Posttraumatic stress disorder and exposure to trauma reminders after a terrorist attack

The aims of this study were twofold: (a) to systematically describe the type and frequency of trauma reminders reported after a terrorist attack and (b) to examine whether posttraumatic stress disorder (PTSD) is associated with frequency of exposure to trauma reminders. A total of 285 survivors (M age = 22.2, SD = 4.3, 53% males) of the 2011 massacre on Utøya Island, Norway, were interviewed face to face 14-15 months after the terror. Participants were asked how often they had experienced a range of different trauma reminders in the past month and which was most distressing. Current posttraumatic stress reactions were measured using the University of California at Los Angeles PTSD Reaction Index. In all, 33.3% of the survivors reported having experienced 1 or more trauma reminders often/very often in the past month. Auditory reminders were most frequently encountered and were reported to be the most distressing, especially sudden and sharp noises. Meeting the diagnostic criteria for PTSD was significantly associated with frequency of exposure to trauma reminders. The findings suggest that trauma reminders are common among survivors of a terrorist attack almost 1.5 years after the trauma and that PTSD is strongly related to the frequency of exposure to reminders. It is important that clinicians are aware of the significant role trauma reminders may play in maintaining PTSD and help trauma survivors recognize and manage reminders.