Skip to main content Accessibility help
×
Home

Serious life events and post-traumatic stress disorder in the Norwegian population

  • Trond Heir (a1), Tore Bonsaksen (a2), Tine Grimholt (a3), Øivind Ekeberg (a4), Laila Skogstad (a3), Anners Lerdal (a5) and Inger Schou-Bredal (a6)...

Abstract

Background

It has been suggested that countries with more resources and better healthcare have populations with a higher risk of post-traumatic stress disorder (PTSD). Norway is a high-income country with good public healthcare.

Aims

To examine lifetime trauma exposure and the point prevalence of PTSD in the general Norwegian population.

Method

A survey was administered to a national probability sample of 5500 adults (aged ≥18 years). Of 4961 eligible individuals, 1792 responded (36%). Responders and non-responders did not differ significantly in age, gender or urban versus rural residence. Trauma exposure was measured using the Life Events Checklist for the DSM-5. PTSD was measured with the PTSD Checklist for the DSM-5. We used the DSM-5 diagnostic guidelines to categorise participants as fulfilling the PTSD symptom criteria or not.

Results

At least one serious lifetime event was reported by 85% of men and 86% of women. The most common event categories were transportation accident and life-threatening illness or injury. The point prevalence of PTSD was 3.8% for men and 8.5% for women. The most common events causing PTSD were sexual and physical assaults, life-threatening illness or injury, and sudden violent deaths. Risk of PTSD increased proportionally with the number of event categories experienced.

Conclusions

High estimates of serious life events and correspondingly high rates of PTSD in the Norwegian population support the paradox that countries with more resources and better healthcare have higher risk of PTSD. Possible explanations are high expectations for a risk-free life and high attention to potential harmful mental health effects of serious life events.

Declaration of interest

None.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Serious life events and post-traumatic stress disorder in the Norwegian population
      Available formats
      ×

      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Serious life events and post-traumatic stress disorder in the Norwegian population
      Available formats
      ×

      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Serious life events and post-traumatic stress disorder in the Norwegian population
      Available formats
      ×

Copyright

This is an Open Access article, distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is unaltered and is properly cited. The written permission of Cambridge University Press must be obtained for commercial re-use or in order to create a derivative work.

Corresponding author

Correspondence: Trond Heir, Norwegian Centre for Violence and Traumatic Stress Studies, Gullhaugveien 1–3, N-0484 Oslo, Norway. Email: trond.heir@medisin.uio.no

References

Hide All
1American Psychiatric Association (APA). Diagnostic and Statistical Manual of Mental Disorders (5th edn). APA, 2013.
2Kessler, RC, Ustun, TB. The WHO World Mental Health Surveys: Global Perspectives on the Epidemiology of Mental Disorders. Cambridge University Press, 2008.
3Dückers, ML, Alisic, E, Brewin, CR. A vulnerability paradox in the cross-national prevalence of post-traumatic stress disorder. Br J Psychiatry 2016; 209: 300–5.
4Organisation for Economic Co-operation and Development (OECD): OECD Better Life Index: Norway. OECD, 2016 (http://www.oecdbetterlifeindex.org/countries/norway/).
5United Nations University – Institute for Environment and Human Security (UNU-EHS), Bündnis Entwicklung Hilft. World Risk Report 2016. UNU-EHS, Bündnis Entwicklung Hilft, 2016 (http://weltrisikobericht.de/wp-content/uploads/2016/08/WorldRiskReport2016.pdf).
6Amstadter, AB, Aggen, SH, Knudsen, GP, Reichborn-Kjennerud, T, Kendler, KS. Potentially traumatic event exposure, posttraumatic stress disorder, and Axis I and II comorbidity in a population-based study of Norwegian young adults. Soc Psychiatry Psychiatr Epidemiol 2013; 48: 215–23.
7Lassemo, E, Sandanger, I, Nygård, JF, Sørgaard, KW. The epidemiology of post-traumatic stress disorder in Norway: trauma characteristics and pre-existing psychiatric disorders. Soc Psychiatry Psychiatr Epidemiol 2017; 52: 11–9.
8Kessler, RC, Aguilar-Gaxiola, S, Alonso, J, Benjet, C, Bromet, EJ, Cardoso, G, et al. Trauma and PTSD in the WHO World Mental Health Surveys. Eur J Psychotraumatol 2017; 8: 1353383.
9Richardson, LK, Frueh, C, Acierno, R. Prevalence estimates of combat-related PTSD: a critical review. Aust N Z J Psychiatry 2010; 44: 419.
10Streiner, DL, Patten, SB, Anthony, JC, Cairney, J. Has ‘lifetime prevalence’ reached the end of its life? An examination of the concept. Int J Methods Psychiatr Res 2009; 18: 221–8.
11Schou-Bredal, I, Heir, T, Skogstad, L, Bonsaksen, T, Lerdal, A, Grimholt, T, et al. Population-based norms of the Life Orientation Test–Revised (LOT-R). Int J Clin Health Psychol 2017; 17: 216–24.
12Bonsaksen, T, Grimholt, TK, Skogstad, L, Lerdal, A, Ekeberg, Ø, Heir, T, et al. Self-diagnosed depression in the Norwegian general population - associations with neuroticism, extraversion, optimism, and general self-efficacy. BMC Public Health 2018; 18: 1076.
13Weathers, FW, Blake, DD, Schnurr, PP, Kaloupek, DG, Marx, BP, Keane, TM. The Life Events Checklist for DSM-5 (LEC-5) – Extended Scale. National Center for PTSD, 2013 (https://www.ptsd.va.gov/professional/assessment/te-measures/life_events_checklist.asp).
14Silverstein, MW, Lee, DJ, Witte, TK, Weathers, FW. Is posttraumatic growth trauma-specific? Invariance across trauma- and stressor-exposed groups. Psychol Trauma 2017; 9: 553–60.
15Gray, MJ, Litz, BT, Hsu, JL, Lombardo, TW. Psychometric properties of the Life Events Checklist. Assessment 2004; 11: 330–41.
16Blevins, CA, Weathers, FW, Davis, MT, Witte, TK, Domino, JL. The Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5): development and initial psychometric evaluation. J Trauma Stress 2015; 28: 489–98.
17Ashbaugh, AR, Houle-Johnson, S, Herbert, C, El-Hage, W, Brunet, A. Psychometric validation of the English and French versions of the Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5). PLoS ONE 2016; 11(10): e0161645.
18Vijver, F, Hambleton, RK. Translating tests: some practical guidelines. Eur Psychol 1996; 1: 8990.
19Sveen, J, Bondjers, K, Willebrand, M. Psychometric properties of the PTSD Checklist for DSM-5: a pilot study. Eur J Psychotraumatol 2016; 7: 30165.
20Benjet, C, Bromet, E, Karam, EG, Kessler, RC, McLaughlin, KA, Ruscio, AM, et al. The epidemiology of traumatic event exposure worldwide: results from the World Mental Health Survey Consortium. Psychol Med 2016; 46: 327–43.
21Chapman, C, Mills, K, Slade, T, McFarlane, AC, Bryant, RA, Creamer, M, et al. Remission from post-traumatic stress disorder in the general population. Psychol Med 2012; 42: 1695–703.
22Van Ameringen, M, Mancini, C, Patterson, B, Boyle, MH. Post-traumatic stress disorder in Canada. CNS Neurosci Ther 2008; 14: 171–81.
23Frans, Ö, Rimmö, PA, Åberg, L, Fredrikson, M. Trauma exposure and post-traumatic stress disorder in the general population. Acta Psychiatr Scand 2005; 111: 291–9.
24De Vries, GJ, Olff, M. The lifetime prevalence of traumatic events and posttraumatic stress disorder in the Netherlands. J Trauma Stress 2009; 22: 259–67.
25World Bank. GDP per capita (current US$). World Bank, 2018 (https://data.worldbank.org/indicator/NY.GDP.PCAP.CD).
26Helliwell, J, Layard, R, Sachs, J. World Happiness Report 2017. Sustainable Development Solutions Network, 2017 (https://worldhappiness.report/ed/2017/).
27Florescu, S, Mihaescu-Pintia, C, Ciutan, M, Sasu, C, Gălăon, M. Trauma and posttraumatic stress disorder in Romania. Eur J Public Health 2014; 24: cku166–158.
28Borges, G, Benjet, C, Petukhova, M, Medina-Mora, ME. Posttraumatic stress disorder in a nationally representative Mexican community sample. J Trauma Stress 2014; 27: 323–30.
29Karam, ÃG, Mneimneh, ZN, Dimassi, H, Fayyad, JA, Karam, AN, Nasser, SC, et al. Lifetime prevalence of mental disorders in Lebanon: first onset, treatment, and exposure to war. PLoS Med 2008; 5: e61.
30Heir, T, Blix, I, Knatten, CK. Thinking that one's life was in danger: perceived life threat in individuals directly or indirectly exposed to terror. Br J Psychiatry 2016; 209: 306–10.
31Giosan, C, Malta, L, Jayasinghe, N, Spielman, L, Difede, J. Relationships between memory inconsistency for traumatic events following 9/11 and PTSD in disaster restoration workers. J Anxiety Disord 2009; 23: 557–61.
32Heir, T, Piatigorsky, A, Weisæth, L. Longitudinal changes in recalled perceived life threat after a natural disaster. Br J Psychiatry 2009; 194: 510–4.
33Schaeffer, NC. Asking questions about threatening topics: a selective overview. In The Science of Self-Report: Implications for Research and Practice (eds Stone, AA, Turkkan, JS, Bachrach, CA, Jobe, JB, Kurtzman, HS, Cain, VS): 105–21. Lawrence Erlbaum Associates, 2000.
34Thoresen, S, Myhre, M, Wentzel-Larsen, T, Aakvaag, HF, Hjemdal, OK. Violence against children, later victimisation, and mental health: a cross-sectional study of the general Norwegian population. Eur J Psychotraumatol 2015; 6: 26259.
35Balvig, F, Kyvsgaard, B. Volden i Danmark 1995 og 2005. [Violence in Denmark 1995 and 2005.] University of Copenhagen, 2006 (https://dkr.dk/materialer/vold-og-voldtaegt/volden-i-danmark/).
37European Agency for Fundamental Rights (FRA). Violence against Women: An EU-Wide Survey. FRA, 2014 (https://fra.europa.eu/sites/default/files/fra_uploads/fra-2014-vaw-survey-main-results-apr14_en.pdf).
38Morina, N, Wicherts, JM, Lobbrecht, J, Priebe, S. Remission from post-traumatic stress disorder in adults: a systematic review and meta-analysis of long term outcome studies. Clin Psychol Rev 2014; 34: 249–55.
39Oakley-Browne, MA, Wells, JE, Scott, KM. Te Rau Hinengaro: the New Zealand Mental Health Survey. In The WHO World Mental Health Surveys: Global Perspectives on the Epidemiology of Mental Disorders (eds Kessler, RC, Ustun, TB): 486508. Cambridge University Press, 2008.
40Kessler, RC, Berglund, PA, Demler, O, Jin, R, Merikangas, KR, Walters, EE. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry 2005; 62: 593602.
41Belli, RF. Autobiographical memory dynamics in survey research. In The SAGE Handbook of Applied Memory (eds Perfect, TJ, Lindsay, DS): 366–84. SAGE Publications; 2014.
42Ehlers, A, Clark, DM. A cognitive model of posttraumatic stress disorder. Behav Res Ther 2000; 38: 319–45.
43Rose, G. The Strategy of Preventive Medicine. Oxford University Press, 1992.
44Rose, G. Sick individuals and sick populations. Int J Epidemiol 2001; 30: 427–32.
45Rubin, DC, Berntsen, D, Bohni, MK. A memory-based model of posttraumatic stress disorder: evaluating basic assumptions underlying the PTSD diagnosis. Psychol Rev 2008; 115: 9851011.
46Berntsen, D, Rubin, DC. When a trauma becomes a key to identity: enhanced integration of trauma memories predicts posttraumatic stress disorder symptoms. Appl Cogn Psychol 2007; 21: 417–31.
47Blix, I, Solberg, O, Heir, T. Centrality of event and symptoms of posttraumatic stress disorder after the 2011 Oslo bombing attack. Appl Cogn Psychol 2014; 28: 249–53.
48Blix, I, Birkeland, MS, Solberg, Ø, Hansen, MB, Heir, T. The launching and ensnaring effects of construing a traumatic event as central to one's identity and life story. Appl Cogn Psychol 2016; 30: 526–31.
49Shultz, JM, Thoresen, S, Galea, S. The Las Vegas shootings – underscoring key features of the firearm epidemic. JAMA 2017; 318: 1753–4.
50Kristensen, P, Dyregrov, A, Weisæth, L, Straume, M, Dyregrov, K, Heir, T, et al. Optimizing visits to the site of death for bereaved families after disasters and terrorist events. Disaster Med Public Health Prep 2018; 12: 523–7.
51Hussain, A, Weisæth, L, Heir, T. Non-response to a population based post disaster questionnaire study. J Trauma Stress 2009; 22: 324–8.
52Hem, C, Hussain, A, Wentzel-Larsen, T, Heir, T. The Norwegian version of the PTSD Checklist (PCL); construct validity in a community sample of 2004 tsunami survivors. Nord J Psychiatry 2012; 66: 355–9.
53Hussain, A, Weisæth, L, Heir, T. Psychiatric disorders and functional impairment among disaster victims after exposure to a natural disaster – a population based study. J Affect Disord 2011; 128: 135–41.
54van Giezen, AE, Arensman, E, Spinhoven, P, Wolters, G. Consistency of memory for emotionally arousing events: a review of prospective and experimental studies. Clin Psychol Rev 2005; 25: 935–53.

Keywords

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed

Serious life events and post-traumatic stress disorder in the Norwegian population

  • Trond Heir (a1), Tore Bonsaksen (a2), Tine Grimholt (a3), Øivind Ekeberg (a4), Laila Skogstad (a3), Anners Lerdal (a5) and Inger Schou-Bredal (a6)...
Submit a response

eLetters

No eLetters have been published for this article.

×

Reply to: Submit a response


Your details


Conflicting interests

Do you have any conflicting interests? *