{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T11:40:13Z","timestamp":1792410013286,"version":"4.4.0"},"reference-count":50,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T00:00:00Z","timestamp":1790121600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T00:00:00Z","timestamp":1790121600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Science Reports"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>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\u2010emotional processing, including locus of control, rumination, self\u2010compassion, and meaning\u2010making. 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\u2010related stress and to define their practical implications for civilian mental health care in Ukraine.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A narrative review of meta\u2010analyses, systematic reviews, and authoritative epidemiological reports indexed in PubMed, PsycINFO, Cochrane Library, and international health organizations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Rumination and externalized control beliefs are associated with poorer psychological outcomes, whereas self\u2010compassion, perceived control, meaning\u2010making, and adaptive coping are associated with more favorable psychological functioning. Self\u2010pity is discussed as a clinically relevant but comparatively under\u2010researched construct. Neurobiological evidence suggests that processes relevant to these psychological patterns involve interacting self\u2010referential, executive\u2010control, salience, and memory\u2010related systems, although direct evidence in Ukrainian civilian populations remains limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Preserving response\u2010focused agency, while supporting self\u2010compassion and meaning\u2010oriented processing, represents an evidence\u2010informed and ethically grounded therapeutic principle for civilians living under prolonged war\u2010related stress, although Ukraine\u2010specific intervention evidence remains limited.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hsr2.73284","type":"journal-article","created":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T09:00:51Z","timestamp":1790154051000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Psychological Adaptation During Prolonged War\u2010Related Stress in Ukraine: A Narrative Review"],"prefix":"10.1002","volume":"9","author":[{"given":"Nataliya","family":"Nekrasova","sequence":"first","affiliation":[{"name":"Department of Neurology and Neurosurgery Course of Kharkiv National Medical University Kharkiv Ukraine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yevgenia","family":"Solovyova","sequence":"additional","affiliation":[{"name":"Department of Neurology and Neurosurgery Course of Kharkiv National Medical University Kharkiv Ukraine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dmytro","family":"Butov","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases and Physiatrics of Kharkiv National Medical University Kharkiv Ukraine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0692-9027","authenticated-orcid":false,"given":"Olivier","family":"Uwishema","sequence":"additional","affiliation":[{"name":"Oli Health Magazine Organization Research and Education Kigali Rwanda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5645-7603","authenticated-orcid":false,"given":"Oksana","family":"Kauk","sequence":"additional","affiliation":[{"name":"Department of Neurology and Neurosurgery Course of Kharkiv National Medical University Kharkiv Ukraine"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,23]]},"reference":[{"key":"e_1_2_19_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(19)30934-1"},{"key":"e_1_2_19_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lanepe.2023.100773"},{"key":"e_1_2_19_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2024.0295"},{"key":"e_1_2_19_5_1","doi-asserted-by":"publisher","DOI":"10.1080\/08995605.2023.2235256"},{"key":"e_1_2_19_6_1","doi-asserted-by":"publisher","DOI":"10.1017\/S2045796017000385"},{"key":"e_1_2_19_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2009.09.029"},{"key":"e_1_2_19_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2009.1132"},{"key":"e_1_2_19_9_1","volume-title":"Ukraine Third Rapid Damage and Needs Assessment (RDNA3): February 2022\u2013December 2023","author":"Government of Ukraine","year":"2024"},{"key":"e_1_2_19_10_1","doi-asserted-by":"publisher","DOI":"10.1037\/a0028596"},{"key":"e_1_2_19_11_1","doi-asserted-by":"publisher","DOI":"10.1037\/a0039050"},{"key":"e_1_2_19_12_1","doi-asserted-by":"publisher","DOI":"10.1521\/psyc.2007.70.4.283"},{"key":"e_1_2_19_13_1","doi-asserted-by":"publisher","DOI":"10.1037\/h0092976"},{"key":"e_1_2_19_14_1","doi-asserted-by":"publisher","DOI":"10.1037\/0022-3514.54.5.718"},{"key":"e_1_2_19_15_1","doi-asserted-by":"publisher","DOI":"10.1037\/0033-295X.84.2.191"},{"key":"e_1_2_19_16_1","doi-asserted-by":"publisher","DOI":"10.1037\/0033-2909.134.3.400"},{"key":"e_1_2_19_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpr.2009.11.004"},{"key":"e_1_2_19_18_1","doi-asserted-by":"publisher","DOI":"10.1037\/0033-2909.134.2.163"},{"key":"e_1_2_19_19_1","volume-title":"Shattered Assumptions: Towards a New Psychology of Trauma","author":"Janoff\u2010Bulman R.","year":"1992"},{"key":"e_1_2_19_20_1","doi-asserted-by":"publisher","DOI":"10.1080\/15298860309032"},{"key":"e_1_2_19_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpr.2012.06.003"},{"key":"e_1_2_19_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12671-015-0390-0"},{"key":"e_1_2_19_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12671-019-01134-6"},{"key":"e_1_2_19_24_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrn3027"},{"key":"e_1_2_19_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpr.2010.08.005"},{"key":"e_1_2_19_26_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrn2648"},{"key":"e_1_2_19_27_1","doi-asserted-by":"publisher","DOI":"10.1177\/2470547017692328"},{"key":"e_1_2_19_28_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrn2317"},{"key":"e_1_2_19_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tics.2011.08.003"},{"key":"e_1_2_19_30_1","doi-asserted-by":"publisher","DOI":"10.1196\/annals.1440.011"},{"key":"e_1_2_19_31_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrn4044"},{"key":"e_1_2_19_32_1","doi-asserted-by":"publisher","DOI":"10.1037\/a0018301"},{"key":"e_1_2_19_33_1","doi-asserted-by":"publisher","DOI":"10.1037\/gpr0000077"},{"key":"e_1_2_19_34_1","doi-asserted-by":"publisher","DOI":"10.1207\/s15327965pli1501_01"},{"key":"e_1_2_19_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.janxdis.2010.05.006"},{"key":"e_1_2_19_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.janxdis.2013.10.005"},{"key":"e_1_2_19_37_1","doi-asserted-by":"publisher","DOI":"10.1177\/0963721413475622"},{"key":"e_1_2_19_38_1","doi-asserted-by":"publisher","DOI":"10.1080\/10615806.2010.529901"},{"key":"e_1_2_19_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.brat.2005.01.009"},{"key":"e_1_2_19_40_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00429-010-0262-0"},{"key":"e_1_2_19_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuron.2007.09.006"},{"key":"e_1_2_19_42_1","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.0800005105"},{"key":"e_1_2_19_43_1","doi-asserted-by":"publisher","DOI":"10.1523\/JNEUROSCI.5587-06.2007"},{"key":"e_1_2_19_44_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tins.2014.03.006"},{"key":"e_1_2_19_45_1","doi-asserted-by":"publisher","DOI":"10.1037\/a0018113"},{"key":"e_1_2_19_46_1","volume-title":"Man's Search for Meaning","author":"Frankl V. E.","year":"2006"},{"key":"e_1_2_19_47_1","doi-asserted-by":"publisher","DOI":"10.1037\/0003-066X.59.1.20"},{"key":"e_1_2_19_48_1","doi-asserted-by":"publisher","DOI":"10.1126\/science.1222942"},{"key":"e_1_2_19_49_1","doi-asserted-by":"publisher","DOI":"10.3402\/ejpt.v5.25338"},{"key":"e_1_2_19_50_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpr.2018.05.008"},{"key":"e_1_2_19_51_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpr.2010.03.001"}],"container-title":["Health Science Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/hsr2.73284","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/hsr2.73284","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/hsr2.73284","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T10:46:13Z","timestamp":1792406773000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/hsr2.73284"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,23]]},"references-count":50,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10.1002\/hsr2.73284"],"URL":"https:\/\/doi.org\/10.1002\/hsr2.73284","archive":["Portico"],"relation":{},"ISSN":["2398-8835","2398-8835"],"issn-type":[{"value":"2398-8835","type":"print"},{"value":"2398-8835","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,23]]},"assertion":[{"value":"2026-02-22","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-15","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-23","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e73284"}}