Factors differentiating risk of sexual abuse victimization by adults and peers among adolescents.

BACKGROUND: Research suggests that around half of all cases of sexual abuse among children and adolescents are perpetrated by peers. Yet, there is limited understanding of the distinct risk factors associated with adult versus peer offenders. OBJECTIVE: To identify factors that increase the risk of sexual abuse victimization and explores variations in these factors depending on whether the perpetrator was an adult or a peer. PARTICIPANTS AND SETTING: 9240 secondary school students aged between 12 and 16 years (M = 14, SD = 0.88) in Norway participated. METHODS: An electronic questionnaire was administered in schools to investigate experiences of sexual abuse and potential risk factors. The data were analyzed using multiple logistic regression analyses. RESULTS: Two factors were related to a greater risk of being a victim of sexual abuse committed by an adult than a peer: background from a non-European country (OR = 1.93, p = 0.038) and other experiences of violence (OR = 1.63-2.91, p < 0.005). The use of alcohol was found to be related to a greater risk of victimization by peers than by adults (OR = 0.53, p = 0.031). CONCLUSIONS: Adolescents vulnerable to sexual abuse exhibit common traits, regardless of whether the perpetrator is an adult or peer. Yet, specific factors heighten the risk with peers over adults, and vice versa. Recognizing distinct risk factors for abuse by adults and peers enables decision-makers and community workers to create targeted prevention strategies for children and adolescents.

Violence and sexual abuse rates before and during the Covid-19 pandemic: A prospective population-based study on Norwegian youth.

BACKGROUND: Considerable concern is raised as to whether the pandemic has led to an increase in violence and sexual abuse against children. OBJECTIVE: The present study objective is to provide rates of violence and sexual abuse against adolescents the year before the pandemic compared to one year into the pandemic. PARTICIPANTS AND SETTING: Two samples of Norwegian 12-16-year-olds were approached. A representative pre-pandemic sample of 9240 adolescents (M age (SD) = 14.11(0.88), and a sample recruited one year into the pandemic resulting in 3540 responses (M age (SD) = 14.5 (0.96)). METHODS: An online survey was administered during school hours including established measures of violence and sexual abuse exposure. Sociodemographic characteristics were assessed. RESULTS: There was 1.4 percentage point increase in sexual abuse by an adult, and a 3.9 percentage point decrease in psychological violence by a parent during the pandemic compared to the year before the pandemic. Otherwise, violence and sexual abuse rates remained stable across these two time periods. Risk factors for violence and sexual abuse were amplified during the pandemic. CONCLUSION: Norway, a high-income welfare state, imposed measures to counteract the burden of the pandemic mitigation actions for adolescents. This might partly explain the absence of the feared increase in violence towards adolescents. The disproportionate risk for violence and sexual abuse for some groups of adolescents is however concerning, and should be followed up over time.

The regulatory role of affective inhibitory control in somatic symptoms among adolescents exposed to child maltreatment: a population-based study.

Adolescents exposed to child maltreatment are at increased risk for various somatic symptoms, but which psychological factors that contribute to this relationship need to be further investigated. Emotion dysregulation is suggested to serve as a proximal link between child maltreatment and somatic complaints. The purpose of the present study was to investigate whether individual differences in affective inhibitory control, a central component in implicit emotion regulation, contribute to the risk of somatic symptoms in adolescents exposed to child maltreatment. Data were drawn from the UEVO study, a national population-based survey of adolescents between 12 and 16 years of age (N = 9240). For this study, we included participants who completed the emotional go/no-go task measuring affective inhibitory control (N = 7241; Mage/SD = 14 years/.87; 52% girls, 47% boys), of which N = 3349 reported at least one incident of maltreatment exposure (57% girls, 41% boys). Exposure to psychological abuse and sexual abuse were associated with somatic symptoms. Affective inhibitory control was related to somatic symptoms, both in the total sample and in adolescents exposed to child maltreatment. The strength of relationships between exposure to psychological abuse and somatic symptoms, as well as sexual abuse and somatic symptoms, were moderated by individual differences in affective inhibitory control problems. Our study suggests that psychological abuse and sexual abuse increase the risk for somatic symptoms in adolescence. Affective inhibitory control, a central component in implicit emotion regulation, was related to somatic symptoms and moderated the relationships between psychological abuse and somatic symptoms, and sexual abuse and somatic symptoms. Revealing these associations in a population-based sample indicates that treatment targeting affective inhibitory control may be beneficial and should be explored further in clinical settings.

Changes in Adolescent Mental and Somatic Health Complaints Throughout the COVID-19 Pandemic: A Three-Wave Prospective Longitudinal Study.

PURPOSE: Measures taken to limit the spread of the COVID-19 may have had unintended consequences for the mental and somatic health of children and adolescents. METHODS: A nationwide three-wave survey in a representative sample of 12-16 year olds in Norway, with baseline data collected in January 2019 (n = 9,240; 49% girls) and follow-ups in June 2020 (n = 3,564; 49% girls) and June 2021 (n = 3,540; 47% girls). Linear mixed-effects models were used to estimate change and identify predictors thereof in mental and somatic health complaints. RESULTS: Following an initial stable trend from before the pandemic to the early phase, both mental health problems (predicted value at T1 .56 [CI .55, .58], T1-T2 change -.04 [CI -.07, -.02], T2-T3 change .12 [CI .09, .14]) and somatic health complaints (predicted value at T1 .59 [95% CI .58, .61], T1-T2 difference -.09 [95% CI -.11, -.65], T2-T3 difference .18 [95% CI .15, .21]) increased significantly 15 months into the pandemic, when controlling for age in the models. When compared to boys, girls had a significantly more pronounced increase in mental health problems and somatic health; loneliness in the early stages of the pandemic significantly predicted health complaints one year later, both mental and somatic complaints. DISCUSSION: Our findings suggest that the prolonged pandemic situation and the related societal restrictions have had an impact on adolescent health in general and on the health of girls in particular. The rise in mental and somatic health complaints can in part be attributed to an increase in loneliness.

Childhood Experiences of Companion Animal Abuse and its Co-Occurrence with Domestic Abuse: Evidence from a National Youth Survey in Norway.

It is increasingly acknowledged that companion animal abuse often occurs in the same contexts as other types of abuse, particularly domestic abuse. However, the co-occurrence and strengths of these associations in the general population have not been well established in research. With data from a large representative sample of Norwegian adolescents, we aimed to determine 1) the extent to which Norwegian children are exposed to companion animal abuse in the family, 2) whether and how companion animal abuse is linked to other forms of domestic abuse that children experience, and 3) background factors associated with companion animal abuse. A total of 9240 adolescents aged 12-16 years (Mage 14.7) participated in the digital school-based survey. Four percent (n = 380) reported that they had ever witnessed a parent being violent towards a family companion animal, whereas 1% (n = 125) had experienced that an adult in the household had threatened to harm a companion animal. There was a substantial overlap between companion animal abuse and child abuse, and it most frequently co-occurred with psychological abuse and less severe forms of physical child abuse. This resonates with conceptualizations of domestic abuse as an ongoing pattern of psychological abuse and coercive control. The risk factors identified for companion animal abuse in this representative sample of adolescents were similar to known risk factors for domestic abuse. Low socioeconomic status and parents' substance abuse, parents' psychiatric illness, and parents' history of incarceration entailed a greater risk of experiencing companion animal abuse. We conclude that companion animal abuse co-occurs with other forms of domestic abuse and that it may be considered a part of the repertoire of domestic abuse that impacts children.

Adolescents' symptoms of anxiety and depression before and during the Covid-19 outbreak - A prospective population-based study of teenagers in Norway.

BACKGROUND: Lockdown policies related to the Sars-Cov-2 pandemic has potential negative consequences for mental health in youths. METHODS: Anxiety and depressive symptoms were assessed in 3 572 adolescents, age 13 to 16 using the Hopkins Symptom Checklist (HSCL-10), in a representative longitudinal survey of Norwegian youths between February 2019 (T1) and June 2020 (T2). Predictors for symptom change were analysed with linear mixed-effects models. FINDINGS: Overall, clinical levels of anxiety and depression increased slightly from 5.5% at T1 to 6.3% at T2; Chi square 224.4 (df = 1), p<.001. However, the observed change was driven by the increase in age between assessments. Being a girl, having pre-existing mental health problems, and living in a single-parent household at T1, predicted higher levels of anxiety and depressive symptoms at T2 (p<.001). Living in a single-parent household was associated with a significant increase in symptoms, also when age was controlled for (p<.001). Living in a poor family however, or having a history of maltreatment, was associated with a significantly lower increase in symptoms (p<.001). INTERPRETATION: Anxiety and depressive symptoms increased slightly in Norwegian youths between 2019 and 2020, but this change seemed to be driven by increase in age rather than pandemic-related measures. Symptom levels were unevenly distributed across demographic groups both before and during the pandemic outbreak, indicating that health disparities persist for adolescents in risk groups during a pandemic . Health inequities related to living conditions need to be addressed in future action plans, and intensified measures to mitigate inequities are needed. FUNDING: The study was funded by the Norwegian Directorate for Children, Adolescents and Family affairs (Bufdir).

Study protocol: the Norwegian Triple-S Cohort Study - establishing a longitudinal health survey of children and adolescents with experiences of maltreatment.

BACKGROUND: Child maltreatment is prevalent and associated with both short- and long-term health problems. Previous studies have established child maltreatment as a risk factor for a wide range of problems over the life course such as mental- and somatic health problems, self-harm, alcohol- and drug abuse and decreased work-life participation. Still, there are few large and well-conducted longitudinal studies focusing on describing prevalence and identifying risk factors and long-term consequences of child maltreatment. The purpose of the current study is to recruit a large number of children and adolescents exposed to maltreatment and follow them long-term. METHODS/DESIGN: The current study is a longitudinal cohort study and will use a multi-informant design (child/adolescent, caregiver, and administrative data). Participants will be recruited from the Stine Sofie Centre (SSC), a learning and coping centre for children and adolescents (≤18 years) exposed to maltreatment, which includes physical and emotional abuse, neglect and/or sexual abuse. Questionnaire-based assessments from self-reports (as well as parent-reports) will be carried out at regular time intervals throughout their lives, on topics such as abuse, negative life events, mental and somatic health problems, resilience and coping, satisfaction with health services, social-, family-, and school function, as well as self-harm and substance abuse. Participants will be assessed upon entry to the centre and followed up annually until they reach 18 years and bi-annually after. Given written consent, participants' responses will be linked to relevant national registries in order to examine predictive factors and important outcomes in terms of subsequent health, education, criminal records and work affiliation. DISCUSSION: This study will examine short- and long-term consequences of child maltreatment across a range of health-related outcomes in a longitudinal perspective. Results from the current study might have implications for the development of preventive and intervention programs related to child maltreatment and the organization and follow-up of the services these children receive. The current study will hopefully contribute with knowledge of risk-factors, short- and long-term health-related and other issues that can contribute to practices aimed at improving the overall life-course for children and adolescents who have experienced childhood maltreatment.

Affective inhibitory control and risk for internalizing problems in adolescents exposed to child maltreatment: A population-based study.

Adolescents' emotion regulatory capacities modulate the relationship between child maltreatment experiences and psychopathology. Affective inhibitory control constitutes an important part of emotion regulation and involves the ability to regulate automatic or prepotent responses to irrelevant and potentially distracting emotional information. The aim of the present study was to investigate the role of affective inhibitory control in the relationship between exposure to child maltreatment and internalizing problems in adolescence. A nationally representative sample of adolescents (n = 9,240; 49% girls; Mage = 14 years; SD = 0.9), of which n = 4,261 (55% girls; Mage = 14 years; SD = 0.9) were exposed to child maltreatment, conducted an emotional go/no-go task. Participants were presented with angry facial expressions as emotional no-go stimuli in order to examine their ability to inhibit behavioral responses to threatening task-irrelevant stimuli. Affective inhibitory control problems were uniquely related to internalizing problems in maltreated adolescents. Gender effects were observed; the relationship was significant in girls but not in boys. Moreover, affective inhibitory control moderated the relationship between exposure to psychological abuse and internalizing problems in girls. We did not observe any relationship between inhibitory control and internalizing problems when neutral faces were presented as task-irrelevant information. Findings suggest that a reduced ability to inhibit threatening, but task-irrelevant, information is related to internalizing problems in maltreated adolescent girls. Results highlight the importance of affective inhibitory control as a potential moderating mechanism in individual risk for experiencing internalizing problems in abused adolescents. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Cohort profile: Norwegian youth study on child maltreatment (the UEVO study).

PURPOSE: Exposure to childhood maltreatment is not uncommon, and is linked to both short-term and long-term health problems. Population-based surveys for adolescent samples provide excellent opportunities for addressing the substantial burden of early-life adversities, because collecting information close in time to exposure may increase accuracy of assessment. Still few large studies have been conducted, following individuals through adolescence. Therefore, the UEVO cohort was created with the aim of investigating prevalence of child maltreatment throughout childhood and adolescence, and its effects on health and functioning in a long-term perspective in a representative sample of Norwegian adolescents. PARTICIPANTS: The baseline for the cohort includes a representative sample of 9240 Norwegian adolescents (response rate 86.6%) aged 12-16 years, surveyed in January and February 2019. The cohort to be followed over time comprises the 5502 adolescents who agreed to be recontacted for subsequent data collection waves. FINDINGS TO DATE: The overall prevalence figures from the first wave of measurement have been published in a comprehensive national report on child maltreatment in Norway. FUTURE PLANS: A second study wave will commence in 2021, including about half of the original cohort (longitudinal), as well as a new sample starting at age 12. For participants above age 16, original survey data will be connected to national registries (pending indvidual consent), enabling the study of real-life functioning within the areas of healthcare utilisation, school drop-out, work-force participation and prescription of medication.

The association of PTSD symptom severity with amygdala nuclei volumes in traumatized youths.

The amygdala is a core component in neurobiological models of stress and stress-related pathologies, including post-traumatic stress disorder (PTSD). While numerous studies have reported increased amygdala activity following traumatic stress exposure and in PTSD, the findings regarding amygdala volume have been mixed. One reason for these mixed findings may be that the amygdala has been considered as a homogenous entity, while it in fact consists of several nuclei with unique cellular and connectivity profiles. Here, we investigated amygdala nuclei volumes of the basolateral and the centrocorticomedial complex in relation to PTSD symptom severity in 47 young survivors from the 2011 Norwegian terror attack 24-36 months post-trauma. PTSD symptoms were assessed 4-5, 14-15 and 24-36 months following the trauma. We found that increased PTSD symptom severity 24-36 months post-trauma was associated with volumetric reductions of all basolateral as well as the central and the medial nuclei. However, only the lateral nucleus was associated with longitudinal symptom development, and mediated the association between 4-5 months and 24-36 months post-trauma symptoms. The results suggest that the amygdala nuclei may be differentially associated with cross-sectional and longitudinal measures of PTSD symptom severity. As such, investigations of amygdala total volume may not provide an adequate index of the association between amygdala and stress-related mental illness.

Patterns of abuse and effects on psychosocial functioning in Lithuanian adolescents: A latent class analysis approach.

BACKGROUND: There is considerable evidence that child abuse and neglect has a significant impact on social relationships and mental health across the lifespan. OBJECTIVE: We aimed to estimate the prevalence of child abuse in Lithuanian adolescents, to identify patterns of abuse experiences using a latent class analysis approach, and to assess psychosocial functioning associated with these patterns of abuse. PARTICIPANTS AND SETTING: The study was based on a sample of 1299 adolescents from the Lithuanian general population aged 12-16 (M = 14.24, SD = 1.26) years. METHODS: Lifetime abuse exposure measures included neglect, emotional abuse, physical abuse, online sexual violence, sexual abuse from adult, and sexual abuse from peers. Psychosocial functioning was measured with the Strength and Difficulties Questionnaire (SDQ). Patterns of abuse were identified by a two-step latent class analysis (LCA). RESULTS: Around two-thirds of adolescents (71 %) reported at least one type of abuse over their lifetime. The results of the LCA indicated that for each type of abuse two different groups of adolescents can be distinguished in terms of the severity of abuse, and four classes 'less-severe', 'peer sexual', 'adult sexual', and 'severe abuse' were identified. Psychosocial functioning varied significantly between the four classes with higher psychosocial functioning problems associated with high severity and sexual abuse. CONCLUSIONS: The study revealed a high child abuse prevalence in Lithuania. The results show that the psychosocial functioning of adolescents is associated with severity and types of abuse experiences.

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.

Purpose: The main aim was to assess long-term post-traumatic stress symptoms, emotional distress, fatigue, sleep disturbances and pain in individuals hospitalized with physical injuries after two terror attacks in Oslo in 2011, approximately three years after the events. A secondary aim was to explore the relationship between these outcomes and medical and psychosocial factors.Materials and methods: Thirty of 43 potential persons participated. Injury characteristics were collected from medical charts. Level of post-traumatic stress, emotional distress, fatigue, sleep disturbances and pain was assessed and the association with injury severity, resilience, optimism, neuroticism and extroversion, and perceived access to social support was explored.Results: Nine of 30 met criteria for full or partial PTSD, and 14 of 30 displayed clinical levels of emotional distress. Fifteen reported moderate to severe fatigue, and 16 said sleep disturbances affected their daily life. Twelve indicated that pain affected daily activities and work ability, and 15 that pain affected their quality of life. I Resilience, optimism, neuroticism, and perceived social support, were associated with outcomes, but injury severity was not. When controlling for pain, many of the psychosocial variables failed to reach significance.Conclusions: Injury severity was not associated with outcomes. On the other hand, psychosocial factors were, but seemed to be influenced by pain.Implications for rehabilitationPersons who have obtained physical injuries under extreme psychological conditions such as terror, are at high risk of poor long-term outcomes, and will often be in need of comprehensive interdisciplinary rehabilitation services.Psychological outcomes are not associated with severity of physical injury, but premorbid and current psychological variables such as resilience, optimism, personality, and access to social support are highly associated with long-term outcome.Longstanding pain seems to diminish or weaken the role of protective psychological factors and should be addressed in the rehabilitation context.

[July 22, 2011 ­ psychological reactions in patients at the accident and emergency department in Oslo]. / 22. juli 2011 ­ psykiske reaksjoner hos pasienter ved Legevakten i Oslo.

BACKGROUND: Following the bomb attack on the government quarter on 22 July 2011, many of the injured were treated at the accident and emergency department in Oslo. MATERIAL AND METHOD: The patients (n=79) were sent a questionnaire ten months after their treatment and again after three years. A total of 42 patients responded on one or both occasions. Post-traumatic stress reactions were measured using PTSD-RI (University of California at Los Angeles PTSD Reaction Index). Symptoms of anxiety and depression were measured with the aid of HSCL-8 (Hopkins Symptom Checklist). Physical symptoms were surveyed using twelve questions. Satisfaction with follow-up was measured with eight questions on a five-point scale. RESULTS: After ten months, the average score for PTSD-RI was 1.4 (95 % CI 1.0-1.7), and 31 % of the responses were at a clinical PTSD level. After three years, the average score was 1.3 (95 % CI 0.9-1.7), and 25 % were at a clinical PTSD level. Symptom score for anxiety and depression after ten months was 0.9 (95 % CI 0.6-1.2) and after three years 0.8 (95 % CI 0.5-1.2). The most frequent physical symptom was headache. The satisfaction with follow-up varied somewhat but was generally good. INTERPRETATION: Several patients who received treatment for injuries at the accident and emergency department in Oslo had mental symptoms for a long period following the terror attack. The patients were satisfied with the follow-up, which was mainly provided by the primary healthcare service.

Who can I trust? Extended fear during and after the Utøya terrorist attack.

OBJECTIVE: The aim of the study was to investigate specific peritraumatic reactions among adolescent and young adult survivors of the 2011 terrorist attack on Utøya Island, Norway. The authors focused specifically on a phenomenon that has so far not been thoroughly investigated: fear of nondangerous stimuli ("extended fear") during and immediately after the traumatic event. METHOD: In total, 325 survivors of the shooting on Utøya Island were interviewed 4-5 months after the attack and provided a free narrative of the event. Posttraumatic stress symptoms were assessed using the UCLA PTSD Reaction Index; depression and anxiety were assessed using HSCL-8. For the purpose of the current study, the authors chose participants who were under the age of 26 at the time of the terrorist attack (M = 18.4 years), which constituted the vast majority of the total sample (93%). RESULTS: The authors found that 54% of the sample felt threatened during and immediately after the attack, not only by the perpetrator himself, but by other people as well; in most cases by people who came to help them (medical personnel, policemen, volunteers). The participants who mentioned experiencing extended fear in their trauma narratives had significantly higher scores of posttraumatic stress symptoms, anxiety, and depression 5 months after the attack than participants who did not peritraumatically experience extended fear. CONCLUSIONS: Early detection of extended fear can help in identifying individuals who will later develop symptomatology. In addition, knowledge of the phenomenon could help policemen and medical personnel understand survivors' seemingly irrational reactions. (PsycINFO Database Record

The relationship between posttraumatic stress symptoms and narrative structure among adolescent terrorist-attack survivors.

BACKGROUND: The structure of trauma narratives is considered to be related to posttraumatic stress symptomatology and thus the capacity to make a coherent narrative after stressful events is crucial for mental health. OBJECTIVE: The aim of this study is to understand more of the relationship between narrative structure and posttraumatic stress symptoms (PTSS). More specifically, we investigated whether internal and external focus, organization, fragmentation, and length differed between two groups of adolescent survivors of a mass shooting, one group with low levels of PTSS and one group with high levels of PTSS. METHOD: The sample comprised 30 adolescents who survived the shooting at Utøya Island in Norway in 2011. They were interviewed 4-5 months after the shooting and provided a free narrative of the event. PTSS were assessed using the UCLA Posttraumatic Stress Disorder Reaction Index (PTSD-RI). RESULTS: We found that survivors with high levels of PTSS described more external events and fewer internal events in their narratives compared with survivors with low levels of symptoms. The analysis also showed that especially narratives containing more descriptions of dialogue and fewer organized thoughts were related to higher levels of PTSS. The groups did not differ in levels of narrative fragmentation or in length of the narratives. CONCLUSION: Specific attributes of narrative structure proved to be related to the level of PTSS. On the basis of our results, we can recommend that practitioners focus especially on two elements of the trauma narratives, namely, the amount of external events, particularly dialogues, within the narrative and the number of organized thoughts. Participants with high levels of PTSS provided trauma narratives with low amount of organized (explanatory) thoughts accompanied by detailed descriptions of dialogues and actions, which is indicative for "here and now" quality of recall and a lack of trauma processing.

Latent classes of posttraumatic stress and growth.

BACKGROUND AND OBJECTIVES: Potentially traumatic events may lead to different patterns of posttraumatic stress symptoms and posttraumatic growth. The objective of the present study was to identify subgroups with different patterns of posttraumatic reactions, and to determine whether these subgroups differed in terms of personal and social resources and indicators of adjustment. DESIGN: This study used survey data collected 10 months after the 2011 Oslo bombing attack to investigate patterns of reactions among ministerial employees (N=1970). METHODS: We applied latent class analyses with covariates to extract subgroups of individuals. RESULTS: Three classes of individual reactions were extracted, and these were similar among those who were and those who were not physically proximate to the bombing attack: "High stress/high growth" (27% and 11%, respectively), "Low stress/high growth" (74% and 42%, respectively), and "Low stress/low growth" (only among the not physically proximate: 47%). The classes differed in terms of gender, neuroticism, and social support as well as life satisfaction and daily functioning. CONCLUSIONS: Heterogeneous patterns of posttraumatic reactions were found. Physical proximity is not necessary to experience posttraumatic stress or growth after political violence. Among individuals with low stress, posttraumatic growth may not encompass higher life satisfaction or functioning.

Posttraumatic growth in children and youth: clinical implications of an emerging research literature.

Posttraumatic growth (PTG), positive change resulting from the struggle with trauma, has garnered significant attention in the literature on adults. Recently, the research base has begun to extend downward, and this literature indicates that youth also evidence PTG-like changes. Researchers have sought to assess the construct, examine its correlates, and understand the factors that contribute to PTG in youth. Drawing from this work, this article considers clinical implications for youth. After briefly describing the PTG construct, its hypothesized process, and its distinction from resilience, the article focuses on key themes in the literature and, with those findings as backdrop, ways in which professionals can facilitate growth in youth who have experienced trauma. This discussion situates PTG within the broader trauma literature and includes specific applications used to date as well as the role of cultural factors. Future directions--salient to practitioners and researchers alike--are considered.

PTSD prevalence and symptom structure of DSM-5 criteria in adolescents and young adults surviving the 2011 shooting in Norway.

BACKGROUND: Diagnostic criteria for Posttraumatic Stress Disorder (PTSD) have been revised for DSM-5. Two key changes include alteration of the clustering of PTSD symptoms and new PTSD symptom criteria related to negative alterations in cognition and mood. In this study, we empirically investigated these changes. METHODS: We interviewed 325 adolescents and young adults who survived the 2011 youth camp shooting at Utøya Island, Norway. The UCLA PTSD Reaction Index for DSM-IV was used to assess symptoms of PTSD. In addition, 11 questions were added to assess the four new symptom criteria within the new DSM-5 symptom categories. RESULTS: PTSD prevalence did not differ significantly whether DSM-IV (11.1%) or DSM-5 (11.7%) criteria were used and the Cohen׳s Kappa for consistency between the diagnoses was 0.061. Confirmatory factor analyses showed that the four-factor structure of the DSM-5 fit the data adequately according to the conceptual model outlined. LIMITATIONS: The homogeneity of this sample of highly exposed subjects may preclude generalization to less severely exposed groups. Also, we did not assess criterion G in regard to symptoms causing clinically significant distress and functional impairment. CONCLUSION: The prevalence of PTSD was quite similar regardless of diagnostic system. The relatively low concordance between the diagnoses has implications for eligibility for a diagnosis of PTSD.