Psychological Adaptation During Prolonged War-Related Stress in Ukraine: A Narrative Review

Civilian populations exposed to prolonged stress, loss, illness, displacement, and other uncontrollable life events demonstrate substantial variability in psychological adaptation. Contemporary research suggests that psychological outcomes are influenced not only by the severity of adversity but also by patterns of cognitive-emotional processing, including locus of control, rumination, self-compassion, and meaning-making. The ongoing war in Ukraine represents a distinct context in which civilians must adapt not after the cessation of trauma, but while recurrent threat, displacement, loss, and disruption of everyday life continue. The aim of this narrative review was to examine psychological and neurobiological mechanisms associated with the preservation of agency during prolonged war-related stress and to define their practical implications for civilian mental health care in Ukraine.

A narrative review of meta-analyses, systematic reviews, and authoritative epidemiological reports indexed in PubMed, PsycINFO, Cochrane Library, and international health organizations.

Rumination and externalized control beliefs are associated with poorer psychological outcomes, whereas self-compassion, perceived control, meaning-making, and adaptive coping are associated with more favorable psychological functioning. Self-pity is discussed as a clinically relevant but comparatively under-researched construct. Neurobiological evidence suggests that processes relevant to these psychological patterns involve interacting self-referential, executive-control, salience, and memory-related systems, although direct evidence in Ukrainian civilian populations remains limited.

Preserving response-focused agency, while supporting self-compassion and meaning-oriented processing, represents an evidence-informed and ethically grounded therapeutic principle for civilians living under prolonged war-related stress, although Ukraine-specific intervention evidence remains limited.