Who is most at risk

Several factors were associated with a greater likelihood of meeting the criteria for PTSD or CPTSD: being female, older age, lower educational attainment, previous military service, displacement due to the war, and a greater number of lifetime traumatic events and war-related stressors. Being single was the only factor specifically linked to CPTSD rather than PTSD.

The findings also carry a warning about assumptions. "It is important to keep in mind that PTSD and CPTSD are not limited to veterans or people close to combat zones," says co-author Volodymyr Kulyk, a professor in the Department of Social Sciences at Kyiv School of Economics. "They are also widespread among other groups heavily affected by the war, such as internally displaced people, people who suffered from missile and drone attacks on their cities and towns far from the front line, and those taking care of wounded or traumatized people."

An unusual collaboration

The study grew out of what the authors describe as "an unusual collaboration" between mental health researchers and social scientists, all interested in how psychological trauma in Ukraine affects both mental health and sociopolitical outcomes. Alongside KCL and Kyiv School of Economics, the team included researchers from The George Washington University, The University of Manchester, The Center for East European and International Studies (ZOiS) in Berlin, and Combat Stress, a U.K. veterans' mental health charity. The research network "Conflict and Cooperation in Eastern Europe" (KonKoop) initiated the project, led by Professor Gwendolyn Sasse of ZOiS.

That interdisciplinary setup enabled rare access to a robust, nationally representative sample under current wartime conditions. The team collected data through a telephone survey.

A snapshot, not a trajectory

The study has limitations. Researchers collected data at a single point during an active conflict, so the results represent a snapshot rather than a picture of how symptoms change over time. The findings also rely on self-reported symptoms, which may depend on how participants interpreted the survey questions.

Still, one result surprised the researchers. "PTSD was much more common than complex PTSD in this representative national sample," says lead author Dr. Emma Facer-Irwin, a child and adult clinical psychologist and clinical lecturer at KCL. "This may suggest that psychological responses to ongoing war do not always fit neatly into models developed in post-conflict settings. When the threat remains active and unpredictable, the ways people experience and adapt to traumatic stress may be different, and this is an important area for future research."

The stakes for Ukraine's health system are high. "As pressure on Ukraine's health system grows and uncertainty around future humanitarian support increases, understanding the prevalence of PTSD and complex PTSD is essential for planning both immediate and long-term mental health services," Kulyk says.

Principal investigator Sasse frames the results as a call for both clinical and community-level responses. "Trauma-focused treatments are important, but our findings also highlight the value of community support, social connection and population-level mental health initiatives," she says. "As the war continues, supporting the psychological well-being of civilians must remain a public health priority."

The researchers' next project will examine the potential effects of trauma on political attitudes.