Objective: The objective of the study was to investigate the relationship between physical injury (no, moderate and severe) and posttraumatic stress reactions (PTSR) at 4-5 months after the attack in survivors of the terror attack at Utøya Island, Norway, 22 July 2011, adjusting for sociodemographic, psychosocial and trauma-related factors. Methods: Overall, 325 young survivors (47% women, mean age 19.4 years) were interviewed 4-5 months (T1) and 14-15 months (T2) after the attack. Variables concerning physical injury, PTSR (UCLA PTSD-RI scale, 0-4), peritraumatic exposure, sociodemographic and psychosocial backgrounds were measured. To evaluate the role of injury, multiple linear regression analyses were conducted. Results: The physically injured (n = 60) reported higher levels of PTSR than did the non-injured. The difference was statistically significant between the moderately injured (n = 37, mean 1.9) and the non-injured (n = 265, mean 1.5). No significant differences were found between the moderately and the severely (n = 23, mean 1.8) injured. Higher levels of peritraumatic events, peritraumatic reactions and loss of close, female sex and non-Norwegian ethnicity were significantly related to higher levels of PTSR in the full regression model. Conclusion: Physical injury was associated with higher PTSR after the terror attack. Moderately injured survivors may, as those severely injured, exhibit high levels of PTSR, and this should be taken into account when targeting early psychosocial health care after terror.
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