Resilience, Mental Health, and Exposure to Death in Wartime Ukraine

Abstract: War exposure represents a severe stressor associated with increased risk of post-traumatic stress symptoms, emotional dysregulation, and suicidal ideation. In the current context, the ongoing Russian occupation of Ukraine provides a relevant setting in which to examine these processes. This study analyzes the joint effects of age, suicidal ideation (SI), and exposure to death-related stressors on psychological resilience among civilians residing in Ukraine during the conflict. Using a wartime civilian sample, a moderated moderation model was conducted to test whether the association between age and resilience varies as a function of SI and exposure to death-related events. The analysis revealed a significant three-way interaction. Age was positively associated with resilience only among individuals reporting suicidal ideation who had not been exposed to death-related stressors. In contrast, among individuals who reported both suicidal ideation and exposure to death-related events, age was not significantly associated with resilience. These findings indicate that the relationship between age and resilience is conditional upon both psychological vulnerability and trauma exposure. The results highlight the importance of considering developmental factors and exposure to severe stressors when designing mental health interventions in war-affected populations.