Post-traumatic Stress Disorder and Moral Injury Among Ukrainian Civilians During the Ongoing War

Abstract

While severity of post-traumatic stress disorder (PTSD) symptoms and moral injury among civilians affected by armed conflicts is generally understudied, even less research exists on civilian populations during an active war. This paper reports a large-scale study that administered standard assessments of PTSD and moral injury severity, as well as rich demographic questionnaires, to nearly 1300 Ukrainian civilians during the ongoing Russian invasion. Analyses revealed an extremely high prevalence of severe PTSD symptoms and moral injury, relative to both proposed clinical cut-offs and to earlier measurements from a similar population. Further regression analyses identified risk factors and protective factors. Greater severity of PTSD symptoms was observed among women, older and forcibly displaced individuals, and individuals from geographic regions under Russian occupation. Higher education correlated with milder PTSD symptoms. Moral injury was particularly strong in younger individuals. The present study is one of the first to report a large scale set of psychological data collected from the civilian population of Ukraine during the ongoing Russian invasion. It is obvious from the scope and long-term nature of the atrocities that psychological treatment of the civilian population will be required both presently, while the hostilities are ongoing, and in the future. This data contributes to a detailed understanding of the psychological response to traumatic stress, including its overall prevalence and presence in specific demographically and geographically defined civilian groups.

Ukraine Trauma Project: the feasibility of introducing advanced trauma-care skills to frontline emergency medical services responders

“…Epstein et al compared some of the lessons learnt from the US ‘Global War on Terror’ to the work of their group in supporting surgical care services in Ukraine 14. Riley has examined the potential lessons from the war for large-scale NATO led medical operations15 and Zasiekina has explored the impact of Post Traumatic Stress Disorder at community level 16. However, we believe that this study is one of the first to describe an intervention aimed at directly improving the care of trauma patients through collaboration and dissemination of critical interventions.…”

“…14 Riley has examined the potential lessons from the war for largescale NATO led medical operations 15 and Zasiekina has explored the impact of Post Traumatic Stress Disorder at community level. 16 However, we believe that this study is one of the first to describe an intervention aimed at directly improving the care of trauma patients through collaboration and dissemination of critical interventions. Further research to evaluate implementation of these procedures and to evaluate effectiveness (to the extent possible in this setting) is being planned.…”

The nexus between peace and mental well-being: contributions for public happiness

“…This exposure to trauma and suffering can lead to secondary traumatic stress, causing mental health issues like those experienced by direct survivors of war. It affects not only individuals directly involved but also health-care workers, aid workers, journalists and others who witness the aftermath of war and provide support to affected populations (Zasiekina et al , 2023).…”

The Effect of Group Psychotherapy on the Mental Health of Servicemen with Post-Traumatic Stress Disorder

“…In particular, the US experience indicates that post-traumatic stress disorder and depression are the most common problems of servicemen and combat veterans (Inoue et al, 2023;Trivedi et al, 2015). In general, the problem of post-traumatic stress disorder manifestations among the civilian population in the context of the Russian-Ukrainian war has only begun to be studied (Zasiekina et al, 2023). At the same time, it was established that the posttraumatic stress disorder of servicemen acquired in the combat zone significantly affects the functioning of the individual (Romaniuk, 2021).…”