Kristoffer Høiland

PhD candidate

Email krihoi@siv.no

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PhD project

"Patient factors predicting completion and outcome in group treatment of alcohol use disorders."

Alcohol use disorder (AUD) is one of the major risk factors for disease and early death, and among the three most common mental disorders in Norway. Nevertheless, a substanial portion of the patients do not receive effective treatment. To provide more effective treatments and facilitate patient selection to treatments, we need more research on how patient factors (psychological, sociodemographic and social factors) impact treatment outcome. Patient factors may explain as much as 30-40 % of treatment outcome. Persons with AUD vary a lot on factors like history of substance use, network, psychiatric comorbidity, cognitive function and personality. These factors seem to have a significant impact on treatment effectiveness, but further studies needed to clarify how. Group treatment is among the most common treatment formats in treatment of AUD in Norway, and has documented effect. Being standardized with an end-point regardless of treatment success, it is particularly suited for this kind of research. In this multi-center trial, we will examine how patient factors in patients enrolled in the specialist health service in Norway mediate or moderate treatment outcome, and see how these factors predict completion of group treatment and outcome after one year.

Other projects

"Improving the methodology for assessing cognitive impairment in persons with substance use disorder: Is the Repeatable Battery of Neuropsychological Status (RBANS) a useful instrument?"

In collaboration with Rune Raudeberg, University of Bergen.

Academic interests

Psychotherapy research
Addiction treatment
Patient factors
Group treatment
Cognition

Background

2018- : Clinical psychologist, RUPO, Avdeling rus og avhengighet, SiV
2017-2018: Clinical psychologist, Furuset BUP
2016-2017: Clinical psychologist, BASIS-prosjektet, OUS
2015-2016: Clinical psychologist, Seksjon ruspoliklinikker, OUS
2014: Licensed specialist in clinical child and adolescent psychology
2013-2014: Clinical psychologist, Follo ARA
2009-2013: Clinical psychologist, BUP Follo
2009: Cand. Psychol., University of Oslo. Licensed psychologist
2002: Bachelor of Music (in Jazz studies). Birmingham Conservatoire

Awards

Bjørn Christiansens memorial prize from the Norwegian Psychological Association 2018 for the article: The Good lives model i behandling av personer dømt for seksuallovbrudd». (The Good lives model in treatment of persons convicted of sexual offenses).

Research team

Main supervisor: Jens Egeland. Director of research, Division for mental health and addiction, Vestfold Hospital Trust (SiV). Professor II, University of Oslo
Co-supervisor: Espen Ajo Arnevik. PhD., leader of RusForsk (Addiction research), Oslo University Hospital

Collaborators

Katie Witkiewitz. Professor, Center on Alcoholism, Substance use and Addictions, Department of Psychology, University of New Mexico, NM, USA
Anette Søgaard Nielsen. Professor MSO, Institute of Clinical research, University of Southern Denmark
Helle Wessel Andersson. Researcher, PhD, St Olavs hospital
Espen Walderhaug. PhD, neuropsychologist

Høiland, K., Arnevik, E. K. A., & Egeland, J. (2024). Alcohol use disorder and fitness to drive: Discrepancies between health professionals’ evaluations and objective measures of alcohol use and cognitive functioning. Nordic studies on alcohol and drugs. https://doi-org.ezproxy.universitetetioslo.no/10.1177/14550725231219972

Høiland, K., & Egeland, J. (2022). Behandling av alkoholbrukslidelser: pasientfaktorers betydning for gjennomføring og utfall. Tidsskrift for norsk psykologforening, 59, 798-808.

Høiland, K. (2018). «The Good lives model» i behandling av personer dømt for seksuallovbrudd. Tidsskrift for norsk psykologforening, 56, 656-665.

Høiland, K. (2015). Om å skape en terapeutisk relasjon i arbeid med traumatiserte barn. Mellanrummet, 33, 45-54.

Høiland, Kristoffer; Arnevik, Espen Ajo & Egeland, Jens (2026). Alcohol Use Disorder and Bariatric Surgery: An Exploratory Study of Patient Factors. Alcoholism Treatment Quarterly. ISSN 0734-7324. doi: 10.1080/07347324.2026.2735619. Full text in Research Archive
Høiland, Kristoffer; Arnevik, Espen Kristian Ajo; Diep, Lien My; Mathisen, Tove; Nielsen, Anette Søgaard & Egeland, Jens (2026). Differences Between Patients with Alcohol Use Disorder Referred to Outpatient or Residential Treatment: An Observational Study. Nordic Studies on Alcohol and Drugs (NAD). ISSN 1455-0725. doi: 10.1177/14550725261463958. Full text in Research Archive Show summary
Aims Identifying the proper treatment setting and treatment level for alcohol use disorder (AUD) is of vital importance for securing favorable treatment outcomes. Clear evidence is lacking, but available research suggests that residential treatment works best for patients with high AUD severity, comorbid mental health disorders, and other social and functional problems. However, it is not evident that patients are referred to this costly treatment option based on these characteristics. We therefore examined whether patients in outpatient and residential AUD treatment differed on key characteristics. Methods Tests of bivariate associations were used to assess group differences between outpatients and patients in residential treatment in severity of alcohol use, other drug use, mental health, cognitive functioning, personality functioning, physical health, and social functioning. Results Severity of alcohol use, as measured by the Alcohol Use Disorders Identification Test (AUDIT), differed between the outpatient and residential groups. The residential group had a higher severity of alcohol use. Patients in the residential group were also somewhat older and much less likely to be employed. Conclusions Patients in outpatient and residential treatment mainly differed in the severity of alcohol use. Potential reasons for referrals to different treatment settings and their implications for clinical practice are discussed.
Erga, Aleksander Hagen; Hetland, Jens; Høiland, Kristoffer; Fodstad, Elise Constance Grude; Drevsjø, Sandra & Braatveit, Kirsten Johanne (2026). Utredning av kognitiv fungering i tverrfaglig spesialisert rusbehandling. Tidsskrift for Norsk psykologforening (Psykologtidsskriftet). ISSN 0332-6470. 63(3), p. 172–172. doi: 10.52734/mdgw7844. Full text in Research Archive Show summary
Kognitive vansker er vanlig blant personer med rusmiddellidelser. Norske psykologer i tverrfaglig spesialisert rusbehandling (TSB) vil møte pasienter med både forbigående og vedvarende kognitive vansker. Å identifisere personer med kognitive vansker er sentralt for å kunne tilpasse behandling og sikre god oppfølging. Basert på klinisk ekspertise og forskningsekspertise innen avhengighetsfeltet og gjennomgang av relevant litteratur presenterer vi en oppsummering av vanlige kognitive utfordringer hos pasienter med rusmiddelproblematikk, og vi gir praktiske råd for utredning i spesialisthelsetjenesten. Eksekutive vansker er blant de hyppigst forekommende og kan skyldes premorbid fungering, rusrelaterte skader eller somatisk sykdom. Vi foreslår en tredelt, nivåbasert utredningsmodell: Nivå 1 inkluderer anamnestisk informasjon og subjektive kartleggingsverktøy. Nivå 2 innebærer repeterbare, globale screeninginstrumenter, og nivå 3 består av en mer omfattende utredning av evnenivå, adaptiv fungering og eventuelt full nevropsykologisk utredning. Modellen gir et rammeverk for utredning av kognitive vansker i TSB, men utfordringer knyttet til falske positive testresultater, ulik kompetanse og begrenset tilgang på validerte norskspråklige verktøy må tas i betraktning. Vi konkluderer med at det er behov for videreutvikling av testverktøy, samt bedre opplæring og integrering av sosial og kognitiv fungering i behandling. En strukturert utredningspraksis kan styrke både behandlingstilbudet og pasientenes rett til velferdsytelser og kommunal oppfølging. Nøkkelord: kognisjon, rusmiddelvansker, avhengighet, utredning
Høiland, Kristoffer; Arnevik, Espen Kristian Ajo; Diep, Lien My; Mathisen, Tove; Nielsen, Anette Søgaard & Egeland, Jens (2025). Predictors of high- and low-risk drinking after group treatment for alcohol use disorder. BJPsych Open. doi: 10.1192/bjo.2025.10047. Full text in Research Archive
Høiland, Kristoffer; Raudeberg, Rune & Egeland, Jens (2025). The repeatable battery for the assessment of neuropsychological status (RBANS) and substance use disorders: a systematic review. Substance Abuse Treatment, Prevention, and Policy. 20(1). doi: 10.1186/s13011-025-00640-2. Full text in Research Archive Show summary
Cognitive deficits are prevalent among substance use disorder (SUD) patients and affect treatment retention and outcome. The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) is a well-researched instrument in diverse patient groups and has the potential to serve as an effective and accurate method for identifying cognitive impairment in SUD patients. This systematic review examines the RBANS’ ability to detect cognitive impairment in SUD patients. Limitations of knowledge and the need for further research are discussed. Methods We conducted a systematic search using PsycINFO, Medline, and Cochrane databases to identify relevant studies and articles on applying RBANS in SUD. No time limits were imposed on the search. Search words were RBANS, substance use disorder, drug use disorder, and alcohol use disorder, and the most common specific types of drugs (e.g., opiates, cannabis, and methamphetamine). Results A systematic search identified 232 articles, of which 17 were found eligible and included in the review. Most studies examined patient groups using either alcohol, methamphetamine, or opioids. The results are presented in the form of a narrative review. We identified some evidence that the RBANS can detect group differences between SUD patients and healthy controls, but the findings were somewhat inconsistent. The literature search revealed little information about cognitive profiles, reliability, factor structure, and construct and criterion validity. Conclusions The evidence concerning the validity and usefulness of the RBANS in SUD populations is scarce. Future research should investigate cognitive profiles, reliability, factor structure, and construct and criterion validity.
Høiland, Kristoffer; Arnevik, Espen Ajo; Diep, Lien My; Mathisen, Tove; Witkiewitz, Katie & Egeland, Jens (2025). Keep on Keeping on? Patient Factors Predicting Discontinuation in Alcohol Use Disorder Treatment. Substance Use & Misuse. ISSN 1082-6084. doi: 10.1080/10826084.2025.2519404. Full text in Research Archive
Høiland, Kristoffer; Arnevik, Espen Ajo; Nielsen, Anette Søgaard & Egeland, Jens (2025). Gender differences in alcohol use disorder treatment: sociodemographic, mental health, personality, and neuropsychological factors. Nordic Journal of Psychiatry. ISSN 0803-9488. doi: 10.1080/08039488.2025.2508415. Full text in Research Archive
Høiland, Kristoffer; Arnevik, Espen Kristian Ajo & Egeland, Jens (2024). Alcohol use disorder and fitness to drive: Discrepancies between health professionals’ evaluations and objective measures of alcohol use and cognitive functioning. Nordic Studies on Alcohol and Drugs (NAD). ISSN 1455-0725. 41(4), p. 426–438. doi: 10.1177/14550725231219972. Full text in Research Archive
Høiland, Kristoffer; Arnevik, Espen Kristian Ajo; Diep, Lien My; Mathisen, Tove; Witkiewitz, Katie & Egeland, Jens (2024). Impaired or not impaired: The accuracy of the Montreal Cognitive Assessment in detecting cognitive impairment among patients with alcohol use disorder. Alcohol, Clinical and Experimental Research. doi: 10.1111/acer.15437. Full text in Research Archive Show summary
Background Cognitive impairments are common in alcohol use disorder (AUD), but only a few studies have investigated the accuracy of the Montreal Cognitive Assessment (MoCA) in this population. We examined the accuracy and precision of the MoCA in detecting cognitive impairment in a sample of patients with AUD. In addition, we investigated whether the MoCA predicts premature discontinuation from treatment. Method A sample of 126 persons with AUD undergoing treatment in specialist health services were administered the MoCA and a battery of 12 neuropsychological tests. Five cognitive domains were derived from the reference tests. A composite total score from these tests was used as a reference criterion for determining correct and incorrect classifications for the MoCA. We analyzed the optimal cut-off score for the MoCA and the accuracy and agreement of classification between the MoCA and the reference tests. Results Receiver operating characteristic (ROC) curve analyzes yielded an area under the curve (AUC) of 0.77 (95% CI [0.67, 0.87]). Applying 25 as the cut-off, MoCA sensitivity was 0.77 and specificity 0.62. The PPV was 0.53. The NPV was 0.84. Using a cut-off score of 24 yielded a lower sensitivity 0.60, but specificity was significantly better i.e., 0.79. PPV was 0.68. The NPV was 0.82. Kappa agreement between MoCA and the reference tests was fair to moderate, 0.38 for the cut-off of 25, and 0.44 for the cut-off of 24. MoCA did not predict discontinuation from treatment. Conclusions Our findings indicate limitations in the classification accuracy of the MoCA in predicting cognitive impairment in AUD. Achieving the right balance between accurately identifying impaired cases without including too many false positives can be challenging. Further, MoCA does not predict discontinuation from treatment. Overall, the results do not support MoCA as a time-efficient screening instrument.
Høiland, Kristoffer & Egeland, Jens (2022). Behandling av alkoholbrukslidelse: pasientfaktorers betydning for gjennomføring og utfall. Tidsskrift for Norsk psykologforening (Psykologtidsskriftet). ISSN 0332-6470. 59(9), p. 798–808. doi: 10.52734/dX5j39y5. Full text in Research Archive Show summary
Alcohol use disorder (AUD) is among the three most common mental disorders in Norway. In general, treatment is provided by interdisciplinary specialized substance use disorder clinics. However, a substantial portion of AUD patients do not receive effective treatments, and we need to develop more efficient treatments that are tailored to the patient. This article presents findings from a clinically situated literature search on the significance of patient factors for completion and outcomes of AUD treatment. We found that severity of alcohol dependence, social network, personality disorders and cognitive impairments were significant factors for completion and outcomes in AUD treatment. Demographic factors such as gender and age were of minor importance. This can be useful hands-on knowledge for clinicians working in the field of addiction treatment when providing and adapting treatment to AUD patients.
Høiland, Kristoffer (2018). The Good Lives Model i behandling av personer dømt for seksuallovbrudd. Tidsskrift for Norsk psykologforening (Psykologtidsskriftet). ISSN 0332-6470. 55(8), p. 657–665. Full text in Research Archive

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Høiland, Kristoffer (2025). Har alkoholforskningen glemt gleden ved å drikke? Nytt Norsk Tidsskrift (NNT). ISSN 0800-336X. doi: 10.18261/nnt.42.2.8. Full text in Research Archive
Høiland, Kristoffer (2024). Kan mennesker med et alkoholproblem være egnede bilførere, eller bør de fratas førerkortet? Full text in Research Archive
Høiland, Kristoffer (2024). Hvit januar, hjelper det? Full text in Research Archive
Høiland, Kristoffer (2024). Alkoholbruk: Nye bøker, gamle myter. Full text in Research Archive
Høiland, Kristoffer (2023). Vi bør slutte å kalle folk alkoholikere. Full text in Research Archive
Høiland, Kristoffer (2023). Vi bør slutte å kalle folk alkoholikere. Full text in Research Archive
Høiland, Kristoffer (2023). Forskning på alkoholbehandling: Hva vet vi? Full text in Research Archive
Høiland, Kristoffer (2022). Folk med alkoholproblemer tilbys for dårlig behandling. Full text in Research Archive
Høiland, Kristoffer (2026). Patient factors in alcohol use disorder treatment. Universitetet i Oslo. Full text in Research Archive Show summary
It is vital to understand how patient factors, namely sociodemographic, psychological, and social factors, are associated with treatment outcomes in alcohol use disorder (AUD) treatment. The current study examined predictors of outcome in group treatment of AUD. The overarching principle behind the project was to study real-life patients and treatments to enhance ecological validity. Therefore, we conducted a multi-site study of patients treated in routine practice within specialist health services in Norway. Data were collected from three clinics and four treatment sites in Eastern Norway. The following series of papers explored various aspects of sociodemographic, psychological, and cognitive functioning in treatment-seeking patients with AUD and assessed potential predictors associated with treatment outcomes and discontinuation. Paper I investigated the usefulness of the Montreal Cognitive Assessment (MoCA) as a tool for detecting cognitive impairment (CI) in patients with AUD. The study found that MoCA's performance was inconsistent, due to difficulties in balancing sensitivity and specificity. Further, MoCA only exhibited a moderate agreement with the reference tests, suggesting it does not effectively measure cognitive functioning in patients with AUD. This suggests apparent limitations in using MoCA to screen for CI in this population, and advocates for alternative assessments specifically tailored to patients with AUD. Paper II focused on gender differences in patients with AUD, particularly noting that women showed similar levels of harmful alcohol use but more psychological distress compared to men. Women also exhibited more maladaptive personality traits and lower general intellectual functioning. This indicates a vulnerability necessitating gender-specific adjustments for women in AUD treatment. Paper III examined predictors of treatment discontinuation among patients with AUD and identified executive functioning (EF) as a significant predictor. Lower EF was associated with increased risk of discontinuation, underscoring the importance of EF assessment in AUD treatment. Paper IV examined short-term outcome predictors, identifying low Responsibility in personality as a predictor for at-risk drinking post-treatment. The percentage of group therapy attended was found to have minimal impact on drinking levels, highlighting personality factors over engagement in group therapy as critical to treatment outcomes. Overall, these studies underscore the need for nuanced and individualized screening and intervention strategies for treatment-seeking patients with AUD. With a particular emphasis on cognitive function, personality traits, and gender-specific differences.

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Published Oct. 25, 2022 9:40 AM - Last modified Mar. 11, 2025 9:26 AM

Research groups

Research Unit of Neuropsychopathology (RUN)