Schizophrenia

Ego-dissolution and psychedelics: validation of the ego-dissolution inventory (EDI)

This study (n=691) aimed to validate the Ego-Dissolution Inventory (EDI) as well as to investigate the specificity of the relationship between psychedelics and ego-dissolution. The results demonstrate the psychometric structure, internal consistency, and construct validity of the EDI. It was confirmed that ego-dissolution is specific for experiences induced by psychedelic drugs and not by alcohol or cocaine.

Authors

  • Robin Carhart-Harris
  • David Nutt
  • John Evans

Published

Frontiers in Human Neuroscience
individual Study

Abstract

Aims

The experience of a compromised sense of “self”, termed ego-dissolution, is a key feature of the psychedelic experience. This study aimed to validate the Ego-Dissolution Inventory (EDI), a new 8-item self-report scale designed to measure ego-dissolution. Additionally, we aimed to investigate the specificity of the relationship between psychedelics and ego-dissolution.

Method

Sixteen items relating to altered ego-consciousness were included in an internet questionnaire; eight relating to the experience of ego-dissolution (comprising the EDI), and eight relating to the antithetical experience of increased self-assuredness, termed ego-inflation. Items were rated using a visual analog scale. Participants answered the questionnaire for experiences with classical psychedelic drugs, cocaine and/or alcohol. They also answered the seven questions from the Mystical Experiences Questionnaire (MEQ) relating to the experience of unity with one’s surroundings.

Results

Six hundred and ninety-one participants completed the questionnaire, providing data for 1828 drug experiences (1043 psychedelics, 377 cocaine, 408 alcohol). Exploratory factor analysis demonstrated that the eight EDI items loaded exclusively onto a single common factor, which was orthogonal to a second factor comprised of the items relating to ego-inflation (rho = −0.110), demonstrating discriminant validity. The EDI correlated strongly with the MEQ-derived measure of unitive experience (rho = 0.735), demonstrating convergent validity. EDI internal consistency was excellent (Cronbach’s alpha 0.93). Three analyses confirmed the specificity of ego-dissolution for experiences occasioned by psychedelic drugs. Firstly, EDI score correlated with drug-dose for psychedelic drugs (rho = 0.371), but not for cocaine (rho = 0.115) or alcohol (rho = −0.055). Secondly, the linear regression line relating the subjective intensity of the experience to ego-dissolution was significantly steeper for psychedelics (unstandardized regression coefficient = 0.701) compared with cocaine (0.135) or alcohol (0.144). Ego-inflation, by contrast, was specifically associated with cocaine experiences. Finally, a binary Support Vector Machine classifier identified experiences occasioned by psychedelic drugs vs. cocaine or alcohol with over 85% accuracy using ratings of ego-dissolution and ego-inflation alone.

Conclusion

Our results demonstrate the psychometric structure, internal consistency and construct validity of the EDI. Moreover, we demonstrate the close relationship between ego-dissolution and the psychedelic experience. The EDI will facilitate the study of the neuronal correlates of ego-dissolution, which is relevant for psychedelic-assisted psychotherapy and our understanding of psychosis.

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Research Summary of 'Ego-dissolution and psychedelics: validation of the ego-dissolution inventory (EDI)'

Introduction

Distortions in the subjective sense of self, often referred to as ego-dissolution, are a central feature of the psychedelic experience. Previous work has reported reductions in self-referential awareness with classical 5-HT2A agonists such as psilocybin, LSD and DMT, and related phenomena have been described in other altered states (for example, during ketamine or nitrous oxide use). Existing questionnaires of altered states capture a range of depersonalisation and visionary experiences, but the authors identify a gap: there was no brief, validated, uni-dimensional self-report measure that directly operationalises ego-dissolution as a construct, which limits psychometric, neurobiological and clinical research into this specific aspect of psychedelic states. Nour and colleagues therefore developed the Ego-Dissolution Inventory (EDI), an 8-item self-report scale intended to measure ego-dissolution succinctly. Using an anonymous internet survey, the study aimed to validate the EDI psychometrically (factor structure, internal consistency, convergent and discriminant validity), to test whether ego-dissolution is specifically associated with psychedelic drugs versus cocaine or alcohol, and to explore relationships with dose, subjective intensity and changes in well-being. A secondary hypothesis was that stimulant drugs such as cocaine would be associated with an opposite phenomenon—termed ego-inflation—rather than ego-dissolution.

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Study Details

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Kuc, J., Kettner, H., Rosas, F. E. et al. · Psychopharmacology (2021)

Day trip to hell: A mixed methods study of challenging psychedelic experiences

Johnstad, P. G. · Journal of Psychedelic Studies (2021)

43 cited
Sub-acute and long-term effects of ayahuasca on mental health and well-being in healthy ceremony attendants: A replication study

van Oorsouw, K., Uthaug, M. V., Mason, N. L. et al. · Journal of Psychedelic Studies (2021)

17 cited
Persisting effects of ayahuasca on empathy, creative thinking, decentering, personality, and well-being

Kiraga, M. K., Mason, N. L., Uthaug, M. V. et al. · Frontiers in Pharmacology (2021)

56 cited
Prefrontal contributions to the stability and variability of thought and conscious experience

Zamani, A., Carhart-Harris, R. L., Christoff, K. · Neuropsychopharmacology (2021)

The effects of tryptamine psychedelics in the brain: a meta-analysis of functional and review of molecular imaging studies

Castelhano, J. M., Lima, G. M., Teixeira, M. et al. · Frontiers in Pharmacology (2021)

Psilocybin-induced changes in brain network integrity and segregation correlate with plasma psilocin level and psychedelic experience

Madsen, M. K., Stenbaek, D. S., Arvidsson, A. et al. · European Neuropsychopharmacology (2021)

This Is Something That Changed My Life: A Qualitative Study of Patients' Experiences in a Clinical Trial of Ketamine Treatment for Alcohol Use Disorders

Mollaahmetoglu, O. M., Keeler, J., Ashbullby, K. J. et al. · Frontiers in Psychiatry (2021)

Turn on, Tune in, and Drop out: Predictors of Attrition in a Prospective Observational Cohort Study on Psychedelic Use

Hübner, S., Haijen, E. C. H. M., Kaelen, M. et al. · Journal of Medical Internet Research (2021)

Does psychedelic therapy have a transdiagnostic action and prophylactic potential?

Kočárová, C., Horacek, J., Carhart-Harris, R. L. · Frontiers in Psychiatry (2021)

73 cited
Trips and Neurotransmitters: Discovering Principled Patterns across 6,850 Hallucinogenic Experiences

Ballentine, G., Friedman, S. F., Bzdok, D. · Science Advances (2021)

44 cited
LSD, madness and healing: Mystical experiences as possible link between psychosis model and therapy model

Wießner, I., Falchi, M., Palhano-Fontes, F. et al. · Psychological Medicine (2021)

Psychedelic medicalization, public discourse, and the morality of ego dissolution

Gearin, A. K., Devenot, N. · International Journal of Cultural Studies (2021)

Future Directions for Clinical Psilocybin Research: The Relaxed Symptom Network

Lewis-Healey, E., Laukkonen, R., Van Elk, M. · Psyarxiv (2021)

1 cited
Relational Processes in Ayahuasca Groups of Palestinians and Israelis

Roseman, L., Ron, Y., Saca, A. et al. · Frontiers in Pharmacology (2021)

30 cited
Psychedelics and Consciousness: Distinctions, Demarcations, and Opportunities

Yaden, D. B., Johnson, M. W., Griffiths, R. R. et al. · International Journal of Neuropsychopharmacology (2021)

The Shipibo Ceremonial Use of Ayahuasca to Promote Well-Being: An Observational Study

González, D., Cantillo, J., Perez, I. et al. · Frontiers in Pharmacology (2021)

Set and Setting in the Santo Daime

Hartogsohn, I. · Frontiers in Pharmacology (2021)

Examining changes in personality following shamanic ceremonial use of ayahuasca

Weiss, B., Miller, J. D., Carter, N. T. et al. · Scientific Reports (2021)

53 cited
Naturalistic Use of Mescaline Is Associated with Self-Reported Psychiatric Improvements and Enduring Positive Life Changes

Agin-Liebes, G. I., Lancelotta, R., Uthaug, M. V. et al. · ACS Pharmacology and Translational Science (2021)

Psychedelic Harm Reduction and Integration: A Transtheoretical Model for Clinical Practice

Palhano-Fontes, F., Gorman, I., Nielson, E. M. et al. · Frontiers in Psychology (2021)

A placebo-controlled study of the effects of ayahuasca, set and setting on mental health of participants in ayahuasca group retreats

Uthaug, M. V., Mason, N. L., Toennes, S. W. et al. · Psychopharmacology (2021)

Lasting effects of a single psilocybin dose on resting-state functional connectivity in healthy individuals

McCulloch, D. E-W., Madsen, M. K., Stenbæk, D. S. et al. · Journal of Psychopharmacology (2021)

Positive expectations predict improved mental-health outcomes linked to psychedelic microdosing

Kaertner, L. S., Steinborn, M. B., Kettner, H. et al. · Scientific Reports (2021)

112 cited
The entropic tongue: Disorganization of natural language under LSD

Sanz, C., Pallavicini, C., Carrillo, F. et al. · Consciousness and Cognition (2021)

24 cited
The potential synergistic effects between psychedelic administration and nature contact for the improvement of mental health

Gandy, S., Forstmann, M., Carhart-Harris, R. L. et al. · Health Psychology Open (2020)

Mood and cognition after administration of low LSD doses in healthy volunteers: A placebo controlled dose-effect finding study

Hutten, N. R. P. W., Mason, N. L., Dolder, P. C. et al. · European Neuropsychopharmacology (2020)

95 cited
Pivotal Mental States

Brouwer, A., Carhart-Harris, R. L. · Journal of Psychopharmacology (2020)

Broadening Your Mind to Include Others: The relationship between serotonergic psychedelic experiences and maladaptive narcissism

Van Mulukom, V., Patterson, R. E., Van Elk, M. · Psychopharmacology (2020)

Me, myself, bye: regional alterations in glutamate and the experience of ego dissolution with psilocybin

Mason, N. L., Kuypers, K. P. C., Reckweg, J. et al. · Neuropsychopharmacology (2020)

Isness: Using Multi-Person VR to Design Peak Mystical Type Experiences Comparable to Psychedelics

Glowacki, D. R., Wonnacott, M. D., Freire, R. et al. · Association for Computing Machinery (2020)

32 cited
A single psilocybin dose is associated with long-term increased mindfulness, preceded by a proportional change in neocortical 5-HT2A receptor binding

Madsen, M. K., Fisher, P. M., Stenbæk, D. S. et al. · European Neuropsychopharmacology (2020)

Dissolving the self: Active inference, psychedelics, and ego-dissolution

Deane, G. · Philosophy and the Mind Sciences (2020)

Learning to Let Go: A Cognitive-Behavioral Model of How Psychedelic Therapy Promotes Acceptance

Wolff, M., Evens, R., Mertens, L. J. et al. · Frontiers in Psychiatry (2020)

Self-reported negative outcomes of psilocybin users: A quantitative textual analysis

Bienemann, B., Ruschel, N. S., Campos, M. L. et al. · PLOS ONE (2020)

57 cited
Therapeutic Use of LSD in Psychiatry: A Systematic Review of Randomized-Controlled Clinical Trials

Fuentes, J. J., Fonseca, F., Elices, M. et al. · Frontiers in Psychiatry (2020)

Transformative experience and social connectedness mediate the mood-enhancing effects of psychedelic use in naturalistic settings

Forstmann, M., Yudkin, D. A., Prosser, A. M. B. et al. · PNAS (2020)

From Egoism to Ecoism: Psychedelics Increase Nature Relatedness in a State-Mediated and Context-Dependent Manner

Kettner, H., Gandy, S., Haijen, E. C. H. M. et al. · International Journal of Environmental Research and Public Health (2019)

131 cited
Prospective examination of synthetic 5-methoxy-N,N-dimethyltryptamine inhalation: effects on salivary IL-6, cortisol levels, affect, and non-judgment

Uthaug, M. V., Lancelotta, R., Szabo, A. et al. · Psychopharmacology (2019)

86 cited
Embedding existential psychology within psychedelic science: reduced death anxiety as a mediator of the therapeutic effects of psychedelics.

Moreton, S. G., Szalla, L., Menzies, R. E. et al. · Psychopharmacology (2019)

47 cited
Characterization and prediction of acute and sustained response to psychedelic psilocybin in a mindfulness group retreat

Smigielski, L., Kometer, M., Scheidegger, M. et al. · Scientific Reports (2019)

126 cited
Toward a contextual psychedelic-assisted therapy: Perspectives from Acceptance and Commitment Therapy and contextual behavioral science

Luoma, J. B., Sabucedo, P., Eriksson, J. et al. · Journal of Contextual Behavioral Science (2019)

Emotional breakthrough and psychedelics: validation of the emotional breakthrough inventory

Roseman, L., Haijen, E. C. H. M., Idialu-Ikato, K. et al. · Journal of Psychopharmacology (2019)

REBUS and the Anarchic Brain: Toward a Unified Model of the Brain Action of Psychedelics

Carhart-Harris, R. L., Friston, K. J. · Pharmacological Reviews (2019)

Replication and extension of a model predicting response to psilocybin

Russ, S. L., Carhart-Harris, R. L., Maruyama, G. et al. · Psychopharmacology (2019)

55 cited
States and traits related to the quality and consequences of psychedelic experiences

Russ, S. L., Carhart-Harris, R. L., Maruyama, G. et al. · Psychology of Consciousness Theory Research and Practice (2019)

Psychedelic effects of psilocybin correlate with serotonin 2A receptor occupancy and plasma psilocin levels

Madsen, M. K., Fisher, P. M., Burmester, D. et al. · Neuropsychopharmacology (2019)

How do psychedelics work?

Carhart-Harris, R. L. · Current Opinion in Psychiatry (2019)

Predicting responses to psychedelics: a prospective study

Haijen, E. C. H. M., Kaelen, M., Roseman, L. et al. · Frontiers in Pharmacology (2018)

339 cited
Awe: a putative mechanism underlying the effects of classic psychedelic-assisted psychotherapy

Hendricks, P. S. · International Review of Psychiatry (2018)

143 cited
Dimensions of consciousness and the psychedelic state

Bayne, T., Carter, O. · Neuroscience of Consciousness (2018)

106 cited
DMT models the near-death experience

Timmermann, C., Roseman, L., Williams, L. et al. · Frontiers in Psychology (2018)

Sub-acute and long-term effects of ayahuasca on affect and cognitive thinking style and their association with ego dissolution

Uthaug, M. V., Van Oorsouw, &. K., Kuypers, &. K. P. C. et al. · Psychopharmacology (2018)

Psychedelic-Assisted Psychotherapy: A Paradigm Shift in Psychiatric Research and Development

Schenberg, E. E. · Frontiers in Pharmacology (2018)

Unifying theories of psychedelic drug effects

Swanson, L. R. · Frontiers in Pharmacology (2018)

Psychedelics and the essential importance of context

Carhart-Harris, R. L., Roseman, L., Haijen, E. C. H. M. et al. · Journal of Psychopharmacology (2018)

Increased nature relatedness and decreased authoritarian political views after psilocybin for treatment-resistant depression

Lyons, T., Carhart-Harris, R. L. · Journal of Psychopharmacology (2018)

Quality of acute psychedelic experience predicts therapeutic efficacy of psilocybin for treatment-resistant depression

Roseman, L., Nutt, D. J., Carhart-Harris, R. L. · Frontiers in Pharmacology (2018)

Serotonin and brain function: a tale of two receptors

Carhart-Harris, R. L., Nutt, D. J. · Journal of Psychopharmacology (2017)

Psychedelics and connectedness

Carhart-Harris, R. L., Erritzoe, D., Haijen, E. C. H. M. et al. · Psychopharmacology (2017)

Self unbound: ego dissolution in psychedelic experience

Letheby, C., Gerrans, P. · Neuroscience of Consciousness (2017)

Looking for the Self: Phenomenology, Neurophysiology and Philosophical Significance of Drug-induced Ego Dissolution

Millière, R. · Frontiers in Human Neuroscience (2017)

Psychedelics, personality and political perspectives

Nour, M. R., Evans, J., Carhart-Harris, R. L. · Journal of Psychoactive Drugs (2017)

164 cited
The psychological and human brain effects of music in combination with psychedelic drugs

Kaelen, M. · Imperial College London (2017)

Psychedelics and the science of self-experience

Nour, M. R., Carhart-Harris, R. L. · British Journal of Psychiatry (2017)

The association of psychedelic use and opioid use disorders among illicit users in the United States

Pisano, V. D., Putnam, N. P., Kramer, H. M. et al. · Journal of Psychopharmacology (2017)

5-HT2A Agonists: A Novel Therapy for Functional Neurological Disorders?

Bryson, A., Carter, O., Norman, T. et al. · International Journal of Neuropsychopharmacology (2017)

18 cited
Phenomenology, Structure, and Dynamic of Psychedelic States

Preller, K. H., Vollenweider, F. X. · Behavioral Neurobiology of Psychedelic Drugs (2016)

The Challenging Experience Questionnaire: Characterization of challenging experiences with psilocybin mushrooms

Barrett, F. S., Bradstreet, M. P., Leoutsakos, J. M. S. et al. · Journal of Psychopharmacology (2016)

New World Tryptamine Hallucinogens and the Neuroscience of Ayahuasca

McKenna, D., Riba, J. · Current Topics in Behavioral Neurosciences (2016)

Serotonergic Hallucinogen-Induced Visual Perceptual Alterations

Kometer, M., Vollenweider, F. X. · Behavioral Neurobiology of Psychedelic Drugs (2016)

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