Depressive DisordersPTSDVeteransMajor Depressive Disorder (MDD)Traumatic Brain Injury (TBI)Neurological InjuryMDMAPsilocybin

Beliefs and Perceived Barriers Regarding Psychedelic-assisted Therapy in a Pilot Study of Service Members and Veterans With a History of Traumatic Brain Injury

In a pilot sample of 21 service members and veterans with traumatic brain injury, brief psychoeducation significantly increased positive attitudes and interest in psychedelic-assisted therapy (PAT), and most participants supported PAT availability in medical settings if proven beneficial. Participants nonetheless expressed health concerns (long-term effects, losing their mind, personality changes) and logistical barriers (time, transport, cost), indicating the need for targeted education, command support and practical facilitation to ensure access if PAT is approved.

Authors

  • Matthew Johnson
  • Jessica Maples-Keller

Published

Military Medicine
individual Study

Abstract

Introduction

Posttraumatic stress disorder (PTSD) and depression are common in service members and veterans, and the response to currently available treatments is often modest at best. Recent studies suggest potential benefit with psychedelic-assisted therapies (PATs), particularly 3,4-methylenedioxymethamphetamine-assisted therapy for PTSD and psilocybin-assisted therapy for depression. This study examined beliefs and perceived barriers regarding PAT among service members and veterans to inform the delivery of these treatments if they are approved by the FDA.

Materials and Methods

Twenty-one service members and veterans (67% male, 81% White, and 43% active duty) with a history of traumatic brain injury and co-occurring cognitive and psychological symptoms completed a measure assessing baseline knowledge and views of PAT, read a brief psychoeducation regarding PAT, and then responded to questions related to their beliefs and perceived barriers to PAT.

Results

Before psychoeducation, participants reported a neutral view of psychedelic drugs (M = 2.76; range: 1-5), PAT (M = 3.33), and interest in PAT (M = 3.10). After psychoeducation, participants reported a significantly more positive view of psychedelic drugs (M = 3.24, P = .014) and interest in PAT (M = 3.67, P = .016). Overall, participants indicated that they would support PAT availability in medical settings if proven beneficial (M = 4.52; 5 = “agree strongly”) and they would support a loved one engaging in PAT (M = 4.29). The most frequently reported health concerns were concern of long-term effects (43%), fear of losing their mind (33%), fear of personality changes (33%), and fear of traumatic brain injury complications (24%). The most frequently endorsed barriers were time commitment, transportation, financial concerns, work, and childcare (33%-19%), with 48% reporting no barriers.

Conclusions

This is the first study to explore beliefs and perceived barriers regarding PAT among service members and veterans. These results indicate that military populations may be interested in PAT, particularly if psychoeducation and outreach regarding these treatments occurred. If FDA approved, it will be important to facilitate command support and address logistical barriers to ensure appropriate access within military contexts.

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Research Summary of 'Beliefs and Perceived Barriers Regarding Psychedelic-assisted Therapy in a Pilot Study of Service Members and Veterans With a History of Traumatic Brain Injury'

Introduction

Randomised controlled trials have recently strengthened interest in psychedelic-assisted therapy (PAT), particularly MDMA-assisted therapy for post-traumatic stress disorder (PTSD) and psilocybin-assisted therapy for major depressive disorder. Gray and colleagues note that Phase III data have shown promising efficacy signals (for example, a substantial proportion of MDMA-treated participants no longer met PTSD criteria in a Phase III trial) and that a Phase III programme for psilocybin is planned. Service members and veterans have high rates of PTSD, depression and co-occurring traumatic brain injury (TBI), and standard treatments often yield modest or incomplete responses in these populations; the authors argue that PAT could be a novel option worthy of attention for patients with treatment-resistant presentations. This study sought to characterise beliefs, familiarity, and perceived barriers regarding PAT among service members and veterans with a history of TBI and co-occurring cognitive or psychological symptoms. Using a brief written psychoeducation module and a questionnaire administered at baseline, the investigators aimed to measure participants' baseline knowledge and attitudes toward psychedelic drugs and PAT, to assess changes in those attitudes after reading the psychoeducation, and to identify anticipated logistical, stigma-related, and health concerns that might affect uptake if PAT becomes FDA approved and available in medical settings. Given the exploratory nature of the work, the authors expected a wide range of familiarity and views among participants.

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Study Details

References (6)

Papers cited by this study that are also in Blossom

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