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We aimed to explore how many of the politically active, highly media-exposed, young survivors of the terrorist attack on Utøya island, Norway, have had personal experiences with hate speech and threats post-terror. Further, we aimed to examine the nature of these experiences, and the impact and consequences they have had for the directly affected. Approximately 8.5 years after the politically motivated terrorist attack on Utøya island in 2011, 289 survivors (51.2 percent females, M age = 27.7, SD = 4.6) were interviewed about their personal experiences with hate speech and threats. Responses were systematically analyzed using thematic analysis. In total, ninety-nine participants (34 percent) had experienced hate speech and/or threats post-terror, of whom a majority believed that this was related to their status as a survivor of the attack. Thematically, the hate/threats mainly revolved around wishes that the survivors had died in the attack, death threats, support for the terrorist, severe accusations related to the attack, and conspiracy theories. This had affected the survivors both emotionally (e.g., inducing fear and anger, but also robustness) and behaviorally (e.g., social and political withdrawal). Immediate measures and long-term strategies need to be developed to mitigate the personal harm and threat to democracy that experiences with hate speech/threats may cause. [ABSTRACT FROM AUTHOR]

Background: The long-term impact of mass violence attacks is practically unknown, especially in children and adolescents. In a previous study, we found that 8.5 years after a terror attack targeting mainly adolescents, nearly half of the survivors met diagnostic criteria for insomnia. Objectives: The aims of this study were to investigate: (1) whether exposure to a single mass violence event during adolescence increases the risk of insomnia almost a decade later above that expected for a non-exposed population; and (2) whether prior interpersonal violence exposure and early post-traumatic reactions predict later insomnia. Method: Participants were survivors of the 2011 Utøya Island terrorist attack (n = 279) and controls from the HUNT Norwegian general population study (n = 35,664). Early adulthood insomnia was assessed using four items from the Karolinska Sleep Questionnaire 8.5 years after the attack. Participants who had also completed earlier data collection waves for both studies (n = 116 and 2382, respectively) were included in logistic regression models testing the associations between predictors during adolescence and later insomnia. Results: Nearly a decade after the Utøya attack, 38.4% (n = 56) of the survivors reported symptoms of insomnia indicative of probable insomnia compared to 20.5% (n = 5771) of controls. Terror exposure during adolescence was a significant predictor of later insomnia [odds ratio (OR) = 3.18, 95% confidence interval (CI) = 2.05–4.87, p < .001]. Early post-trauma symptoms of anxiety and depression (OR = 1.34, 95% CI = 1.02–1.76, p = .033) and weekly headaches (OR = 1.64, 95% CI = 1.08–2.47, p = .018) were also significant predictors while controlling for background factors and other predictors. Conclusion: Long-term assessment and treatment are needed for survivors of mass violence to improve resilience and recovery [ABSTRACT FROM AUTHOR]

After traumatic experiences, it is common to think about alternative scenarios or outcomes of the event. This is often referred to as counterfactual thoughts (CFT), and CFT after trauma have been associated with posttraumatic stress reactions (PTSR). In this study, we aimed to: (1) investigate the relationship between the vividness and frequency of CFT and PTSR, and to (2) examine the associations between exposure, peri‐traumatic reactions, physical injury and the loss of someone close, and the subsequent vividness and frequency of CFT. The participants (N = 289) were survivors of a terror attack in Norway. More vivid and frequent CFT were significantly and independently related to more PTSR. Exposure during trauma was significantly associated with more vivid CFT in the unadjusted regression model. No further significant relationships were found between exposure, peri‐traumatic reactions, physical injury and the loss of someone close, and the vividness and frequency of CFT. As CFT are common after trauma and potentially cause distress, clinicians should identify and validate CFT, and provide coping assistance. [ABSTRACT FROM AUTHOR]

Objectives: This study investigated academic achievement among adolescents exposed to violence, sexual abuse and bullying. Moreover, we sought to determine the individual and contextual influence of the adolescents' school environment in terms of bullying, classmate relationships and teacher support on academic achievement. Finally, we wished to assess whether school-level influence is different for the adolescents exposed to violence and sexual abuse versus the adolescents not exposed to these forms of abuse. Methods: This is a cross-sectional study of a sample of 7,343 adolescents between the ages of 15 and 16 from 56 schools in Oslo, Norway. We investigated associations between violence, sexual abuse, bullying, classmate relationships, teacher support and academic achievement. Linear regression was used to investigate associations on the individual level. Multilevel analyses were conducted to test for school level differences while controlling for both individual and contextual factors. Results: On the individual level, all combinations of violence and sexual abuse categories were significantly associated with lower grades. This was also true for bullying, while teacher support resulted in better grades. At the school level, the analysis showed that students in schools with higher levels of bullying performed worse academically. Each unit of increment in bullying in school corresponded to an average 0.98 point decrease in grades (p less than 0.01) when we controlled for sociodemographic characteristics. The association remained significant when the model was tested separately for the nonbullied students, with a small reduction in the coefficient value (-0.84, p less than 0.01). No overall significance was found for the interaction between the school environment and adolescent exposure to violence, indicating that the school environment affects all students. Conclusion: Factors on both levels can contribute to reduced grades. This stresses the need to investigate individual and contextual factors simultaneously when examining academic achievement. Our results indicated that students attending schools with higher levels of bullying may show poorer school performance. This was true for all students regardless of previous exposure to violence and sexual abuse. This emphasizes the need for preventive efforts that focus not only on vulnerable groups, but on all students and the school context. (Contains 4 tables.)

The aim of this study was to evaluate the structure of posttraumatic stress reaction factors and their relation to general mental health problems in Norwegian children exposed to the tsunami on December 26, 2004. A total of 133 children and adolescents (ages 6-17) were interviewed 10 months posttsunami using the UCLA PTSD Reaction Index, and 104 were interviewed again 2.5 years after the tsunami. Confirmatory factor analyses supported the theory of a four-factor model of intrusion, active avoidance, numbing, and arousal as a better division of symptoms than the three-factor model used in the present diagnostic criteria. The factors of intrusion and active avoidance were highly correlated 2.5 years posttsunami. This association may be due to nonspecificity in these trauma-related factors as posttraumatic stress reaction levels diminish over time. General mental health problems were highly related to arousal at both assessments, supporting the theory that some symptoms of posttraumatic stress reactions overlap with other, concurrent mental problems. (Contains 4 tables.)