Anxiety DisordersSuicidalitySchizophreniaSafety & Risk Management

Clinically relevant acute subjective effects of psychedelics beyond mystical experience

This review (2024) examines the acute subjective effects of classic psychedelics, their relationship to risks and therapeutic benefits, and the current limitations in measuring these effects. It discusses existing measures, their construct validity, and predictive value for outcomes, while proposing recommendations for improving conceptualization and measurement in future research.

Authors

  • Roland Griffiths
  • Brandon Weiss
  • David Yaden

Published

Nature Reviews Psychology
meta Study

Abstract

The administration of classic psychedelics has been associated with well-being and mental health benefits as well as risks and adverse events. The acute subjective effects of psychedelics might have a causal role in these risks and therapeutic benefits, but inconsistencies and limitations in the conceptualization and measurement of these acute subjective effects hinder research and clinical advances. In this Review, we outline current characterizations and psychometric examinations of the acute subjective effects of psychedelics, evaluate the construct validity of commonly used measures and describe findings showing that specific acute subjective effects predict certain outcomes. We discuss how to balance the limitations of existing measures with methodological advances in practice and elaborate on well-known methods and other psychological processes that can help inform the creation of new measures. We suggest actionable recommendations for how the field can transcend current conceptualizations and provide guidance on best practices until the next generation of measures is validated.

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Research Summary of 'Clinically relevant acute subjective effects of psychedelics beyond mystical experience'

Introduction

Classic psychedelics such as psilocybin, DMT, mescaline and LSD produce a distinctive set of acute subjective effects that alter perception, cognition and affect. These effects range from positive experiences—visual alterations, heightened affect, connectedness, insight and moments rated as highly meaningful—to challenging states including anxiety, fear, dissociation and confusion that can require therapeutic support. Although several clinical studies have reported therapeutic benefits (for example, in mood and substance-use disorders), these findings are preliminary because of limitations in design, sample size and blinding, and serious adverse experiences (for example, psychosis or increased suicidality) have been observed in some cases, emphasising the need for careful assessment of both risks and benefits. Yaden and colleagues set out to clarify how acute subjective effects have been conceptualised and measured, to evaluate the construct validity of commonly used instruments, and to examine empirical relations between specific acute effects and later outcomes. The Review contrasts two broad explanatory classes—higher-level subjective processes versus lower-level pharmacological and neurobiological mechanisms—surveys psychometric approaches (broad versus narrow measures), assesses threats to validity, and offers concrete recommendations to improve measurement practices and guide future research and clinical applications.

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References (64)

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