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As Ukraine marks the fourth anniversary of Russia’s full-scale invasion, new research from Duke University sheds light on how prolonged war is shaping not only young people’s mental health, but their biology.
Ann Skinner, Jennifer Godwin and Emmy Reilly, from Duke Sanford’s Center for Child and Family Policy led a striking study examining how living through war affects the body’s stress system. The team collected hair samples and survey data from 221 Ukrainian university students between November 2023 and March 2024, and paired them with regional data on air alarms and explosions. Hair cortisol concentrations (HCC) provide a roughly 90-day snapshot of cumulative cortisol production, offering a window into long-term biological stress.
Cortisol is a hormone that helps the body respond to danger. In short bursts, it plays a critical role in survival by mobilizing energy and sharpening attention. But when danger becomes constant, the body can recalibrate. Over time, the stress system may reduce, or down-regulate, cortisol production. Although that shift may protect the body from damage caused by high cortisol in the short term, it can also increase the risk of immune problems, inflammation, fatigue, and other long-term health concerns.
The researchers found that the more air alarms and explosions students experienced over the prior 90 days, the lower their hair cortisol levels tended to be. In contrast, hair cortisol was not significantly linked to students’ recent self-reported post-traumatic stress symptoms. In other words, how distressed a young person said they felt over the past week did not necessarily match what their stress biology showed over the past three months.
This study is among the first to measure objective war exposure, psychological distress, and a long-term biological stress marker while youth remain in an active conflict zone. Skinner, Godwin, Reilly and their colleagues say the findings highlight the need to monitor not only mental health, but also the hidden physiological toll of sustained conflict, and to identify protective factors such as strong social support and trauma-informed care that may help stabilize stress systems during and after war.
The study, “Hair cortisol concentrations among youth in Ukraine: Associations with war experiences and post-traumatic-stress symptoms,” appears in the journal Psychoneuroendocrinology (2026). In addition to Ann T. Skinner, Jennifer Godwin, and Emily B. Reilly of Duke University’s Center for Child and Family Policy at the Sanford School of Public Policy, co-authors include Iuliia Pavlova (affiliated with Ukrainian research institutions) and Anastasia Georgiades. The research reflects a cross-national collaboration focused on understanding risk and resilience among youth living through ongoing conflict.
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