Topic: Disasters, terror and stress management

The terror attack: Experience and reactions among Utøya survivors

On July 22nd 2011, the gravest terror attack executed in Norway during peacetime was carried out by a single perpetrator. Politically active youth were targeted at Utøya Island, a small island 40 kilometers north of Oslo, where they were gathered for the Labour Party’s youth organization’s annual summer camp . Disguised as a police officer, the perpetrator chased the youth around the island for more than one and a half hours, shooting those he came across. The island is accessible only by boat, and many tried to escape by swimming. Several of the youths also had contact with their parents by mobile phones during the massacre. The terror attack left 69 persons killed and 66 physically injured. It took more than three hours before all survivors were brought to safety. The focus of this project is the 490 survivors and their parents. The Utøya massacre is considered a severe trauma due to the scope of injuries and fatalities, the young age of those affected, and the fact that they were designated targets. How individuals cope after extreme stress depends on a number of factors and will vary over time. The study will provide new and important knowledge about the impact of terrorism on young survivors and their families, as well as the course of the trauma and risk factors. This knowledge is essential for planning early interventions and treatment after disasters and other traumatic events. The Utøya study started in 2011, a few months after the terror attack at Utøya Island on July 22nd 2011. The study has during the last five years become a reputable study which has produced a large number of publications. Through three rounds of data collection, the research project has had a participation of 66 percent (325 survivors). Parents of youth under age 20 are also included in the study. The study will provide new and important knowledge about the impact of terrorism on young survivors and their families, as well as the course of the trauma and risk factors. This knowledge is essential for planning early interventions and treatment after disasters and other traumatic events.

 
2011 This project is ongoing 2020

Project Manager

  • Dyb, Grete

    Dyb, Grete

    Research professor / professor, University of Oslo / dr. med.

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Project Members

Main objective

The overall aim of this study is to identify factors associated with long-term health development and everyday functioning in adolescent and young adult victims of a terrorist attack. The study will also provide knowledge about how young people and their next of kin experienced their encounter with the support system, and how they were met in local communities and schools.

Subsidiary objectives

 

Method

The Utøya Study is a prospective, longitudinal interview study (2011-2014), in which data collection has been conducted at three points: 4-5 months, 10-11 months and 30-31 months after the disaster. All 490 survivors) of the mass-shootings on the Utøya island (youth aged 13 and older) were invited to participate in the study, of whom 360 (72%) took part in at least one of the three waves. Additionally, the survivors’ parents were invited to participate. Survivors, as well as parents of youth 20 years or younger, were interviewed face-to-face separately. Parents of older survivors received a questionnaire by mail.

In the third wave of interviews, the interview data will also be linked to register-based data on the informants’ utilization of municipal and specialized health services during 2008-2014.

The study was approved by the Regional Committee for Medical and Health Research Ethics in Norway.

Reports summarizing the study: del I, del II og del III.

Collaborating partners

Oslo University Hospital, represented by Trond Diseth, Professor/MD, PhD, and Øyvind Ekeberg, Professor/MD, PhD.

Sunnaas rehabilitation hospital trust, representanted by Marianne Løvstad, Clinical Neuropsychologist, PhD, and Anne-Kristine Schancke, Professor/PhD.

Further information

 

Publications

Glad, K. A., & Hafstad, G. S. (2019). Positive endringer etter traumatiske opplevelser. In G. Dyb & T. K. Jensen (Red.) Å leve videre etter katastrofen: Stressreaksjoner og oppfølging etter traumer (pp. 95-105). Gyldendal Akademisk.

Glad, K. A., Czajkowski, N. O., Dyb, G., & Hafstad, G. S. (2019). Cross-Lagged Association Between Symptoms of Posttraumatic Stress Disorder and Perceived Centrality of a Terrorist Attack. Clinical Psychological Science. doi:10.1177/2167702619873590

Løvstad, M., Månum, G., Wisløff-Aase, K., Hafstad, G. S., Ræder, J., Larsen, I. H., Larsen, I., . . . Schanke, A. K. et al. (2019). Persons injured in the 2011 terror attacks in Norway – Relationship between post-traumatic stress symptoms, emotional distress, fatigue, sleep, and pain outcomes, and medical and psychosocial factors. Disability and Rehabilitation. doi:10.1080/09638288.2019.1585489

Månum, G., Løvstad, M., Wisløff-Aase, K., Ræder, J., Schanke, A. K., Larsen, I. H., Larsen, I., Dyb, G., Ekeberg, Ø., & Stanghelle, J. K. (2019). Clinical characteristics and physical functioning in persons hospitalized following the Norwegian terror attacks in July 2011: A follow-up study. Journal of Rehabilitation Medicine, 51(3), 225-233. doi:10.2340/16501977-2521

Wisløff-Aase, K., Ræder, J., Månum, G., Løvstad, M., Schanke, A. K., Dyb, G., . . . Stanghelle, J. K. et al. (2019). Chronic pain among the hospitalized patients after the 22 july 2011 terror attacks in Oslo and at Utøya Island. Acta Anaesthesiologica Scandinavica. doi:10.1111/aas.13373

Bugge, I., Jensen, T. K., Nilsen, L. G., Ekeberg, Ø., Dyb, G., & Diseth, T. H. (2018). Psychosocial care for hospitalized young survivors after the terror attack on Utøya Island: A qualitative study of the survivors’ experiences. Injury, 1-8. doi:10.1016/j.injury.2018.10.024

Dyb, G. (2018). Utøya-filmen er ikke nok for å gi forståelse. Aftenposten.

Glad, K. A., Thoresen, S., Hafstad, G. S., & Dyb, G. (2018). Survivors Report Back. Young people reflect on their media experiences after a terrorist attack. Journalism Studies, 19(11), 1652-1668. doi:10.1080/1461670X.2017.1291313

Jakobsen, K. K., Stridbeck, U., & Langballe, Å. (2018). Objektivitet i avhør: Avhør av fornærmede i straffesaker i Norge. Tidsskrift for strafferett, 18(2), 74-101. doi:10.18261/issn.0809-9537-2018-02-02

Nilsen, L. G., Hafstad, G. S., Staksrud, E., & Dyb, G. (2018). Five reasons for using social media among young terror survivors: Results from the Utøya study. Computers in Human Behavior, 84, 285-294. doi:10.1016/j.chb.2018.03.006

Stene, L. E., Schultz, J. H., & Dyb, G. (2018). Returning to school after a terror attack: a longitudinal study of school functioning and health in terror-exposed youth. European Child and Adolescent Psychiatry, 1-10. doi:10.1007/s00787-018-1196-y

Stensland, S., Zwart, J. A., Wentzel-Larsen, T., & Dyb, G. (2018). The headache of terror: A matched cohort study of adolescents from the Utøya and the HUNT Study. Neurology, 90(2), e111-e118. doi:10.1212/WNL.0000000000004805

Bugge, I., Dyb, G., Stensland, S., Ekeberg, Ø., Wentzel-Larsen, T., & Diseth, T. H. (2017). Physical Injury and Somatic Complaints: The Mediating Role of Posttraumatic Stress Symptoms in Young Survivors of a Terror Attack. Journal of Traumatic Stress, 30(3), 229-236. doi:10.1002/jts.22191

Glad, K. A., Hafstad, G. S., Jensen, T. K., & Dyb, G. (2017). A longitudinal study of psychological distress and exposure to trauma reminders after terrorism. Psychological Trauma, 9, 145-152. doi:10.1037/tra0000224

Hafstad, G. S., Thoresen, S., Wentzel-Larsen, T., Maercker, A., & Dyb, G. (2017). PTSD or not PTSD? Comparing the proposed ICD-11 and the DSM-5 PTSD criteria among young survivors of the 2011 Norway attacks and their parents. Psychological Medicine, 47(7), 1283-1291. doi:10.1017/S0033291716002968

Haga, J. M., Stene, L. E., Thoresen, S., Wentzel-Larsen, T., & Dyb, G. (2017). Does posttraumatic stress predict frequency of general practitioner visits in parents of terrorism survivors? A longitudinal study. European Journal of Psychotraumatology, 8(1). doi:10.1080/20008198.2017.1389206

Haga, J. M., Thoresen, S., Stene, L. E., Wentzel-Larsen, T., & Dyb, G. (2017). Healthcare to parents of young terrorism survivors: A registry-based study in Norway. BMJ Open, 7(12). doi:10.1136/bmjopen-2017-018358

Holt, T., Jensen, T. K., Dyb, G., & Wentzel-Larsen, T. (2017). Emotional reactions in parents of the youth who experienced the Utøya shooting on 22 July 2011; results from a cohort study. BMJ Open, 7(10). doi:10.1136/bmjopen-2016-015345

Jakobsen, K. K., Langballe, Å., & Schultz, J. H. (2017). Trauma-exposed young victims: possibilities and constraints for providing trauma support within the investigative interview. Psychology, Crime and Law, 23(5), 427-444. doi:10.1080/1068316X.2016.1269903

Langballe, Å., & Schultz, J. H. (2017). ‘I couldn’t tell such things to others’: Trauma-exposed youth and the investigative interview. Police Practice & Research, 18(1), 62-74. doi:10.1080/15614263.2016.1229185

Langballe, Å., & Schultz, J. H. (2017). Er det skadelig å delta i politiavhør? Å bli avhørt kort tid etter en traumatiserende hendelse kan gi utslag både i positiv og negativ retning. Politiforum.

Laugerud, S., & Langballe, Å. (2017). Turning the Witness Stand into a Speaker’s Platform: Victim Participation in the Norwegian Legal System as Exemplified by the Trial Against Anders Behring Breivik. Law & society review, 51(2), 227-251. doi:10.1111/lasr.12268

Nilsen, L. G., Stene, L. E., Glad, K. A., Hafstad, G. S., & Dyb, G. (2017). Oppfølgingen av de som overlevde på Utøya. Erfaringer med tiltakene fra det offentlige hjelpeapparatet. [Post-disaster follow-up of the Utøya survivors. Experiences with measures implemented by public health care services.] Norwegian only. Nasjonalt kunnskapssenter om vold og traumatisk stress. (Rapport 3/2017).

Shultz, J. M., Thoresen, S., & Galea, S. (2017). The Las Vegas Shootings—Underscoring Key Features of the Firearm Epidemic. Journal of the American Medical Association (JAMA). doi:10.1001/jama.2017.16420

Skarstein, D., & Schultz, J. H. (2017). Identity at risk: Students’ identity configuration in the aftermath of trauma. Scandinavian Journal of Educational Research, 62(5), 798-812. doi:10.1080/00313831.2017.1307273

Dyb, G., Glad, K. A., & Hafstad, G. S. (2016). Utøya-studien: Forskningsetiske betraktninger. In V. Enebakk, H. Ingierd & N. O. Refsdal (Red.) De berørte etter 22. juli. Forskningsetiske perspektiver (pp. 27-51). Cappelen Damm Akademisk.

Filkukova, P., Hafstad, G. S., & Jensen, T. K. (2016). Who can I trust? Extended fear during and after the Utøya terrorist attack. Psychological Trauma, 8(4), 512-519. doi:10.1037/tra0000141

Filkukova, P., Jensen, T. K., Hafstad, G. S., Minde, H. T., & Minde, H. T., & Dyb, G. (2016). The relationship between posttraumatic stress symptoms and narrative structure among adolescent terrorist-attack survivors. European Journal of Psychotraumatology, 7. doi:10.3402/ejpt.v7.29551

Glad, K. A., Jensen, T. K., Hafstad, G. S., & Dyb, G. (2016). Posttraumatic stress disorder and exposure to trauma reminders after a terrorist attack. Journal of Trauma & Dissociation, 17(4), 435-447. doi:10.1080/15299732.2015.1126777

Hafstad, G. S., & Glad, K. A. (2016). Personlig vekst eller økt sårbarhet? Posttraumatisk vekst fra et utviklingsperspektiv. In C. Øverlien, M. I. Hauge & J. H. Schultz (Red.) Barn, vold og traumer. Møter med unge i utsatte livssituasjoner. (pp. 76-89). Universitetsforlaget.

Nilsen, L. G., Langballe, Å., & Dyb, G. (2016). “Men hva er det egentlig ment for?” Voldsoffererstatning til de overlevende etter terrorangrepet på Utøya 22. juli 2011 [But what are they actually meant for?” The Utøya Survivors’ Experiences with the State Compensation Scheme
]
Norwegian only. Oslo: Nasjonalt kunnskapssenter om vold og traumatisk stress. (Rapport 2/2016).

Røkholt, E. G., Schultz, J. H., & Langballe, Å. (2016). Negotiating a new day: Parents’ contributions to supporting students’ school functioning after exposure to trauma. Psychology Research and Behavior Management, 9, 81-93. doi:10.2147/PRBM.S97229

Stene, L. E., & Dyb, G. (2016). Research participation after terrorism: An open cohort study of survivors and parents after the 2011 Utøya attack in Norway. BMC Research Notes, 9(57). doi:10.1186/s13104-016-1873-1

Stene, L. E., Wentzel-Larsen, T., & Dyb, G. (2016). Healthcare needs, experiences and satisfaction after terrorism: A longitudinal study of survivors from the Utøya attack. Frontiers in Psychology, 7:1809. doi:10.3389/fpsyg.2016.01809

Stensland, S., & Dyb, G. (2016). Traumatiske hendelser og utvikling av posttraumatiske stressreaksjoner hos barn og ungdom: En kilde til helseplager. Universitetsforlaget.

Strøm, I. F., Schultz, J. H., Wentzel-Larsen, T., & Dyb, G. (2016). School performance after experiencing trauma: a longitudinal study of school functioning in survivors of the Utøya shootings in 2011. European Journal of Psychotraumatology, 7:31359, 1-11. doi:10.3402/ejpt.v7.31359

Thoresen, S., Jensen, T. K., Wentzel-Larsen, T., & Dyb, G. (2016). Parents of terror victims. A longitudinal study of parental mental health following the 2011 terrorist attack on Utøya Island. Journal of Anxiety Disorders, 38, 47-54. doi:10.1016/j.janxdis.2016.01.004

Wiström, E. D., Stene, L. E., & Dyb, G. (2016). Etter Utøya-angrepet – hvem fikk tidlig hjelp. Tidsskrift for Den norske legeforening, 136(14-15), 1223-1226. doi:10.4045/tidsskr.15.0691

Wiström, E. D., Stene, L. E., & Dyb, G. (2016). Following the Utøya attack – who received early assistance?. Tidsskrift for Den norske legeforening, 136(14-15), 1223-1226. doi:10.4045/tidsskr.15.0691

Bugge, I., Dyb, G., Stensland, S., Ekeberg, Ø., Wentzel-Larsen, T., & Diseth, T. H. (2015). Physical injury and posttraumatic stress reactions. A study of the survivors of the 2011 shooting massacre on Utøya Island, Norway. Journal of Psychosomatic Research, 79(5), 384-390. doi:10.1016/j.jpsychores.2015.09.005

Dyb, G., & Næslund, M. B. (2015). «Opplevelser og reaksjoner hos de som var på Utøya 22. juli 2011». En oppsummering av tredje intervjurunde. Oslo: Nasjonalt kunnskapssenter om vold og traumatisk stress.

Haga, J. M., & Dyb, G. (2015). Dem vi glemte etter 22. juli. Aftenposten (morgenutg. : trykt utg.).

Haga, J. M., Stene, L. E., Wentzel-Larsen, T., Thoresen, S., & Dyb, G. (2015). Early postdisaster health outreach to modern families: a cross-sectional study. BMJ Open, 5:e009402. doi:10.1136/bmjopen-2015-009402

Jensen, T. K., Thoresen, S., & Dyb, G. (2015). Coping responses in the midst of terror: The July 22 terror attack at Utøya Island in Norway. Scandinavian Journal of Psychology, 56(1), 45-52. doi:10.1111/sjop.12182

Stene, L. E., & Dyb, G. (2015). Health service utilization after terrorism: A longitudinal study of survivors of the 2011 Utøya attack in Norway. BMC Health Services Research, 15(1). doi:10.1186/s12913-015-0811-6

Dyb, G., & Olff, M. (2014). Understanding terror and violence in the lives of children and adolescents. European Journal of Psychotraumatology, 5. doi:10.3402/ejpt.v5.25121

Dyb, G., Jensen, T. K., Glad, K. A., Nygaard, E., & Thoresen, S. (2014). Early outreach to survivors of the shootings in Norway on the 22nd of July 2011. European Journal of Psychotraumatology, 5. doi:10.3402/ejpt.v5.23523

Dyb, G., Jensen, T. K., Nygaard, E., Ekeberg, Ø., Diseth, T. H., Wentzel-Larsen, T., & Thoresen, S. (2014). Post-traumatic stress reactions in survivors of the 2011 massacre on Utøya Island, Norway. British Journal of Psychiatry, 204(5), 361-367. doi:10.1192/bjp.bp.113.133157

Glad, K. A., Jensen, T. K., & Dyb, G. (2014). “Er det hjelp du har savnet etter terroranslaget på Utøya?” : foreldrene forteller[ ”Have you experienced any unmet needs after the terrorist attack at Utøya?”
The parents describe
] Norwegian only. Tidsskrift for Norsk Psykologforening, 51(7), 537-545.

Hafstad, G. S., Dyb, G., Jensen, T. K., Steinberg, A. M., & Pynoos, R. S. (2014). PTSD prevalence and symptom structure of DSM-5 criteria in adolescents and young adults surviving the 2011 shooting in Norway. Journal of Affective Disorders, 169(1), 40-46. doi:10.1016/j.jad.2014.06.055

Schultz, J. H., Langballe, Å., & Raundalen, M. (2014). Explaining the unexplainable: designing a national strategy on classroom communication concerning the 22 July terror attack in Norway. European Journal of Psychotraumatology, 5(22758).

Thoresen, S., Jensen, T. K., & Dyb, G. (2014). Media Participation and Mental Health in Terrorist Attack Survivors. Journal of Traumatic Stress, 27(6), 639-646. doi:10.1002/jts.21971

Thoresen, S., Jensen, T. K., Wentzel-Larsen, T., & Dyb, G. (2014). Social support barriers and mental health in terrorist attack survivors. Journal of Affective Disorders, 156, 187-193. doi:10.1016/j.jad.2013.12.014

Aakvaag, H. F., Thoresen, S., Wentzel-Larsen, T., Røysamb, E., & Dyb, G. (2014). Shame and guilt in the aftermath of terror: the Utøya Island study. Journal of Traumatic Stress, 27(5), 618-621. doi:10.1002/jts.21957

Dyb, G., & Glad, K. A. (2013). “Opplevelser og reaksjoner hos de som var på Utøya 22. juli 2011”. Deloppsummering nr. 2 fra prosjektgruppen. NKVTS nettpublikasjon.

Reifels, L., Pietrantoni, L., Prati, G., Yoshiharu, K., Kilpatrick, D. G., Dyb, G., . . . O`Donnell, M. et al. (2013). Lessons learned about psychosocial responses to disaster and mass trauma: an international perspective. European Journal of Psychotraumatology, 4. doi:10.3402/ejpt.v4i0.22897

Glad, K. A., Aadnanes, M., & Dyb, G. (2012). “Opplevelser og reaksjoner hos de som var på Utøya 22. juli 2011” Deloppsummering nr. 1 fra prosjektgruppen. NKVTS.

Thoresen, S., Aakvaag, H. F., Wentzel-Larsen, T., Dyb, G., & Hjemdal, O. K. (2012). The day Norway cried: Proximity and distress in Norwegian citizens following the 22nd July 2011 terrorist attacks in Oslo and on Utøya Island. European Journal of Psychotraumatology, 3. doi:10.3402/ejpt.v3i0.19709