Anxiety, posttraumatic stress, insomnia and quality of life in Ukrainian schoolchildren during wartime.

Abstract

Background: Children who have remained in Ukraine during the ongoing war are continuously exposed to threat and disruption of services, which places them at high risk of internalizing and trauma-related symptoms.

Methods: In a school-based cross-sectional survey conducted in Ukraine (January-February 2024), 781 students aged 10-17 years completed standardized measures of quality of life (QoL) (PedsQL 4.0), depressive symptoms (CDI 2:SR), state and trait anxiety (STAIC), posttraumatic stress symptoms (CRIES-8), insomnia (Athens Insomnia Scale), resilience (CYRM-R) and coping (JSR). Four multiple linear regression models with forward stepwise selection were estimated.

Results: All models were significant and explained 25-50% of the variance. Emotional functioning (R² = 0.50) was inversely associated with trait anxiety, PTSD symptoms, state anxiety and insomnia, while caregiver/relational resilience and situational emotion-focused coping made small positive contributions. Social functioning (R² = 0.33) was negatively related to trait anxiety and PTSD and positively related to personal resilience. School functioning (R² = 0.26) was negatively related to PTSD, depressive symptoms and insomnia, and positively related to situational resilience and caregiver/relational resilience. Physical functioning (R² = 0.25) was inversely related to state anxiety, PTSD and insomnia, and positively related to caregiver/relational resilience and active coping.

Conclusions: Among war-exposed Ukrainian children who stayed in the country, QoL is mainly determined by symptom burden, especially anxiety, PTSD and sleep disturbance. Resilience and coping have smaller and domain-specific effects. School-based, trauma-informed and sleep-focused interventions should be prioritised in ongoing conflict settings.