The changing role of empathy in the link between direct and indirect trauma exposure and anxiety symptoms.

Objective: In wartime, civilians are frequently exposed to trauma both directly (e.g., missile attacks) and indirectly (e.g., distressing stories). Responses to trauma differ among individuals; some exhibit increased negative emotional reactions, while others can maintain their psychological well-being. This variability may stem from differences in affective and cognitive empathy levels. Research indicates that under stressful conditions, heightened affective empathy often increases negative emotions. Conversely, cognitive empathy typically alleviates distress. The present study has explored the potential conflict between these forms of empathy and their impact on anxiety symptoms in cases of direct and indirect cumulative trauma exposure during war. Method: One hundred twenty-two civilians (M = 26.80, SD = 7.43) were evaluated for trauma exposure, empathy, and the severity of anxiety symptoms during the first month of a distressing war. Results: The findings revealed differential patterns based on both the nature of exposure and the form of empathy. In conditions of indirect trauma exposure, cognitive empathy moderates the relationship between trauma exposure and anxiety. Specifically, individuals with low cognitive empathy exhibited heightened symptoms as exposure increased. In contrast, those with high cognitive empathy maintained low anxiety levels regardless of exposure. Affective empathy, however, consistently correlated with higher anxiety. Conversely, in conditions of direct trauma exposure, anxiety remained elevated regardless of the type or level of empathy. Conclusions: These findings emphasize the necessity of distinguishing between types of exposure and support the development of cognitive empathy-focused interventions to enhance civilian mental health during continuous conflict situations.