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After traumatic experiences, many survivors are preoccupied with imagined alternative scenarios of the event(s) and thoughts about how the outcome could have been different. A line of research has linked this form of thinking to worse outcomes for mental health but only a few studies in this field have been done in trauma exposed populations, and to our knowledge, no previous studies have investigated predictors of CFT after trauma. The aims of the present study were twofold; 1) to examine whether exposure during the traumatic episode and peri-traumatic reactions are associated with more vivid counterfactuals and higher frequency of CFT, 2) and to replicate Blix et al. (2018) finding that vividness and frequency of counterfactuals are significantly associated with symptoms of PTSD.

In this study, we will look at predictors for maladaptive cognitive appraisals in adolescents after different forms of trauma. We will investigate if the number and types of traumas are related to levels of maladaptive appraisals. We will also look at the relationship between different maladaptive appraisals and symptoms of PTSD, anxiety, and depression in adolescents that had been exposed to different forms of trauma. The study is a part of the Cognito project at the Norwegian center of violence and traumatic stress studies.

Additional file 1.

In this article, we summarize some of the main findings from The Utøya Study, a comprehensive longitudinal study on the impact on the survivors of the July 22 Utøya Island terrorist attack, and describe some implications for future policy. In total, 398 (79%) of the survivors participated in one or more of the four data collections in the study. Their mean age at the time of the terrorist attack was 19.2 years (SD=4.3, range 13.1–56.7, 94.0% < 26 years of age), and 49.0% were female. The vast majority (88.9%) were of Norwegian origin. Participants were interviewed face-to-face at 4-5 months (T1), 14-15 months (T2), 30-32 months (T3), and 8.5 years (T4), post-attack. We found that the terrorist attack had negative repercussions for the survivors’ mental and somatic health for years after the attack, including symptoms of posttraumatic stress, anxiety, depression, complicated grief, headache, and other somatic symptoms. Exposure to the attack also led to long-term functional impairment for many, particularly in relation to the survivors’ academic performance and well-being at school. Furthermore, it had negative health consequences for people close to the survivors, such as their caregivers. An important factor associated with how survivors cope after a terrorist attack is the support and help they receive from their social network, but also from the health care system. In line with the national health outreach plan, most survivors had received early proactive outreach from their municipality, but many missed a broader and longer lasting follow-up. The comprehensive documentation of short- and long-term health and social consequences in this study underlines the challenges societies are faced with after terrorist attacks. This insight calls for actions from decision makers in providing adequate outreach programs in health and social services. In particular, survivors with a non- Norwegian origin reported higher levels of PTSD symptoms and were less satisfied with the follow-up. After future attacks, the official outreach should be proactive, long lasting, and consider the diverse needs and characteristics of the affected individuals. For example, there should be a particular focus on survivors with a minority background. Furthermore, the outreach should be broad, and include people in the survivors’ immediate social network, schools and workplaces.

Supplemental material, Glad_Supplemental_Material for Cross-Lagged Association Between Symptoms of Posttraumatic Stress Disorder and Perceived Centrality of a Terrorist Attack by Kristin Alve Glad, Nikolai Olavi Czajkowski, Grete Dyb and Gertrud S. Hafstad in Clinical Psychological Science

Additional file 2: Appendix 2. Survivor characteristics by maternal and paternal participation in wave 2 among survivors aged 13–32 years who participated in wave 1 or 2 (n = 348).

Additional file 3. STROBE checklist.

Additional file 1: Appendix 1. Survivor characteristics by maternal and paternal participation in wave 1 among survivors aged 13–32 years who participated in wave 1 or 2 (n = 348).

Hva er omfanget av erfaringer med seksuelle overgrep og vold blant ungdom i Oslo? Avviker omfanget av slike erfaringer fra det som ungdom i andre deler av Norge rapporterer om? Og hvordan opplever ungdom å bli eksponert for slike erfaringer? På grunnlag av data fra to forskjellige undersøkelser gir vi noen svar på spørsmålene. Rapporten viser at det er noen forskjeller mellom hvor mye ungdom rapporterer om disse erfaringene både innad i Oslo og mellom Oslo og andre deler av landet. Noen av forskjellene kan knyttes til ulikheter i levekår, rus blant foreldre og foreldres innvandrerbakgrunn. Forskjellene er ikke store, men funnene i undersøkelsene kan likevel gi grunnlag for å identifisere noen innsatsområder for forebygging og hjelpetiltak, både i forhold til vold og særlig når det gjelder seksuelle overgrep som finner sted i relasjoner mellom jevnaldrende ungdommer.