Cross-Lagged Association Between Symptoms of Posttraumatic Stress Disorder and Perceived Centrality of a Terrorist Attack

Numerous cross-sectional studies have found a positive association between level of event centrality and symptoms of posttraumatic stress disorder (PTSD), but the temporal course of this relationship is unclear. We aimed to investigate the concurrent and longitudinal association between event centrality and symptoms of PTSD in a trauma-exposed sample. In total, 319 survivors of the 2011 massacre on Utøya island, Norway, were interviewed 14 to 15 and 30 to 32 months after the event. A cross-lagged panel model was used to explore the association between event centrality and PTSD symptoms over time. Level of event centrality was significantly associated with concurrent PTSD symptoms at both time points. PTSD symptoms were significantly associated with prospective levels of event centrality but not vice versa. This finding indicates that the degree to which survivors perceive a terrorist attack as central to their identity may be an effect, not a cause, of their PTSD symptoms.