Predictors of psychedelic treatment outcomes among special operations forces veterans

A prior study demonstrated that psychedelic-assisted therapy was related to reductions in mental health symptoms and associated consequences among U.S. Special Operations Forces Veterans seeking treatment in Mexico. The present study extends this analysis to explore the prospective associations of baseline predictors on treatment outcomes and whether changes in psychological flexibility mediate the relationship between acute changes in consciousness and clinical outcomes. Data were prospectively collected in an ibogaine-and-5-methoxy-N,N-dimethyltryptamine treatment program at pretreatment, 1-, 3-, and 6-month follow-up during September 2019-March 2021 among Special Operations Forces Veterans with a history of trauma exposure (N = 86; Mage = 42.9; Caucasian = 87.2%; male = 100%). Findings showed younger age and higher levels of depression and anxiety at baseline were correlated with greater improvements in satisfaction with life, cognitive functioning, psychological flexibility, trauma symptoms, and acute effects on personal meaningfulness and spiritual significance from baseline to 1-month follow-up. Additionally, greater intensity of changes in consciousness (e.g., personal meaningfulness, spiritual significance, psychological insightfulness) was correlated with greater improvements in long-term mental health outcomes (e.g., cognitive functioning, trauma symptoms) and psychosocial outcomes (e.g., social relationships, attitudes about life, behavioral changes, spirituality) from baseline to 6-month follow-up. Furthermore, increases in psychological flexibility from baseline to 1-month follow-up mediated the relationship between the greater intensity of changes in consciousness and greater decreases in trauma, depression, and anxiety symptoms at 1-month follow-up. Findings suggest that acute effects of the combined ibogaine-and-5-methoxy-N,N-dimethyltryptamine treatment experience, and improvements in psychological flexibility are critical factors associated with positive outcomes, as are younger age and greater symptom severity before treatment.