Coping responses in the midst of terror: the July 22 terror attack at Utøya Island in Norway.

This study examined the peri-trauma coping responses of 325 survivors, mostly youth, after the July 22, 2011 terror attack on Utøya Island in Norway. The aim was to understand peri-trauma coping responses and their relation to subsequent post-traumatic stress (PTS) reactions. Respondents were interviewed face-to-face 4-5 months after the shooting, and most were interviewed at their homes. Peri-trauma coping was assessed using ten selected items from the "How I Cope Under Pressure Scale" (HICUPS), covering the dimensions of problem solving, positive cognitive restructuring, avoidance, support seeking, seeking understanding, and religious coping. PTS reactions were assessed with the UCLA PTSD Reaction Index. The participants reported using a wide variety of coping strategies. Problem solving, positive cognitive restructuring, and seeking understanding strategies were reported most often. Men reported using more problem-solving strategies, whereas women reported more emotion-focused strategies. There were no significant associations between age and the use of coping strategies. Problem solving and positive cognitive restructuring were significantly associated with fewer PTS reactions. The results are discussed in light of previous research and may help to inform early intervention efforts for survivors of traumatic events.