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Post-traumatic stress reactions in survivors of the 2011 massacre on Utøya Island, Norway

Published online by Cambridge University Press:  02 January 2018

Grete Dyb*
Norwegian Centre for Violence and Traumatic Stress Studies, and Institute of Clinical Medicine, Faculty of Medicine, University of Oslo
Tine K. Jensen
Norwegian Centre for Violence and Traumatic Stress Studies, and Department of Psychology, Faculty of Social Sciences, University of Oslo
Egil Nygaard
Norwegian Centre for Violence and Traumatic Stress Studies, and Department of Psychology, Faculty of Social Sciences, University of Oslo
Øivind Ekeberg
Department of Acute Medicine, Oslo University Hospital, and Department of Behavioural Sciences in Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo
Trond H. Diseths
Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, and Department of Clinical Neurosciences for Children, Women and Children's Division, Oslo University Hospital
Tore Wentzel-Larsen
Norwegian Centre for Violence and Traumatic Stress Studies, and Center for Child and Adolescent Mental Health, Eastern and Southern Norway
Siri Thoresen
Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
Grete Dyb, MD, PhD, Norwegian Centre for Violence and Traumatic Stress Studies, Postbox 181 Nydalen, 0409 OSLO, Norway. Email:
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Although youths in many countries have been exposed to terrorism, few studies have examined early risk and protective factors for the subsequent development of mental health problems.


To investigate the levels of post-traumatic stress in survivors of the 2011 massacre on Ut⊘ya Island compared with the general population in Norway, and to identify predictive factors.


Four hundred and ninety survivors were invited to participate. Structured face-to-face interviews were performed 4–5 months after the attack.


There were 325 study participants (response rate 66%). Survivors had been highly exposed to danger and loss. Post-traumatic stress levels were more than six times higher in survivors than in the general population. Predictors were female gender, minority ethnic status, high level of trauma exposure, pain, the loss of someone close and social support.


Survivor characteristics that can be assessed in the early aftermath of a terrorist attack strongly predict the subsequent mental health problems of exposed youths. The highly elevated symptoms observed were largely attributable to the traumatic experience and reflect the mental health costs of the terrorist attack.

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This is an Open Access article, distributed under the terms of the Creative Commons Attribution-NonCommercial licence (, which permits noncommercial 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.
Copyright © Royal College of Psychiatrists, 2014


See editorial, pp. 329–330, this issue.

This study was funded by the Norwegian Directorate of Health.

Declaration of interest



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