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Trauma Exposure, Psychological Distress, and Burnout Among Psychologists in the Ukrainian Armed Forces, National Guard, and National Police: The Central Role of Secondary Traumatic Stress

This study of 795 psychologists in Ukraine's security sector reveals that secondary traumatic stress serves as a central mechanism linking cumulative trauma exposure to both psychological distress and burnout, highlighting the critical need to address the indirect trauma absorbed by these professionals.

Original authors: Viktor Burlaka, Vladyslav Klochkov, Oleksii Serdiuk, Julia Burlaka, Maksym Chubyk, Arash Javanbakht

Published 2026-09-09

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CC BY 4.0

Original authors: Viktor Burlaka, Vladyslav Klochkov, Oleksii Serdiuk, Julia Burlaka, Maksym Chubyk, Arash Javanbakht

Original paper licensed under CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). ✨ This is an AI-generated explanation of the paper below. It is not written or endorsed by the authors. For technical accuracy, refer to the original paper. Read full disclaimer

In the midst of a war, the people tasked with healing the psychological wounds of soldiers and citizens face a unique and invisible danger. They are not just observers of the conflict; they are living through it alongside the people they treat, absorbing the stories of trauma, loss, and fear that their clients carry. This phenomenon, known as secondary traumatic stress, occurs when a helper develops symptoms similar to post-traumatic stress disorder simply by listening to and empathizing with those who have suffered. It is distinct from burnout, which is the emotional exhaustion that comes from the sheer volume of work and chronic demands of a job. While both are serious, they are different experiences. Understanding how these pressures interact is vital, because if the healers themselves break down, the entire system of care for a traumatized nation collapses.

A team of researchers recently turned their attention to the psychologists serving within Ukraine's security and defense sector, including the Armed Forces, the National Guard, and the National Police. These professionals operate in some of the most demanding environments imaginable, treating individuals who have witnessed combat, occupation, and mass displacement, all while facing the same daily threats of bombardment and danger. The researchers wanted to understand how the trauma these psychologists carry—both from their own pasts and from their current work—translates into mental health struggles and job-related exhaustion. They specifically tested whether the stress absorbed from listening to others acts as a bridge, connecting a psychologist's history of hardship and their current service to their overall mental well-being and their ability to keep working.

To find the answers, the team surveyed 795 psychologists working across these three branches of service. The participants ranged in age from 18 to 62 and included both men and women, with a significant portion having been forced to leave their homes due to the war. The researchers asked them detailed questions about their lives, including any difficult experiences they faced as children, the total number of traumatic events they had encountered in their lives, and the specific branch of service they were in. They also measured how often the psychologists felt symptoms of depression, anxiety, and post-traumatic stress, as well as their levels of burnout and the stress they felt from hearing about the trauma of others. The study used a sophisticated statistical approach to map out how these different factors connect, treating the mental health symptoms of depression, anxiety, and post-traumatic stress as a single, unified measure of psychological distress.

The results revealed a clear and powerful pattern. Secondary traumatic stress emerged as the single strongest link to both psychological distress and burnout. In other words, the more a psychologist felt the weight of the trauma they heard from their clients, the more likely they were to suffer from mental health symptoms and feel exhausted by their work. This connection held true even when the researchers looked at distress and burnout separately, proving that the stress of hearing others' pain is a broad threat to a clinician's well-being, not just a specific occupational complaint. The study found that this secondary stress was not the only factor at play, but it was the central one. A psychologist's own history of childhood adversity and the total number of traumatic events they had experienced in their lifetime both predicted higher levels of this secondary stress. Furthermore, those serving in the Armed Forces reported higher levels of this stress compared to their colleagues in the National Guard and National Police.

The researchers also discovered that the path from a psychologist's personal history to their current struggles was not a straight line. While childhood hardships and a lifetime of trauma did have a direct impact on mental health and job exhaustion, a significant portion of their influence flowed through secondary traumatic stress. This means that the personal difficulties a psychologist brings to the job make them more vulnerable to absorbing the trauma of their clients, and it is this absorption that then drives much of their subsequent distress and burnout. Interestingly, the study found that being internally displaced or living in a smaller versus larger settlement did not change these outcomes. The intensity of the trauma exposure and the nature of the service branch mattered far more than the specific location where the psychologist was living.

Despite the heavy burden, the study noted that the average levels of distress and burnout among the group were relatively low, with many psychologists reporting high satisfaction from helping others. However, a clinically significant minority, about 15 percent, screened positive for probable post-traumatic stress disorder, indicating that while many are resilient, a vulnerable group is suffering deeply. The findings suggest that protecting these professionals requires more than just addressing their personal histories; it demands a focus on the indirect trauma they absorb daily. By recognizing secondary traumatic stress as the central mechanism linking exposure to impairment, organizations can better design support systems that buffer this specific type of harm, ensuring that the healers of a war-torn nation remain strong enough to continue their vital work.

Technical Summary: Trauma Exposure, Psychological Distress, and Burnout Among Psychologists in the Ukrainian Security Sector

Problem Statement
The full-scale war in Ukraine has precipitated a population-level mental health crisis, yet the psychologists serving within the country's security and defense sector (Armed Forces, National Guard, and National Police) face a unique dual burden: they treat trauma-affected personnel while simultaneously living through the same war. While the mental health of the general population and civilian aid workers has been studied, the mechanisms linking cumulative trauma exposure to impairment among these uniformed psychologists remain poorly specified. Specifically, it is unclear whether Secondary Traumatic Stress (STS) functions as a central mechanism linking cumulative trauma (childhood adversity, lifetime trauma, and service branch) to both psychological distress and occupational burnout, or if these outcomes are driven by distinct pathways. Furthermore, existing literature often conflates distress and burnout or fails to model them concurrently to isolate their unique correlates.

Methodology
The study employed a cross-sectional design with a sample of 795 psychologists employed by the Ukrainian Armed Forces ( $n=260$ ), National Guard ( $n=263$ ), and National Police ( $n=255$ ). Data were collected via an anonymous online survey in Ukrainian.

Measures:
- Exposures: Adverse Childhood Experiences (ACE-10), Lifetime Trauma Exposure (LEC-5), and Service Branch (Armed Forces vs. Ministry of Internal Affairs).
- Outcomes: Professional Quality of Life (ProQOL-5) for STS and Burnout; Patient Health Questionnaire (PHQ-9) for depression; Generalized Anxiety Disorder scale (GAD-7) for anxiety; and Child PTSD Symptom Scale (CPSS) for post-traumatic stress.
- Covariates: Age, sex, years of service, internal displacement status, and settlement size.
Analytic Approach: The study utilized Structural Equation Modeling (SEM) to test an integrative model. Depression, anxiety, and PTSD symptoms were modeled as indicators of a single latent "psychological-distress" factor due to high intercorrelation ( $r = .73–.82$ ). STS and Burnout were modeled as single-indicator latent variables with measurement error variance fixed to correct for unreliability. The model tested STS as an intervening variable linking cumulative trauma exposure to the latent distress factor and burnout, estimating both outcomes simultaneously to discriminate their pathways. Full-information maximum likelihood was used to handle missing data.

Key Results
The structural model demonstrated good incremental fit (CFI = .95). The analysis yielded the following findings:

Central Role of STS: STS was the strongest predictor of both outcomes, independently associated with psychological distress ( $\beta = .42, p < .001$ ) and burnout ( $\beta = .64, p < .001$ ) when modeled concurrently.
Pathways of Exposure:
- Indirect Effects: Childhood adversity, lifetime trauma exposure, and Armed Forces service all predicted higher STS. These variables exerted significant indirect effects on both distress and burnout through STS ( $p < .05$ ).
- Direct Effects: Childhood adversity and lifetime trauma had direct associations with psychological distress ( $\beta = .28$ and $.18$, respectively). Childhood adversity also had a direct effect on burnout ( $\beta = .13$ ).
- Service Branch Specificity: Armed Forces service predicted higher STS ( $\beta = .09$ ) and higher burnout ( $\beta = .09$ ) directly, but did not show a significant direct association with psychological distress ( $\beta = .04, p = .183$ ).
Symptom Prevalence: While mean scores for STS and burnout were generally low, a clinically meaningful minority (15.1%) screened positive for probable PTSD. Armed Forces psychologists reported the highest symptom levels.
Null Findings: Internal displacement status and settlement size were unrelated to the outcomes. Compassion satisfaction was high and essentially independent of STS ( $r = .00$ ).

Key Contributions

Differentiation of Pathways: By modeling distress and burnout concurrently, the study demonstrates that STS is a common antecedent to both clinical and occupational impairment, rather than being preferentially tied to one. This distinguishes the study from descriptive literature that often conflates these outcomes.
Mechanism Identification: The study identifies STS as a specific affective mechanism through which cumulative trauma exposure (developmental, lifetime, and institutional) translates into impairment, extending previous work that focused primarily on coping strategies.
Population Specificity: It provides empirical data on a security-sector workforce (Armed Forces, National Guard, Police) that has been largely absent from the literature on providers in conflict settings, moving beyond programmatic descriptions to epidemiological modeling.

Significance and Claims
The paper claims that STS functions as a central correlate of both clinical and occupational impairment in this workforce, supporting Conservation of Resources (COR) theory which posits that resource depletion in one domain spills into others. The authors assert that the findings suggest efforts to protect security-sector psychologists should address the indirect trauma they absorb (STS) in addition to their personal trauma histories.

The study highlights that while the average levels of impairment are low, a significant minority is in marked distress, with Armed Forces psychologists bearing the heaviest burden. The authors conclude that safeguarding these professionals requires sustained attention to the indirect trauma they absorb, particularly for those on the military front line.

Limitations and Modesty
The authors explicitly note that the cross-sectional design precludes causal inference; the indirect associations describe statistical structure at a single time point and do not confirm that STS mediates the effects of trauma exposure in a temporal sequence. The study relies on self-reported measures and single-subscale indicators for STS and burnout (though corrected for reliability). Additionally, the model omitted protective resources such as social support and coping, leaving the "resource-gain" side of COR theory untested. The single-country, convenience sample limits generalizability. The authors caution that the null findings regarding displacement should be interpreted cautiously due to the modest size of the displaced subsample.

Technical Summary: Trauma Exposure, Psychological Distress, and Burnout Among Psychologists in the Ukrainian Security Sector

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