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European Journal of Psychotraumatology logoLink to European Journal of Psychotraumatology
. 2024 Oct 2;15(1):2394296. doi: 10.1080/20008066.2024.2394296

High rates of probable PTSD among Ukrainian war refugees: the role of intolerance of uncertainty, loss of control and subsequent discrimination

Tasas altas de probable TEPT entre refugiados de guerra ucranianos: el papel de la intolerancia a la incertidumbre, la pérdida del control y la discriminación posterior

Michał Bilewicz a, Maria Babińska a, Anna Gromova a,b,CONTACT
PMCID: PMC11448335  PMID: 39355973

ABSTRACT

Background: Intolerance of uncertainty is a well-known predictor of post-traumatic stress symptoms following a traumatic event. At the same time, it is relatively unknown whether intolerance of uncertainty amplifies the effects of other adverse life events on PTSD symptoms among traumatized individuals.

Objective: This article addresses this problem in a study of Ukrainian war refugees’ experiences with post-migration discrimination and powerlessness (loss of control).

Method: 4972 forced immigrants from Ukraine took part in the study (90.2% women, Mage = 40.4, SD = 12.5) completing the PTSD-8 scale, measures of post-migration discrimination and loss of control experiences, and intolerance of uncertainty.

Results: Almost half of respondents (47.5%) have probable PTSD. Regression analysis confirmed that war-related experiences, as well as intolerance of uncertainty, post-migration loss of control and experiences of discrimination were significant predictors of self-reported PTSD symptoms. Also, intolerance of uncertainty weakly moderated the effects of experienced discrimination and control deprivation on self-reported PTSD symptoms, so that the effects of adverse post-migration experiences were more pronounced among individuals high in intolerance of uncertainty.

Conclusions: Understanding the effect of post-migration experiences on war refugees’ mental health is crucial for developing improved acculturation policies and fostering a supportive environment for forced migrants.

KEYWORDS: PTSD, Ukrainian forced migrants, intolerance of uncertainty, discrimination, war

HIGHLIGHTS

  • Ukrainian forced migrants have high levels of probable PTSD symptoms.

  • Post-migration experiences increase the probability of self-reported post-traumatic stress symptoms.

  • IU weakly moderates the effects of discrimination and loss of control on self-reported post-traumatic stress symptoms.

The Russian invasion on Ukraine in February 2022 triggered a cascading series of events, resulting in mass migration of Ukrainian citizens seeking safety and refuge. The influx of over 9.5 million individuals fleeing Ukraine has placed significant pressure on neighbouring countries, including Poland, which has witnessed the registration of more than 1.5 million Ukrainian refugees seeking Temporary Protection (Ukraine Refugee Situation, n.d.). This forced migration, intertwined with the traumatic experience of active warfare, adds a distinct layer of complexity to the challenges faced by these immigrants. The disruption of their familiar environments, separation from loved ones, experiences with the host country population and ongoing uncertainty create an environment conducive to the development of PTSD symptoms (Sayed et al., 2015).

In this article, we aimed to focus on the role of post-migration experiences that might contribute to the increased probability of PTSD among Ukrainian refugees. By examining the unique circumstances surrounding their forced relocation (Duszczyk et al., 2023), we sought to shed light on the potential long-term consequences of experiencing war-related trauma coupled with the stressors inherent in the process of immigration. Furthermore, we explored the role of intolerance of uncertainty as a factor contributing to the development of PTSD symptoms in this population and discussed potential strategies for intervention and support. We hypothesized that loss of control and experiences of post-migration discrimination experiences increase PTSD symptoms among the war refugee population and that these stressors mostly affect people with the highest intolerance of uncertainty levels. This report presents the results of a large empirical study of the Ukrainian refugee population which was conducted in 2022.

1. Intolerance of uncertainty and PTSD

Beliefs regarding one's ability to effectively cope with uncertainty play a vital role in shaping a negative attitude towards unexpected events and may determine the degree to which individuals perceive a stressful event as challenging, unpleasant, and distressing (Zvolensky et al., 2010). In the development of post-traumatic stress symptoms, both among student participants (Boelen, 2019), as well as in a diverse group of civilians with a history of trauma (Bardeen et al., 2013; Fetzner et al., 2013) intolerance of uncertainty, was found to be key predictor. The results indicated a significant association between intolerance of uncertainty and the avoidance, hyperarousal, and emotional numbing clusters of post-traumatic stress disorder (PTSD) symptoms, while there was no significant correlation with the re-experiencing cluster (Fetzner et al., 2013; Oglesby et al., 2017).

Although multiple studies explored the role of intolerance of uncertainty in PTSD, most of them analysed the direct relationship between these two psychological phenomena (e.g. Fetzner et al., 2013; Oglesby et al., 2017), rather than looking on a potential moderating role of intolerance of uncertainty. The current research proposed that higher tolerance of uncertainty could serve as a protective factor against adverse environmental stressors that elevate PTSD symptoms in a traumatized population. In contrast, low tolerance of uncertainty, as a negative psychological coping strategy, would enhance the effect of such stressors on post-war PTSD. Recent research about the effects of mental health among refugees in Indonesia found that the effects of negative coping strategies are stronger among refugees experiencing higher levels of external stress (Nickerson et al., 2023), whereas a study performed on a small sample of American college students demonstrated that worry increases post-traumatic stress symptoms among people with higher intolerance of uncertainty (Bardeen et al., 2013). These findings suggest that intolerance of uncertainty should be examined as a moderator of post-migration stressors on refugee war-related PTSD rather than a direct predictor of PTSD levels.

2. Post-migration experiences: discrimination and loss of control

The symptoms of post-traumatic stress disorder among refugees are determined not only by direct war experiences but also amplified by the post-migration situation that might lead to a sense of powerlessness. Various factors, such as experienced xenophobic slurs, cultural marginalization, unequal treatment, and hate speech, can exacerbate the traumatic experiences and increase the vulnerability of refugees to develop PTSD (Asnaani & Hall-Clark, 2017). Recent systematic review of studies focused on racial discrimination in the United States proved that up to 70% of the trauma symptomology outcomes could be associated with the experiences of discrimination (Kirkinis et al., 2021).

Furthermore, control deprivation, resulting from loss of autonomy and agency in the face of displacement, can intensify psychological distress and hinder the recovery process. Studies of violence survivors (Salcioglu et al., 2017) and war survivors (Başoğlu et al., 2005) showed that control deprivation and helplessness increase the probability of PTSD. In the life of a war refugee, the sense of control deprivation is relatively frequent and can be experienced in work contexts as well as in everyday life situations. Therefore, it is crucial to analyse the role of post-migration personal control deprivation in refugees’ mental health.

3. The situation of Ukrainian war refugees in Poland

The initial reactions of Poles to asylum-seekers from Ukraine in 2022 was generally positive (Babińska et al., 2022; Baszczak et al., 2022; Domaradzki et al., 2022) and there was substantial institutional support offered by Poland at the state level (Duszczyk et al., 2023). At the same time, a number of problems that always accompany forced displacement (Javanbakht, 2022) were also shared by refugees from Ukraine (Ociepa-Kicińska & Gorzałczyńska-Koczkodaj, 2022).

Chudzicka-Czupała et al. (2023) found that Ukrainians reported significantly higher scores for depression, anxiety, stress, and post-traumatic stress in the first months of full-scale Russian invasion compared to Poles and Taiwanese. In a short survey by Rizzi et al. (2022) high scores for anxiety, anger, and depression were found both in Ukrainians who left the country and those who had inner displacement experience (IDPs). However, some of these reactions could be viewed as psychologically adaptive in war contexts (Bilewicz, 2022).

As the war continued, the situation of uncertainty and loss of control also became chronic. As of September 2022, about 40% of Ukrainians entering Poland due to the war could not answer how long they would stay abroad and when they would return (Górny & Kaczmarczyk, 2023). Concern about the future was expressed by 26.4% staying in transit in Poland in spring 2022 (Rizzi et al., 2022). Meta-analyses of refugee mental health suggest that, on average, rates of depression and PTSD symptoms in refugee samples approach 25% and 31%, respectively (Mesa-Vieira et al., 2022). One of the key motivations of the current research was to assess the extent of war-related self-reported PTSD symptoms in the population of Ukrainian refugees in Poland, to explore the role of post-migration stressors in PTSD symptomology, and to analyse a potential moderating role of intolerance of uncertainty in these effects.

4. Method

4.1. Sample

The survey was conducted in August-September 2022. 7617 forced immigrants from Ukraine from which 4972 (65.3%) came to Poland after 24 February 2022 took part in the study. The largest part of the sample were women (90.2%) and 9,6% were men, 0.2% indicated that they do not want to indicate their gender. Such distribution resembles the gender-skewed characteristics of the Ukrainian war refugee population in Poland. The mean age was 40.4, SD = 12.5 (for more details see Table 1). Participants were informed that 10 PLN per survey would be donated to organizations supporting Ukrainians. The Ethics Committee of the Center for Migration Research at the University of Warsaw provided the ethics approval for this research (CMR/EC/6/2022).

Table 1.

Descriptive statistics for the variables, n = 4972.

Variable N (%) Mean (SD)
Gender    
 Men 477 (9.6) –
 Women 4486 (90.2) –
 Refuse to answer 9 (.2) –
Age – 40.43 (12.55)
Marital status    
 Married 2674 (53.8) –
 Divorced 872 (17.5) –
 Widow 293 (5.9) –
 Single 1121 (22.5) –
Number of children    
 1–2 children 3301 (66.4) –
 3 and more 566 (11.3) –
 No children 1067 (21.5) –
Education    
 Primary education or below 66 (1.3) –
 Basic or secondary vocational education 387 (7.8) –
 Completed secondary or specialized education 1246 (25.1) –
 Higher education 3273 (65.8) –
Reason for leaving Ukraine:    
 Job and finance difficulties 654 (13.1) –
 Desire to start or continue studying abroad 125 (2.5) –
 Direct military attacks near my house 3054 (61.4) –
 Destruction of my house 232 (4.7) –
 Lack of access to basic needs (water, electricity, shopping, etc.) 423 (8.5) –
 Organized evacuation from Ukraine 537 (10.8) –
 Feeling of danger personally or for the family 3092 (62.2) –
 Desire to join family, friends or acquaintances who have left Ukraine 392 (7.9) –
 Other 333 (6.7) –
Discrimination experience – 2.42 (0.91)
Intolerance of Uncertainty – 3.74 (0.81)
Control deprivation – 3.53 (1.04)
Self-reported PTSD symptoms (total score) - 21.28 (4.88)
 Intrusion symptoms - 9.55 (2.99)
 Avoidance - 4.99 (1.86)
 Hypervigilance - 5.90 (1.68)
Probable PTSD prevalence 2363 (47.5) -
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4.2. Measures

Post-traumatic stress disorder symptoms were measured using the PTSD-8 scale (Bilewicz & Wojcik, 2018; Hansen et al., 2010) in a Ukrainian adaptation by Wypych and Bilewicz (2024). PTSD-8 is a self-report screening instrument that allows to assess the severity of all categories of PTSD symptoms. It was previously shown to work efficiently in trauma samples characterized by different periods of time elapsed from traumatic stress and with differing prevalence rates of PTSD (Hansen et al., 2010). The scale consists of 8 items (α = .82 in the present study) that are organized in three clusters of PTSD symptoms: intrusions, avoidance, and hypervigilance. The items are answered on a four-point Likert scale, ranging from ‘not at all’ (1), to ‘all the time’ (4). The summed score provides a score for symptom severity. For assessing probability of PTSD at least one answer on a question in every cluster should be ≥ 3. In the current study, the PTSD-8 was presented with anchoring information reminding participants that the questions were related to the current war in Ukraine.

The experience of discrimination was measured with three questions taken from the discrimination subscale of the Riverside Acculturation Stress Inventory (Miller et al., 2011) in its Ukrainian version (Wypych & Bilewicz, 2024) and showed good consistency (α = .82 in the present study).

Intolerance of uncertainty was measured with a brief, 2-item instrument (α = .63 in the present study) that included questions tapping two key components of this phenomenon (‘When I am uncertain I can’t function very well’ and ‘I feel uncomfortable when I don't understand the reason why an event occurred’) based on existing measures of uncertainty avoidance and intolerance of uncertainty (Carleton et al., 2007; Webster & Kruglanski, 1994) in its Ukrainian version (Hromova, 2021).

Control deprivation was measured with one question ‘It seems to me that there are a lot of things happening in my life now that I have no influence over’ (Cichocka et al., 2018). This single-item instrument has been translated into Ukrainian in a procedure of committee-based translation by a Polish-Ukrainian group of researchers proficient in the languages. Responses to the questions about experience of discrimination, intolerance of uncertainty and control deprivation were recorded using Likert-type scale ranging from 1 to 5.

We additionally asked about the reasons for leaving Ukraine by offering multiple-choice responses such as ‘exposure to shelling’, ‘destruction of home’, ‘lack of basic necessities (e.g. water, food)’. Answers to this question were aggregated in a variable labelled ‘war experience’, which reflects actual conditions encountered during the war (Table 1). All questions were translated into Ukrainian and were first checked by native speakers, after that a small sample of Ukrainian refugees answered the questions and gave feedback about their clarity.

4.3. Analysis

The analysis plan involved descriptive statistics of post-war self-reported PTSD symptoms in the studied population, as well as other variables of interest. In the second step, we aimed at determining the role of intolerance of uncertainty, and the post-migration experiences (control deprivation and discrimination) in self-reported PTSD symptoms symptoms. For that reason, multiple regression analysis was performed. In order to test the different effects of post-migration experiences among people with high and low intolerance of uncertainty, two interactive tests were performed. For that aim, we used Model 1 in the SPSS PROCESS macro (Hayes, 2013), with 95% bias-corrected (BC) bootstrapped confidence intervals based on 5000 bootstrap samples. We included age and sex as covariates. All analyses were conducted using IBM SPSS Statistics 29, and to visualize the effects, we used the ‘interactions’ package in R (Long, 2022).

5. Descriptive results

The prevalence rate of probable PTSD diagnosis was 47.5% in this sample of Ukrainian refugees (forced immigrants) residing in Poland. The most frequently mentioned experiences that led to migration were military attacks near participants’ houses and direct war-related physical danger (both mentioned by more than 60% of participants). Full descriptive statistics are presented in Table 1.

Basic comparative analyses showed significant differences between men and women in self-reported PTSD symptoms symptoms t(4908) = 14.99, p < .001, discrimination experience t(4961) = 4.19, p < .001, loss of control t(4961) = 3.87, p < .001, and intolerance of uncertainty t(4961) = 6.13, p < .001. There were significant correlations between all variables (Table 2).

Table 2.

Zero-order correlations between variables in the model.

Variable Discrimination Intolerance of uncertainty Control deprivation War experiences
Discrimination        
Intolerance of uncertainty .12**      
Control deprivation .11** .30**    
War experience .05** .03* .06**  
Self-reported PTSD symptoms .19** .25** .21** .18**
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Note: *p < .05, **p < .001.

We conducted a regression analysis in order to determine the effects of intolerance of uncertainty and post-migration experiences (discrimination and control deprivation) on PTSD levels. We entered demographic variables in the first step of regression (R2 = .05), intolerance of uncertainty in the second step (ΔR2 = .05), traumatic war experiences in the third step (ΔR2 = .03) and post-migration experiences (discrimination and control deprivation) in the third step (ΔR2 = .04) as predictors. The results of analyses proved that not only war-related experiences, but also intolerance of uncertainty and both post-migration experiences (feelings of control deprivation and discrimination experiences) were all significant positive predictors of self-reported PTSD symptoms among Ukrainian refugees in Poland (see Table 3). The overall model explained 17% of PTSD variance.

Table 3.

Regression analyses of PTSD predictors.

  B SE Beta t p CI 95%  
Step 1. Gender −3.65 .25 −.22 −14.44 <.001 −4.15 −3.16
Age .00 .01 .00 .072 .942 -.01 .01
Step 2. Intolerance of uncertainty 1.38 .09 .23 15.30 <.001 1.20 1.56
Step 3. Intensity of war experiences 1.31 .11 .18 12.29 <.001 1.10 1.51
Step 4. Subsequent discrimination .79 .08 .15 9.92 <.001 .63 .94
Control deprivation .55 .07 .12 7.70 <.001 .41 .69
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Note: aDependent Variable: self-reported PTSD symptoms (total score).

Although the gender distribution was highly imbalanced in the studied sample, we decided to reanalyse the regression analysis separately for both genders for exploratory purposes. The analysis revealed almost identical results for both genders, indicating that higher levels of intolerance of uncertainty, more severe war experiences, increased discrimination, and control deprivation were positively associated with PTSD scores. However, in the case of men, control deprivation was only marginally significant due to the small sample size (see Supplementary Materials https://osf.io/yv8fm/?view_only = 54a3f0a0d0dd4bd7b0e89a2c0ceac459).

Additionally, we have observed two significant, although rather weak interaction effects. Intolerance of uncertainty moderated the effects of control deprivation on self-reported PTSD symptoms, b = .16, SE = 0.07, p = 0.03, R2 = .001, F(1, 3989) = 4.79, 95%CIboot [.02, .30]. The relationship between control deprivation and self-reported PTSD symptoms increased with higher levels of intolerance of uncertainty (b = .80, SE = .10, p < .001, 95%CI [.61, .99] for refugees with high intolerance of uncertainty; and b = .54, SE = .09, p < .001, 95%CI [.37, .72] for refugees with low intolerance of uncertainty, see Figure 1). Intolerance of uncertainty also moderated the effects of experienced discrimination on self-reported PTSD symptoms, b = .24, SE = .09, p = 0.01; R2 = .001, F(1, 3989) = 6.79, 95%CIboot [.06, .43]. The relationship between discrimination and probable PTSD increased with higher levels of intolerance of uncertainty (b = 1.06, SE = 1.12, p < .001, 95%CI [.85, 1.26] for refugees with high intolerance of uncertainty, and b = .65, SE = 12, p < .001, 95%CI [.42, .89] for refugees with low intolerance of uncertainty, see Figure 2).

Figure 1.

Figure 1.

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The effects of control deprivation on PTSD intensity among refugees with high and low intolerance of uncertainty.

Figure 2.

Figure 2.

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The effects of experienced discrimination on PTSD intensity among refugees with high and low intolerance of uncertainty.

6. Discussion

The first aim of this study was to measure and analyse the prevalence of self-reported PTSD symptoms among Ukrainian citizens who flew to Poland due to the beginning of the full-scale invasion. A significant proportion (47.5%) of forced Ukrainian migrants met the criteria of probable PTSD diagnosis, although high rates had also been reported in other refugee populations measured with the same instrument – e.g. 31% among Australian humanitarian immigrants (Chen et al., 2017), or 38% among Australian refugee caregivers (Bryant et al., 2018). It is also possible that several aspects of PTSD in refugee populations were remnants of adaptive strategy in the war context, where hypervigilance, arousal, anxiety and generalized mistrust might contribute to civilian survival (Bilewicz, 2022). In women, the severity of self-reported PTSD symptoms was higher both in terms of the total score and in each of the clusters. These results resembled the global data of a large body of PTSD research, which notes a greater tendency for women to develop PTSD symptoms, which did not change even after taking into account the type of traumatic event (Hu et al., 2017; Tolin & Foa, 2006). At the same time studies of refugees who lived not in the camp, but who were granted permanent residence in Sweden did not find a gender difference in PTSD symptomatology (Gottvall et al., 2019; Tinghög et al., 2017), which might be a consequence of changing life circumstances and reducing uncertainty and insecurity about the future (Sagaltici et al., 2022), but could be also attributed to floor or ceiling effects in such studies.

All studied variables provided a significant contribution to the severity of self-reported PTSD symptoms among Ukrainian migrants. As expected, intolerance of uncertainty was found to be a significant moderator of the effects of post-migration experiences on PTSD symptoms, increasing stress reactions both in the face of discrimination and personal control deprivation. Although the contribution of intolerance of uncertainty to PTSD symptom severity is well known (Hernández-Posadas et al., 2024), only a few studies have examined the relationship between intolerance of uncertainty and mental health in refugees (Morales et al., 2023; Nickerson et al., 2023).

Most studies looking at the role of intolerance of uncertainty in PTSD symptomology assessed the direct effects of uncertainty intolerance on mental health. Meta analytic data indicates that intolerance to uncertainty is a stable characteristic (McEvoy et al., 2019), so it can be viewed as a trait-like moderator of the effects of subsequent life events and environmental pressures on PTSD symptoms. Recent empirical evidence from studies looking at a larger category of negative coping strategies that include intolerance of uncertainty (Nickerson et al., 2023) and from small student-sample studies (Bardeen et al., 2013) suggest this moderating role of intolerance of uncertainty in developing the post-violence PTSD.

Our study elaborated on these insights, offering a moderational model of PTSD among refugees experiencing further stressors in a host country. We found that the effects of discrimination and loss of control increase PTSD levels to greater extent among people with high intolerance of uncertainty. Although statistically significant, these effects were rather weak. Therefore we conclude that discrimination and loss of control are risk factors in PTSD among people of both high and low levels of uncertainty intolerance.

The main limitation of this study was its cross-sectional design and the use of shortened versions of questionnaires to measure some variables. This is a typical shortcoming in large population-representative studies where shorter versions of instruments are commonly applied. On the other hand, a sufficiently large sample size allowed us to assert that the identified relationships were not random and would be replicated when using the full versions of the relevant questionnaires. The imbalance of the sample by gender is noteworthy. However, it reflected the objective composition of the population leaving Ukraine, where only mostly women with children and seniors were allowed to migrate.

Another limitation concerned post-stress symptomatology. The brief test PTSD-8 is certainly not sufficient for diagnosis of PTSD and does not claim to be. First, because formal diagnosis implies an interview (not conducted in this study) and a life-threatening experience, criterion ‘A’ (about which we have only indirect information). Second, an official diagnosis of PTSD requires a certain amount of time to have elapsed since the traumatic event was experienced. The war has not ended and daily shelling of Ukrainian territory continues. Forced migrants, having a sense of relative safety in the host country, are still included in the experience of events in Ukraine, as many of relatives and friends remained there.

Understanding the role of post-migration stressors in war refugees’ mental health is essential for designing more effective acculturation policies and providing adequate support to people affected by violent conflicts. Our study showed that effective antidiscriminatory practices in work and education environments could decrease the levels of PTSD among traumatized populations, and this effect is particularly profound among refugees with lower tolerance of uncertainty. A host society offering such support, together with opportunities for restoring the sense of personal control could create a prosperous environment for all groups affected by mass war trauma, similar to the one that was experienced by Ukrainians fleeing in times of 2022 Russian invasion.

Acknowledgements

The authors acknowledge Agata Górny from the Center for Migration Research at the University of Warsaw for her support in organizing the data collection.

Funding Statement

This research was funded from Narodowym Centrum Nauki, funding scheme ‘OPUS', grant UMO-2023/49/B/HS6/01428 and data collection was possible through IDUB Excellence Initiative funds from the Polish Ministry of Education and Science.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The data presented in this study is available on OSF repository https://osf.io/yv8fm/?view_only = 54a3f0a0d0dd4bd7b0e89a2c0ceac459.

Open Scholarship

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This article has earned the Center for Open Science badge for Open Data are openly accessible at https://osf.io/yv8fm/?view_only=54a3f0a0d0dd4bd7b0e89a2c0ceac459.

References

  1. Asnaani, A., & Hall-Clark, B. (2017). Recent developments in understanding ethnocultural and race differences in trauma exposure and PTSD. Current Opinion in Psychology, 14, 96–101. 10.1016/j.copsyc.2016.12.005 [DOI] [PubMed] [Google Scholar]
  2. Babińska, M., Bilewicz, M., Górska, P., Toruńczyk-Ruiz, S., & Wypych, M. (2022). Polacy wobec Ukraińców: Wyniki badań sondażowych zrealizowanych po inwazji rosyjskiej na Ukrainę w 2022 roku [Poles toward Ukrainians: The results of survey studies after the Russian invasion of Ukraine in 2022]. Nauka, 4, 37–58. 10.24425/nauka.2022.142919 [DOI] [Google Scholar]
  3. Bardeen, J. R., Kumpula, M. J., & Orcutt, H. K. (2013). Emotion regulation difficulties as a prospective predictor of posttraumatic stress symptoms following a mass shooting. Journal of Anxiety Disorders, 27(2), 188–196. 10.1016/j.janxdis.2013.01.003 [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Baszczak, Ł, Kiełczewska, A., Kukołowicz, P., Wincewicz, A., & Zyzik, R. (2022). How Polish society has been helping refugees from Ukraine. Polish Economic Institute. [Google Scholar]
  5. Başoğlu, M., Livanou, M., Crnobarić, C., Frančišković, T., Suljić, E., Đurić, D., & Vranešić, M. (2005). Psychiatric and cognitive effects of war in former Yugoslavia: Association of lack of redress for trauma and posttraumatic stress reactions. JAMA, 294(5), 580–590. 10.1001/jama.294.5.580 [DOI] [PubMed] [Google Scholar]
  6. Bilewicz, M. (2022). Conspiracy beliefs as an adaptation to historical trauma. Current Opinion in Psychology, 47, Article 101359. 10.1016/j.copsyc.2022.101359 [DOI] [PubMed] [Google Scholar]
  7. Bilewicz, M., & Wojcik, A. D. (2018). Visiting Auschwitz: Evidence of secondary traumatization among high school students. American Journal of Orthopsychiatry, 88(3), 328–334. 10.1037/ort0000302 [DOI] [PubMed] [Google Scholar]
  8. Boelen, P. A. (2019). Intolerance of uncertainty predicts analogue posttraumatic stress following adverse life events. Anxiety, Stress, & Coping, 32(5), 498–504. 10.1080/10615806.2019.1623881 [DOI] [PubMed] [Google Scholar]
  9. Bryant, R. A., Edwards, B., Creamer, M., O'donnell, M., Forbes, D., Felmingham, K. L., Silove, D., Steel, Z., Nickerson, A., McFarlane, A. C., Van Hooff, M., & Hadzi-Pavlovic, D. (2018). The effect of post-traumatic stress disorder on refugees’ parenting and their children's mental health: a cohort study. The Lancet Public Health, 3(5), e249–e258. 10.1016/S2468-2667(18)30051-3 [DOI] [PubMed] [Google Scholar]
  10. Carleton, R. N., Norton, M. P. J., & Asmundson, G. J. (2007). Fearing the unknown: A short version of the Intolerance of Uncertainty Scale. Journal of Anxiety Disorders, 21(1), 105–117. 10.1016/j.janxdis.2006.03.014 [DOI] [PubMed] [Google Scholar]
  11. Chen, W., Hall, B. J., Ling, L., & Renzaho, A. M. (2017). Pre-migration and post-migration factors associated with mental health in humanitarian migrants in Australia and the moderation effect of post-migration stressors: Findings from the first wave data of the BNLA cohort study. The Lancet Psychiatry, 4(3), 218–229. 10.1016/S2215-0366(17)30032-9 [DOI] [PubMed] [Google Scholar]
  12. Chudzicka-Czupała, A., Hapon, N., Chiang, S. K., Żywiołek-Szeja, M., Karamushka, L., Lee, C. T., Grabowski, D., Paliga, M., Rosenblat, J. D., Ho, R., McIntyre, R. S., & Chen, Y. L. (2023). Depression, anxiety and post-traumatic stress during the 2022 Russo-Ukrainian war, a comparison between populations in Poland, Ukraine, and Taiwan. Scientific Reports, 13(1), Article 3602. 10.1038/s41598-023-28729-3 [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Cichocka, A., De Zavala, A. G., Marchlewska, M., Bilewicz, M., Jaworska, M., & Olechowski, M. (2018). Personal control decreases narcissistic but increases non-narcissistic in-group positivity. Journal of Personality, 86(3), 465–480. 10.1111/jopy.12328 [DOI] [PubMed] [Google Scholar]
  14. Domaradzki, J., Walkowiak, D., Bazan, D., & Baum, E. (2022). Volunteering in the front line of the Ukrainian refugee crisis: A brief report from Poland. Frontiers in Public Health, 10, Article 979751. 10.3389/fpubh.2022.979751 [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Duszczyk, M., Górny, A., Kaczmarczyk, P., & Kubisiak, A. (2023). War refugees from Ukraine in Poland–one year after the Russian aggression. Socioeconomic consequences and challenges. Regional Science Policy & Practice, 15(1), 181–200. 10.1111/rsp3.12642 [DOI] [Google Scholar]
  16. Fetzner, M. G., Horswill, S. C., Boelen, P. A., & Carleton, R. N. (2013). Intolerance of uncertainty and PTSD symptoms: Exploring the construct relationship in a community sample with a heterogeneous trauma history. Cognitive Therapy and Research, 37(4), 725–734. 10.1007/s10608-013-9531-6 [DOI] [Google Scholar]
  17. Gottvall, M., Vaez, M., & Saboonchi, F. (2019). Social support attenuates the link between torture exposure and post-traumatic stress disorder among male and female Syrian refugees in Sweden. BMC International Health and Human Rights, 19(1), 1–11. 10.1186/s12914-019-0214-6 [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Górny, A., & Kaczmarczyk, P. (2023). Between Ukraine and Poland. Ukrainian migrants in Poland during the war. CMR Spotlight, 2(48), 1–15. https://www.migracje.uw.edu.pl/wp-content/uploads/2023/02/Spotlight-FEBRUARY-2023.pdf [Google Scholar]
  19. Hansen, M., Andersen, T. E., Armour, C., Elklit, A., Palic, S., & Mackrill, T. (2010). PTSD-8: A Short PTSD Inventory. Clinical Practice & Epidemiology in Mental Health, 6(1), 101–108. 10.2174/1745017901006010101 [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Hayes, A. F. (2013). Introduction to mediation, moderation, and conditional process analysis: A regression-based approach. Guilford Press. [Google Scholar]
  21. Hernández-Posadas, A., Lommen, M., De La Rosa Gómez, A., Bouman, T., Díaz, J. M. M., & Del Palacio-Gonzalez, A. (2024). Transdiagnostic factors in symptoms of depression and post-traumatic stress: A systematic review. Current Psychology, 43(7), 5933–5948. 10.1007/s12144-023-04792-x [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Hromova, H. (2021). Інструменти вимірювання толерантності до невизначенності. Адаптація тесту «Шкала інтолерантності до невизначеності» Н. Карлетона. [Uncertainty tolerance measurement tools. Adaptation of N. Carleton ‘Intolerance of uncertainty scale’ (short vertion)]. Naukovì Studìï Ìz Socìal′noï Ta Polìtičnoï Psihologìï, 47(50), 115–130. 10.33120/ssj.vi47(50).217 [DOI] [Google Scholar]
  23. Hu, J., Feng, B., Zhu, Y., Wang, W., Xie, J., & Zheng, X. (2017). Gender differences in PTSD: Susceptibility and resilience. In A. Alvinius (Ed.), Gender differences in different contexts (pp. 21–42). Intechopen. 10.5772/65287 [DOI] [Google Scholar]
  24. Javanbakht, A. (2022). Addressing war trauma in Ukrainian refugees before it is too late. European Journal of Psychotraumatology, 13(2), 1–4. 10.1080/20008066.2022.2104009 [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. Kirkinis, K., Pieterse, A. L., Martin, C., Agiliga, A., & Brownell, A. (2021). Racism, racial discrimination, and trauma: A systematic review of the social science literature. Ethnicity & Health, 26(3), 392–412. 10.1080/13557858.2018.1514453 [DOI] [PubMed] [Google Scholar]
  26. Long, J. A. (2022). Interactions: Comprehensive, user-friendly toolkit for probing interactions. R package version 1.1.6, https://cran.r-project.org/package=interactions
  27. McEvoy, P. M., Hyett, M. P., Shihata, S., Price, J., & Strachan, L. P. (2019). The impact of methodological and measurement factors on transdiagnostic associations with intolerance of uncertainty: A meta-analysis. Clinical Psychology Review, 73, Article 101778. 10.1016/j.cpr.2019.101778 [DOI] [PubMed] [Google Scholar]
  28. Mesa-Vieira, C., Haas, A. D., Buitrago-Garcia, D., Roa-Díaz, Z. M., Minder, B., Gamba, M., Salvador, D., Gómez, D. I., Lewis, M., Gonzalez-Jaramillo, W. C., De Mortanges, A. P., Buttia, C., Muka, T., Trujillo, N., & Franco, O. H. (2022). Mental health of migrants with pre-migration exposure to armed conflict: A systematic review and meta-analysis. The Lancet Public Health, 7(5), e469–e481. 10.1016/S2468-2667(22)00061-5 [DOI] [PubMed] [Google Scholar]
  29. Miller, M. J., Kim, J., & Benet-Martínez, V. (2011). Validating the riverside acculturation stress inventory with Asian Americans. Psychological Assessment, 23(2), 300–310. 10.1037/a0021589 [DOI] [PubMed] [Google Scholar]
  30. Morales, A. U., Baeza-Rivera, M. J., Caqueo-Urízar, A., & Henríquez, D. (2023). Optimism and intolerance to uncertainty may mediate the negative effect of discrimination on mental health in migrant population. Healthcare, 11(4), Article 503. 10.3390/healthcare11040503 [DOI] [PMC free article] [PubMed] [Google Scholar]
  31. Nickerson, A., Hoffman, J., Keegan, D. L., Kashyap, S., Argadianti, R., Tricesaria, D., Pestalozzi, Z., Nandyatama, R. W., Khakbaz, M., Nilasari, N., & Liddell, B. J. (2023). Intolerance of uncertainty, posttraumatic stress, depression, and fears for the future among displaced refugees. Journal of Anxiety Disorders, 94, Article 102672. 10.1016/j.janxdis.2023.102672 [DOI] [PubMed] [Google Scholar]
  32. Ociepa-Kicińska, E., & Gorzałczyńska-Koczkodaj, M. (2022). Forms of aid provided to refugees of the 2022 Russia–Ukraine war: The case of Poland. International Journal of Environmental Research and Public Health, 19(12), Article 7085. 10.3390/ijerph19127085 [DOI] [PMC free article] [PubMed] [Google Scholar]
  33. Oglesby, M. E., Gibby, B. A., Mathes, B. M., Short, N. A., & Schmidt, N. B. (2017). Intolerance of uncertainty and post-traumatic stress symptoms: An investigation within a treatment seeking trauma-exposed sample. Comprehensive Psychiatry, 72, 34–40. 10.1016/j.comppsych.2016.08.011 [DOI] [PubMed] [Google Scholar]
  34. Rizzi, D., Ciuffo, G., Sandoli, G., Mangiagalli, M., de Angelis, P., Scavuzzo, G., Nych, M., Landoni, M., & Ionio, C. (2022). Running away from the war in Ukraine: The impact on mental health of internally displaced persons (IDPs) and refugees in transit in Poland. International Journal of Environmental Research and Public Health, 19(24), Article 16439. 10.3390/ijerph192416439 [DOI] [PMC free article] [PubMed] [Google Scholar]
  35. Sagaltici, E., Şahin, Ş. K., Alpak, G., & Altindag, A. (2022). Gender differences in the symptomatology of posttraumatic stress disorder among Syrian refugees settled in a camp in Turkey. Psichiatria Danubina, 34(2), 253–262. 10.24869/psyd.2022.253 [DOI] [PubMed] [Google Scholar]
  36. Salcioglu, E., Urhan, S., Pirinccioglu, T., & Aydin, S. (2017). Anticipatory fear and helplessness predict PTSD and depression in domestic violence survivors. Psychological Trauma: Theory, Research, Practice, and Policy, 9(1), 117–125. 10.1037/tra0000200 [DOI] [PubMed] [Google Scholar]
  37. Sayed, S., Iacoviello, B. M., & Charney, D. S. (2015). Risk factors for the development of psychopathology following trauma. Current Psychiatry Reports, 17(8), 1–7. 10.1007/s11920-015-0612-y [DOI] [PubMed] [Google Scholar]
  38. Tinghög, P., Malm, A., Arwidson, C., Sigvardsdotter, E., Lundin, A., & Saboonchi, F. (2017). Prevalence of mental ill health, traumas and postmigration stress among refugees from Syria resettled in Sweden after 2011: A population-based survey. BMJ Open, 7(12), Article e018899. 10.1136/bmjopen-2017-018899 [DOI] [PMC free article] [PubMed] [Google Scholar]
  39. Tolin, D. F., & Foa, E. B. (2006). Sex differences in trauma and posttraumatic stress disorder: A quantitative review of 25 years of research. Psychological Bulletin, 132(6), 959–992. 10.1037/0033-2909.132.6.959 [DOI] [PubMed] [Google Scholar]
  40. Ukraine Refugee Situation . (n.d.). UNHCR. https://data.unhcr.org/en/situations/ukraine
  41. Webster, D. M., & Kruglanski, A. W. (1994). Individual differences in need for cognitive closure. Journal of Personality and Social Psychology, 67(6), 1049–1062. 10.1037/0022-3514.67.6.1049 [DOI] [PubMed] [Google Scholar]
  42. Wypych, M., & Bilewicz, M. (2024). Psychological toll of hate speech: The role of acculturation stress in the effects of exposure to ethnic slurs on mental health among Ukrainian immigrants in Poland. Cultural Diversity & Ethnic Minority Psychology, 30(1), 35–44. 10.1037/cdp0000522 [DOI] [PubMed] [Google Scholar]
  43. Zvolensky, M. J., Vujanovic, A. A., Bernstein, A., & Leyro, T. (2010). Distress tolerance. Current Directions in Psychological Science, 19(6), 406–410. 10.1177/0963721410388642 [DOI] [PMC free article] [PubMed] [Google Scholar]

Associated Data

This section collects any data citations, data availability statements, or supplementary materials included in this article.

Data Availability Statement

The data presented in this study is available on OSF repository https://osf.io/yv8fm/?view_only = 54a3f0a0d0dd4bd7b0e89a2c0ceac459.

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