Edvard Hauff

• Mainali, Anustha; Søegaard, Erik Ganesh Iyer; Hauff, Edvard & Thapa, Suraj Bahadur (2024). A comparative study of comorbidities, symptom profiles, and childhood trauma in PTSD and non-PTSD trauma patients at Oslo University Hospital. Nordic Journal of Psychiatry. ISSN 0803-9488. p. 1–8. doi: 10.1080/08039488.2024.2415306. Full text in Research Archive Show summary

  Purpose To explore the differences in mental health symptom profiles, trauma profiles, childhood trauma and comorbidities in patients with PTSD and those without PTSD. Materials and methods A cross-sectional study was carried out on 110 adult patients with trauma backgrounds attending a mental health outpatient clinic in Southern Oslo, Norway. In addition to self- report questionnaires, several standardized validated diagnostic tools were used to assess mental disorders. Multiple linear regression models were used to assess the association between trauma history, the mental health symptom profile of the patients, and PTSD diagnosis. Bivariate logistic regression was used to examine if childhood trauma/adversities were associated with PTSD. Results Patients diagnosed with PTSD had significantly higher rates of comorbid major depressive disorder, panic disorder, agoraphobia disorder, and social phobia compared to those without PTSD. We also found a positive association between PTSD diagnosis and all the different mental health symptoms domains of the Symptom Checklist-90-Revised instrument. When adjusted for age, gender, education, smoking habits, immigration, relationship, and employment status, these associations persisted with varying effects. We did not find any association between PTSD and childhood trauma/adversities, however, sexual abuse trended towards an association. Conclusion Adult trauma patients with PTSD may have more comorbid disorders and mental health symptoms. Childhood trauma may be less critical for the PTSD diagnosis in this group. In clinical practice, personalized treatment plans addressing both the symptom burden and its comorbidities may be beneficial.

• Koirala, Rishav; Aass, Hans Christian; Søegaard, Erik Ganesh Iyer; Dhakal, Hari Prasad; Ojha, Saroj Prasad & Hauff, Edvard [Show all 7 contributors for this article] (2023). Association of pro-inflammatory cytokines with trauma and post-traumatic stress disorder visiting a tertiary care hospital in Kathmandu. PLOS ONE. 18(2). doi: 10.1371/journal.pone.0281125. Full text in Research Archive Show summary

  Post-traumatic stress disorder (PTSD) is a mental disorder that can occur after trauma. Although inflammatory markers such as cytokines are found altered in trauma and PTSD, there is no consensus regarding which can be considered as biomarkers. Studies from South Asia region is also rare. We studied cytokines among trauma affected patients and matched healthy controls. Fifty patients (cases) with trauma, visiting the University hospital in Kathmandu and thirty-nine healthy controls were selected, and the levels of cytokines were determined using a Luminex IS 200. We compared the levels of the cytokines in thirty-four age and gender matched pairs of case and control among three groups: healthy volunteers, cases diagnosed as PTSD, and cases without PTSD. Among the 34 pair-matched cases and controls, IL-6 was significantly higher in both PTSD positive cases [2.43 (0.00–14.54) pg/ml; p = 0.004] and PTSD negative cases [3.00 (0.92–3.86) pg/ml; p = 0.005], than in controls [0.39 (0.00–11.38) pg/ml]. IL-1β was significantly higher in PTSD positive cases [0.17 (0.00–5.27) pg/ml; p = 0.011] than in controls 0.00 (0.00–0.12) pg/ml. Other cytokines did not show significant differences. IL-6 was higher in both the trauma affected groups and IL-1β was higher in the trauma affected group with PTSD when compared to healthy controls. This supports the immune system activation hypothesis after trauma.

• Søegaard, Erik Ganesh Iyer; Kan, Zhanna; Aass, Hans Christian Dalsbotten; Koirala, Rishav; Hauff, Edvard & Thapa, Suraj (2022). Abnormal Cytokines in Trauma Patients Explained by Obesity, Musculoskeletal Disease, Smoking, and Lung Disease. Neuropsychobiology. ISSN 0302-282X. 81(6), p. 516–530. doi: 10.1159/000526806. Full text in Research Archive Show summary

  Introduction: Low-grade inflammation observed through abnormal plasma cytokine levels has been associated with post-traumatic stress disorder (PTSD). It is not clear whether PTSD independently causes the inflammation or if it is mainly through co-occurring somatic factors such as smoking and obesity. We wanted to explore the effects of biopsychosocial factors on cytokine levels in a clinical setting. Methods: The sample consisted of 51 patients with PTSD, 58 trauma patients without PTSD, and 40 matched controls. We selected cytokines and relevant risk factors for systemic inflammation through pairwise correlations. Then, we used linear regression to analyze the individual and combined effects of these on the (Log10) cytokines, particularly estimating the effect of PTSD adjusted for other factors. Results: Higher age, female gender, cigarette smoking, presence of lung and musculoskeletal disease, use of antipsychotic medication, and higher BMI were correlated with higher levels of interleukins IL-1RA, IL-2RA, and IL-6. In the adjusted regression analysis, higher BMI was associated with increased IL-1RA (B = 0.06, p < 0.01), IL-2RA (B = 0.01, p < 0.01), and IL-6 (B = 0.01, p = 0.03). Presence of musculoskeletal disease was associated with increased IL-1RA (B = 0.72, p < 0.01) and IL-6 (B = 0.16, p = 0.01), and decreased IL-2RA (B = −0.09, p < 0.01). Cigarette smoking (B = 0.16, p = 0.01) and presence of lung disease (B = 0.14, p = 0.02) were associated with increased IL-6. PTSD diagnosis was associated with decreased IL-2RA (B = −0.06, p = 0.04). Discussion/Conclusion: Altered cytokine levels in distressed trauma-affected individuals are probably mostly through co-occurring risk factors and not PTSD diagnosis. Increased BMI and musculoskeletal (pain) disease may be particularly strong risk factors and should be addressed.

• Sanhori, Zeinat Balla Mohamed Ahmed; Lien, Lars; Hauff, Edvard; Ayazi, Touraj; Mdala, Ibrahimu & Eide, Arne Henning (2022). Change in Disability Associated with Psychological Distress among Internally Displaced Persons in Central Sudan. International Journal of Environmental Research and Public Health (IJERPH). ISSN 1661-7827. 19(9). doi: 10.3390/ijerph19095347. Full text in Research Archive Show summary

  Individuals with disabilities are particularly vulnerable in conflict settings, and a high rate of psychopathology is well documented among persons with disabilities. The objective of this study was to explore the change in disability prevalence among IDPs in two settlement areas in central Sudan and the association between disability and psychological distress. In this one-year follow-up study, 1549 IDPs were interviewed twice using the General Health Questionnaire (GHQ) to investigate emotional distress. Disability was measured using the Washington Group Short Set. Households were randomly selected using the community health center as the starting point. All household members above eighteen years of age in the sampled households were interviewed. There is an increase in disability prevalence among internally displaced persons over time, associated with rural residency and poverty, low education, unemployment, IDP status, originating from western Sudan, young age, male gender, and being married. Disability was further found to be associated with psychological distress. Disability among displaced persons should be considered as a risk factor for increase in psychopathological disorders and is closely related to poverty. The study is limited to individual-level data and does not incorporate relevant environmental variables that may have influenced the changes in disability rates.

• Abraham, Ruth; Leonhardt, Marja; Lien, Lars; Hanssen, Ingrid; Hauff, Edvard & Thapa, Suraj Bahadur (2021). The relationship between religiosity/spirituality and quality of life among female Eritrean refugees living in Norwegian asylum centres. International Journal of Social Psychiatry. ISSN 0020-7640. doi: 10.1177/00207640211010207. Full text in Research Archive Show summary

  Background: Women are more vulnerable to mental health problems than men after migration, but little is known about the influence of religiosity/spirituality on their quality of life. The purpose of this study was to explore religiosity/spirituality, in relationships with various domains of quality of life, among female Eritrean refugees staying in Norwegian asylum centres. Method: A questionnaire assessing sociodemographic characteristics was used together with the World Health OrganizationQuality of Life – Spirituality, Religiosity and Personal Beliefs (WHOQOL-SRPB) questionnaire, which assesses religiosity/spirituality and domains of quality of life. A total of 63 adult female Eritrean refugees who had been granted asylum but were still living in asylum reception centres located in southern and central Norway participated. Results: Religiosity/spirituality was independently associated with psychological quality of life (B = 0.367, p < .001), level of independence (B = 0.184, p = .028), social quality of life (B = 0.500, p = .003), environmental quality of life (B = 0.323, p < .001) and overall quality of life (B = 0.213, p < .001), but not with physical quality of life (B = 0.056, p = .679). There were no significant differences between religious affiliations on religiosity/spirituality or quality of life measures. Conclusion: Consistent with previous research, this study highlights the correlation between religiosity/spirituality and overall quality of life. We recommend a longitudinal follow-up study of similar populations, after they are resettled and integrated into their host countries, to understand the associations between quality of life and religiosity/spirituality over time. Keywords Eritrea, refugees, religiosity, spirituality, quality of life, well-being

• Koirala, Rishav; Søegaard, Erik Ganesh Iyer; Kan, Zhanna; Ojha, Saroj Prasad; Hauff, Edvard & Thapa, Suraj (2021). Exploring complex PTSD in patients visiting a psychiatric outpatient clinic in Kathmandu, Nepal. Journal of Psychiatric Research. ISSN 0022-3956. 143, p. 23–29. doi: 10.1016/j.jpsychires.2021.08.030. Full text in Research Archive Show summary

  Decades of research on trauma patients have shown that a post-traumatic stress disorder (PTSD) diagnosis does not always cover the full spectrum of symptoms after severe trauma. Complex PTSD (CPTSD) was recently introduced in the International Classification of Diseases 11th Revision. There have been no published studies on CPTSD in the South Asian region to date. The objective of this study was to evaluate CPTSD in a sample of trauma patients in Nepal. We also examined quality of life (QOL) and mental health comorbidities and their association with CPTSD caseness. One hundred patients with a history of trauma who visited the outpatient psychiatry clinic at a hospital in Kathmandu from 2017 to 2018 were assessed. The Composite International Diagnostic Interview Version 2.1 was used to evaluate PTSD, major depressive disorder, and generalized anxiety disorder (GAD). Disturbance of self-organization symptoms from the Structured Interview for Disorders of Extreme Stress (SIDES) together with the PTSD diagnosis was used to confirm CPTSD caseness. The World Health Organization (WHO) QOL Scale Brief Version (WHOQOL-BREF) was used to assess QOL in four domains. Among the 83 patients who had PTSD, 42 also had CPTSD. CPTSD was significantly associated with major depressive disorder, GAD, female gender, and lower QOL in all four domains. CPTSD was prevalent among these patients. Having CPTSD was significantly associated with worse outcomes in terms of QOL and comorbid mental disorders, even with similar trauma. There is a need to explore CPTSD symptoms and to address trauma patients with CPTSD in this region.

• Søegaard, Erik Ganesh Iyer; Kan, Zhanna; Koirala, Rishav; Hauff, Edvard & Thapa, Suraj Bahadur (2021). Gender differences in a wide range of trauma symptoms after victimization and accidental traumas: a cross-sectional study in a clinical setting. European Journal of Psychotraumatology. 12(1), p. 1–13. doi: 10.1080/20008198.2021.1975952. Full text in Research Archive Show summary

  Background There are large gender differences in PTSD prevalence. Gender differences in a wide range of trauma symptoms including disturbances in self-organization have not been extensively researched. Objective To explore gender differences in a wide range of trauma symptoms by comparing victimization trauma (VT) with accidental trauma (AT). Method A cross-sectional study of 110 traumatized patients attending a mental health outpatient clinic in Oslo, Norway (38.2% men, Mage = 40.4, 40% ethnic Norwegians). The trauma was categorized as VT or AT based on the Life Events Checklist. The Structured Clinical Interview for DSM-IV-PTSD-module and Structured Interview for Disorders of Extreme Stress Not-Otherwise-Specified (DESNOS) assessed a wide range of trauma symptoms. First, we examined gender differences within the trauma categories, then MANCOVA for an adjusted two-by-two between-groups analysis. Results Among VT patients, men reported more symptoms of alteration of negative self-perception (p = .02, ES = 0.50) and alteration in systems of meaning (p < .01, ES = 1.04). Within the AT group, women reported more symptoms of affect and impulses (p = .01, ES = 0.94). The VT-AT difference was significantly higher in men in intrusion (p < .01, η2 = 0.04), affect and impulses (p < .01, η2 = 0.12), negative self-perception (p < .01, η2 = 0.11), difficulty in relations (p = .01, η2 = 0.10) and alterations in systems of meaning (p = .01, η2 = 0.14). Conclusion: Comparing the VT-AT differences between the genders, men with VT had relatively more symptoms of intrusion, self-organization, identity, ideology/meaning, cognition, and relations difficulties. Effect sizes were moderate to large. Men may be relatively more vulnerable to VT than AT, while women may be more equally affected by VT and AT. Acknowledging possible gender differences in a wider range of trauma symptoms depending on trauma category may have clinical benefits

• Koirala, Rishav; Søegaard, Erik Ganesh Iyer; Ojha, Saroj Prasad; Hauff, Edvard & Thapa, Suraj B. (2020). Trauma related psychiatric disorders and their correlates in a clinical sample: A cross-sectional study in trauma affected patients visiting a psychiatric clinic in Nepal. PLOS ONE. 15(6), p. e0234203–e0234203. doi: 10.1371/journal.pone.0234203. Full text in Research Archive Show summary

  Background Nepal, like many other low-income countries, has a great burden of mental health issues but few resources to meet them. In addition, Nepal has endured several traumatic events in recent decades but the impact on mental health has not been studied in clinical settings. This study explores trauma-related psychiatric disorders and their correlates. Methods 100 patients with a history of trauma who visited the outpatient psychiatry clinic at a University hospital in Kathmandu were assessed. The Composite International Diagnostic Interview 2.1 (CIDI) was used to evaluate lifetime and current depressive disorder, generalized anxiety disorder (GAD) and lifetime post-traumatic stress disorder (PTSD). Current PTSD was evaluated using PSTD Checklist—Civilian Version (PCL-C). Results The median number of lifetime traumatic events was two. Natural disaster was the most common trauma type (84%) compared to other types of trauma. Rape was reported as the most traumatizing. Current PTSD was found in 15%, depression in 33% and GAD in 38% of the patients. The lifetime rates were PTSD 83%, depression 45% and GAD 40%. There was high comorbidity between the disorders. The 31 to 45 years age group, above high school education level and trauma types other than earthquake were independently associated with current PTSD. Marital status and upper socioeconomic status (SES) compared to upper-middle SES were independently associated with lifetime PTSD. Both lifetime and current depression rates were independently associated with the upper SES compared to upper-middle SES. Place of living, education above high school and lower-middle SES were significantly associated with lifetime and current GAD. Conclusion PTSD, depression and GAD were prevalent in a trauma exposed patient population visiting a psychiatric clinic in Nepal. High rates of comorbidities and several risk factors were identified. Our findings highlight the need for addressing trauma related disorders in clinical settings in developing countries.

• Fausiah, Fitri; Turnip, Sherly Saragih & Hauff, Edvard (2020). Gender differences and the correlates of violent behaviors among high school students in a post-conflict area in Indonesia. Asia-Pacific Psychiatry. ISSN 1758-5864. 12(3). doi: 10.1111/appy.12383. Full text in Research Archive
• Sanhori, Zienat Balla Mohamed Ahmed; Hauff, Edvard; Eide, Arne Henning; Mdala, Ibrahimu; Abdelrahman, Abdullah & Brunborg, Cathrine [Show all 7 contributors for this article] (2020). Changes in prevalence of mental disorders among internally displaced persons in central Sudan: a 1-year follow-up study. Cambridge Prisms: Global Mental Health (GMH). 7. doi: 10.1017/gmh.2020.16. Full text in Research Archive Show summary

  Background Sudan has one of the largest numbers of internally displaced persons (IDPs) in the world, estimated at five million. The main cause of displacement was the civil war. Attention to the health and in particular the mental health of IDPs has been lacking. That includes limited population longitudinal data describing the “natural” fluctuations of mental morbidity among these groups. The aim of this study is to investigate the level and stability of mental disorders among IDPs over a 1-year period. Method In this 1-year follow-up of IDPs in two settlement areas in central Sudan, 1549 persons 18 years or older were interviewed twice using the MINI International Neuropsychiatric Interview. Trained psychologists collected the data in a random household survey in the selected IDP areas. Results We found overall high stability among those having and those free of mental disorders in this 1-year follow-up study. There were, however, discernible and statistically significant increases in overall new cases of mental disorders from T1 to T2 as major depression increased by 1.4%, generalized anxiety by 2.8% and social phobia by 1.4%. Conclusion The study revealed continued high levels and increases of mental disorders over time, although with a pattern of substantial persistence among those initially ill and limited recovery. This might be due to a complex set of factors such as unavailability of mental health services, poverty, low educational level and social exclusion.

• Søegaard, Erik Ganesh Iyer; Kan, Zhanna; Koirala, Rishav; Hauff, Edvard & Thapa, Suraj Bahadur (2020). Variations in psychiatric morbidity between traumatized Norwegian, refugees and other immigrant patients in Oslo. Nordic Journal of Psychiatry. ISSN 0803-9488. 74(6), p. 390–399. doi: 10.1080/08039488.2020.1714724. Full text in Research Archive Show summary

  Background: There is a lack of clinical studies that focus on different psychiatric disorders after trauma and the relationship with migration status. Purpose: To examine differences in psychiatric morbidity in traumatized patients referred to psychiatric treatment in Southern Oslo. Materials and methods: Hundred and ten patients with trauma background attending an outpatient clinic in Southern Oslo were studied. Forty-four of the participants (40%) were ethnic Norwegians, 25 (22.7%) had refugee background and 41 (37.3%) were first- or second-generation immigrants without refugee background. Thorough diagnostic assessment was done by experienced psychiatrists through several structured clinical interviews and self-report questionnaires. Results: Ninety-eight patients (89%) were diagnosed with at least one Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision (DSM-IV-TR) disorder. There was a clear difference in the presentation of certain psychiatric disorders between the groups. Ethnic Norwegian patients were more likely to have anxiety disorders: agoraphobia, social phobia and panic disorder than non-refugee immigrant patients. They also had higher rates of alcohol abuse/dependence. Somatoform pain disorder was more common in both the refugee and other-immigrant groups than among the ethnic Norwegian patients. The refugee patients had significantly more major depressive disorder, post-traumatic stress disorder (PTSD) and both co-occurring. Conclusion: Trauma is frequently associated with depression, anxiety disorders, somatoform pain disorder and PTSD in a clinical population. The clinical presentation and comorbidity of these disorders seem to vary significantly between traumatized patients with Norwegian, refugee and non-refugee immigrant backgrounds. After a major trauma, refugees may be at greater risk for both PTSD and depression than other immigrants and the native population.

• Fausiah, Fitri; Turnip, Sherly Saragih & Hauff, Edvard (2019). Community violence exposure and determinants of adolescent mental health: A school-based study of a post-conflict area in Indonesia. Asian Journal of Psychiatry. ISSN 1876-2018. 40, p. 49–54. doi: 10.1016/j.ajp.2019.01.020. Full text in Research Archive Show summary

  Introduction Studies have shown the adverse impact of exposure to community violence on adolescent health. However, most of the studies were conducted in high-income countries. This study aimed at assessing the community violence exposure and the determinants of mental health problems among adolescents in Ambon, a post-conflict area in Indonesia. Material and methods We conducted a cross-sectional, school-based study involving 511 of 10th-graders from six randomly selected high schools in Kotamadya Ambon. Our participants were assessed using a set of questionnaires including the Strength Difficulties Questionnaire (SDQ) to measure mental health problems, and the child version of the Screen for Adolescent Violence Exposure (KID-SAVE) to measure community violence exposure. The hierarchical regression analyses were used to explore the determinants of mental health problems. Results In this study, boys reported more exposure to community violence (both in frequency and severity) than girls. Meanwhile, the girls reported higher emotional problems than boys. The hierarchical regression analyses revealed that in the total sample and among boys, the community violence exposure was associated with mental health problems. However, it was the perceived impact of community violence exposure which showed an association with mental health problems among girls. Conclusions This study revealed the high community violence exposure among adolescents living in a post-conflict setting in Indonesia. The study also found gender differences in the determinants of mental health problems among adolescents who were exposed to CVE.

• Siqveland, Johan; Hauff, Edvard; Ruud, Torleif & Brennen, Timothy John (2018). Posttraumatic stress and autobiographical memory in chronic pain patients. Scandinavian Journal of Pain. ISSN 1877-8860. doi: 10.1515/sjpain-2018-0044. Full text in Research Archive
• Siqveland, Johan; Hussain, Ajmal; Lindstrøm, Jonas Christoffer; Ruud, Torleif & Hauff, Edvard (2017). Prevalence of posttraumatic stress disorder in persons with chronic pain: A meta-analysis. Frontiers in Psychiatry. 8:164, p. 1–9. doi: 10.3389/fpsyt.2017.00164. Full text in Research Archive Show summary

  Objective: To summarize evidence for the prevalence of posttraumatic stress disorder (PTSD) among persons with chronic pain (CP). Methods: We searched databases for studies published between January 1995 and December 2016, reporting the prevalence of PTSD in persons with CP. Two reviewers independently extracted data and assessed the risk of bias. We calculated the pooled prevalence using a random-effects model and performed subgroup analyses according to pain location, the population and assessment method. Results: Twenty-one studies were included and the PTSD prevalence varied from 0–57%, with a pooled mean prevalence of 9.7%, 95% CI (5.2–17.1). In subgroup analysis, the PTSD prevalence was 20.5%, 95% CI (9.5–39.0) among persons with chronic widespread pain, 11.2%, 95% CI (5.7–22.8) among persons with headache, and 0.3%, 95% CI (0.0–2.4) among persons with back pain. The prevalence in clinical populations was 11.7%, 95% CI (6.0–21.5) and in non-clinical populations 5.1%, 95% CI (0.01–17.2). In studies of self-reported PTSD symptoms, PTSD prevalence was 20.4%, 95% CI (10.6–35.5), and in studies where structured clinical interviews had been used to assess PTSD its prevalence was 4.5%, 95% (CI 2.1–9.3). The risk of bias was medium for most studies and the heterogeneity was high (I2 = 98.6). Conclusion: PTSD is overall more prevalent in clinical cohorts of persons with CP and particularly in those with widespread pain, but may not always be more prevalent in non-clinical samples of persons with CP, compared to the general population. There is a large heterogeneity in prevalence across studies. Future research should identify sources of heterogeneity and the mechanisms underlying the comorbidity of the two conditions.

• Kjøsnes, Ragnhild; Waal, Helge; Hauff, Edvard & Gossop, Michael (2017). Severe trauma among substance users in opioid maintenance treatment: Users? assessment of worst trauma and clinical assessment of PTSD. Heroin Addiction and Related Clinical Problems. ISSN 1592-1638. 19(1), p. 5–12. Full text in Research Archive
• Siqveland, Johan; Ruud, Torleif & Hauff, Edvard (2017). Post-traumatic stress disorder moderates the relationship between trauma exposure and chronic pain. European Journal of Psychotraumatology. 8(1). doi: 10.1080/20008198.2017.1375337. Full text in Research Archive Show summary

  Background: Trauma exposure and post-traumatic stress disorder (PTSD) are risk factors for chronic pain. Objective: This study investigated how exposure to intentional and non-intentional traumatic events and PTSD are related to pain severity and outcome of treatment in chronic pain patients. Methods: We assessed exposure to potentially traumatizing events, psychiatric diagnosis with structured clinical interview, and pain severity in 63 patients at a secondary multidisciplinary pain clinic at the beginning of treatment, and assessed level of pain at follow up. Exposure to potentially traumatizing events and PTSD were regressed on pain severity at the initial session and at follow up in a set of multiple regression analysis. Results: The participants reported exposure to an average of four potentially traumatizing events, and 32% had PTSD. Exposure to intentional traumatic events and PTSD were significantly associated with more severe pain, and PTSD significantly moderated the relationship between trauma exposure and pain (all p < .05). The treatment programme reduced pain moderately, an effect that was unrelated to trauma exposure and PTSD. Conclusions: Trauma exposure is related to chronic pain in the same pattern as to mental disorders, with intentional trauma being most strongly related to pain severity. PTSD moderated the relationship between trauma exposure and pain. While pain patients with PTSD initially report more pain, they responded equally to specialist pain treatment as persons without PTSD.

• Hagen, Christina; Lien, Lars; Hauff, Edvard & Heir, Trond (2016). Mindfulness, Sustained Attention and Post-traumatic Stress in Tsunami Survivors. PSYCHOLOGY AND COGNITIVE SCIENCES. ISSN 2380-727X. 2 (2 ), p. 54–63. doi: 10.17140/PCSOJ-2-115. Full text in Research Archive
• Ayazi, Touraj; Swartz, Leslie; Eide, Arne Henning; Lien, Lars & Hauff, Edvard (2016). Psychotic-like experiences in a conflict-affected population: a cross-sectional study in South Sudan. Social Psychiatry and Psychiatric Epidemiology. ISSN 0933-7954. 51(7), p. 971–979. doi: 10.1007/s00127-016-1243-2. Full text in Research Archive Show summary

  Purpose This study investigates the prevalence of psychotic- like experiences (PLEs) and examines exposure to potentially traumatic events and other relevant risk factors for PLEs in the general population of a conflict-affected, low-income country. Methods We conducted a cross-sectional community based study of four Greater Bahr el Ghazal States, South Sudan (n = 1200). The Harvard Trauma Questionnaire was applied to investigate exposure to potentially traumatic events. The Mini-International Neuropsychiatric Interview was used to detect PLEs. Results The estimated prevalence of lifetime PLEs was 23.3 % and the rate of PLEs which were evaluated as bizarre was 9.5 %. Exposure to higher number of potentially traumatic events, younger age, rural residency, being unemployed, not having a regular income and having traditional religion were significantly associated with having PLEs. PLEs were significantly associated with reporting of psychological distress when controlling for other covariates. Conclusions The finding of association between traumatic exposure and PLEs calls for greater attention to the diversity of negative mental health outcomes in conflictaffected populations.

• Hagen, Christina; Lien, Lars; Hauff, Edvard & Heir, Trond (2016). Is mindfulness protective against PTSD? A neurocognitive study of 25 Tsunami disaster survivors. Journal of Negative Results in Biomedicine (JNRBM). 15(1). doi: 10.1186/s12952-016-0056-x. Full text in Research Archive Show summary

  Background: It has been suggested that mindfulness is a protective factor that buffers individuals from experiencing severe posttraumatic stress following exposure to a trauma. We aimed to examine the association between dispositional (trait) mindfulness and posttraumatic stress in individuals who had been exposed to the trauma of a natural disaster. Method: A disaster group (n = 25) consisting of Norwegian tourists who survived the 2004 South East Asian tsunami at a location with high mortality rates was recruited. Dispositional mindfulness and posttraumatic stress were measured with the Five-Facet Mindfulness Questionnaire and the Impact of Event Scale-Revised Version, respectively. Results: There was no significant association between mindfulness and posttraumatic stress. Moreover, there were no significant associations between posttraumatic stress and the mindfulness sub-facets of observing, acting with awareness, non-judging, and non-reacting. However, there was a significant positive correlation between the descriptive factor of mindfulness and IES-R total. There were no significant linear correlations between the five sub-facets of mindfulness and the three categories of posttraumatic symptoms, intrusion, avoidance and hyper-arousal. Conclusions: Our findings do not indicate a relationship between dispositional mindfulness and posttraumatic stress levels after exposure to a trauma, except for the descriptive sub-facet of mindfulness and here the correlation is positive and not negative as would be expected if mindfulness is a protective factor for posttraumatic stress. Future studies should investigate the relationship between mindfulness and posttraumatic stress while accounting for factors such as trauma history, type of trauma, and individual differences in traumatic stress reactions.

• Nilsen, Andre Sevenius; Hilland, Eva; Kogstad, Norunn; Heir, Trond; Hauff, Edvard & Lien, Lars [Show all 7 contributors for this article] (2016). Right temporal cortical hypertrophy in resilience to trauma: an MRI study. European Journal of Psychotraumatology. 7. doi: 10.3402/ejpt.v7.31314. Full text in Research Archive Show summary

  Background: In studies employing physiological measures such as magnetic resonance imaging (MRI), it is often hard to distinguish what constitutes risk-resilience factors to posttraumatic stress disorder (PTSD) following trauma exposure and what the effects of trauma exposure and PTSD are. Objective: We aimed to investigate whether there were observable morphological differences in cortical and sub-cortical regions of the brain, 7–8 years after a single potentially traumatic event. Methods: Twenty-four participants, who all directly experienced the 2004 Indian Ocean Tsunami, and 25 controls, underwent structural MRI using a 3T scanner. We generated cortical thickness maps and parcellated sub-cortical volumes for analysis. Results: We observed greater cortical thickness for the trauma-exposed participants relative to controls, in a right lateralized temporal lobe region including anterior fusiform gyrus, and superior, middle, and inferior temporal gyrus. Conclusions: We observed greater thickness in the right temporal lobe which might indicate that the region could be implicated in resilience to the long-term effects of a traumatic event. We hypothesize this is due to altered emotional semantic memory processing. However, several methodological and confounding issues warrant caution in interpretation of the results.

• Turnip, Sherly Saragih; Sörbom, D & Hauff, Edvard (2016). Predicting positive mental health in internally displaced persons in Indonesia: the roles of economic improvement and exposure to violent conflict. Psychology, Health & Medicine. ISSN 1354-8506. 21(3), p. 286–294. doi: 10.1080/13548506.2015.1051554. Full text in Research Archive
• Lien, Lars; Hauff, Edvard; Martinez, Priscilla; Eide, Arne Henning; Swarts, Leslie & Ayazi, Touraj (2016). Alcohol use in South Sudan in relation to social factors, mental distress and traumatic events. BMC Public Health. 16(937). doi: 10.1186/s12889-016-3605-9. Full text in Research Archive Show summary

  Background Alcohol use is a major public health problem with vast implications for poor, war-torn countries. The objective of this study was to describe prevalence of alcohol use and risky drinking across socio-demographic factors in South Sudan, and to determine the association between risky drinking, traumatic events and mental distress. Methods This is a randomized, population based, cross-sectional study from the north-western part of South Sudan with nearly 500 participants. We used the Alcohol Use Disorders Identification Test (AUDIT) as main outcome variable, the General Health Questionnaire (GHQ-28) for mental distress and five questions to assess traumatic events. Results The mean AUDIT score was 2.7 (SD 0.3) with 14,2 % in the high risk problem drinking category. Being male, lack of a regular income and psychological distress were significantly associated with higher AUDIT score. Traumatic events, however, was not associated with higher score on AUDIT. Conclusion Despite decades of civil war and great poverty the alcohol use in this population was at the same level as other countries in Southern Africa. Traumatic events were not related to risk of problem drinking.

• Skogstad, Laila; Heir, Trond; Hauff, Edvard & Ekeberg, Øivind (2016). Post-traumatic stress among rescue workers after terror attacks in Norway. Occupational Medicine. ISSN 0962-7480. 66(7), p. 528–535. doi: 10.1093/occmed/kqw063. Full text in Research Archive
• Ayazi, Touraj; Swartz, Leslie; Eide, Arne Henning; Lien, Lars & Hauff, Edvard (2015). Perceived current needs, psychological distress and functional impairment in a war-affected setting: a cross-sectional study in South Sudan. BMJ Open. 5(8). doi: 10.1136/bmjopen-2014-007534. Full text in Research Archive Show summary

  Objectives To examine the current perceived needs of the general population in a war-affected setting, and to study the influence of perceived needs on the participants’ mental health status and functional impairment across genders. Methods A cross-sectional community survey (n=464) was conducted in war-affected South Sudan. Three regression models were analysed. Perceived needs were assessed with the Humanitarian Emergency Settings Perceived Needs Scale. Psychological distress was measured with the General Health Questionnaire and level of functioning by the Short Form Health Survey (SF-12). Results The most frequently expressed needs were related to drinking water, alcohol and drug use in the community and access to sanitation facilities. No gender differences were found regarding the level of perceived needs or the number of traumatic events. Higher level of perceived needs significantly predicted psychological distress and lower level of functioning even when numbers of experienced trauma events were taken into account. Conclusions The associations of higher level of needs and trauma experiences, on the one hand, and negative health outcomes on the other, necessitate a greater integration of interventions directed towards the population's perceived needs and mental health, particularly for those who have been exposed to trauma.

• Salah, Tarig; Ayazi, Touraj; Lien, Lars; Eide, Arne Henning & Hauff, Edvard (2015). Social phobia among long-term internally displaced persons: An epidemiological study of adults in two internally displaced person settlements in Sudan. International Journal of Social Psychiatry. ISSN 0020-7640. 61(6), p. 550–559. doi: 10.1177/0020764014564800. Full text in Research Archive Show summary

  Background: Despite the high worldwide prevalence and association with other mental disorders and disability, only few studies are available on social phobia in low-income countries. Aims: This study aims to assess the prevalence, socio-demographic correlates and comorbidity of social phobia and its association with disability among long-term internally displaced persons (IDPs) in one urban and one rural area in Central Sudan. Methods: This cross-sectional study was implemented in two IDP areas in Central Sudan. Data were collected during face-to-face interviews using structured questionnaires to assess socio-demographic factors and the Mini International Neuropsychiatric Interview (MINI) to determine psychiatric diagnoses. A total of 1,876 adults were enrolled from both study areas. Results: The overall lifetime prevalence of social phobia was 14.2%, with higher rates among IDPs in the rural area and among those who were less educated. Social phobia was associated with other mental disorders in both study areas. Disability and prolonged displacement increased the risk of having social phobia in the rural area. Conclusion: Further work needs to be done to improve our understanding and to establish proper interventions in dealing with social phobia, other common mental disorders and disability among long-term IDPs in these impoverished areas.

• Teodorescu, Dinu-Stefan; Heir, Trond; Siqveland, Johan; Hauff, Edvard; Wentzel-Larsen, Tore & Lien, Lars (2015). Chronic pain in multi-traumatized outpatients with a refugee background resettled in Norway: a cross-sectional study. BMC Psychology. 3(1). doi: 10.1186/S40359-015-0064-5. Full text in Research Archive Show summary

  Traumatized refugees often report significant levels of chronic pain in addition to posttraumatic stress disorder symptoms, and more information is needed to understand pain in refugees exposed to traumatic events. This study aimed to assess the frequency of chronic pain among refugee psychiatric outpatients, and to compare outpatients with and without chronic pain on trauma exposure, psychiatric morbidity, and psychiatric symptom severity. We conducted a cross-sectional study of sixty-one psychiatric outpatients with a refugee background using structured clinical diagnostic interviews to assess for traumatic events [Life Events Checklist (LEC)], PTSD (Posttraumatic Stress Disorder) and complex PTSD [Structured Clinical Interview for DSM-IV PTSD Module (SCID-PTSD) and Structured Interview for Disorders of Extreme Stress (SIDES)], chronic pain (SIDES Scale VI) and psychiatric symptoms [M.I.N.I. International Neuropsychiatric Interview (M.I.N.I.)]. Self-report measures were used to assess symptoms of posttraumatic stress [Impact of Event Scale-revised (IES-R)], depression and anxiety [Hopkins Symptom Checklist (HSCL-25)] and several markers of acculturation in Norway. Of the 61 outpatients included, all but one reported at least one chronic pain location, with a mean of 4.6 locations per patient. Chronic pain at clinical levels was present in 66% of the whole sample of outpatients, and in 88% of the outpatients with current PTSD diagnosis. The most prevalent chronic pain locations were head (80%), chest (74%), arms/legs (66%) and back (62%). Women had significantly more chronic pain locations than men. Comorbid PTSD and chronic pain were found in 57% of the outpatients. Significant differences were found between outpatients with and without chronic pain on posttraumatic stress, psychological distress, and DESNOS severity. Chronic pains are common in multi-traumatized refugees in outpatient clinics in Norway, and are positively related to symptomatology and severity of psychiatric morbidity. The presence of chronic pain, as well as comorbid chronic pain and PTSD, in psychiatric outpatients with a refugee background call for an integrated assessment and treatment for both conditions

• Berg, Akiah Ottesen; Aas, Monica; Larsson, Sara; Nerhus, Mari; Hauff, Edvard & Andreassen, Ole Andreas [Show all 7 contributors for this article] (2015). Childhood trauma mediates the association between ethnic minority status and more severe hallucinations in psychotic disorder. Psychological Medicine. ISSN 0033-2917. 45(01), p. 133–142. doi: 10.1017/S0033291714001135. Full text in Research Archive Show summary

  Background Ethnic minority status and childhood trauma are established risk factors for psychotic disorders. Both are found to be associated with increased level of positive symptoms, in particular auditory hallucinations. Our main aim was to investigate the experience and effect of childhood trauma in patients with psychosis from ethnic minorities, hypothesizing that they would report more childhood trauma than the majority and that this would be associated with more current and lifetime hallucinations. Method In this cross-sectional study we included 454 patients with a SCID-I DSM-IV diagnosis of non-affective or affective psychotic disorder. Current hallucinations were measured with the Positive and Negative Syndrome Scale (P3; Hallucinatory Behaviour). Lifetime hallucinations were assessed with the SCID-I items: auditory hallucinations, voices commenting and two or more voices conversing. Childhood trauma was assessed with the Childhood Trauma Questionnaire, self-report version. Results Patients from ethnic minority groups (n = 69) reported significantly more childhood trauma, specifically physical abuse/neglect, and sexual abuse. They had significantly more current hallucinatory behaviour and lifetime symptoms of hearing two or more voices conversing. Regression analyses revealed that the presence of childhood trauma mediated the association between ethnic minorities and hallucinations. Conclusions More childhood trauma in ethnic minorities with psychosis may partially explain findings of more positive symptoms, especially hallucinations, in this group. The association between childhood trauma and these first-rank symptoms may in part explain this group's higher risk of being diagnosed with a schizophrenia-spectrum diagnosis. The findings show the importance of childhood trauma in symptom development in psychosis. Copyright © Cambridge University Press 2014

• Tingvold, Laila; Vaage, Aina Basilier; Allen, James; Wentzel-Larsen, Tore; Ta, Thong Van & Hauff, Edvard (2015). Predictors of acculturative hassles among Vietnamese refugees in Norway: Results from a long-term longitudinal study. Transcultural Psychiatry. ISSN 1363-4615. 52(5), p. 700–714. doi: 10.1177/1363461515572208. Full text in Research Archive
• Lie, Birgit; Sveaass, Nora & Hauff, Edvard (2014). Refugees and healthcare in Norway : historical view and critival perspectives. In Guribye, Eugene; Lie, Birgit & Øverland, Gwynyth (Ed.), Nordic work with traumatised refugees: Do we really care. Cambridge Scholars Publishing. ISSN 9781443861366. p. 30–39. Full text in Research Archive
• Ayazi, Touraj; Lien, Lars; Eide, Arne Henning; Swartz, Leslie & Hauff, Edvard (2014). Association between exposure to traumatic events and anxiety disorders in a post-conflict setting: a cross-sectional community study in South Sudan. BMC Psychiatry. 14:6(6 (Article number)). doi: 10.1186/1471-244X-14-6. Full text in Research Archive Show summary

  Background The negative effect of exposure to traumatic events on mental health is well known. Most studies of the effects of trauma on mental health in war-affected populations have focused on post-traumatic stress disorder (PTSD) and depression. Although some studies confirm the existence of anxiety symptoms in war-affected populations, the extent to which exposure to traumatic events is independently associated with anxiety diagnoses (other than PTSD) has received less attention. The study aimed to determine whether having an anxiety diagnosis, other than PTSD, was associated with experiencing traumatic events in a post-conflict setting, across genders and after controlling for demographic and socio-economic variables. Methods In this cross-sectional community study (n = 1200), we applied the Harvard Trauma Questionnaire (HTQ) to investigate the extent of trauma exposure and PTSD. The Mini-International Neuropsychiatric Interview (MINI) was used to investigate the prevalence of anxiety disorders: generalized anxiety disorder (GAD), panic disorder (PD), social phobia, obsessive-compulsive disorder (OCD), and agoraphobia. Multinomial logistic regression analyses were conducted to examine the association between these disorders, previous trauma exposure, and socio-economic factors. Results The participants were 56.4% male and 43.6% female. The age ranged between 18 and 73 years old (Mean 34.63, SD = 12.03). The estimated rates of GAD-only and PD-only (without comorbidity with PTSD) were 5.5% and 3.1%, respectively. Exposure to traumatic events and socio-economic disadvantage were significantly associated with having one or more anxiety diagnoses. After controlling for age, sex, rural/urban setting, and socio-economic disadvantage, exposure to trauma was independently associated with anxiety diagnosis. There were gender differences in the pattern of risk factors for having PTSD, GAD or PD. Conclusion In individuals with a history of war-related trauma exposure, attention should be given to symptoms of GAD and PD, in addition to PTSD symptoms

• Berg, Akiah Ottesen; Andreassen, Ole Andreas; Aminoff, Sofie Ragnhild; Romm, Kristin Lie; Hauff, Edvard & Melle, Ingrid (2014). The impact of immigration and visible minority status on psychosis symptom profile. Social Psychiatry and Psychiatric Epidemiology. ISSN 0933-7954. 49(11), p. 1747–1757. doi: 10.1007/s00127-014-0897-x. Full text in Research Archive Show summary

  Purpose Immigrants have heightened risks of psychotic disorders, and it is proposed that migration influences symptom profiles. The purpose of this study was to investigate if either migration experience and/or visible minority status affected symptom profiles, using a cross-culturally validated five-factor model of the Positive and Negative Syndrome Scale (PANSS), in patients with broadly defined psychotic disorders. Methods PANSS was assessed in a large catchment area based sample of patients with psychotic disorders verified with the Structured Clinical Interview for DSM-IV (n = 1,081). Symptom profiles based on Wallwork et al. five-factor model were compared for Norwegians (73 %), white immigrants (10.5 %), and visible minority groups (16.5 %). Results Visible minorities were significantly younger, had less education, more often a schizophrenia diagnosis and higher PANSS positive, negative and disorganized/concrete factor scores than Norwegians and white immigrants. After controlling for confounders only the items “Delusions” and “Difficulty in abstract thinking” differed between groups. Multivariate analyses indicated that these items were not associated with immigration per se, but rather belonging to a visible minority. Conclusion We found mostly similarities in psychotic symptoms between immigrants and Norwegians when using a cross-culturally validated five-factor model of the PANSS. Immigration did not directly influence psychotic symptom profiles but visible minority groups had higher levels of “Delusions” and “Difficulty in abstract thinking”, both symptoms that are partially context dependent. The final publication is available at Springer.

• Ayazi, Touraj; Lien, Lars; Eide, Arne; Jenkins, Rachel; Albino, Rita A. & Hauff, Edvard (2013). Disability associated with exposure to traumatic events: results from a cross-sectional community survey in South Sudan. BMC Public Health. 13(1). doi: 10.1186/1471-2458-13-469. Full text in Research Archive Show summary

  There is a general lack of knowledge regarding disability and especially factors that are associated with disability in low-income countries. We aimed to study the overall and gender-specific prevalence of disability, and the association between exposure to traumatic events and disability in a post-conflict setting. We conducted a cross-sectional community based study of four Greater Bahr el Ghazal States, South Sudan (n = 1200). The Harvard Trauma Questionnaire (HTQ) was applied to investigate exposure to trauma events. Disability was measured using the Washington Group Short Measurement Set on Disability, which is an activity-based scale derived from the WHO’s International Classification of Disability, Functioning and Health. The estimated prevalence of disability (with severe difficulty) was 3.6% and 13.4% for disability with moderate difficulties. No gender differences were found in disability prevalence. Almost all participants reported exposure to at least one war-related traumatic event. The result of a hierarchical regression analysis showed that, for both men and women, exposure to traumatic events, older age and living in a polygamous marriage increased the likelihood of having a disability. The finding of association between traumatic experience and disability underlines the precariousness of the human rights situation for individuals with disability in low-income countries. It also has possible implications for the construction of disability services and for the provision of health services to individuals exposed to traumatic events.

• Salah, Tarig; Abdelrahman, Abdallah; Lien, Lars; Eide, Arne Henning; Martinez, Priscilla & Hauff, Edvard (2013). The mental health of internally displaced persons: An epidemiological study of adults in two settlements in Central Sudan. International Journal of Social Psychiatry. ISSN 0020-7640. 59(8), p. 782–788. doi: 10.1177/0020764012456810. Full text in Research Archive Show summary

  Aims: There is a scarcity of data on mental health problems among Sudanese internally displaced persons (IDPs). This study aims to assess the prevalence of mental disorders of IDPs in Sudan, and to determine and compare the association between mental disorders and socio-demographic variables between the rural and urban long-term IDP populations. Methods: This cross-sectional study was implemented in two IDP areas in Central Sudan. Data were collected during face-to-face interviews using structured questionnaires to assess socio-demographic factors and the Mini International Neuropsychiatric Interview (MINI) to determine psychiatric diagnoses. A total of 1,876 adults were enrolled from both study areas. Results: The overall prevalence of having any mental health disorder in the IDP population was 52.9%. The most common disorders were major depressive disorder (24.3%), generalized anxiety disorder (23.6%), social phobia (14.2%) and post-traumatic stress disorder (12.3%). Years of displacement and education were associated with different mental disorders between the two areas, and there were no gender differences in prevalence of mental disorders in either area. Conclusion: This study shows high prevalence rates of mental disorders in both urban and rural IDP populations in Sudan, indicating a need to explore the circumstances for these high rates and to develop appropriate responses.

• Ayazi, Touraj; Lien, Lars; Eide, Arne Henning; Shadar, Elizabeth Joseph Shadar & Hauff, Edvard (2013). Community attitudes and social distance towards the mentally ill in South Sudan: a survey from a post-conflict setting with no mental Health services. Social Psychiatry and Psychiatric Epidemiology. ISSN 0933-7954. doi: 10.1007/s00127-013-0775-y. Full text in Research Archive Show summary

  Purpose This study investigates attitudes and social distance towards the mentally ill in a post-conflict, low-income country. Methods A cross-sectional community survey (n = 1,200) was conducted in South Sudan. Associations between various sociodemographic variables and attitudes toward/social distance from the mentally ill were investigated. Results The regression analysis showed that lower levels of education were positively associated with social distance, and Christian or Muslim beliefs, compared with traditional beliefs, were negatively associated with social distance. Familiarity with mental illness or psychological distress was not significantly associated with social distance. Participants who endorsed community-oriented attitudes (rather than hospital/drug-oriented attitudes) about health care for the mentally ill were more likely show a decreased social distance. Participants who believed that the mentally ill were dangerous had higher scores on the social distance scale. Conclusions A high level of stigma towards the mentally ill exists in South Sudan, especially in the rural areas. Alongside efforts to build up mental health services in South Sudan, the existing stigma needs to be addressed. Information regarding the role of the community both in preventing mental illnesses and in service delivery should be prioritised.

• Tennegedara, Saheer; Lien, Lars; Hauff, Edvard & Kumar, Bernadette. N (2013). Ethnic differences in seasonal affective disorder and associated factors among five immigrant groups in Norway. Journal of Affective Disorders. ISSN 0165-0327. 151(1), p. 237–242. doi: 10.1016/j.jad.2013.05.086. Full text in Research Archive
• Thapa, Suraj Bahadur & Hauff, Edvard (2012). Perceived needs, self-reported health and disability among displaced persons during an armed conflict in Nepal. Social Psychiatry and Psychiatric Epidemiology. ISSN 0933-7954. 47(4), p. 589–595. doi: 10.1007/s00127-011-0359-7. Full text in Research Archive
• Teodorescu, Dinu-Stefan; Heir, Trond; Hauff, Edvard; Wentzel-Larsen, Tore & Lien, Lars (2012). Mental health problems and post-migration stress among multi-traumatized refugees attending outpatient clinics upon resettlement to Norway. Scandinavian Journal of Psychology. ISSN 0036-5564. 53(4), p. 316–332. doi: 10.1111/j.1467-9450.2012.00954.x. Full text in Research Archive Show summary

  Refugees have often been exposed to multiple traumas making them prone to mental health problems later. The aim of this study is to describe the prevalence and symptom load of psychiatric disorders in refugees admitted to psychiatric outpatient clinics and to investigate the relationship between multiple exposure to traumatic events, the severity of traumatic symptoms and post-migration stressors. A clinical sample of 61 refugee outpatients from psychiatric clinics in Southern Norway was cross-sectionally examined using three structured clinical interviews (SCID-PTSD, SIDES and MINI) and self-report psychometric instruments (HSCL-25, IES-R). Post-traumatic Stress Disorder (PTSD) was diagnosed in 82% of the patients, while Disorders of Extreme Stress Not Otherwise Specified (DESNOS) was present in 16% of them. Comorbidity was considerable; 64% of the patients had both PTSD and major depression disorder (MDD) and 80% of those who had PTSD had three or more additional diagnoses. Multi-traumatized refugees in outpatient clinics have high prevalence of PTSD, DESNOS, comorbid depression and anxiety disorders. A more severe symptomatology was found in patients diagnosed with both PTSD and DESNOS, than in those diagnosed with only PTSD. Higher rates of unemployment, weak social network and weak social integration were also prevalent in these outpatients, and related to increased psychiatric comorbidity and severity of symptoms. Further research may clarify the existence of a cumulative relationship between pre-resettlement traumas and post-resettlement stressors in the mental health of refugees, which in turn may help to improve therapeutic interventions.

• Tingvold, Laila; Hauff, Edvard; Allen, James & Middelthon, Anne-Lise Orvin (2012). Seeking balance between the past and the present: Vietnamese refugee parenting practices and adolescent well-being. International Journal of Intercultural Relations. ISSN 0147-1767. 36(4), p. 563–574. doi: 10.1016/j.ijintrel.2012.03.004. Full text in Research Archive
• Tingvold, Laila; Middelthon, Anne-Lise Orvin; Allen, James & Hauff, Edvard (2012). Parents and children only? Acculturation and the influence of extended family members among Vietnamese refugees. International Journal of Intercultural Relations. ISSN 0147-1767. 36(2), p. 260–270. doi: 10.1016/j.ijintrel.2011.03.005. Full text in Research Archive
• Teodorescu, Dinu-Stefan; Siqveland, Johan; Heir, Trond; Wentzel-Larsen, Tore; Hauff, Edvard & Lien, Lars (2012). Posttraumatic growth, depressive symptoms, posttraumatic stress symptoms, post-migration stressors and quality of life in multi-traumatized psychiatric outpatients with a refugee background in Norway. Health and Quality of Life Outcomes. 10(84). doi: 10.1186/1477-7525-10-84. Full text in Research Archive Show summary

  Background Psychiatric outpatients with a refugee background have often been exposed to a variety of potentially traumatizing events, with numerous negative consequences for their mental health and quality of life. However, some patients also report positive personal changes, posttraumatic growth, related to these potentially traumatic events. This study describes posttraumatic growth, posttraumatic stress symptoms, depressive symptoms, post-migration stressors, and their association with quality of life in an outpatient psychiatric population with a refugee background in Norway. Methods Fifty five psychiatric outpatients with a refugee background participated in a cross-sectional study using clinical interviews to measure psychopathology (SCID-PTSD, MINI), and four self-report instruments measuring posttraumatic growth, posttraumatic stress symptoms, depressive symptoms, and quality of life (PTGI-SF, IES-R, HSCL-25-depression scale, and WHOQOL-Bref) as well as measures of social integration, social network and employment status. Results All patients reported some degree of posttraumatic growth, while only 31% reported greater amounts of growth. Eighty percent of the patients had posttraumatic stress symptoms above the cut-off point, and 93% reported clinical levels of depressive symptoms. Quality of life in the four domains of the WHOQOL-Bref levels were low, well below the threshold for the’life satisfaction’ standard proposed by Cummins. A hierarchic regression model including depressive symptoms, posttraumatic stress symptoms, posttraumatic growth, and unemployment explained 56% of the total variance found in the psychological health domain of the WHOQOL-Bref scale. Posttraumatic growth made the strongest contribution to the model, greater than posttraumatic stress symptoms or depressive symptoms. Post-migration stressors like unemployment, weak social network and poor social integration were moderately negatively correlated with posttraumatic growth and quality of life, and positively correlated with psychopathological symptoms. Sixty percent of the outpatients were unemployed. Conclusions Multi-traumatized refugees in outpatient clinics reported both symptoms of psychopathology and posttraumatic growth after exposure to multiple traumatic events. Symptoms of psychopathology were negatively related to the quality of life, and positively related to post-migration stressors such as unemployment, weak social network and poor social integration. Posttraumatic growth was positively associated with quality of life, and negatively associated with post-migration stressors. Hierarchical regression modeling showed that posttraumatic growth explained more of the variance in quality of life than did posttraumatic stress symptoms, depressive symptoms or unemployment. It may therefore be necessary to address both positive changes and psychopathological symptoms when assessing and treating multi-traumatized outpatients with a refugee background.

• Ayazi, Touraj; Lien, Lars; Eide, Arne; Ruom, Majok Malek & Hauff, Edvard (2012). What are the risk factors for the comorbidity of posttraumatic stress disorder and depression in a war-affected population? a cross-sectional community study in South Sudan. BMC Psychiatry. 12(1), p. 175–175. doi: 10.1186/1471-244X-12-175. Full text in Research Archive
• Vaage, Aina Basilier; Thomsen, Per Hove; Rousseau, Cécile; Wentzel-Larsen, Tore; Ta, Tong V & Hauff, Edvard (2011). Paternal predictors of the mental health of children of Vietnamese refugees. Child and Adolescent Psychiatry and Mental Health (CAPMH). 5(2). doi: 10.1186/1753-2000-5-2. Full text in Research Archive Show summary

  Background: Intergenerational transmission of trauma as a determinant of mental health has been studied in the offspring of Holocaust survivors and combat veterans, and in refugee families. Mainly negative effects on the children are reported, while a few studies also describe resilience and a possible positive transformation process. A longitudinal prospective cohort study of Vietnamese refugees arriving in Norway in 1982 reports a 23 years followup, including spouses and children born in Norway, to study the long-term effects of trauma, flight, and exile on the offspring of the refugees. Objectives of the study: 1. To study the association between the psychological distress of Vietnamese refugee parents and their children after 23 years resettlement. 2. To analyse paternal predictors for their children’s mental health. Methods: Information from one or both parents at arrival in 1982 (T1), at follow-up in 1985 (T2), and 23 years after arrival (T3) was included. The mental health was assessed by the Global Severity Index (GSI) of the self-report Symptom Check List-90-R (SCL-90-R) for parents (n = 88) and older children (age 19-23 yrs, n = 12), while children aged 4-18 (n = 94) were assessed using the Strengths and Difficulties Questionnaire (SDQ). Results: Thirty percent of the families had one parent with a high psychological distress score ("probable caseness” for a mental disorder), while only 4% of the children aged 10 - 23 years were considered as probable cases. In spite of this, there was an association between probable caseness in children and in fathers at T3. A significant negative paternal predictor for the children’s mental health at T3 was the father’s PTSD at arrival in Norway, while a positive predictor was the father’s participation in a Norwegian network three years after arrival. Conclusions: Children of refugees cannot be globally considered at risk for mental health problems. However, the preceding PTSD in their fathers may constitute a specific risk for them.

• Thapa, Suraj Bahadur & Hauff, Edvard (2011). Perceived needs, self-reported health and disibility among displaced persons during an armed conflict in Nepal. Social Psychiatry and Psychiatric Epidemiology. ISSN 0933-7954. p. 359–359. doi: 10.1007/s00127-011-0359-7. Full text in Research Archive
• Berg, Akiah Ottesen; Melle, Ingrid; Røssberg, Jan Ivar; Romm, Kristin Lie; Larsson, Sara & Lagerberg, Trine Vik [Show all 8 contributors for this article] (2011). Perceived discrimination is associated with severity of positive and depression/anxiety symptoms in immigrants with psychosis: a cross-sectional study. BMC Psychiatry. 11. doi: 10.1186/1471-244X-11-77. Full text in Research Archive Show summary

  Background Immigration status is a significant risk factor for psychotic disorders, and a number of studies have reported more severe positive and affective symptoms among immigrant and ethnic minority groups. We investigated if perceived discrimination was associated with the severity of these symptoms among immigrants in Norway with psychotic disorders. Methods Cross-sectional analyses of 90 immigrant patients (66% first-generation, 68% from Asia/Africa) in treatment for psychotic disorders were assessed for DSM-IV diagnoses with the Structured Clinical Interview for DSM Disorders (SCID-I, sections A-E) and for present symptom severity by The Structured Positive and Negative Syndrome Scale (SCI-PANSS). Perceived discrimination was assessed by a self-report questionnaire developed for the Immigrant Youth in Cultural Transition Study. Results Perceived discrimination correlated with positive psychotic (r = 0.264, p < 0.05) and depression/anxiety symptoms (r = 0.282, p < 0.01), but not negative, cognitive, or excitement symptoms. Perceived discrimination also functioned as a partial mediator for symptom severity in African immigrants. Multiple linear regression analyses controlling for possible confounders revealed that perceived discrimination explained approximately 10% of the variance in positive and depression/anxiety symptoms in the statistical model. Conclusions Among immigrants with psychotic disorders, visible minority status was associated with perceived discrimination and with more severe positive and depression/anxiety symptoms. These results suggest that context-specific stressful environmental factors influence specific symptom patterns and severity. This has important implications for preventive strategies and treatment of this vulnerable patient group.

• Turnip, Sherly Saragih; Klungsøyr, Ole & Hauff, Edvard (2010). The mental Health of populations directly and indirectly exposed to violent conflict in Indonesia. Conflict and Health. 4(14). doi: 10.1186/1752-1505-4-14. Full text in Research Archive Show summary

  Background Large disasters affect people who live both near and far from the areas in which they occur. The mental health impact is expected to be similar to a ripple effect, where the risk of mental health consequences generally decreases with increasing distance from the disaster center. However, we have not been able to identify studies of the ripple effect of man-made disaster on mental health in low-income countries. Objectives The objective was to examine the hypothesis of a ripple effect on the mental health consequences in populations exposed to man-made disasters in a developing country context, through a comparison of two different populations living in different proximities from the center of disaster in Mollucas. Methods Cross-sectional longitudinal data were collected from 510 Internally Displaced Persons (IDPs) living in Ambon, who were directly exposed to the violence, and non-IDPs living in remote villages in Mollucas, Indonesia, who had never been directly exposed to violence in Mollucas. Data were collected during home visits and statistical comparisons were conducted by using chi square tests, t-test and logistic regression. Results There was significantly more psychological distress "caseness" in IDPs than non-IDPs. The mental health consequences of the violent conflict in Ambon supported the ripple effect hypothesis as displacement status appears to be a strong risk factor for distress, both as a main effect and interaction effect. Significantly higher percentages of IDPs experienced traumatic events than non-IDPs in all six event types reported. Conclusions This study indicates that the conflict had an impact on mental health and economic conditions far beyond the area where the actual violent events took place, in a diminishing pattern in line with the hypothesis of a ripple effect.

• Turnip, Sherly Saragih; Klungsøyr, Ole & Hauff, Edvard (2010). The Mental Health Impact of Disaster of Populations Directly and Indirectly Exposed to violent Conflict in Indonesia. Conflict and Health. 4, p. 14–14. doi: 10.1186/1752-1505-4-14. Full text in Research Archive
• Lien, Lars; Thapa, Suraj Bahadur; Rove, Jon Andreas; Kumar, Bernadette. N & Hauff, Edvard (2010). Premigration Traumatic Events and Psychological Distress Among Five Immigrant Groups. International Journal of Mental Health. ISSN 0020-7411. 39(3), p. 3–19. doi: 10.2753/IMH0020-7411390301. Full text in Research Archive
• Vaage, Aina Basilier; Thomsen, Per Hove; Silove, Derrick; Wentzel-Larsen, Tore; Ta, Thong Van & Hauff, Edvard (2010). Long-term mental health of Vietnamese refugees in the aftermath of trauma. British Journal of Psychiatry. ISSN 0007-1250. 196(2), p. 122–125. doi: 10.1192/bjp.bp.108.059139. Full text in Research Archive
• Berg, Akiah Ottesen; Melle, Ingrid; Torjesen, Peter A; Lien, Lars; Hauff, Edvard & Andreassen, Ole Andreas (2010). A Cross-Sectional Study of Vitamin D Deficiency Among Immigrants and Norwegians With Psychosis Compared to the General Population. Journal of Clinical Psychiatry. ISSN 0160-6689. 71(12), p. 1598–1604. doi: 10.4088/JCP.09m05299yel. Full text in Research Archive
• Vaage, AB; Tingvold, Laila; Hauff, Edvard; Wentzel-Larsen, T; Clench-Aas, Jocelyne & Thomsen, PH (2009). Better mental health in children of Vietnamese refugees compared with their Norwegian peers - a matter of cultural difference? Child and Adolescent Psychiatry and Mental Health (CAPMH). p. 2–34. Full text in Research Archive
• Lien, Lars & Hauff, Edvard (2008). Psykiatri i fattige land: Ingen helse uten mental helse! Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 128(24), p. 2882–2884. Full text in Research Archive
• Hauff, Edvard (2008). Immigrants and mental health services. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 128(2), p. 158–158. Full text in Research Archive
• Lindencrona, F; Ekblad, S & Hauff, Edvard (2008). Mental health of recently resettled refugees from the Middle East in Sweden: the impact of pre-resettlement trauma, resettlement stress and capacity to handle stress. Social Psychiatry and Psychiatric Epidemiology. ISSN 0933-7954. 43, p. 121–131. doi: 10.1007/s00127-007-0280-2. Full text in Research Archive
• Martinez, Priscilla; Andia, I; Emenyonu, N; Hahn, JA; Hauff, Edvard & Pepper, L [Show all 7 contributors for this article] (2008). Alcohol use, depressive symptoms and the receipt of antiretroviral therapy in Southwest Uganda. Aids and Behavior. ISSN 1090-7165. 12, p. 605–612. doi: 10.1007/s10461-007-9312-x. Full text in Research Archive
• Thapa, SB; Dalgard, OS; Claussen, Bjørgulf; Sandvik, L & Hauff, Edvard (2007). Psychological distress among immigrants from high- and low-income countries: Findings from the Oslo Health Stuedy. Nordic Journal of Psychiatry. ISSN 0803-9488. 61, p. 459–465. Full text in Research Archive
• Turnip, Sherly Saragih & Hauff, Edvard (2007). Household roles, poverty and psychological distress in internally displaced persons affected by violent conflicts in Indonesia. Social Psychiatry and Psychiatric Epidemiology. ISSN 0933-7954. 42(12), p. 997–1004. doi: 10.1007/s00127-007-0255-3. Full text in Research Archive
• Vaage, Aina Basilier; Garløv, Ida; Hauff, Edvard & Thomsen, Per Hove (2007). Psychiatric symptoms and service utilization in refugee children referred to a child psychiatric department. A retrospective comparative case note study. Transcultural Psychiatry. ISSN 1363-4615. 44, p. 440–458. Full text in Research Archive
• Thapa, SB; Dalgard, OS; Claussen, Bjørgulf; Sandvik, Leiv & Hauff, Edvard (2007). Psychological distress among immigrants from high- and low-income countries. Nordic Journal of Psychiatry. ISSN 0803-9488. 61(6), p. 459–465. Full text in Research Archive
• Hauff, Edvard (2007). Loss, reconnection and reconstruction: a former child soldier’s return to Cambodia. In Drožđek, Boris & Wilson, John P. (Ed.), Voices of Trauma Treating Psychological Trauma Across Cultures. Springer Science+Business Media B.V.. ISSN 9780387697949. p. 440–458. Full text in Research Archive
• Vaage, Aina Basilier; Garløv, Ida; Hauff, Edvard & Thomsen, Per Hove (2007). Psychiatric Symptoms and Service Utilization among Refugee Children Referred to a Child Psychiatric Department: A Retrospective Comparative Case Note Study. Transcultural Psychiatry. ISSN 1363-4615. 44(3), p. 440–458. Full text in Research Archive Show summary

  Refugee children may encounter barriers to accessing mental health services. We conducted a case-control study based on a systematic review of clinic records to compare psychopathology and service utilization in refugee and Norwegian children referred to a child psychiatry department in a county in southern Norway. Sixty-one refugee children were compared with 61 Norwegian-born children matched for gender, age and time of referral to the clinic. There was no significant difference in rates of referral or level of service utilization, which were proportional to the population. Compared with Norwegian children, refugee children were diagnosed more frequently with post-traumatic stress disorder and other affective and emotional disorders, and less often with pervasive developmental disorders and attention deficit hyperactivity disorder. The results are discussed in terms of referral pathways and the need for culturally competent care for refugee children.

• Hauff, Edvard (2007). Har pasienten din innvandrerbakgrunn? In Vaglum, Per Jørgen Wiggen & Finset, Arnstein (Ed.), Helse, sykdom og atferd. Innføring i medisinske atferdsfag. Cappelen Damm Akademisk. ISSN 9788202269876. p. 256–270. Full text in Research Archive
• Hauff, Edvard (2007). Tekster i norsk psykiatri. Norsk psykiatrisk forening 100 år. In Øiesvold, Terje (Eds.), Engasjement og kunnskap. Tekster i norsk psykiatri. Tidsskrift for Den norske lægeforening. ISSN 9788280700605. p. 165–166. Full text in Research Archive
• Knutzen, Maria; Sandvik, L.; Hauff, Edvard; Ilner, Opjordsmoen Stein E. & Friis, Svein (2007). Association between patients' gender, age and immigrant background and use of restraint - A 2 year retrospective study at a department of emergency psychiatry. Nordic Journal of Psychiatry. ISSN 0803-9488. 61, p. 201–206. Full text in Research Archive
• Grut, Lisbet; Tingvold, Laila & Hauff, Edvard (2006). Fastlegens møte med flyktninger. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 126(10), p. 1318–1320. Full text in Research Archive
• Dalgard, Odd Steffen; Suraj, Bahadur Thapa; Hauff, Edvard; McCubbin, Michael & Syed, Hammad Raza Zaidi (2006). Immigration, lack of control and psychological distress: Findings from the Oslo Health Study. Scandinavian Journal of Psychology. ISSN 0036-5564. 47, p. 551–558. Full text in Research Archive
• Allen, James; Vaage, Aina Basilier & Hauff, Edvard (2006). Refugees and asylum seekers in societies. In Sam, David Lackland & Berry, John W. (Ed.), The Cambridge handbook of acculturation psychology. Cambridge University Press. ISSN 9780521849241. p. 198–217. Full text in Research Archive
• Hauff, Edvard (2006). Innvandrerfamilien. In Roness, Atle & Matthiesen, Stig Berge (Ed.), I klem eller balanse. Om arbeid, stress og familieliv. Fagbokforlaget. ISSN 9788245003253. Full text in Research Archive
• Allen, James; Vaage, Aina Basilier & Hauff, Edvard (2006). Refugees and asylum seekers in societies. In Sam, David L. & Berry, John W (Ed.), Acculturation psychology. Cambridge University Press. ISSN 9780521849241. p. 198–217. Full text in Research Archive
• Lien, Lars; Oppedal, Brit; Haavet, Ole Rikard; Hauff, Edvard; Thoresen, Magne & Bjertness, Espen (2006). Own and parental war experience as a risk factor for mental health problems among adolescents with an immigrant ackground: results from a cross sectional study in Oslo, Norway. Clinical Practice and Epidemiology in Mental Health. 2. doi: 10.1186/1745-0179-2-30. Full text in Research Archive Show summary

  Background An increasing proportion of immigrants to Western countries in the past decade are from war affected countries. The aim of this study was to estimate the prevalence of war experience among adolescents and their parents and to investigate possible differences in internalizing and externalizing mental health problems between adolescents exposed and unexposed to own and parental war experience. Method The study is based on a cross-sectional population-based survey of all 10th grade pupils in Oslo for two consecutive years. A total of 1,758 aadolescents were included, all with both parents born outside of Norway. Internalizing and externalizing mental health problems were measured by Hopkins Symptom Checklist-10 and subscales of the Strengths and Difficulties Questionnaire, respectively. Own and parental war experience is based on adolescent self-report. Results The proportion of adolescents with own war experience was 14% with the highest prevalence in immigrants from Eastern Europe and Sub-Saharan Africa. The proportion of parental war experience was 33% with Sub-Saharan Africa being highest. Adolescents reporting own war experience had higher scores for both internalizing and externalizing mental health problems compared to immigrants without war experience, but only externalizing problems reached statistically significant differences. For parental war experience there was a statistically significant relationship between parental war experience and internalizing mental health problems. The association remained significant after adjustment for parental educational level and adolescents' own war experience. Conclusion War exposure is highly prevalent among immigrants living in Oslo, Norway, both among adolescents themselves and their parents. Among immigrants to Norway, parental war experience appears to be stronger associated with mental health problems than adolescents own exposure to war experience.

• Dahl, Solveig & Hauff, Edvard (2005). Det kliniske møtet med pasienter med flyktningebakgrunn i et kjønnsperspektiv. In Opjordsmoen, Stein; Vaglum, Per Jørgen Wiggen & Thorsen, Gerd Ragna Bloch (Ed.), Oss imellom.Om relasjonenes betydning for mental helse. Hertervig Akademisk. ISSN 9788292023860. p. 201–216. Full text in Research Archive
• Suraj, Bahadur Thapa & Hauff, Edvard (2005). Gender differences in factors associated with psychological distress among immigrants from low- and middle-income countries - Findings from the Oslo Health Study. Social Psychiatry and Psychiatric Epidemiology. ISSN 0933-7954. 40. Full text in Research Archive
• Lien, Lars; Claussen, Bjørgulf; Hauff, Edvard; Thoresen, Magne & Bjertness, Espen (2005). Bodily pain and associated mental distress among immigrant adolescents. A population-based cross-sectional study. European Child and Adolescent Psychiatry. ISSN 1018-8827. 14(7), p. 371–375. Full text in Research Archive
• Suraj, Bahadur Thapa & Hauff, Edvard (2005). Psychological distress among displaced persons during an armed conflict in Nepal. Social Psychiatry and Psychiatric Epidemiology. ISSN 0933-7954. 40(6). Full text in Research Archive
• Hauff, Edvard (2004). Prospektive befolkningsstudier av psykisk helse hos flyktninger, Ubevisst sjeleliv og bevisst samfunnsliv. Psykisk helse i en sammenheng. Universitetet i Oslo. ISSN 9788292192238. p. 145–153. Full text in Research Archive
• Dubois, V; Tonglet, R; Hoyois, P; Sunbaunat, K; Roussaux, JP & Hauff, Edvard (2004). Household survey of psychiatric morbidity in Cambodia. International Journal of Social Psychiatry. ISSN 0020-7640. 50, p. 174–185. Full text in Research Archive
• Thapa, Suraj Bahadur; Ommeren, Mark Van; Sharma, Bhogendra; Jong, JTVM de & Hauff, Edvard (2003). Psychiatric disability among Bhutanese refugees. American Journal of Psychiatry. ISSN 0002-953X. 160, p. 2032–2037. Full text in Research Archive
• Ruud, Torleif & Hauff, Edvard (2003). Community mental health services in Norway. International Journal of Mental Health. ISSN 0020-7411. 31(4), p. 3–14. Full text in Research Archive
• Thapa, SB; Ommeren, M; Sharma, B; Jong, JTVM De & Hauff, Edvard (2003). Psychiatric disability among tortured Bhutanese refugees in Nepal. American Journal of Psychiatry. ISSN 0002-953X. 160, p. 2030–2037. Full text in Research Archive
• Care, G; Hauff, Edvard & Willigen, L van (2003). The refugee convention applied: Moral, medical, ethical and judicial questions and limitation, The refugee convention at fifty. A view from forced migration studies. Lexington Books. p. 47–63. Full text in Research Archive
• Hauff, Edvard (2003). A "Welfare Society" for Refugees ? - National issues in refugee mental health, Counseling refugees. A psychosocial approach to innovative multicultural interventions. Greenwood Press. p. 47–63. Full text in Research Archive
• Hauff, Edvard; Varvin, Sverre; Laake, Petter; Melle, Ingrid; Vaglum, Per & Friis, Svein (2002). Inpatient Psychotherapy Compared with Usual Care for Patients Who Have Schizophrenic Psychoses. Psychiatric Services. ISSN 1075-2730. 53(4), p. 471–473. Full text in Research Archive
• Afana, Abdel Hamid; Dalgard, Odd Steffen; Bjertness, Espen; Grünfeld, Berthold & Hauff, Edvard (2002). The Prevalence and Associated Socio-demographic Variables of Post-traumatic Stress Disorder among Patients attending Primary Care Centres in the Gaza Strip. Journal of Refugee Studies. ISSN 0951-6328. 15(3). Full text in Research Archive
• Afana, Abdel Hamid; Dalgard, Odd Steffen; Hauff, Edvard; Bjertness, Espen & Grünfeld, Berthold (2002). The prevalence and associated socio-demographic variables of Posttraumatic Stress Disorder (PTSD) among patients attending Primary health care centres in the Gaza Strip. Journal of Refugee Studies. ISSN 0951-6328. 15(3). Full text in Research Archive
• Hauff, Edvard (2001). Kyol Goeu in Cambodia. Transcultural Psychiatry. ISSN 1363-4615. 38(4), p. 468–473. Full text in Research Archive
• Hauff, Edvard (2000). Har pasienten din innvandrerbakgrunn? Innføring i medisinske atferdsfag. Cappelen Damm Akademisk. ISSN 9788202198596. p. 179–193. Full text in Research Archive
• Melle, Ingrid; Friis, Svein; Hauff, Edvard & Vaglum, Per (2000). Social risks for patients with schizophrenia in high welfare societies. Psychiatric Services. ISSN 1075-2730. 51, p. 223–228. Full text in Research Archive
• Melle, Ingrid; Friis, Svein; Hauff, Edvard & Vaglum, Per (2000). A cohort of acutely admitted schizophrenic patients: seven years service consumption and clinical cource. Nordic Journal of Psychiatry. ISSN 0803-9488. 54, p. 47–54. Full text in Research Archive
• Varvin, Sverre & Hauff, Edvard (1998). Psychoanalytically Oriented Psychotherapy With Torture Victims. In Jaranson, James M. & Popkin, Michael K. (Ed.), Caring for Victims of Torture. American Psychiatric Press, Inc. Washington DC and London, England. ISSN 9780880487740. p. 117–130. Full text in Research Archive Show summary

  Basic principles of psychoanalytical psychotherapy with survivors of torture is described illustrated with case-vignettes.

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• Lie, Birgit; Sveaass, Nora & Hauff, Edvard (2014). Refugees and health care in Norway: Historical view and critical perspective. Cambridge Scholars Publishing. ISBN 9781848722569. 10 p. Full text in Research Archive
• Vaglum, Per; Ekeberg, Øivind; Finset, Arnstein; Hauff, Edvard & Moum, Torbjørn (2000). Innføring i medisinske atferdsfag. Cappelen Damm Akademisk. ISBN 9788202198596. 271 p. Full text in Research Archive

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• Berg, Akiah Ottesen; Aas, Monica; Larsson, Sara; Nerhus, Mari; Hauff, Edvard & Andreassen, Ole Andreas [Show all 7 contributors for this article] (2014). Childhood Trauma Mediates the Association Between Ethnic Minority Status and More Severe Hallucinations in Psychotic Disorder. Full text in Research Archive
• Berg, Akiah Ottesen; Aas, Monica; Andreassen, Ole Andreas; Hauff, Edvard; Larsson, Sara & Melle, Ingrid [Show all 7 contributors for this article] (2014). Childhood Trauma Mediates the Association Between Ethnic Minority Status and More Severe Hallucinations in Psychotic Disorder. Full text in Research Archive
• Siqveland, Johan; Hauff, Edvard & Ruud, Torleif (2013). Trauma disorders and self-poisoning in out patients. Full text in Research Archive
• Berg, Akiah Ottesen; Melle, Ingrid; Aminoff, SR; Andreassen, Ole Andreas & Hauff, Edvard (2009). HEIGHTENED RATES OF SCHIZOAFFECTIVE DISORDER AMONG IMMIGRANTS? A CROSS-SECTIONAL STUDY. Schizophrenia Bulletin. ISSN 0586-7614. 35, p. 2–2. Full text in Research Archive
• Hauff, Edvard (2007). Institutt for psykiatri ved Universitetet i Oslo. In Øiesvold, Terje (Eds.), Engasjement og kunnskap. Tekster i norsk psykiatri. Tidsskrift for Den norske lægeforening. ISSN 9788280700605. p. 165–166. Full text in Research Archive
• Olsen, Rune; Hauff, Edvard & Rosvold, Elin Olaug (2007). Psychological distress among Norwegian and foreign students at the University of Oslo, Norway. Full text in Research Archive
• Hauff, Edvard (2000). Samarbeid mellom brukere, pårørende og fagfolk: En psykiaters refleksjoner. Dialog. ISSN 0012-2033. p. 90–103. Full text in Research Archive
• Berg, Akiah Ottesen & Hauff, Edvard (2011). Psychosis in immigrants : a cross-sectional study of symptom profile and environmental stressors. Universitetet i Oslo. ISSN 9788282640299. Full text in Research Archive
• Mburu, Christina Brux; Hilden, Per Kristian & Hauff, Edvard (2011). Understanding Mental Health in a Context of Violence, Forced Displacement, Oppression and Suffering: A Qualitative Analysis of the Mental Health Realities among the Southern Sudanese Migrants of Khartoum. Universitetet i Oslo. Full text in Research Archive
• Hauff, Edvard (1998). The Stresses of War, Organised Violence and Exile: A Prospective Community Cohort Study of the Mental Health of Vietnamese Refugees in Norway. Universitetet i Oslo. ISSN 9788291061795. Full text in Research Archive

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