Citation

Porcheret K, Dyb G, Wentzel-Larsen T, Stensland S. Eur. J. Psychotraumatol. 2024; 15(1): e2312750.

Copyright

(Copyright © 2024, The Author(s), Publisher Co-action Publishing)

DOI

10.1080/20008066.2024.2312750

PMID

38386049

Abstract

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.

Language: en

Keywords

*Exposure to Violence; *Sleep Initiation and Maintenance Disorders/epidemiology; *Terrorism; Adolescent; Adult; Alteración del sueño; Child; Follow-Up Studies; Humans; jóvenes; longitudinal; mass shooting; Sleep disturbance; tiroteo masivo; trauma; Violence; young people