Anxiety DisordersDepressive Disorders

Psychological flexibility mediates the relations between acute psychedelic effects and subjective decreases in depression and anxiety

This survey study (n=985) finds that psychological flexibility fully mediated the effects of mystical/peak experiences on depression/anxiety.

Authors

  • Roland Griffiths
  • Alan Davis
  • Frederick Barrett

Published

Journal of Contextual Behavioral Science
individual Study

Abstract

Prior research has shown that acute subjective psychedelic effects are associated with both spontaneous and intended changes in depression and anxiety. Psychedelics are also theorized to produce increases in psychological flexibility, which could explain decreases in depression and anxiety following a psychedelic experience. Therefore, the present cross-sectional survey study sought to examine whether psychological flexibility mediated the relationship between acute psychedelic experiences and spontaneous or intended changes in depression and anxiety among a large international sample of people who reported having used a psychedelic (n = 985; male = 71.6%; Caucasian/white = 84.1%; Mage = 32.2, SD = 12.6). Regression analysis showed that acute effects (i.e., mystical and insightful effects) were significantly associated with decreases in depression/anxiety following a psychedelic experience. A path analysis revealed that, while controlling for age and sex, increases in psychological flexibility fully mediated the effect of mystical and insightful experiences on decreases in depression and anxiety following a psychedelic experience. This suggests that psychological flexibility may be an important mediator of the therapeutic effects of psychedelic drugs. Future prospective experimental studies should examine the effect of psychedelic drug administration on psychological flexibility in order to gain a better understanding of the psychological processes that predict therapeutic effects of psychedelics.

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Research Summary of 'Psychological flexibility mediates the relations between acute psychedelic effects and subjective decreases in depression and anxiety'

Introduction

Depression and anxiety are highly prevalent and burdensome mental health conditions for which many existing treatments are inaccessible or insufficiently effective for a sizable subset of people. Interest has grown in the therapeutic potential of classic serotonergic psychedelics (for example psilocybin, LSD, ayahuasca, 5‑MeO‑DMT), which produce profound alterations in perception, mood and cognition and have shown preliminary efficacy for reducing symptoms of depression and anxiety in both clinical trials and naturalistic contexts. Prior work suggests that the intensity of certain acute subjective effects during a psychedelic session—notably mystical-type phenomena and psychological insight—relates to subsequent reductions in depressive and anxious symptoms, but the psychological mechanisms that might explain these associations remain incompletely specified. Davis and colleagues set out to test whether increases in psychological flexibility could account for the relationship between acute psychedelic effects and self-reported decreases in depression and anxiety. Psychological flexibility is a transdiagnostic construct central to Acceptance and Commitment Therapy (ACT), encompassing processes such as acceptance, cognitive defusion, present-moment contact, values-based action and self-as-context; reductions in psychological flexibility (i.e., inflexibility) are theorised to underlie many forms of psychopathology. The study hypothesised that (H1) greater acute mystical and insight effects would predict larger decreases in depression/anxiety, and in a path model that (H2) acute effects would predict increases in psychological flexibility, (H3) increases in psychological flexibility would predict decreases in depression/anxiety, and (H4) psychological flexibility would mediate the relationship between acute effects and symptom change.

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Study Details

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