Warning signals? An explorative study of distant recollections of the moments before a disaster

ABSTRACT

Background: How do we remember what happened shortly before a traumatic experience? There has been little focus on the temporal context of trauma memories, but a few studies suggest that aspects of what happened in the moments prior to a traumatic experience may be selectively enhanced and prioritized in memory.

Objective: The main aim of this study was to investigate the occurrence, nature, and content of voluntary memories about what happened shortly before a disaster. The participants were individuals who had survived a fire on the passenger ferry Scandinavian Star 26 years earlier.

Methods: Data collection took the form of face-to-face interviews. The analysis was carried out in two steps. First, all the narratives from participants who were aged 7 years or older at the time of the fire (N = 86) were coded in terms of the presence of detailed descriptions of what happened before the fire. Next, the narratives that included detailed descriptions of the moments before (N = 28) were included in a thematic analysis, focusing on coding the mode and the content.

Results: More than one-third of the participants reported detailed accounts of what happened in the hours, minutes, or seconds before the fire. These memories included detailed descriptions of sensory impressions, dialogues, actions, and thoughts. Two themes stood out in the thematic analysis: (1) unusual observations and danger cues; and (2) counterfactual thoughts.

Conclusion: The finding that specific details from the moments before a traumatic event may be vividly recalled indicates that peripheral details of traumatic events can be prioritized in memory. Such details may be interpreted as warning signals. Future research should examine whether such memories might stimulate long-standing thoughts of the world as being dangerous, and hence carry the threat forward in time.

HIGHLIGHTS

• A qualitative study exploring the occurrence, nature, and content of memories about what happened shortly before a disaster.

• For some trauma survivors, experiences or observations shortly before a traumatic event can be vividly recalled in detail, after more than two decades.

• Such detailed memories of what happened before a traumatic experience may be interpreted as warning signals; furthermore, they may stimulate long-standing thoughts of the world as dangerous, thus carrying the threat forward in time.

Antecedentes: ¿Cómo recordamos lo que sucedió poco antes de una experiencia traumática? Se ha prestado poca atención al contexto temporal de los recuerdos del trauma, pero algunos estudios sugieren que los aspectos de lo que sucedió en los momentos previos a una experiencia traumática podrían mejorarse y priorizarse selectivamente en la memoria.

Objetivo: El objetivo principal de este estudio fue investigar la ocurrencia, naturaleza y contenido de las memorias voluntarias sobre lo que sucedió poco antes de un desastre. Los participantes fueron personas que sobrevivieron a un incendio en el ferry de pasajeros Scandinavian Star 26 años atrás.

Método: La recolección de datos se hizo mediante entrevistas presenciales. El análisis se llevó a cabo en dos pasos. Primero, todas las narraciones de los participantes que tenían 7 años o más en el momento del incendio (N = 86) se codificaron en términos de la presencia de descripciones detalladas de lo que sucedió antes del incendio. Luego, las narraciones que incluían descripciones detalladas momentos antes (N = 28) se incluyeron en un análisis temático, centrándose en codificar el modo y el contenido.

Resultados: Más de un tercio de los participantes reportaron relatos detallados de lo sucedido en las horas, minutos o segundos previos al incendio. Estos recuerdos incluían descripciones detalladas de impresiones sensoriales, diálogos, acciones y pensamientos. Dos temas se destacaron en el análisis temático: (1) observaciones inusuales y señales de peligro; (2) pensamientos contrafactuales.

Conclusión: Que los detalles específicos de los momentos previos a un evento traumático se puedan recordar vívidamente, indica que los detalles periféricos de los eventos traumáticos se pueden priorizar en la memoria. Tales detalles pueden interpretarse como señales de advertencia. La investigación futura debería examinar si tales recuerdos pudiesen estimular pensamientos antiguos sobre el mundo como peligroso y, por lo tanto, sostener la amenaza en el futuro.

背景：我们如何记住创伤经历之前不久发生的事情？很少有人关注创伤记忆的时间背景，但一些研究表明，创伤经历之前发生事情的各个方面可能会在记忆中被选择性地增强和优先考虑。

目的：本研究主要旨在考查自愿记忆灾难前不久发生事情的发生、性质和内容。 参与者是 26 年前在斯堪的纳维亚之星号客轮上发生火灾的幸存者。

方法：数据收集采用面对面访谈形式。 分两步进行分析。 首先，火灾发生时 7 岁或以上的参与者 (N = 86) 的所有叙述都根据是否有火灾前发生事情的详细描述进行编码。 接下来，将之前包含详细描述的叙述 (N = 28) 纳入到主题分析中，重点对模式和内容进行编码。

结果：超过三分之一的参与者报告了火灾前几小时、几分钟或几秒内发生的事情的详细描述。 这些记忆包括对感官印象、对话、动作和思想的详细描述。 主题分析中突出了两个主题：(1) 不寻常的观察和危险线索 (2) 反事实的想法。

结论：可以生动回忆起创伤事件发生前瞬间的具体细节，表明在记忆中优先考虑了创伤事件相关细节。 这些细节可能被解读为警告信号。 未来的研究应该考查这样的记忆是否会激发长期认为世界是危险的想法，从而不断将威胁传播下去。

KEYWORDS:

• Trauma
• autobiographical memory
• warning signals
• post-traumatic stress
• trauma narrative

PALABRAS CLAVE:

• Trauma
• memoria autobiográfica
• señales de advertencia
• estrés post traumático
• memoria traumática

关键词:

• 创伤
• 自传记忆
• 警告信号
• 创伤后应激
• 创伤记忆

1. Introduction

Traumatic experiences are prioritized in memory, compared to those life experiences that are more mundane. Furthermore, several studies have demonstrated that the memory of stressful or traumatic experiences can be characterized by a so-called tunnel effect, where memory is enhanced for the worst or the more central details of the traumatic experience, while memory for the context and more peripheral details is compromised (Berntsen, 2002; Christianson & Loftus, 1990; Safer et al., 1998). According to Safer et al. (1998), negative emotional arousal leads to a narrowing of attention, and, in turn, enhanced memory for the critical details during a traumatic experience. Correspondingly, experimental studies of memory for words have shown an enhancement effect for emotional words, along with impaired recollection for the stimuli that precede the emotional stimuli (Strange et al., 2003).

Another line of research has suggested that neutral items, sharing a close temporal relationship with emotionally arousing stimuli, can acquire the same attention-demanding quality as the most central details, and therefore can be enhanced. For example, in an experimental study by Knight and Mather (2009), participants demonstrated an enhanced recollection of neutral items that preceded emotionally arousing items. A similar enhanced recollection of preceding stimuli has been found with real-life trauma memories. In a study investigating the content of intrusive autobiographical memories, as recalled by patients with post-traumatic stress disorder (PTSD), Ehlers et al. (2002) reported that these memories included detailed accounts about what happened shortly before the traumatic experience. Indeed, these narratives included a high level of sensory information, which was temporally linked to the traumatic event. For instance, a patient involved in a head-on car crash kept seeing the bright headlights that were coming towards her shortly before the accident happened. Similar findings were reported by Hackmann and Holmes (2004): when classifying the content of intrusive memories from 22 patients diagnosed with PTSD, they found that only a minority (17%) of these memories included what the patient identified as the most traumatic element of the experience. Most of these memories represented stimuli that preceded the onset of the traumatic experience.

Based on their findings, Ehlers et al. (2002) proposed the warning signal hypothesis, suggesting that stimuli that are present shortly before a traumatic incident may acquire the status of a warning signal (i.e. ‘stimuli that if encountered again would indicate impending danger’, p. 995). From an evolutionary perspective, such memories can be adaptive, as they can serve as valuable early indicators of danger that can be avoided. However, according to Ehlers et al. (2002), such warning signals may also trigger involuntary, intrusive, and distressing memories of the traumatic event. This warning signal hypothesis is, however, underexplored. There is a gap in the literature regarding the temporal aspects of trauma memories. Hitherto, as far as we know, there has been no narrative study focusing on voluntary memories of what happened just before the traumatic event.

The studies by Ehlers et al. (2002) and Hackmann and Holmes (2004) on intrusive memories in patients with PTSD suggest that aspects of what happened in the moments prior to a traumatic experience may be selectively enhanced and prioritized in autobiographical memory. However, both studies focus on intrusive memories in clinical groups of patients with PTSD, and vivid recollections of what happened prior to trauma may not be limited to intrusive memories, or to patients with PTSD.

The main aim of the present study was to explore voluntary memories of what happened shortly before a traumatic event in a group of trauma-exposed individuals. The participants had survived a fire on the passenger ferry Scandinavian Star 26 years earlier. In qualitative interviews, the survivors were asked to describe their memories of what happened from the moment when they knew that something was wrong until they were safe. From these descriptions, we investigated the occurrence, nature, and content of memories about what happened shortly before the disaster. More specifically, we analysed how these memories were described, in terms of both the narrative mode (e.g. descriptions of sensory impressions, description of dialogues) and the narrative content (what they were about).

2. Methods

2.1. The fire on the Scandinavian Star ferry

On 7 April 1990, at about 2 o’clock in the morning, a fire broke out on the passenger ferry Scandinavian Star, and as a result of this disaster 159 people died. The police concluded that the fire was probably arson; however, the perpetrator(s) was never identified. The aftermath of the disaster has been riddled with conflict and has received regular media attention for almost three decades. Following requests from survivor groups, the Norwegian Parliament appointed an independent commission in 2015 with the mandate to evaluate several aspects of the Scandinavian Star case. As part of its work, in 2016 the commission requested a systematic investigation of the current mental health status of survivors and those who were bereaved by the ferry disaster.

2.2. Participants and procedure

The present cross-sectional study was part of the systematic investigation of the current mental health status of Norwegian survivors and bereaved people, as requested by the Norwegian Parliament in 2016 (Thoresen et al., 2017). The present study will focus on the survivors. At the time of the fire, 482 people were on board the ferry, of whom 159 (33%) died.

At the time of this study, 163 Norwegian survivors were alive and traceable. An invitation to participate was sent by post, and those who did not want to participate were given the possibility to notify us if they did not wish to be contacted. The interviewers made contact by telephone and asked whether they wished to participate. In total, 94 survivors participated in the study, resulting in a response rate of 57%. In the present study, narratives from all participants who were 7 years or older at the time of the fire were included in the initial analysis (N = 86). The sample consisted of 40 women (46.5%) and 46 men, with an age range of 33–86 years (mean = 55 years, standard deviation = 13) at the time of interview. Among the 86 participants included in the initial analysis, six people were under 12 years old at the time of the disaster. Out of the 28 participants whose narratives were included in the thematic analysis, the youngest participant was 13 years of age when the disaster happened.

The traumatic exposure was severe for many of the survivors. Among survivors who were 7 years or older, 80% were in areas of the ferry with heavy smoke, 44% heard people screaming or calling for help, 41% saw injured people or bodies of deceased people, and 65% experienced a dangerous situation during the evacuation of the ferry (Thoresen et al., 2018). A small minority (5%) lost a close family member. Using a cut-off score of 31 on the PTSD Checklist (PCL) (Blevins et al., 2015), 15% (13 out of 86) of the participants scored above the cut-off for PTSD 26 years after the disaster. For the 28 participants which narratives were included in the qualitative analysis, five people scored above the cut-off score of 31 on the PCL.

The participants were asked about trauma exposure before and after the fire. Among the 28 participants three people reported having experienced a life-threatening accident before the fire on the Scandinavian Star. When adding together exposure to different types of violence before the fire on the Scandinavian Star, 20 participants reported having had no experience of any of the types of violence. Only one participant reported having experienced a life-threatening accident after the fire on the Scandinavian Star. When adding together six questions regarding different types of exposure to violence, 25 participants reported having had no such experiences before the fire.

Data collection took the form of face-to-face interviews, combined with questionnaires filled out by the participants on a tablet, with the interviewer available. The interviewers were health personnel; the majority had previous experience with conducting research interviews, and all had participated in a 1 day training seminar for this study. The responses were recorded and transferred in encrypted form to storage within the University of Oslo’s services for sensitive data (TSD). Strict procedures were followed to ensure confidentiality, and the study was approved by the regional committee for medical and health research ethics (REK-nord 2016/1527). The study also included a follow-up service for participants in distress.

2.3. Measures

2.3.1. Trauma narrative

The participants were asked to tell their trauma narrative. More specifically, they were asked to describe what happened from the moment they understood that something was wrong until they were safe. They were not specifically asked about what happened before the fire. The narratives were recorded and later transcribed.

2.4. Analyses

The analysis was carried out in two steps. First, two raters (the first and second authors) coded all of the narratives for the presence of detailed descriptions of what happened before the fire. Next, only the narratives that included descriptions of specific moments before the fire (N = 28) were included in a thematic analysis, focusing on coding the mode and the content of the narratives.

2.4.1. Detailed descriptions of the moments before

Two raters (the first and second authors) read the complete narrative for each participant. All descriptions of what happened before the disaster were identified and coded on level of detail: (1) detailed descriptions of the moments before; and (2) general description of the moments before, or no descriptions of the moments before. Detailed descriptions of the moments before included details of sensory impressions, actions, dialogues, or thoughts. General descriptions of the moments before included brief descriptions of the context, time, and place, but without any detailed information. Those that were coded as ‘no moments before’ included narratives that started at the time of the fire, and descriptions that only briefly stated when and where they were just before the fire started.

The two raters reached a high level of agreement about detailed versus no description/general descriptions of the moments before (Cohen’s kappa .86). The raters reread and came to an agreement on the narratives where there was initial disagreement (five narratives).

2.4.2. Thematic analysis

Detailed descriptions of the moments before were analysed following the principles of thematic analysis, ‘a method for identifying, analysing and reporting patterns (themes) within data’ (Braun & Clarke, 2006, p. 79). Both how the memories of what happened before were described, that is, the narrative mode (e.g. descriptions of sensory impressions), and what these memories were about, that is, the narrative content, was coded. First, the coders carefully read and wrote reflective notes on all parts of the interviews containing specific descriptions of the moments before the disaster. Then, the coders organized the data into meaningful units, codes, in line with Boyatzis’ (1998, p. 63) definition of a code: ‘the most basic segment, or element, of the raw data or information that can be assessed in a meaningful way regarding the phenomenon’. Subsequently, the initial codes were sorted into preliminary themes. The coders then reread the statements multiple times and systematically compared the statements within each theme. Finally, subthemes were discussed, defined, and labelled. The coders also went back to the transcripts and reread the text before making final decisions regarding codes and labels.

3. Results

In total, 28 out of 86 narratives (33%) included detailed descriptions of the hours, minutes, or seconds before the fire on the Scandinavian Star. The remaining 58 narratives (67%) did not include any detailed descriptions of the moments before; some provided a general description of the context, whereas others simply described what happened during the disaster. There was great variation in how long before the fire the episodes described had happened. Ten narratives included descriptions of episodes occurring hours before, whereas 18 narratives included memories of what happened in the minutes or seconds before the fire.

The narratives that included detailed descriptions of the moments before (N = 28) were included in the thematic analysis, focusing on narrative mode and the content of the narratives.

3.1. Narrative mode: how were the memories described?

In the narratives, we identified four categories of narrative mode: (1) sensory impressions, (2) dialogues, (3) thoughts, and (4) actions (self and others). Of note, most narratives were described in more than one mode and sometimes modes were overlapping. For example: ‘Fuck (!), did someone throw cigarette butts or something in there? And then we get a hold of someone from the crew, and they clean up and everything, and then we go to bed’. In such instances, the unit was coded as both dialogue and action.

3.1.1. Sensory impressions

We found that 22 of 28 narratives contained descriptions of sensory impressions from the time before the fire, including visual impressions, auditory impressions, smell, and bodily sensation. In total, 35 units were coded under this category. Several participants described visual impressions of things they noticed when they got on the ferry, in the hallway, or in their cabin; including electrical cords, or that it was dirty and messy. For example, one participant said:

And when we entered the ferry there were loose – loose wires, I mean electrical wires, almost everywhere.

Others described detailed auditory impressions. For example, one participant described having heard two loud sounds before the fire started:

Then I woke up by, I think, hearing two clangs, a lot of people didn’t hear, but I did, and I thought we had arrived in Frederikshavn.

Another participant described noises in the corridor before the fire:

And when I was in bed trying to sleep, some time passed, and suddenly I heard noise and movement in the corridor, and I turn in bed because I hear someone grabbing the door handle. And then, then our door handle turns down, and it slowly goes back up when I turn and look at it. Then there’s a bang, a steel-like bang in the corridor.

Similarly, another participant described the noise of iron on the bridge when entering the ferry:

Yes, it was all loose and unhinged, and there were none of those railings to hold on to. It was one of those where you ascend like this. And it was all iron, I think, it clinked.

A few participants described sensory impressions related to smell, touch, and temperature. For example, one participant described the smell of cigarette smoke when entering his cabin. Another participant described taking off her shoes and noticing that the carpet on the cabin was wet. Two participants described that their cabin was very hot, while another described that it was very cold when they were waiting for the ferry: ‘And that it was cold, it was a cold day and everyone was standing waiting for the ferry to arrive’.

Descriptions of sensory impressions were mainly related to things that were unusual or wrong with the ferry. However, some were related to other unusual observations or experiences. For example, one participant described how she had noticed some beer bottles that apparently had been left behind on the bar counter:

I sat by the bar; I didn’t know if I was finished drinking what I had. I had been drinking alcohol, but I was not drunk by any means. I recall that two or three Tuborg bottles of beer were placed on the bar, and no one was drinking from them.

Another participant described how she found a pair of white socks, which had been left behind in a drawer in her cabin.

3.1.2. Dialogues

Dialogues were described in 21 of the 28 narratives, and altogether 48 units of dialogues were coded. Many of these dialogues were quite detailed and quoted both what the participants themselves and what others had said. Some of the dialogues concerned conversations they had had with their travel partners in the moments before the fire. For example, one participant stated: ‘I said, “Then you and [your friend] can go to bed, I want to stay up and have another beer, because I want to buy the band a drink”’. Another participant said:

And then I won a lot of money, so I actually took my coat with all the coins and said: ‘ I just have to go to my cabin and put this money away, and I’ll be back’.

Of note, some of these dialogues played a key role in what happened later, in the fire. The fire broke out in the middle of the night, and some participants described dialogues with friends or family members who chose to go to bed – and later died in their cabin. Here, one participant refers to a dialogue he had with his wife, who died in the fire: ‘So I said: “Can’t you stay up, there’s entertainment and everything”’. Another participant described a dialogue she had had with a person she travelled with that was significant for her survival:

Then she [the travel companion] said: ‘But aren’t you going to stay and get to know [other people they were travelling with] and wait a while before you go to bed?’ And I thought Okay, I’ll stay for a bit. (Crying) So I didn’t go to bed, but the two others did’.

The two friends who went to bed did not survive the fire.

Others described conversations about a feeling that something was wrong with the ferry, and/or about being hesitant about getting on the ferry. For example, one participant stated:

Then we thought: ‘God, are we going to … ’. We said it out loud: ‘are we going to get to Frederikshavn?’ (…) ‘then we’re bloody lucky, if we get to Frederikshavn by this ferry’.

Others were also joking about the state of the ferry and how something might happen:

And then someone shouted: ‘Hey guys, you’ve – you’ve paid your insurance, right?’ Imagine that! And everyone laughed, because it was really funny, right?

3.1.3. Actions (self and others)

Actions were described by 20 participants, and in total 36 action units were coded. For example, one participant described not being able to fall asleep: ‘I couldn’t sleep, I put my pillow on my stomach and turned against the wall, trying to sleep’. Another participant said:

We had to find somewhere to sleep, so we asked where we could lie down, somewhere quiet. Without, without having a cabin. So, they said: ‘Go to bar in the back of the ferry’. So, we did. We put our bags there, bought a case of beer, put that in the ice machine and, and went out and chilled out in the bar around there somewhere as well, and after a while we went to sleep.

Another participant described, in detail, walking around on the ferry, and recalling the location of the reception, the restaurant, and the shop:

But I remember really well before we were going to the shop and the restaurant that were, at least in my mind they were kind of close to each other, it might not be like that, but I think so any way. Then I remember we walked the wrong way. So we went out of our cabin and then we went to the left and then there was a staircase and then we got up on the deck. Oh, here we are on deck and that was a mistake. Then we went down and we walked towards reception and then we got to the shop and later on the restaurant. And the shop is important to me, because then I discovered that I saw someone I saw later. And the restaurant as well. I ate a little and we had to wait to get seated.

Others described actions that became vital for their survival. For example, one participant who herself had gone to sleep just before the fire, described how someone she knew decided not to sleep in her cabin, because she had been too scared:

And my wife was really desperate, so she sat in the reception area and slept there. So she didn’t want to be in the room. So that was good for us as well. Because it was she who came and woke us up during the fire.

3.1.4. Thoughts (internal monologue)

Internal monologues or thoughts were described in 11 narratives and coded in 16 units. The participants described thoughts about whether to go on the ferry or not (e.g. ‘So I thought I’d turn the car around and disembark’), whether to go to bed or not (e.g. ‘One of my friends, she was usually tired on Fridays so, so she wanted to go to bed. And back then I was really rather shy and modest so, so I thought I would go to bed too. So, so I thought ‘since I’m her friend I’ll go along’), and how they interpreted the first signs that something was wrong/the first signs of fire. For example, one participant said:

And I don’t like cigarette smoke and – there were actually some ashtrays there – back then it was probably normal that one could – well, smoke in the cabins, you know. It’s kind of relevant because, well, when we discovered there was a fire I thought: ‘Oh, it’s probably a cigarette or something’, because there were cigarettes put out in the ashtray in the cabin.

Another participant stated:

And I go into the shower, and all that comes out of it is hot steam. But I don’t think of fire – I’m one of those, a very optimistic person. And I still am, even with this experience. So, all I thought was: ‘What a crappy ship’, pardon my language.

In sum, we found that for some individuals the memories of what happened shortly before the disaster were represented with a high level of detail. There was a variation in narrative mode, and most narratives were represented by more than one mode.

3.2. Narrative content: what were these memories about?

In the thematic analysis of the narrative content, we identified two main themes: (1) unusual observations and danger cues; and (2) counterfactual thoughts.

3.2.1. Unusual observations and danger cues

The majority of the narratives about what happened before the fire (23 out of 28) included incidents or impressions that were perceived as unusual or as potential danger cues onboard the ferry, including loose wires, open electrical cabinets, and doors that were broken or missing. Some participants remembered that they got a strange impression even before boarding the ferry. For example, one participant described an incident where the personnel were unable to throw the hawser ashore:

We did think the ferry was strange before we left. A lot of weird things happened before we even started. (…) … they couldn’t throw the hawser ashore, it went into the water again and again, and we laughed about that because we thought it was lame for a passenger ship.

Another participant described the chaos inside the ferry and the joke they made about it:

Because these things were hanging – it was a building site as well – and there were loose wires, electrical cords, cans of paint, a lot of sheets of fabric lying around. And open elevator shafts. And eh, everything was really disorganized, and it looked like the ship really wasn’t ready for a cruise. But we kind of said that jokingly, and said, ‘anything could happen here’ and well, it did.

Some participants talked about these potential dangers in a descriptive manner, without explicitly mentioning the perception of risk:

I had a new camera, so I walked around taking a few pictures, of the ferry that is, of strange things on the ferry. Like, some things. Well, kind of bizarre stuff. Like open relay cabinets and such things. Very strange, anyone could get an electric shock, like kids and all.

In some of the narratives describing unusual observations onboard the ferry, the details remembered were connected to the fire. For example, one participant described a distinct incident he experienced when dancing, and this episode has probably been strengthened in his memory when, after the fire, the participant became aware that the man involved in the incident was, for a brief period, a suspect:

And my dancing partner, we were swing dancing, and she knocked into a table. And it was that man, the one who was blamed for the fire, who sat there. Then he walked on to the dance floor and grabbed me ‘there’ and everything. I said, ‘what do you want’, and he said ‘you knocked over all the glasses on my table’ so, I want over to his table. ‘But nothing is wet here’, I told him, ‘what a way to behave!’ And then he and the others left and I didn’t see him again that night.

Some survivors indicated that the observations they had made about things that were unusual, or potentially dangerous, with the ferry, gave them a bad feeling and made them think about danger ahead. Such descriptions of forewarnings were coded 14 times, in 10 narratives, and concerned how they or their travel partners feared that something was seriously wrong before the disaster took place. Some of the narratives described how the participants or their travel partners had explicitly stated that they did not want to get on the ferry, or even turned around in the queue to the ferry, but then ended up getting on it after all. For example, one participant said:

Firstly, when the ferry arrived, I thought that there was something strange about it. So – everything – and then we simply turned around in the queue and were going to go by road to [country] instead, because we were going to [country]. But then [the travel companion], he said ‘we’ve paid for it (…), we have to get on the ferry’. So, we returned to the queue and got on the ferry.

Similarly, another participant stated:

The queues were long, and Mozart’s Requiem, a mass, played on the radio. Everything was messy and there was little information. So, finally, we could drive aboard, and we noticed a very makeshift kind of ramp, as I remember it, and a lot of crates and mess. And then my husband said, ‘you know, I don’t think we should do this, Let’s disembark’. And I said ‘Really, we’ve waited for two hours, we’re going aboard’. So, I won that one, but I shouldn’t have. So, so. Everything started there and it went on.

3.2.2. Counterfactual thoughts

In the narratives of what happened before the fire, counterfactual thoughts were described 10 times, coded in 10 units. These counterfactual thoughts represented actions of events that would have resulted in a very different outcome. In some of these narratives, the counterfactual outcome was explicitly stated, whereas in others it was more implicit. Thematically, most of these counterfactual narratives were about downward counterfactuals (i.e. thoughts about how the situation could have turned out even worse), and described the close-call situation they had been in, and how circumstances and coincidences determined that they survived the disaster. For example, one participant described how they changed from their original assigned cabin to another cabin on a higher deck:

All I can remember is when we got aboard the ferry, there was – there was nothing in the reception and there was work being done everywhere, and all I remember is Dad saying, well, that we had to wait – kind of, had a bad feeling, because they said ‘No, we don’t want to stay that low’, they had been down to check and said we wouldn’t stay in the first cabin on a low deck. So luckily, we could exchange for one on a higher deck. And, really, where our first cabin was, I don’t think anyone survived.

Similarly, another participant, travelling with his family and a friend, described in detail how the cabin was not in order, and because of his friend’s efforts he relocated to another cabin. The change of cabin turned out to be critical:

We got assigned a cabin, but it wasn’t in order. We were escorted up on deck and got a cabin at the front of the ship. And as it turned out  …  that exactly the cabin we were assigned first that was destroyed the most by the fire. So I told my friend, the one I travelled with, later on that if you hadn’t been there I don’t know what would have happened. If we had accepted everything as it was. The margins were small and it just wasn’t our time that time.

Another participant said:

But it was insane that – that at the table next to us someone had opened a bottle of wine, and we asked the waiter if we could have it. And if we hadn’t, then we would have gone down – to sleep. In the car. So, that was really dramatic.

A few narratives were about upward counterfactuals (i.e. thoughts about a better outcome), which described the circumstances leading up to the disaster and how details or coincidences led to a tragic outcome. For example, one participant, who lost his partner in the fire, said:

Then she, my partner, wanted to go to the cabin because she had taken travel sickness medicine and she wanted to sleep. I told her: ‘Can’t you please try to stay up and watch the show’, but she couldn’t and went to bed. And I stayed there and watched the show.

In sum, the thematic analysis of the narrative content showed that when recalling what happened before the disaster, many participants had detailed memories about observations that were unusual or about potential danger cues. In some of these narratives, these recollections were described as potential warnings about the danger ahead. Some of the participants reported details from the moments before the disaster that were critical for the actual outcome of the disaster, and for the counterfactual thoughts that they had following the incident.

4. Discussion

This was the first study to explore voluntary recollections of what happened in the moments before a traumatic event. We found that even though 26 years had passed since the disaster on the Scandinavian Star ferry, one-third of the participants reported detailed accounts of what happened in the hours, minutes, or seconds before the fire. These memories included detailed descriptions of sensory impressions, dialogues, actions, and thoughts. In the thematic analysis, two themes stood out: (1) unusual observations and danger cues; and (2) counterfactual thoughts.

The present findings show that for some trauma survivors, experiences that happened or observations that were made shortly before a traumatic event can be vividly recalled, with a great level of detail, after more than two decades. This can be interpreted in line with Knight and Mather’s (2009) suggestion that stimuli with a predictive value for the onset of emotional arousing events are prioritized in memory. As such, the detailed recollections of episodes that happened shortly before the fire may have been prioritized in memory because of their temporal association and potential for predicting the onset of the fire. At the same time, some of these details may have been prioritized because of the perceived danger and emotional arousal associated with these observations and experiences.

According to Ehlers et al. (2002), stimuli that are temporally linked to a traumatic event can be strengthened through associative learning. They reported that narratives describing intrusive memories often consist of stimuli that were present immediately before the traumatic event, or shortly before the moments that had the largest emotional impact. In the present study, we extend their findings by showing that detailed memories of what happened before a traumatic episode are also evident in voluntary memories. Furthermore, we found that many participants described detailed sensory impressions from what happened before the disaster and, similarly to the findings of Ehlers et al. (2002), most were of visual impressions.

Although associative learning may play a role in strengthening memories of what happened before a traumatic event, as suggested by Ehlers et al. (2002), other basic memory processes, such as rehearsal and reconsolidation, probably also play important roles. Humans strive to make sense of the world and to experience a sense of meaning (Heine et al., 2006). The process of trying to make sense of what happened during the fire and creating a coherent autobiographical narrative may have enhanced the rehearsal of some memories. A need for meaning and an understanding of what happened may have promoted the survivors to think and talk about distinct and unusual experiences that happened before the fire. In the present study, several participants described detailed recollections about strange circumstances, some of which were without any explicit reference to potential danger. However, through a process of meaning making, these details may have been strengthened in memory and become central in their narrative about the fire. The memories of what happened before the fire are probably tainted by the traumatic experiences that followed. In line with this, several participants also provided detailed memories about how they interpreted things that were strange or problems with the ferry as forewarnings about the disaster ahead.

Furthermore, exposure to the public debate about the disaster over almost three decades, new information, thoughts, and interpretations of what happened after a delayed period have probably played a key role in the reconsolidation and strengthening of these memories. The special circumstances before the fire on the Scandinavian Star must also be considered when interpreting the present results. The renovation of the boat was not complete and, as a result, parts of the boat appeared messy and things were out of place. In addition, the crew was not familiar with the ferry, and several cabins had been double booked. Many of the details that people recalled about what happened before the disaster were, at least in retrospect, perceived as danger cues. The perceived danger may have strengthened the memory for these details.

Previous research has demonstrated that autobiographical memories from specific episodes serve a directive function, by providing important models for present and future problem solving (Pillemer, 2003). Some of the themes that we identified in the narrative analysis in the present study may serve a directive function. For example, memories of things that were strange or unusual before the disaster can provide directives for the future about what situations to avoid or what clues to look for in the environment. Detailed memories of strange or unusual things that occurred right before a traumatic incident may prompt responses to be alert and aware of danger and avoid such situations in the future.

Counterfactual thoughts were central in some of the memories from the moments before the disaster. These accounts included specific descriptions of actions or details that might have been critical for the actual outcome of the disaster, for themselves or people close to them. In connection to these descriptions, some participants talked about thoughts about what could have happened, or how the incident could have turned out differently. We know from previous research that such counterfactual thoughts tend to arise after traumatic experiences (Blix et al., 2016; Teigen & Jensen, 2010). In a counterfactual narrative, details about what happened just before a disaster can be a determining factor for what could have happened, or how a particular misfortune could have been avoided. This will give meaning to some crucial details, and it is therefore likely that counterfactual thoughts can influence what details we remember from shortly before a traumatic incident.

The present study has some limitations that should be addressed. All of the participants in this study had experienced the same disaster, so the extent to which the present findings are generalizable to other types of traumatic experiences is uncertain. There was a broad age range among the participants in the present study, and we cannot exclude the possibility that there are age-related differences in the tendency to recall what happened before the disaster. The present study relies on trauma narratives constructed in an interview setting and are not necessarily generalizable to how these memories are represented when arising spontaneously in daily life. The way in which the participants were asked about their experiences on the Scandinavian Star may have influenced how they began their story. On the one hand, the participants were not specifically asked about warning signals or about what happened shortly before the fire, and thus it is likely that these types of thoughts are underrepresented. On the other hand, survivors were asked to describe their memories of what happened from the moment when they knew that something was wrong until they were safe, and this way of asking about the trauma narrative may have prompted thoughts about the first signs of danger. Some of the participants in the present study had experienced traumatic incidents prior to the fire on the Scandinavian Star. It is possible that previously experienced trauma can influence how subsequent traumatic experiences are remembered. For example, the ability to perceive and direct attention towards potential danger cues in the environment may be influenced by previous trauma exposure, and this should be addressed in future studies.

The fire started in the middle of the night, when many of the passengers were already sleeping. Many woke up suddenly when the fire broke out. This may also have affected what they recalled from the moments before. The present study cannot establish the accuracy or consistency of these long-lasting memories of what happened shortly before the disaster. It is probable that aspects of these memories have changed over time.

Knowledge about how and what we remember from the moments before a traumatic experience may have important clinical implications. As suggested by Ehlers et al. (2002), warning signals may trigger involuntary, intrusive, and distressing memories of the traumatic event, which can drive PTSD symptom development and chronicity. Clinicians who elicit their patients’ memories about the moments before, as well as the actual traumatic event, may gain a better understanding about the inner logic of the content of their patients’ maladaptive thoughts, which may be useful during the reprocessing of the traumatic event in treatment.

Furthermore, according to the predictive processing perspective (Kube et al., 2020), sensory information with survival value may also lead to overly general beliefs (e.g. ‘The world is not safe’), which can be quite resistant to later disconfirmatory evidence and may contribute to the maintenance of PTSD symptoms. This may be particularly evident in situations where perceiving warning signals and acting upon these may have consequences for the survival of other people. For example, when an individual did not act according to a warning signal (e.g. did not try to stop her friend going to bed, resulting in her friend’s death), she may perceive herself as unable to act protectively when confronted with danger. This can stimulate thoughts of the world as dangerous and oneself as incompetent, and hence carry the threat forward in time and contribute towards the development of PTSD.

The warning signal hypothesis needs to be further explored in longitudinal and experimental studies. There is a need for research to establish the association between warning signals and intrusive memories. Future research should investigate the relationship between this type of memory and post-traumatic stress symptoms, and whether targeting such memories in therapy might prove to be beneficial to reduce intrusions. There is also a need to examine how trauma memories form; for example, the role of counterfactual thoughts in construing memories of traumatic episodes. Future studies that examine how memories of what happened prior to trauma may lead to general maladaptive thoughts, including thoughts about guilt and shame, as well as rumination, may provide knowledge that is useful in designing interventions that may prevent such early thoughts from developing into PTSD, or help to reduce PTSD symptoms in those who have developed it.

5. Conclusion

In summary, our results indicate that specific details from the moments before a traumatic event may be vividly recalled. Our results document that memories dating back 26 years for some individuals can be experienced with a high level of detail, even for aspects of the incident that do not seem central. The present finding, that some trauma-exposed individuals spontaneously include detailed actions, dialogues, thoughts, and sensory impressions from the moments before the disaster in their trauma narrative, indicates that peripheral details of traumatic events can be prioritized in memory. This can be interpreted in line with the warning signal hypothesis.

Disclosure statement

No potential conflict of interest was reported by the authors.

Data availability statement

The data cannot be made available because of the personal and sensitive content of participants’ experiences.

Additional information

Funding

This work was supported by the independent commission for the Scandinavian Star case, appointed by the Norwegian Parliament. The commission had no role in the study, and the funding was unconditional.