The Cost of Cumulative Trauma: The Mediating Role of Callous-Unemotional Traits in the Development of Psychopathology Among Institutionalized Children in India

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Introduction: Early childhood trauma can cause long-term psychological and medical deficiencies. Childhood trauma, especially cumulative trauma, can cause changes leading to behavioral and cognitive dysfunctions. The purpose of the study is to examine the association between cumulative trauma and behavioral problems caused by callous-unemotional traits among institutionalized children. Method: In this cross-sectional study, data were collected from 314 participants (Girls = 167, Boys = 147) aged 13 to 17 years (Mage = 15). Data were collected from November 2022 to June 2023 from child care institutions located in the Kamrup Metro, Nagaon, and Sonitpur districts of Assam, India, using purposive sampling. Inferential statistics, comprising linear regression and mediation analysis, were performed using the JASP (Jeffreys’ Amazing Statistics Program). Results: Linear regression analysis indicated that cumulative trauma as well as age of onset of trauma were significant predictors of externalizing problems, internalizing problems, personal adjustment, and school problems. Additionally, mediation analysis showed that both callousness trait and unemotional trait (β = 0.04, t = 2.59, P ≤ 0.01 and β = 0.02, t = 1.89, P ≤ 0.05, respectively) partially mediated the link between cumulative trauma and externalizing problems; callousness trait partially mediated the link between cumulative trauma and internalizing problems (β = 0.03, t = 2.19, P ≤ 0.05); unemotional trait partially mediated the association between cumulative trauma and personal adjustment (β = 0.02, t = 2.05, P ≤ 0.05) and both callousness trait and unemotional trait (β = 0.02, t = 2.07, P ≤ 0.05 and β = 0.04, t = 2.65, P ≤ 0.05, respectively) partially mediated the association between cumulative trauma and school problems. Conclusion: This study demonstrates that cumulative trauma, as well as callous-unemotional traits, should be targeted in prevention programs among children who report they have experienced trauma.