{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T14:26:52Z","timestamp":1786112812580,"version":"build-2736575974"},"reference-count":52,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T00:00:00Z","timestamp":1785888000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T00:00:00Z","timestamp":1785888000000},"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":["Journal of Traumatic Stress"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    War profoundly affects the well\u2010being of civilian populations and shapes subsequent mental health outcomes. This study aimed to investigate the effects of continuous traumatic stress (CTS) and coping efficacy on mental health outcomes among adults in Ukraine amid ongoing warfare over time. We examined how changes in CTS responses, coping efficacy, and stressful life events predicted posttraumatic stress disorder (PTSD) symptoms and broad mental health outcomes (depression, anxiety, insomnia, well\u2010being). Participants were 157 adults who experienced war\u2010related stress and completed two online surveys approximately 12 months apart. Moderately small but significant symptom reductions were observed,\n                    <jats:italic>d<\/jats:italic>\n                    s = 0.18\u20130.32,\n                    <jats:italic>p<\/jats:italic>\n                    s =\u00a0.005\u2013.026. Structural equation models analyzing the associations between initial status and changes in CTS, coping efficacy, and stressful life events and Time 2 PTSD symptoms and broad mental health outcomes explained most of the variance in PTSD symptoms and broad mental health outcomes,\n                    <jats:italic>R<\/jats:italic>\n                    <jats:sup>2<\/jats:sup>\n                    =\u00a0.84\u2012.85. Higher initial severity and worsening CTS responses over time predicted higher PTSD symptom severity, standardized estimate (Est\n                    <jats:sub>std<\/jats:sub>\n                    ) = 0.29\u20120.32,\n                    <jats:italic>p<\/jats:italic>\n                    s =\u00a0.001\u2012.006, and poorer broad mental health outcomes, Est\n                    <jats:sub>std<\/jats:sub>\n                    = 0.25\u20120.28,\n                    <jats:italic>p<\/jats:italic>\n                    s =\u00a0.001\u2012.016. Increased stressful life event exposure was linked to worse broad mental health outcomes, Est\n                    <jats:sub>std<\/jats:sub>\n                    = 0.16,\n                    <jats:italic>p<\/jats:italic>\n                    =\u00a0.001. Improvements in coping efficacy predicted superior broad mental health outcomes, Est\n                    <jats:sub>std<\/jats:sub>\n                    = \u22120.43,\n                    <jats:italic>p<\/jats:italic>\n                    &lt;\u00a0.001. Assessing and addressing the impact of CTS, considering the toll of stressful life events, and enhancing coping efficacy may help to optimize service delivery in ongoing war environments.\n                  <\/jats:p>","DOI":"10.1002\/jts.70115","type":"journal-article","created":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T16:29:03Z","timestamp":1785947343000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effects of continuous traumatic stress and coping efficacy on mental health outcomes during an ongoing war in Ukraine"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9371-6849","authenticated-orcid":false,"given":"Iryna","family":"Frankova","sequence":"first","affiliation":[{"name":"Department of Clinical, Neuro\u2010 and Developmental Psychology Vrije Universiteit Amsterdam  Amsterdam the Netherlands"},{"name":"Centrum\u201945, ARQ National Psychotrauma Centre  Oegstgeest the Netherlands"},{"name":"Department of Medical Psychology, Psychosomatic Medicine and Psychotherapy Educational and Scientific Institute of Mental Health, Bogomolets National Medical University  Kyiv Ukraine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2911-0409","authenticated-orcid":false,"given":"Kathryn S.","family":"Macia","sequence":"additional","affiliation":[{"name":"Health Systems Research Center for Innovation to Implementation Veterans Affairs Palo Alto Health Care System  Menlo Park California USA"},{"name":"National Center for PTSD Dissemination and Training Division Veterans Affairs Palo Alto Health Care System  Menlo Park California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimberly K.","family":"Ecker","sequence":"additional","affiliation":[{"name":"Health Psychology Program University of North Carolina at Charlotte  Charlotte North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9458-1840","authenticated-orcid":false,"given":"Kayleigh N.","family":"Watters","sequence":"additional","affiliation":[{"name":"Psychology Department Palo Alto University  Palo Alto California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leah","family":"Danson","sequence":"additional","affiliation":[{"name":"VA Boston Healthcare System  Boston Massachusetts USA"},{"name":"Department of Psychiatry Boston University Chobanian &amp; Avedisian School of Medicine  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monika","family":"F\u0148a\u0161kov\u00e1","sequence":"additional","affiliation":[{"name":"Central European Institute of Technology (CEITEC), Centre for Neuroscience Masaryk University  Brno Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daija","family":"Jackson","sequence":"additional","affiliation":[{"name":"Department of Mental Health Brooke Army Medical Center  San Antonio Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iryna","family":"Leshchuk","sequence":"additional","affiliation":[{"name":"Department of Medical Psychology, Psychosomatic Medicine and Psychotherapy Educational and Scientific Institute of Mental Health, Bogomolets National Medical University  Kyiv Ukraine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tolou","family":"Maslahati","sequence":"additional","affiliation":[{"name":"Department for Psychiatry and Neurosciences Charit\u00e9\u2013Universi\u00e4tsmedizin Berlin, Campus Benjamin Franklin  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vuyokazi","family":"Ntlantsana","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Faculty of Clinical Medicine University of KwaZulu\u2010Natal  Durban South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jenna","family":"Sanfilippo","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences Feinberg School of Medicine, Northwestern University  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9425-050X","authenticated-orcid":false,"given":"Arieh Y.","family":"Shalev","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Hadassah University Medical Center  Jerusalem Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,5]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.32999\/2663\u2010970X\/2024\u201011\u20105"},{"key":"e_1_2_8_3_1","doi-asserted-by":"crossref","DOI":"10.1176\/appi.books.9780890425787","volume-title":"Diagnostic and statistical manual of mental disorders","author":"American Psychiatric Association","year":"2022"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.heliyon.2020.e03306"},{"issue":"1","key":"e_1_2_8_5_1","article-title":"Adaptation of the Clinician\u2010Administered PTSD Scale and PTSD Checklist for Ukrainian population","volume":"1","author":"Bezsheiko V.","year":"2016","journal-title":"Psychosomatic Medicine and General Practice"},{"key":"e_1_2_8_6_1","first-page":"29","volume-title":"Digital innovations for the prevention and treatment of PTSD in military contexts","author":"Bonanno G. 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