Ukraine G – Funds collection Received: 05.04.2025; Accepted: 17.05.2025; Published: 30.06.2025 Abstract Background and The war in Ukraine, which is still ongoing, has a significant impact on the mental Aim of Study: state of each individual. The same applies to university students forced to seek refuge inside or outside the country. The aim of the study: to identify the characteristics of psychological distress experienced by university students in a war context and the role of a healthy lifestyle in overcoming it. Material and Methods: The study was conducted by Uzhhorod National University (Ukraine) in February 2025, involving the administration of adapted DASS-21 and HPLP-II psychological tests via the Google Forms platform. The respondents, aged between 18 and 35, were divided into two groups: those who were forced to relocate to other regions (European Union and Ukraine) and those who did not change their place of residence (Ukraine). Psychological distress and healthy lifestyle behaviours among students in wartime were identified using the DASS and HPLP-II. These tools demonstrated high internal consistency, with values ranging from 0.916 to 0.951. There was a statistically significant negative correlation between psychological distress and health-promoting lifestyles. Results: The levels of depression and anxiety were significantly higher among students in Group 1 than among those in Group 2. The study revealed the following gender- related findings: high average scores on the Depression and Anxiety scales (13.4 and 12.3 points, respectively) among women in Group 1; high average scores on the Stress scale (12.4 and 12.1 points, respectively) among men in all groups. The following healthy lifestyle practices play an important role in helping both groups to overcome the symptoms of psychological distress: interpersonal relationships (2.8 / 3.0 points), spiritual growth (2.8 / 2.9 points), and stress management (2.6 / 2.7 points). They had high and moderate HPLP-II scores. Students in Groups 1 and 2 demonstrated poor use of practices such as taking responsibility for their health (2.15 and 2.23 points), being physically active (2.2 and 2.3 points) and eating healthily (2.3 and 2.4 points). They had low HPLP-II scores. Conclusions: The high levels of depression and anxiety experienced by university students during the war were caused by a combination of psychogenic factors and their own behaviour. It does not promote mental health. The study results indicate the need to introduce measures that increase motivation for personal health and physical activity among university students, tailored to their specific requirements and needs. Keywords: psychological distress, anxiety, depression, stress, healthy lifestyle students, war Copyright: © 2025 Stadnik A. V., Mykhaylyshyn U. B., Wasilewski B., Pypenko I. S. Published by Archives of International Journal of Science Annals DOI: https://doi.org/10.26697/ijsa.2025.1.3 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 33 International Journal of Science Annals, Vol. 8, No. 1, 2025 рrint ISSN: 2617-2682; online ISSN: 2707-3637; DOI:10.26697/ijsa Information about Stadnik Anatoliy Volodymyrovych – https://orcid.org/0000-0002-1472-4224; the authors: Doctor of Philosophy in Medicine, Affiliated Associate Professor, Kharkiv Regional Public Organization “Culture of Health”, Kharkiv, Ukraine; Uzhhorod National University, Uzhhorod, Ukraine. Mykhaylyshyn Ulyana Bohdanivna – https://orcid.org/0000-0002-0225-8115; Doctor of Psychological Sciences, Full Professor; Head of the Department of Psychology, Uzhhorod National University, Uzhhorod, Ukraine. Wasilewski Bohdan – https://orcid.org/0000-0001-6892-4021; Doctor of Philosophy in Medicine, MD, Professor, Psychosomatic Institute, Warsaw, Poland. 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”; Scientific Research Institute KRPOCH, Ukraine. Introduction Full-scale war has been raging in Ukraine for four years, negative emotional states such as depression, anxiety affecting the psychological well-being of every and stress. The number of students displaying normal, Ukrainian citizen. People were forced to save their lives mild, moderate, severe or extremely severe and those of their loved ones. They had to leave their manifestations is assessed. On the Depression/Anxiety/ homes and move to a safer city, which meant changing Stress scales, the scores are as follows: normal their lifestyle and experiencing losses: loved ones, manifestations: 0–3/0–4/0–7 points; mild homes and their way of life. Like all Ukrainians, manifestations: 5–6/4–5/8–9 points; moderate students are trying to adapt to the war. Some have fled manifestations: 7–10/6–7/10–12 points; severe to safer regions of Ukraine or European Union (EU) manifestations: 11–13/8–9/13–16 points; extremely countries, while others have remained in their homes. severe manifestations: 14+ / 10+ / 17+. The average Current research (Blanco et al., 2021; Chao et al., 2023; score on each scale is calculated using the arithmetic Morais et al., 2020; Pypenko et al., 2020) shows that mean. The DASS-21 is a quick and effective way of adapting to new conditions and reducing distress assessing psychological distress and its components. It involves changing to a particular lifestyle to a more is widely used in scientific and clinical research. appropriate one that promotes health. The DASS-21 scores showed good internal consistency. The aim of the study. To identify the characteristics of The Cronbach’s alphas were 0.916 and 0.951 for Group psychological distress experienced by university 1 students (who had been temporarily displaced) and students during wartime and the role of a healthy Group 2 students (who had not left their usual place of lifestyle in overcoming it. residence), respectively. The Health Promotion Lifestyle Profile-II (HPLP-II, Materials and Methods Walker et al., 1987; Ukrainian adaption by Melnyk & The study was conducted among students aged between Stadnik, 2025) questionnaire assesses health-promoting 18 and 35 at Uzhhorod National University in February behaviours and lifestyles. The questionnaire assesses 2025. health-promoting behaviours. The HPLP-II is a widely All respondents were divided into two groups: used tool for evaluating health-promoting behaviours Group 1 comprised 109 university students who were and lifestyles. It has been shown to be valid and reliable forced to change their residence during the war, moving in numerous studies. The questionnaire contains 52 to other regions of Ukraine or EU countries. Of these statements about attitudes towards healthy lifestyles. students, 28 (25.7%) were men and 81 (74.3%) were These statements are classified into six subscales: health women. responsibility (HR), physical activity (PA), nutrition Group 2 comprised 117 university students who did not (Nu), spiritual growth (SG), interpersonal relationships leave their usual place (Ukraine) of residence during the (IR) and stress management (SM). Taking responsibility war. Of these students, 18 (15.4%) were men and 99 for one’s health means recognising the importance of (84.6%) were women. improving one’s health and the health of others. Physical Due to the war in Ukraine, the study was conducted by activity includes regular physical exercise. Eating habits sharing psychological techniques via Google Forms involve establishing a nutritional routine and making with potential participants. In addition, all groups were informed food choices. Spiritual growth involves observed during both remote and face-to-face classes. achieving self-realisation. Interpersonal relationships Individual interviews were conducted as required. are about fostering intimacy and closeness with others. The Depression Anxiety Stress Scales (DASS-21, Stress management involves recognising the sources of Lovibond et al., 1995; Ukrainian adaptation by Melnyk stress and taking steps to control it and achieve & Stadnik, 2023) are used to collect data on the level of relaxation. The frequency of each behaviour was distress and its content. The DASS-21 is a shortened determined using a 4-point Likert response scale version of the 21-question DASS designed to measure consisting of the following options: 1 – “Never”; 2 – 34 International Journal of Science Annals, Vol. 8, No. 1, 2025 рrint ISSN: 2617-2682; online ISSN: 2707-3637; DOI:10.26697/ijsa “Sometimes”; 3 – “Often”; 4 – “Regularly”. The average (who had been temporarily displaced) and Group 2 score for each subscale is obtained by adding the scores students (who had not left their usual place of residence), for each item and dividing by the number of items. respectively. HPLP-II subscale mean scores below 2.5 are considered low; between 2.5 and 3.0, moderate; and above 3.0, high Results (Dhiman & Chawla, 2017). The total HPLP-II score is We examined the characteristics of psychological obtained by taking the average of all 52 responses. distress among university students using the DASS-21 According to the guidelines (Lim et al., 2016; Walker et questionnaire, which enables us to evaluate levels of al., 1987), the overall HPLP II score is categorised as depression, anxiety and stress. one of the following four levels: poor (52–90), moderate Mean scores for all item measures were calculated. The (91–129), good (130–168) or excellent (169–208). general results of psychological distress for two groups Higher scores indicate a higher frequency of health- of university students by the scales of depression, promoting behaviours. anxiety, and stress during wartime are shown in Table 1. The data were collected and analysed using the Figure 1 illustrates how psychological distress manifests Statistical Package for the Social Sciences (SPSS), in the two groups, as measured by the Depression, version 30.0. Anxiety and Stress Scales (DASS). The Cronbach’s alphas for the HPLP-II scores in the present study were 0.918 and 0.926 for Group 1 students Table 1 The Scores for the Assessment of Psychological Distress by the Scales (Depression, Anxiety, and Stress) among Students in Wartime Figure 1 Comparative Characteristics of the Manifestations of Depression, Anxiety and Stress among Students in Both Groups Among Group 1 students who are internally displaced, almost identical across all groups, indicating a we observe high average scores on the Depression and consistent level of acute stress among students. Anxiety scales (12.3 and 11.7 points, respectively). It It should be noted that the women in Group 1 scored indicates an increase in neurotic symptoms among highly on the Depression and Anxiety scales, with university students as the war in Ukraine continues, as scores of 13.4 and 12.3 points, respectively. We believe evidenced by an increase in reports of low mood, low this is due to their heightened emotional response to self-esteem, pessimism, apathy, lethargy, fatigue, Ukraine’s uncertain military and humanitarian situation. constant dissatisfaction, and hopelessness. Students in It manifested as increased helplessness, uncertainty, Group 2 had significantly lower scores on the powerlessness, insecurity, loneliness, a sense of failure, Depression and Anxiety scales (10.9 and 10.1 points, and an inability to make decisions. On average, men in respectively), indicating that they had adapted better to Groups 1 and 2 have higher scores on the Stress scale the current conditions. The scores on the Stress scale are (12.4 and 12.1 points, respectively). These scores are 35 International Journal of Science Annals, Vol. 8, No. 1, 2025 рrint ISSN: 2617-2682; online ISSN: 2707-3637; DOI:10.26697/ijsa associated with acute psychogenic factors related to Figure 2 presents further details on the manifestations of possible mobilisation, unemployment, and a lack of depression among university students in wartime. funds. Figure 2 Levels of Depression Severity among Students in Wartime The profile of depression among Group 1 students (20.5%) and mild (14.5%) manifestations. It suggests exhibits certain peculiarities. The highest rates of that this group of students has adapted well to war depression are observed: 44.04% are extremely severe, conditions. and 22.94% are severe. At the same time, no The absence of depressive symptoms was most manifestations (19.6%), mild and moderate prevalent among men in Group 1 (21.4%), which was manifestations of depression were significantly lower more than twice as high as in other gender groups. It may (11.0%, 10.1% and 11.9%, respectively). It suggests indicate latent depression, which can manifest as that, despite being in a safe place, there is a significant substance abuse, somatic vegetative disorders, and psychogenic burden. The rate of extremely severe deviant behaviour. depression among students in Group 2 (who did not Additionally, we found that women in Group 1 (49.4%) leave their usual place of residence during the war) was exhibited the most severe symptoms of depression, almost three times lower (16.2%) than in Group 1. This indicating significant mental distress. group shows the highest prevalence of moderate Figure 3 shows the manifestations of anxiety among depression (38.5%), with smaller percentages for severe students in wartime. Figure 3 Levels of Anxiety among Students in Wartime 36 International Journal of Science Annals, Vol. 8, No. 1, 2025 рrint ISSN: 2617-2682; online ISSN: 2707-3637; DOI:10.26697/ijsa Among the students who did not change their place of trembling, weakness, fatigue, dizziness, frequent residence during the war (Group 2), 5.1% showed no urination and sleep problems. signs of anxiety, 16.2% showed mild symptoms, 19.7% According to the results of the gender study, the highest showed severe symptoms, and 22.2% showed extremely rates of extremely severe anxiety were found among severe symptoms. women in Group 1 (70.4%), which was significantly The moderate level of anxiety was the most prevalent in higher than the rate found among men in Group 1 this group (36.8%). The highest rates of severe and (46.4%). In Group 2, the highest rates of moderate extremely severe anxiety were observed among students anxiety were observed in both men and women (36.4% of Group 1 (14.7% and 64.2%, respectively), indicating and 36.4%, respectively). a significant deterioration in their psychological state Severe and extremely severe anxiety was more prevalent and the presence of neurotic disorders and in women (20.2% and 23.2%, respectively) than in men maladjustment in the fourth year of the war. (16.7%), indicating greater maladjustment in women. These symptoms included heart palpitations, pain Figure 4 shows the manifestations of stress among behind the sternum, rapid breathing, excessive sweating, students in wartime. Figure 4 Levels of Stress among Students in Wartime Among students who are internally displaced persons Table 3 summarises the descriptive and correlational (Group 1), manifestations on the Stress scale showed statistics obtained for the total DASS-21 scale and its that 35.8% had no stress, 8.3% had mild stress, 20.2% three subscales. The results showed that the subscales of had moderate stress, 12.8% had severe stress, and 22.9% Stress and Depression were more strongly associated had extremely severe stress. with each other than with Anxiety. Meanwhile, Group 2 The manifestations of stress were slightly lower in has a higher level of subscale connectivity than Group 1 Group 2 students. (0.853 and 0.764, respectively). Mild manifestations of stress were observed in 9.4% of Cronbach’s alpha coefficients were calculated to study people, moderate manifestations in 52.1%, severe internal consistency (coefficients for Group 1 / manifestations in 8.6%, and extremely severe Group 2). The total DASS scale showed a high internal manifestations in 7.7%. It indicates a stabilisation of consistency (alpha = 0.916 / 0.951. acute stress symptoms among Group 2 students in The Depression subscale had the highest measure of wartime conditions. internal consistency (alpha = 0.893 / 0.905), followed Gender-specific stress manifestations among students by the Anxiety subscale (alpha = 0.851 / 0.893), and are severe and extremely severe among men in Groups finally, the Stress subscale (alpha = 0.808 / 0.833). 1 and 2 (25.0% and 16.7%, respectively), which is The subscales demonstrate convergent validity with higher than the corresponding figures for women (8.6% other measures of depression (Crawford & Henry, 2003) and 7.1%, respectively, for severe stress; 22.2% and and anxiety (Bedford & Deary, 1999). For the present 6.1%, respectively, for extremely severe stress). It study, composite and individual scale scores were indicates that male students have a worse ability to adapt calculated for each respondent. to stress. It was hypothesised that there would be a negative The general characteristics of psychological distress correlation between the total and subscale (Depression, among students in wartime are shown in Table 2, as Anxiety and Stress) scores of the DASS and the HPLP- measured by the Depression, Anxiety and Stress Scales. II scores. 37 International Journal of Science Annals, Vol. 8, No. 1, 2025 рrint ISSN: 2617-2682; online ISSN: 2707-3637; DOI:10.26697/ijsa Table 2 General Characteristics of Psychological Distress among Students in Wartime, as Measured by the Depression, Anxiety and Stress Scales Table 3 Descriptive Statistics and Pearson Correlation Coefficients of the Subscales and Total DASS Score Note. **Correlation is significant at the 0.01 level; correlations for Group 1 are presented above the diagonal and correlations for Group 2 below the diagonal; DASS-total – the DASS-21 scale in total. The study of students’ health-promoting behaviour and Table 4 presents the results of calculating the total lifestyle was conducted using the Health Promotion healthy lifestyle indicator among university students in Lifestyle Profile-II questionnaire. a war context. Table 4 Overall Score for the General Indicator of a Healthy Lifestyle among University Students in Wartime According to the overall HPLP II score, Group 1 has a concerned about leading a healthy lifestyle than women, moderate health-promoting lifestyle (126.3 points), achieving the lowest overall score (122.0 points) of all while Group 2 has a good one (132.2 points). It suggests the gender groups. that Group 2 is better able to adopt health-promoting Meanwhile, men in Group 2 achieved the highest score behaviours. At the same time, men in Group 1 were less (136.1 points). 38 International Journal of Science Annals, Vol. 8, No. 1, 2025 рrint ISSN: 2617-2682; online ISSN: 2707-3637; DOI:10.26697/ijsa We believe that it is mainly because they are financially Figure 5 shows the grouping of healthy lifestyle insecure and lack support from relatives who are also in indicators by subscales and the assessment of their difficult circumstances. manifestation. Figure 5 Assessing Healthy Lifestyle Indicators Grouped by Subscales Students in Group 1 achieved moderate mean scores on with family and friends, and the lack of opportunity to the interpersonal relationships (IR) (2.81), spiritual care about personal health when people are killed and growth (SG) (2.77 points) and stress management (SM) injured during the war. (2.58 points) subscales and low mean scores on the The gender-specific characteristics of the students in health responsibility (HR) (2.15 points), physical Group 1 were as follows: the highest mean scores were activity (PA) (2.20 points) and nutrition (Nu) (2.31 in the spiritual growth (SG) subscale for men (2.74 points) subscales. It demonstrates how important it is for points) and in the interpersonal relationships (IR) them to deal with personal uncertainty (e.g. how long subscale for women (2.89 points). The lowest scores will the war last, and what should I do?) and were in the health responsibility (HR) subscale for both psychological pressure (e.g. academic pressure, family men and women in Groups 1 and 2 (2.04 and 2.20 points pressure, peer pressure, etc.) daily. Personal health, for Group 1 and 2.14 and 2.24 points for Group 2). It purposeful physical activity, and good nutrition are should be noted that men in Group 1 achieved lower often neglected. scores than women on the physical activity (PA) The mean scores were higher for Group 2. They subscale (2.15 and 2.21 points, respectively). For group achieved high scores on the interpersonal relationships 2, men had a higher mean score on the stress (IR) subscale (3.00 points) and moderate scores on the management subscale (3.03 points) than women, who spiritual growth (SG) (2.85 points) and stress had a higher mean score on the interpersonal management (SM) (2.74 points) subscales. Group 2 relationships subscale (3.02 points). students had the lowest mean score on the health Table 5 summarises the descriptive and correlational responsibility (HR) subscale (2.23 points), which statistics obtained for the total HPLP-II scale and its six indicates their stability, the ability to spend more time subscales. Table 5 Descriptive Statistics and Pearson Correlation Coefficients of the HPLP-II Subscales and Total HPLP-II Score Note. **Correlation is significant at the 0.01 level; correlations for Group 1 (G1) are presented below the diagonal and correlations for Group 2 (G2) above the diagonal; HR – health responsibility subscale of the HPLP-II scale; PA – physical activity subscale of the HPLP-II scale; Nu – nutrition subscale of the HPLP-II scale; SG – spiritual growth subscale of the HPLP-II scale; IR – interpersonal relationships subscale of the HPLP-II scale; SM – stress management subscale of the HPLP-II scale; HPLP-total – the HPLP-II scale in total. 39 International Journal of Science Annals, Vol. 8, No. 1, 2025 рrint ISSN: 2617-2682; online ISSN: 2707-3637; DOI:10.26697/ijsa Cronbach’s alpha coefficients were calculated to study SM subscale (alpha = 0.905 / 0.924), the IR subscale internal consistency (coefficients for Group 1 / (alpha = 0.872 / 0.898), followed by the PA (alpha = Group 2). The total HPLP-II scale showed a high 0.845 / 0.881) and Nu (alpha = 0.841 / 0.874) subscales, internal consistency (alpha = 0.918 / 0.926). The SG, and finally, the HR subscale (alpha = 0.806 / 0.842). SN, and IR subscales had the highest measure of internal Table 6 shows the correlations between the total DASS- consistency: the SG subscale (alpha = 0.914 / 0.931), the 21, its subscales and the total HPLP-II scale. Table 6 Bivariate Correlations with Validation Measures for the DASS and HPLP Subscales and Total Score Note. Correlation is significant at the 0.001 level; correlations for Group 1 are presented above the diagonal and correlations for Group 2 below the diagonal; DASS (D) – Depression subscale of the DASS-21 scale; DASS (A) – Anxiety subscale of the DASS-21 scale; DASS (S) – Stress subscale of the DASS-21 scale; DASS Total – the DASS-21 scale in total; HPLP (HR) – Health responsibility subscale of the HPLP-II scale; HPLP (PA) – Physical activity subscale of the HPLP-II scale; HPLP (Nu) – Nutrition subscale of the HPLP-II scale; HPLP (SG) – Spiritual growth subscale of the HPLP-II scale; HPLP (IR) – Interpersonal relationships subscale of the HPLP-II scale; HPLP (SM) – Stress management subscale of the HPLP-II scale; HPLP Total – the HPLP-II scale in total. As expected, the depression, anxiety, stress subscales and prevalence of depression and anxiety among university the total DASS scale were negatively correlated with the students are unemployment, financial insecurity, and total score of the HPLP and its subscales. poverty (Islam et al., 2020). Significant negative correlations were found between the Some scholars (Hope & Henderson, 2014; Melnyk & total DASS scale and the spiritual growth subscale of the Stadnik, 2020; Melnyk et al., 2022) have noted the HPLP-II scale (-0.44 and -0.46 for Group 1 and 2, prevalence of depression, anxiety, and stress among respectively). students in different countries. They have pointed to the following variations: depression occurs in 7.7–65.5% of Discussion students; anxiety in 6.0–66.5%; and psychological Depression, anxiety and stress are common among distress in 12.2–96.7%. students (Melnyk et al., 2024; Mykhaylyshyn et al., Recent empirical studies have revealed an overall decline 2024). These factors are exacerbated by the peculiarities in the physical and emotional well-being of migrants and of university life, such as independence from parental internally displaced individuals (Agudelo-Suárez et al., control, the use of psychotropic substances (alcohol, 2009). It is due to discrimination experienced in everyday tobacco and drugs), peer pressure, the need for social life and perceived discrimination at work and home. recognition and the desire to develop one’s personality Several studies have found (Kang et al., 2012; Kurt et al., (Dhiman & Chawla, 2017; Kegler, 1999; Stadnik et al., 2021; Leiler et al., 2019; Vrabel et al., 2023) that the 2022; 2023). prevalence of depression and anxiety symptoms among An analysis of scientific publications on mental health migrants is 3-5 times higher than in the general disorders during the pandemic shows that the prevalence population. of depression, anxiety and stress varied among students In addition, migrants are affected by additional stressors in different countries. For instance, the prevalence of (Jasinskaja-Lahti et al., 2007), such as instability, fewer depression among university students in Greece was desirable employment opportunities, and discrimination reported to be between 74.3% and 80.7% (Kaparounaki based on potential language and ethnic restrictions, as et al., 2020), while in Uganda it was found to be 51.2% well as low socioeconomic status. (Sazakli et al., 2021). In India, 58% of students suffered The present study has shown that even staying in a secure from depression during the pandemic, whereas in environment abroad can be stressful. University students Bangladesh, this figure was 80.2% (Biswas, 2022). It is who were forced to move during the war experienced estimated that the prevalence of anxiety among significantly higher levels of depression and anxiety. The university students in different regions during the scores for extremely severe depression and anxiety were pandemic was 60%, 71.5% and 87.7% (Safa et al., 2021; 2–3 times higher for Group 1 students (44.0 and 64.2 Siddik et al., 2024). The main reasons for the high points, respectively) than for Group 2 students who did 40 International Journal of Science Annals, Vol. 8, No. 1, 2025 рrint ISSN: 2617-2682; online ISSN: 2707-3637; DOI:10.26697/ijsa not change residence (16.2 and 22.2 points, respectively). and the limitations of war, such as possible mobilisation, The high average scores of Group 1 students on the unemployment and lack of funds. Depression and Anxiety scales (12.3 and 11.7 points, Promoting healthy lifestyles and mental health is a respectively) suggest an increase in neurotic symptoms crucial public health priority, involving educational among university students in the context of the ongoing policies and initiatives that ensure the overall well-being war in Ukraine. It manifests as an increase in complaints of university students. of low mood, low self-esteem, pessimism, apathy, lethargy, fatigue, constant dissatisfaction and Conclusions hopelessness. Our research in February 2025 revealed that staying in an Further analysis of academic research on the role of unfamiliar environment, even abroad, can be stressful. healthy lifestyles in overcoming psychological distress University students who were forced to move during the shows that many publications (Bi et al., 2014; Mohamed war experienced significantly higher levels of depression et al., 2022; Wei et al., 2012; Yahia et al., 2014) assess and anxiety. Thus, the indicators of extremely severe the impact of health-promoting behaviours on the mental depression and anxiety were 2-3 times higher among health of university students in Japan, Africa, China, etc. students in Group 1 (44.0 and 64.2 points, respectively) A healthy lifestyle includes taking responsibility for one's than among students in Group 2 who did not change their health, being physically active, eating healthily, growing place of residence (16.3 and 22.2 points, respectively). spiritually, developing good interpersonal relationships, The high average scores among Group 1 students on the and managing stress. A healthy lifestyle is key to Depression and Anxiety scales (12.3 and 11.7 points, maintaining and improving health (Blanco et al., 2021; respectively) suggest that their neurotic symptoms are Morais et al., 2020). There is sufficient evidence to show worsening in the context of the ongoing war in Ukraine. that a healthy lifestyle significantly impacts physical and It is evident through increased reports of low mood, low mental health. self-esteem, pessimism, apathy, lethargy, fatigue, We found a statistically significant inverse correlation constant dissatisfaction, and hopelessness. The study between health-promoting behaviour and psychological revealed that women in Group 1 scored higher than men distress. This finding aligns with previous studies on the Depression and Anxiety scales (13.4 and 12.3 (Castillo-Díaz et al., 2024; Safaie et al., 2020; Slonim et points, respectively). This can be explained by their al., 2015; Sousa et al., 2015). Adopting a healthier greater emotional sensitivity to the uncertainty of the lifestyle appears to enhance students’ mental well-being. military and humanitarian situation in Ukraine. On Several studies (Chao, 2023; Du et al., 2022; Nazik et al., average, men in all groups scored highly on the stress 2015; Ors, 2024) have found a negative correlation scale (12.4 and 12.1 points, respectively), indicating the between healthy lifestyles and mental distress in different presence of acute psychogenesis associated with possible population groups, including teachers, postpartum mobilisation, unemployment, and a lack of funds. women, senior citizens and students. In addition, Our study found that healthy lifestyle practices such as Basharpoor et al. (2015) found that lifestyles maintaining good interpersonal relationships, spiritual emphasising spiritual growth, stress management, and growth and stress management played an important role interpersonal relationships are inversely related to in alleviating symptoms of depression and anxiety for symptoms of depression and anxiety. both groups, for which we recorded medium to high Much research has also been conducted into the gender- mean scores. At the same time, we found that the average specific aspects of a healthy lifestyle (Johnson, 2005; Li scores in all groups were low in the following areas: et al., 2022; Zheng, 2023). These studies show that men responsibility for health (2.2 and 2.23 points), physical perform better in physical activity and stress activity (2.2 and 2.3 points), and nutrition (2.3 and 2.4 management. In contrast, women perform better in points). It indicates that, in the context of war, students interpersonal relationships and health responsibilities. neglect their personal health, physical activity, and the The present study confirms the important role of healthy quality of their nutrition. It should be noted that, in lifestyle practices, such as maintaining positive contrast to those who did not change their place of interpersonal relationships (mean score: 2.8 / 3.0 points), residence, men of Group 1 (internally displaced) had fostering spiritual growth (mean score: 2.8 / 2.9 points), lower average scores than women in the areas of physical and managing stress (mean score: 2.6 / 2.7 points), in activity (2.15 and 2.21 points, respectively) and nutrition alleviating symptoms of depression and anxiety. Medium (2.2 and 2.3 points, respectively). It may be due to the to high mean scores were recorded for both groups. At high psychogenic load and restrictions imposed by the the same time, we found low mean scores for all groups war, such as possible mobilisation, unemployment and on the responsibility for health, physical activity and lack of funds. nutrition subscales (2.15, 2.23, 2.20, 2.32 and 2.31, 2.37 Thus, the high levels of depression and anxiety points respectively), indicating that students neglect their experienced by university students during the war are due personal health, physical activity and nutrition in the not only to numerous psychogenic factors, but also to context of war. Unlike previous studies, we also found behaviours that hinder the preservation of mental health. that men in Group 1 (internally displaced) had lower The study results indicate the need to introduce health mean scores than women in the areas of physical activity and physical activity programmes into the educational (2.15 vs. 2.21 points) and nutrition (2.24 vs. 2.33 points). process of university students based on their specific We believe that it is due to a substantial psychogenic load requirements and needs. 41 International Journal of Science Annals, Vol. 8, No. 1, 2025 рrint ISSN: 2617-2682; online ISSN: 2707-3637; DOI:10.26697/ijsa Acknowledgments students: a structural equation model. Health The authors would like to thank the respondents for their Promotion International, 39(4), Article daae082. participation in the survey. https://doi.org/10.1093/heapro/daae082 Chao, D. P. (2023). 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International Journal of Science Annals, 8(1), 33–44. https://doi.org/10.26697/ijsa.2025.1.3 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). 44