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Psychological distress and life-event burden in conflict-affected Ukrainian adolescents: a cross-sectional exploratory psychometric study in two cohorts
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DOI：10.1186/s13034-026-01153-x.png)
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Abstract
En 中文
Armed conflict exposes adolescents to sustained environmental stressors that may influence emotional well-being and developmental trajectories. Despite increasing concern regarding youth mental health in conflict settings, systematic psychometric characterization of emotional distress and exposure to adverse life events remains limited, particularly in active conflict settings. This study aimed to assess emotional distress, emotional state, and exposure to adverse life events among Ukrainian adolescents, and to examine associations between psychological symptoms and cumulative adversity. This study was designed as an exploratory, cross-sectional analysis. Self-reported psychometric data were collected from 43 adolescents across two cohorts assessed in 2024 (n = 15) and 2025 (n = 28). Emotional distress was measured using the Depression Anxiety Stress Scales (DASS-21), emotional state using the Emotional State Assessment Tool (ESAT), and adversity exposure using the Life Events Checklist for DSM-5 (LEC-5). After data cleaning and harmonization, descriptive statistics, symptom severity distributions, and Spearman rank-order correlations were conducted to examine relationships between psychological measures. Across cohorts, more than half of participants reported depression, anxiety, or stress scores above the normal range. The proportion of participants scoring above the normal range for depressive symptoms was higher in the 2025 cohort (71.4%) than in the 2024 cohort (53.3%). Participants reported substantial exposure to adverse life events, with mean numbers of endorsed event types of 5.53 and 6.50 in the 2024 and 2025 cohorts, respectively. In the 2024 cohort, negative emotional state scores were positively correlated with depression (r = 0.71, p = 0.003), anxiety (r = 0.86, p < 0.001), and stress (r = 0.82, p < 0.001). Positive emotional state scores also correlated positively with depression (r = 0.86, p < 0.001), anxiety (r = 0.78, p = 0.001), and stress (r = 0.79, p < 0.001). Life-event exposure was positively correlated with stress symptoms (r = 0.62, p = 0.013). In the 2025 cohort, negative emotional state scores were positively correlated with anxiety symptoms (r = 0.38, p = 0.046). Ukrainian adolescents living under prolonged conflict conditions exhibited substantial psychological distress alongside high exposure to adverse life events. These findings highlight the importance of systematic mental health monitoring and trauma-informed support strategies for conflict-affected youth. These findings should, however, be interpreted as preliminary and hypothesis-generating.
Keywords:
Adolescents
Armed conflict
Emotional distress
Trauma exposure
DASS-21
Mental health
Ukraine
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