Ecological Factors Associated with Psychological Resilience Among War-Displaced Ukrainians Across Europe and Ukraine: A Cross-Sectional Study.

Since Russia's full-scale invasion of Ukraine in 2022, millions of Ukrainians have experienced forced displacement. This study examined multilevel social determinants of resilience among Ukrainian refugees and internally displaced persons, guided by Bronfenbrenner's bioecological model. In 2025, we conducted a cross-sectional, multi-country study involving 1.622 Ukrainian adults living in seven European countries and internally displaced persons living in Ukraine. Participants completed the Resilience Scale-25, the Cultural Symptoms of Trauma Scale, and a sociodemographic questionnaire. Country-adjusted, domain-specific multivariable logistic regression models were used to identify factors independently associated with moderate-to-high versus low resilience. Resilience levels were heterogeneous: 30.2% of participants had low resilience, 38.4% moderate resilience, and 31.4% high resilience. After adjustment for country of residence, stronger social relationships (OR = 1.20, p < 0.005), stronger family relationships (OR = 1.20, p < 0.005), supporting local initiatives for Ukraine (OR = 1.32, p < 0.05), greater satisfaction with work or education (OR = 1.33, p < 0.001), and better economic condition (OR = 1.24, p < 0.001) were independently associated with moderate-to-high resilience. Diminished competence and agency (OR = 0.45, p < 0.001) and spiritual or existential distress (OR = 0.78, p < 0.05) were negatively associated with resilience, whereas frequency of prayer was positively associated with resilience (OR = 1.23, p < 0.005). Departure from Ukraine more than three months after the outbreak of war was associated with lower odds of moderate-to-high resilience (OR = 0.75, p < 0.05), while stable or improved socioeconomic functioning after migration was associated with higher odds (OR = 1.46, p < 0.05). Resilience among war-displaced Ukrainians was associated with relational, socioeconomic, cultural, and temporal determinants. Responses to forced displacement should extend beyond trauma-focused care to strengthen social ties, support work and education, reduce economic insecurity, and restore competence and agency.