Determinants of perceived stress among adolescents during wartime in Ukraine

Adolescents living in war-affected environments are exposed to prolonged and multifactorial stressors that may adversely impact their mental health. In Ukraine, the ongoing war has created conditions of chronic stress even among those not directly exposed to combat. Understanding the determinants of perceived stress in this population is essential for developing targeted preventive strategies. The aim of this study was to assess the level of perceived stress among adolescents and to examine its associations with demographic characteristics, sleep patterns, and physical activity.

A cross-sectional study was conducted among adolescents to evaluate levels of perceived stress and its associated factors. Perceived stress was assessed using the 10-item Perceived Stress Scale (PSS-10). Data on sleep duration, sleep quality, physical activity, and selected health-related factors were collected using self-reported questionnaires. Correlation and comparative analyses were performed to evaluate associations between variables.

The study included 198 participants. A high prevalence of perceived stress was observed, with 52.0% of participants reporting moderate and 37.4% high levels of perceived stress, while only 10.6% demonstrated low stress levels. A significantly higher proportion of females reported high stress levels compared to males (21.5% vs. 5.1%, p < 0.0005). Poor sleep quality and difficulties initiating sleep were also associated with higher stress levels (p < 0.05). Adolescents sleeping more than 8 h per night were significantly more likely to report low stress levels compared to those sleeping less than 8 h (33.3% vs. 11.8%, p = 0.0006). Higher levels of physical activity were associated with lower stress (p < 0.05). Participants engaging in physical activity ≥5 days per week more frequently reported low stress compared to less active peers (32.7% vs. 9.4%, p < 0.001). No significant association was found between perceived stress and the presence of chronic diseases.

Adolescents in a war-affected setting demonstrate a markedly elevated level of perceived stress. Sleep and physical activity are significantly but modestly associated with perceived stress. These findings support the integration of lifestyle-focused and psychosocial interventions into adolescent health strategies to help mitigate the long-term impact of chronic stress.