Abstract
Objective: Children in conflict zones face repeated and cumulative trauma exposure, increasing their risk for post-traumatic stress disorder (PTSD). Despite the critical role of empathy in coping with trauma, research on how children's cognitive and affective empathy relates to their psychological adjustment remains limited. Adult studies suggest that cognitive empathy may support better coping, whereas affective empathy could increase vulnerability to PTSD symptoms. However, it remains unclear whether this differential pattern holds in children and how it interacts with levels of trauma exposure. This study investigated the moderating role of cognitive and affective empathy in the relationship between cumulative trauma exposure and PTSD symptoms in children.Method: Sixty-two children (Mean age = 9.64, SD = 1.15) from regions with varying proximity to conflict zones completed self-report questionnaires to evaluate cumulative trauma exposure, empathy, and anxiety, and were interviewed to assess PTSD symptoms.Results: While cognitive empathy moderated the relationship between cumulative trauma exposure and PTSD symptoms, it did not serve as a protective factor as hypothesised. Specifically, children with low cognitive empathy demonstrated a positive relationship between trauma exposure and PTSD symptom severity, whereas those with high cognitive empathy exhibited consistently high PTSD symptoms, regardless of exposure level. Affective empathy did not moderate this relationship but was positively associated with PTSD.Conclusions: High cognitive and affective empathy emerged as vulnerability factors for PTSD, potentially due to developmental challenges in its adaptive use during childhood. These findings question the traditional view of cognitive empathy as universally protective, highlighting the need to monitor its role throughout development.