Травматичні стресори війни та статус здоров’я: кумулятивний стрес упродовж життя та ресурси стійкості
Анотація
Війна є одним з найвпливовіших стресорів, на які може наразитися людство. Як і будь-який збройний конфлікт, війна в Україні має ймовірність вилитися в руйнівні наслідки для здоров’я нашої нації, спричиняючи довготривалу фізичну і психологічну шкоду дорослим і дітям, зменшення людського капіталу, збільшення кількості дітей, на чию долю випало сирітство та роз’єднана сім’я, розвиток бідності в регіонах, безпосередньо уражених під час гарячої фази конфлікту, психічні травми, брак нормального харчування, ерозію соціальних мереж тощо. Останні дослідження засвідчують значне підвищення рівня дистресу та емоційного страждання українців. Водночас результати цих досліджень доводять високу резильєнтність, яку українське населення протиставляє жорстоким реаліям війни. Аналізуючи вплив на здоров’я людини травматичних стресорів, викликаних війною, необхідно врахувати стресовий досвід, отриманий індивідом до війни, оскільки цей досвід також має велику вагу. Проте кумулятивний стрес, пережитий людиною упродовж життя, часто не береться до уваги під час оцінки впливу війни на індивідуальне здоров’я українців. У даній статті фокусується на теоретичній та практичній значущості вивчення наслідків впливу акумульованого стресового досвіду упродовж життя у його поєднанні із травматичними стресорами війни, що сприятиме розробці всеохоплюючих метрик стресу та його впливу на здоров’я людини. Дослідження кумулятивних ефектів стресу мають доповнюватися аналізом дії захисних чинників, що забезпечить більш вичерпне пояснення зв’язку між стресом та здоров’ям людей. У процесі вивчення впливу травматичних подій війни на здоров’я українців важливо також акцентувати увагу на поєднанні кумулятивного стресу упродовж життя та ресурсів стресостійкості особистості.
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American Psychiatric Association (2013) Diagnostic and Statistical Manual of Mental Disorders (DSM-5). 5th edn. Washington, DC: American Psychiatric Association, p. 271.
American Psychological Association (2017) Stress and health disparities: Contexts, mechanisms, and interventions among racial/ethnic minority and low socioeconomic status populations. American Psychological Association. https://doi.org/10.1037/e500202018-001. (дата звернення: 02 травня 2025 р.).
Benjet, C., Lépine, J. P., Shahl, V., et al. (2018) 'Trauma and Posttraumatic Stress Disorder: Global Perspectives from the WHO World Mental Health Surveys', in Bromet, E. J., Karam, E. G., Koenen, K. C., et al. (eds.) Trauma and Posttraumatic Stress Disorder: Global Perspectives from the WHO World Mental Health Surveys. Cambridge: Cambridge University Press, pp. 42–71.
Besser, A., Zeigler-Hill, V., Weinberg, M., Pincus, A. L., & Neria, Y. (2015) ‘Intrapersonal resilience moderates the association between exposure-severity and PTSD symptoms among civilians exposed to the 2014 Israel–Gaza conflict’, Self and Identity, 14(1), pp. 1–15. doi: https://doi.org/10.1080/15298868.2014.966143
Carver, C. S. & Scheier, M. F. (2017) Optimism, coping, and well-being. In Cooper, C.L. & Campbell, J. (eds.) The handbook of stress and health: A guide to research and practice
Einarsdottir, T. S., Asgeirsdottir, B. B., Sigurvinsdottir, R., Ullman, S. E. & Gudmundsdottir, B. (2024) 'Prevalence of trauma exposure and PTSD symptoms among the Icelandic population: gender and regional differences', Scandinavian Journal of Public Health, 52(8), pp. 968–977. https://doi.org/10.1177/14034948231217019;
Fauver, M., Clark, E. M., & Schwartz, C. E. (2024) ‘A new framework for understanding stress and disease: The developmental model of stress as applied to multiple sclerosis’, Frontiers in Integrative Neuroscience, 18, 1365672. doi: https://doi.org/10.3389/fnint.2024.1365672
Fink, G. (2016) Stress, definitions, mechanisms, and effects outlined: Lessons from anxiety. In G. Fink (ed.), Stress concepts, cognition, emotion, and behavior. Handbook of Stress Series, vol. 1, ch. 1, pp. 3-12. Academic Press, New York, NY;
Greene, T., Itzhaky, L., Bronstein, I., & Solomon, Z. (2018) ‘Psychopathology, risk, and resilience under exposure to continuous traumatic stress: A systematic review of studies among adults living in southern Israel’, Traumatology, 24(2), pp. 83–103. doi: https://doi.org/10.1037/trm0000136
Helou, M., Weinstein, E. S., Kalaji, J., Chaaban, T., & Yammine, K. (2024) ‘Pager explosion in Beirut: An unprecedented event’, Disaster Medicine and Public Health Preparedness, 18, Article e215. doi: https://doi.org/10.1017/dmp.2024.281
Helpman, L., Besser, A., & Neria, Y. (2015) ‘Acute posttraumatic stress symptoms but not generalized anxiety symptoms are associated with severity of exposure to war trauma: A study of civilians under fire’, Journal of Anxiety Disorders, 35, pp. 27–34. doi: https://doi.org/10.1016/j.janxdis.2015.08.001
Hoppen, T. H. et al. (2021) ‘Global burden of post-traumatic stress disorder and major depression in countries affected by war between 1989 and 2019: A systematic review and meta-analysis’, BMJ Global Health, 6, e006303. doi: https://doi.org/10.1136/bmjgh-2021-006303
Hughes, K. et al. (2017) The effect of multiple adverse childhood experiences on health: a systematic review and meta-analysis. The Lancet Public Health, vol. 2, no. 8, pp. e356–e366. https://doi.org/10.1016/s2468-2667(17)30118-4;
I-Khoury, J. et al. (2025) ‘Mental health is still a human right during times of war’, International Journal of Social Psychiatry, online first April 13, 2025. doi: 10.1177/00207640251331856
Karam, E., & Bou Ghosn, M. (2003) ‘Psychosocial consequences of war among civilian populations’, Current Opinion in Psychiatry, 16(4), pp. 413–419. doi: https://doi.org/10.1097/00001504-200307000-00007
Karatzias, T. et al. (2023) ‘War exposure, posttraumatic stress disorder, and complex posttraumatic stress disorder among parents living in Ukraine during the Russian war’, Acta Psychiatrica Scandinavica, 147(3), pp. 276–285. doi: https://doi.org/10.1111/acps.13529
Kessler, R. C., Aguilar-Gaxiola, S., Alonso, J., et al. (2017) 'Trauma and PTSD in the WHO World Mental Health Surveys', European Journal of Psychotraumatology, 8. doi: https://doi:10.1080/20008198.2017.1353383
Kovalenko, J. (2024) ‘Surviving the atrocity: A study of resilience and coping behaviour among Ukrainians during the Russo-Ukrainian war’, Journal of Health Psychology, 29(14), pp. 1688-1703. doi: https://doi.org/10.1177/13591053241274464
Kurapov, A. et al. (2023) ‘Toward an understanding of the Russian-Ukrainian war impact on university students and personnel’, Journal of Loss and Trauma, 28(2), pp. 167-174. doi: https://doi.org/10.1080/15325024.2022.2084838
Leatherman, T. & Goodman, A. (2020) Building on the biocultural syntheses: 20 years and still expanding. American Journal of Human Biology, 32(4), e23360 doi: https://doi.org/10.1002/ajhb.23360
Leatherman, T. & Goodman, A. (2022) Critical biocultural approaches to health and illness. In C. Abadía-Barrero, M. Singer & P. I. Erickson (eds.), A companion to medical anthropology, ch. 2. John Wiley & Sons, Hoboken, Canada,
Lim, I. C. Z. Y. et al. (2022) ‘Prevalence of depression, anxiety and post-traumatic stress in war- and conflict-afflicted areas: A meta-analysis’, Frontiers in Psychiatry, 13, 978703. doi: https://doi.org/10.3389/fpsyt.2022.978703
Maltseva, K. (2024) ‘Stress exposure, perceived stress, protective psychosocial factors, and health status in Ukraine after the full-scale invasion’, Journal of Health Psychology, 29(14), pp. 1640–1652. doi: https://doi.org/10.1177/13591053241259728
Maltseva, K., & Sereda, P. (2025). The relationships between war-induced stressor exposure, endorsement of values dimensions, and quality of life in Ukraine. Journal of Cognition and Culture, 25, 438–467. doi: http://dx.doi.org/10.1163/15685373-12340219
Marín C, Gómez-Gutiérrez M del M, Vázquez C, Crespo M, Hervás G. (2025) ‘Trauma and well-being in terrorism survivors in Spain’, Journal of Health Psychology, 0(0). doi:10.1177/1359105325132424
May, C. L. and Wisco, B. E. (2016) ‘Defining trauma: How level of exposure and proximity affect risk for posttraumatic stress disorder’, Psychological Trauma: Theory, Research, Practice and Policy, 8(2), pp. 233–240. https://doi.org/10.1037/tra0000077
Miguel-Tobal J J, Cano-Vindel A, Gonzalez-Ordi H, Iruarrizaga I, Rudenstine S, Vlahov D, & Galea S. (2006) ‘PTSD and depression after the Madrid March 11 train bombings’ Journal of Traumatic Stress, 19(1), pp. 69–80. doi:10.1002/jts.2009
Miller, K. E., & Rasmussen, A. (2017) ‘The mental health of civilians displaced by armed conflict: An ecological model of refugee distress’, Epidemiology and Psychiatric Sciences, 26(2), pp. 129–138. doi: https://doi.org/10.1017/s2045796016000172
Morina, N. et al. (2018) ‘Prevalence of depression and posttraumatic stress disorder in adult civilian survivors of war who stay in war-afflicted regions: A systematic review and meta-analysis of epidemiological studies’, Journal of Affective Disorders, 239, pp. 328–338. doi: https://doi.org/10.1016/j.jad.2018.07.027
Norris, F. H., Friedman, M. J., Watson, P. J., Byrne, C. M., Diaz, E. and Kaniasty, K. (2002) ‘60,000 disaster victims speak: Part I. An empirical review of the empirical literature, 1981-2001’, Psychiatry, 65(3), pp. 207–239. https://doi.org/10.1521/psyc.65.3.207.20173
Oishi, S. and Westgate, E. C. (2022) ‘A psychologically rich life: Beyond happiness and meaning’, Psychological Review, 129(4), pp. 790–811. https://doi.org/10.1037/rev0000317
Oishi, S. and Westgate, E. C. (2025) ‘Psychological richness offers a third path to a good life’, Trends in Cognitive Sciences. Advance online publication. https://doi.org/10.1016/j.tics.2025.04.002
Pavlova, I. et al. (2022) ‘Early evidence on the mental health of Ukrainian civilian and professional combatants during the Russian invasion’, European Psychiatry, 65(1), e79. doi: https://doi.org/10.1192/j.eurpsy.2022.2335
Rigutto, C., Sapara, A. O. and Agyapong, V. I. O. (2021) ‘Anxiety, depression and posttraumatic stress disorder after terrorist attacks: A general review of the literature’, Behavioural Sciences, 11(140). https://doi.org/10.3390/bs11100140
Scoglio, A. A. J., & Salhi, C. (2021) ‘Violence exposure and mental health among resettled refugees: A systematic review’, Trauma, Violence & Abuse, 22(5), pp. 1192–1208. doi: https://doi.org/10.1177/1524838020915584
Segerstrom, S. C., & O'Connor, D. B. (2012) ‘Stress, health and illness: Four challenges for the future’, Psychology & Health, 27(2), pp. 128–140. doi: https://doi.org/10.1080/08870446.2012.659516
Shields G. S, Fassett-Carman A., Gray Z. J., Gonzales J, E., Snyder H. R., & Slavich G. M. (2023) ‘Why is subjective stress severity a stronger predictor of health than stressor exposure? A preregistered two-study test of two hypotheses’, Stress and Health, 39(1), pp. 87–102. https://doi.org/10.1002/smi.3165
Slavich, G. M., & Shields, G. S. (2018) ‘Аssessing lifetime stress exposure using the Stress and Adversity Inventory for Adults (Adult STRAIN): An overview and initial validation’, Psychosomatic Medicine, 80(1), pp. 17–27. doi: https://doi.org/10.1097/psy.0000000000000534
United Nations (2024). Universal declaration of human rights, Article 25. Available at: https://www.un.org/en/about-us/universal-declaration-of-human-rights (дата звернення: 02 травня 2025 р.);
World Health Organization (2024). Constitution of the World Health Organization. Available at: https://www.who.int/about/governance/constitution (дата звернення: 02 травня 2025 р.).
American Psychiatric Association (2013) Diagnostic and Statistical Manual of Mental Disorders (DSM-5). 5th edn. Washington, DC: American Psychiatric Association, p. 271.
American Psychological Association (2017) Stress and health disparities: Contexts, mechanisms, and interventions among racial/ethnic minority and low socioeconomic status populations. American Psychological Association. https://doi.org/10.1037/e500202018-001. (дата звернення: 02 травня 2025 р.).
Benjet, C., Lépine, J. P., Shahl, V., et al. (2018) 'Trauma and Posttraumatic Stress Disorder: Global Perspectives from the WHO World Mental Health Surveys', in Bromet, E. J., Karam, E. G., Koenen, K. C., et al. (eds.) Trauma and Posttraumatic Stress Disorder: Global Perspectives from the WHO World Mental Health Surveys. Cambridge: Cambridge University Press, pp. 42–71.
Besser, A., Zeigler-Hill, V., Weinberg, M., Pincus, A. L., & Neria, Y. (2015) ‘Intrapersonal resilience moderates the association between exposure-severity and PTSD symptoms among civilians exposed to the 2014 Israel–Gaza conflict’, Self and Identity, 14(1), pp. 1–15. doi: https://doi.org/10.1080/15298868.2014.966143
Carver, C. S. & Scheier, M. F. (2017) Optimism, coping, and well-being. In Cooper, C.L. & Campbell, J. (eds.) The handbook of stress and health: A guide to research and practice
Einarsdottir, T. S., Asgeirsdottir, B. B., Sigurvinsdottir, R., Ullman, S. E. & Gudmundsdottir, B. (2024) 'Prevalence of trauma exposure and PTSD symptoms among the Icelandic population: gender and regional differences', Scandinavian Journal of Public Health, 52(8), pp. 968–977. https://doi.org/10.1177/14034948231217019;
Fauver, M., Clark, E. M., & Schwartz, C. E. (2024) ‘A new framework for understanding stress and disease: The developmental model of stress as applied to multiple sclerosis’, Frontiers in Integrative Neuroscience, 18, 1365672. doi: https://doi.org/10.3389/fnint.2024.1365672
Fink, G. (2016) Stress, definitions, mechanisms, and effects outlined: Lessons from anxiety. In G. Fink (ed.), Stress concepts, cognition, emotion, and behavior. Handbook of Stress Series, vol. 1, ch. 1, pp. 3-12. Academic Press, New York, NY;
Greene, T., Itzhaky, L., Bronstein, I., & Solomon, Z. (2018) ‘Psychopathology, risk, and resilience under exposure to continuous traumatic stress: A systematic review of studies among adults living in southern Israel’, Traumatology, 24(2), pp. 83–103. doi: https://doi.org/10.1037/trm0000136
Helou, M., Weinstein, E. S., Kalaji, J., Chaaban, T., & Yammine, K. (2024) ‘Pager explosion in Beirut: An unprecedented event’, Disaster Medicine and Public Health Preparedness, 18, Article e215. doi: https://doi.org/10.1017/dmp.2024.281
Helpman, L., Besser, A., & Neria, Y. (2015) ‘Acute posttraumatic stress symptoms but not generalized anxiety symptoms are associated with severity of exposure to war trauma: A study of civilians under fire’, Journal of Anxiety Disorders, 35, pp. 27–34. doi: https://doi.org/10.1016/j.janxdis.2015.08.001
Hoppen, T. H. et al. (2021) ‘Global burden of post-traumatic stress disorder and major depression in countries affected by war between 1989 and 2019: A systematic review and meta-analysis’, BMJ Global Health, 6, e006303. doi: https://doi.org/10.1136/bmjgh-2021-006303
Hughes, K. et al. (2017) The effect of multiple adverse childhood experiences on health: a systematic review and meta-analysis. The Lancet Public Health, vol. 2, no. 8, pp. e356–e366. https://doi.org/10.1016/s2468-2667(17)30118-4;
I-Khoury, J. et al. (2025) ‘Mental health is still a human right during times of war’, International Journal of Social Psychiatry, online first April 13, 2025. doi: 10.1177/00207640251331856
Karam, E., & Bou Ghosn, M. (2003) ‘Psychosocial consequences of war among civilian populations’, Current Opinion in Psychiatry, 16(4), pp. 413–419. doi: https://doi.org/10.1097/00001504-200307000-00007
Karatzias, T. et al. (2023) ‘War exposure, posttraumatic stress disorder, and complex posttraumatic stress disorder among parents living in Ukraine during the Russian war’, Acta Psychiatrica Scandinavica, 147(3), pp. 276–285. doi: https://doi.org/10.1111/acps.13529
Kessler, R. C., Aguilar-Gaxiola, S., Alonso, J., et al. (2017) 'Trauma and PTSD in the WHO World Mental Health Surveys', European Journal of Psychotraumatology, 8. doi: https://doi:10.1080/20008198.2017.1353383
Kovalenko, J. (2024) ‘Surviving the atrocity: A study of resilience and coping behaviour among Ukrainians during the Russo-Ukrainian war’, Journal of Health Psychology, 29(14), pp. 1688-1703. doi: https://doi.org/10.1177/13591053241274464
Kurapov, A. et al. (2023) ‘Toward an understanding of the Russian-Ukrainian war impact on university students and personnel’, Journal of Loss and Trauma, 28(2), pp. 167-174. doi: https://doi.org/10.1080/15325024.2022.2084838
Leatherman, T. & Goodman, A. (2020) Building on the biocultural syntheses: 20 years and still expanding. American Journal of Human Biology, 32(4), e23360 doi: https://doi.org/10.1002/ajhb.23360
Leatherman, T. & Goodman, A. (2022) Critical biocultural approaches to health and illness. In C. Abadía-Barrero, M. Singer & P. I. Erickson (eds.), A companion to medical anthropology, ch. 2. John Wiley & Sons, Hoboken, Canada,
Lim, I. C. Z. Y. et al. (2022) ‘Prevalence of depression, anxiety and post-traumatic stress in war- and conflict-afflicted areas: A meta-analysis’, Frontiers in Psychiatry, 13, 978703. doi: https://doi.org/10.3389/fpsyt.2022.978703
Maltseva, K. (2024) ‘Stress exposure, perceived stress, protective psychosocial factors, and health status in Ukraine after the full-scale invasion’, Journal of Health Psychology, 29(14), pp. 1640–1652. doi: https://doi.org/10.1177/13591053241259728
Maltseva, K., & Sereda, P. (2025). The relationships between war-induced stressor exposure, endorsement of values dimensions, and quality of life in Ukraine. Journal of Cognition and Culture, 25, 438–467. doi: http://dx.doi.org/10.1163/15685373-12340219
Marín C, Gómez-Gutiérrez M del M, Vázquez C, Crespo M, Hervás G. (2025) ‘Trauma and well-being in terrorism survivors in Spain’, Journal of Health Psychology, 0(0). doi:10.1177/1359105325132424
May, C. L. and Wisco, B. E. (2016) ‘Defining trauma: How level of exposure and proximity affect risk for posttraumatic stress disorder’, Psychological Trauma: Theory, Research, Practice and Policy, 8(2), pp. 233–240. https://doi.org/10.1037/tra0000077
Miguel-Tobal J J, Cano-Vindel A, Gonzalez-Ordi H, Iruarrizaga I, Rudenstine S, Vlahov D, & Galea S. (2006) ‘PTSD and depression after the Madrid March 11 train bombings’ Journal of Traumatic Stress, 19(1), pp. 69–80. doi:10.1002/jts.2009
Miller, K. E., & Rasmussen, A. (2017) ‘The mental health of civilians displaced by armed conflict: An ecological model of refugee distress’, Epidemiology and Psychiatric Sciences, 26(2), pp. 129–138. doi: https://doi.org/10.1017/s2045796016000172
Morina, N. et al. (2018) ‘Prevalence of depression and posttraumatic stress disorder in adult civilian survivors of war who stay in war-afflicted regions: A systematic review and meta-analysis of epidemiological studies’, Journal of Affective Disorders, 239, pp. 328–338. doi: https://doi.org/10.1016/j.jad.2018.07.027
Norris, F. H., Friedman, M. J., Watson, P. J., Byrne, C. M., Diaz, E. and Kaniasty, K. (2002) ‘60,000 disaster victims speak: Part I. An empirical review of the empirical literature, 1981-2001’, Psychiatry, 65(3), pp. 207–239. https://doi.org/10.1521/psyc.65.3.207.20173
Oishi, S. and Westgate, E. C. (2022) ‘A psychologically rich life: Beyond happiness and meaning’, Psychological Review, 129(4), pp. 790–811. https://doi.org/10.1037/rev0000317
Oishi, S. and Westgate, E. C. (2025) ‘Psychological richness offers a third path to a good life’, Trends in Cognitive Sciences. Advance online publication. https://doi.org/10.1016/j.tics.2025.04.002
Pavlova, I. et al. (2022) ‘Early evidence on the mental health of Ukrainian civilian and professional combatants during the Russian invasion’, European Psychiatry, 65(1), e79. doi: https://doi.org/10.1192/j.eurpsy.2022.2335
Rigutto, C., Sapara, A. O. and Agyapong, V. I. O. (2021) ‘Anxiety, depression and posttraumatic stress disorder after terrorist attacks: A general review of the literature’, Behavioural Sciences, 11(140). https://doi.org/10.3390/bs11100140
Scoglio, A. A. J., & Salhi, C. (2021) ‘Violence exposure and mental health among resettled refugees: A systematic review’, Trauma, Violence & Abuse, 22(5), pp. 1192–1208. doi: https://doi.org/10.1177/1524838020915584
Segerstrom, S. C., & O'Connor, D. B. (2012) ‘Stress, health and illness: Four challenges for the future’, Psychology & Health, 27(2), pp. 128–140. doi: https://doi.org/10.1080/08870446.2012.659516
Shields G. S, Fassett-Carman A., Gray Z. J., Gonzales J, E., Snyder H. R., & Slavich G. M. (2023) ‘Why is subjective stress severity a stronger predictor of health than stressor exposure? A preregistered two-study test of two hypotheses’, Stress and Health, 39(1), pp. 87–102. https://doi.org/10.1002/smi.3165
Slavich, G. M., & Shields, G. S. (2018) ‘Аssessing lifetime stress exposure using the Stress and Adversity Inventory for Adults (Adult STRAIN): An overview and initial validation’, Psychosomatic Medicine, 80(1), pp. 17–27. doi: https://doi.org/10.1097/psy.0000000000000534
United Nations (2024). Universal declaration of human rights, Article 25. Available at: https://www.un.org/en/about-us/universal-declaration-of-human-rights (дата звернення: 02 травня 2025 р.);
World Health Organization (2024). Constitution of the World Health Organization. Available at: https://www.who.int/about/governance/constitution (дата звернення: 02 травня 2025 р.).

