The day Norway cried: Proximity and distress in Norwegian citizens following the 22nd July 2011 terrorist attacks

Background: Terrorism may create fear and stress reactions not only in the direct victims, but also in the general population. Objective: This study investigated emotional responses in the Norwegian population following the 22nd July 2011 terrorist attacks. We hypothesized that Oslo residents would report a higher level of fear responses compared with people living outside Oslo and that proximity would be associated with early distress and later post-traumatic stress reactions. Method: Representative samples were drawn from the Norwegian Population Registry. Telephone interviews were conducted 45 months after the attacks. The response rate for the Oslo sample (N465) was 24 % of the total sample, and 43 % of those who were actually reached by phone and asked to participate. Corresponding figures for the sample living outside Oslo (N716) were 19 % and 30%. Results: Our results show strong immediate emotional responses, particularly sadness and a feeling of unreality, in both samples. Jumpiness and other fear responses were significantly higher among Oslo residents. Current level of risk perception was low 45 months after the attacks; however, a significant minority reported to feel less safe than before. Geographical and psychological proximity were associated with early emotional responses. Psychological proximity was significantly associated with post-traumatic stres