Investigating the relationship between changes in metaphysical beliefs and death anxiety following a significant psychedelic experience

A growing literature indicates that psychedelic drugs can produce durable psychological changes, including reductions in death anxiety and shifts in attitudes about mortality. Previous clinical and naturalistic studies have reported lower fear of death following single doses of psilocybin or LSD and psychedelic-induced phenomenology that resembles near-death experiences. However, the mechanisms linking psychedelic experiences to reduced death anxiety remain unclear. One candidate mechanism is change in metaphysical beliefs about the nature of reality and consciousness, ranging from physicalist positions to non-physicalist positions such as dualism or panpsychism; early work suggests psychedelics can produce lasting shifts away from strict physicalism and toward broader attributions of consciousness across entities. Moreton and colleagues set out to test whether changes in metaphysical beliefs following a single significant psychedelic experience are associated with changes in death anxiety. The study hypothesised an overall reduction in death anxiety, a shift away from physicalist beliefs toward non-physicalist beliefs, and correlations between those belief changes and changes in death anxiety. The investigators also predicted that acute subjective effects of the experience—mystical-type experiences and psychological insights—would predict changes in death anxiety and metaphysical beliefs, and included an exploratory aim to identify which specific metaphysical beliefs best predict changes in death anxiety.

The researchers conducted a cross-sectional, retrospective online survey recruiting adults who reported at least one significant psychedelic experience that altered their attitudes or anxieties about death. Eligibility required participants to be 18 or older, fluent in English, and to have taken a classic psychedelic (LSD, DMT, psilocybin, ayahuasca, or mescaline). Recruitment used online platforms, social media and snowball sampling targeted at psychedelic communities. Of 226 responses, 71 were excluded for incompleteness or implausible responses, leaving a final sample of 155 (97 men, 53 women, four non-binary, one 'prefer not to say'; mean age 29.5, SD = 7.78). Participants reported on a single noteworthy psychedelic episode and indicated which substance was used (78 LSD, 38 psilocybin, 39 ayahuasca, 29 DMT, 13 mescaline). A sensitivity analysis indicated the sample had 80% power to detect correlations of r = 0.22 at alpha = 0.05. Data collection used Qualtrics and obtained informed electronic consent. Participants completed demographic questions and lifetime psychedelic-use history, then retrospectively rated their beliefs and attitudes for the three months before and up to three months after the chosen experience. Acute subjective measures included the Mystical Experience Questionnaire-30 (MEQ30; mean scores computed; α = .97 in this sample) and the Psychological Insights Questionnaire (PIQ; 23 items; α = .97). Enduring effects were measured with a novel 13-item Metaphysical Beliefs Questionnaire (MBQ), presented twice to capture pre- and post-experience beliefs and yielding physicalist (PB) and non-physicalist (NPB) subscales (PB pre α = .79, post α = .83; NPB pre α = .90, post α = .90). Death anxiety was assessed using the Fear of Death subscale of the Death Attitude Profile-Revised (DAP-R; seven items; pre α = .90, post α = .93). Analyses focused on within-subject change and associations with acute effects. Paired-sample t-tests compared pre- and post-scores on metaphysical belief subscales, individual MBQ items, and DAP-R fear of death. For correlation analyses, the team computed residualised change scores by regressing post-scores on pre-scores to reduce bias from baseline values and regression to the mean. Relationships between MEQ/PIQ scores, changes in metaphysical beliefs, and changes in death anxiety were tested using correlations and reported variables were adjusted for multiple comparisons with the Benjamini-Hochberg False Discovery Rate procedure. The extracted text does not report additional covariate-adjusted models or whether analyses controlled for substance type, setting, or time since the experience.

Paired-sample comparisons showed a significant average reduction in fear of death from before to after the reported psychedelic experience. The sample displayed heterogeneous responses: 81 participants reported decreased fear of death, 57 reported increased fear, and 17 reported no change. For metaphysical beliefs, there was a significant average increase in non-physicalist beliefs overall, but only two individual MBQ items showed significant pre-to-post increases: MPQ1 (ontological transcendentalism) and MPQ7 (non-naturalism). The extracted text states that the study did not detect a significant overall pre-post increase specifically for panpsychism. Correlational analyses indicated that MEQ scores (mystical experience intensity) were significantly associated with residualised change scores for fear of death, the non-physicalist beliefs subscale, and eight of the 13 individual metaphysical belief items. PIQ scores (psychological insight) were significantly correlated with residualised change scores for both the physicalist and non-physicalist MBQ subscales and with seven of the 13 individual items, but PIQ scores were not significantly correlated with changes in fear of death. Importantly, changes in fear of death were largely unrelated to most metaphysical belief changes; the only significant association that survived the multiple-comparisons adjustment was between change in fear of death and the MBQ item measuring panpsychism. The paper reports internal consistencies for key scales (MEQ α = .97; PIQ α = .97; MBQ PB pre α = .79, post α = .83; MBQ NPB pre α = .90, post α = .90; DAP-R pre α = .90, post α = .93).

Moreton and colleagues interpret their findings as evidence that, averaged across participants, a single significant psychedelic experience was associated with reduced death anxiety and an increase in non-physicalist metaphysical beliefs, with mystical-type experiences predicting reductions in death anxiety. The investigators note that despite the average reduction, a substantial minority reported increased death anxiety, underscoring the heterogeneous outcomes of naturalistic psychedelic use and the need to investigate potential harms more systematically. The discussion highlights the somewhat unexpected finding that changes in death anxiety were not broadly correlated with shifts in metaphysical beliefs: only change in belief in panpsychism showed a significant association with reductions in fear of death. The authors offer speculative mechanisms consistent with psychological theory—panpsychist beliefs might reduce fear of non-existence by implying some continuity of consciousness, or enhance feelings of universal connectedness, both of which have been linked to lower death anxiety in prior work. The paper contrasts its panpsychism results with other studies that found greater panpsychist endorsement after psychedelics, proposing that gender composition (their sample was predominantly male) and variation in set and setting (including non-ceremonial and unguided experiences) may explain differences. The authors reference ideas such as 'emotional synchrony' and 'pre-state identity fusion' as contextual factors that could amplify shifts away from physicalism. Limitations acknowledged by the study team include the retrospective design and attendant recall and response biases (social desirability, hindsight bias, effort justification), cross-sectional data that preclude causal inference, limited power for substance-specific comparisons, and the possibility that single-item metaphysical measures do not fully capture complex beliefs. The authors note they did not measure participants' perceived recall accuracy. For future research they recommend larger, prospective studies that can disentangle drug, set-and-setting, and demographic moderators, use more comprehensive measures of metaphysical beliefs, and examine mediators such as connectedness and the specific qualitative features of mystical experience.

The study concludes that, in this retrospective sample of individuals reporting a significant psychedelic experience that altered their attitudes toward death, there was an average reduction in death anxiety that was predicted by the intensity of mystical experience. Changes in death anxiety correlated significantly only with changes in belief in panpsychism among the metaphysical belief items assessed. The authors present these results as preliminary groundwork for further research into how psychedelic-induced shifts in metaphysical beliefs relate to existential outcomes such as death anxiety.