Scoping Review of Experiential Measures from Psychedelic Research and Clinical Trials
This review (2022) investigates the subjective (experiential) measures that are being used in psychedelic trials and finds good correlations between mystical experiences (MEQ) and oceanic boundlessness and therapeutic/mood outcomes. Similar results (with fewer participants studied) are also found for challenging experiences, psychological insight, and emotional breakthroughs. Alas, not much comment is made about the construct validity of the measures.
Authors
- Michael Earleywine
Published
Abstract
Subjective responses to psychoactive drugs have served as intriguing windows into consciousness as well as useful predictors. Subjective reactions to psychedelic molecules are particularly interesting given how they covary with subsequent improvements associated with psychedelic-assisted treatments. Although links between subjective reactions and decreases in treatment-resistant clinical depression, end-of-life anxiety, and maladaptive consumption of alcohol and nicotine appear in the empirical literature, the measurement of these subjective responses has proven difficult. Several scales developed over many decades show reasonable internal consistency. Studies suggest that many have a replicable factor structure and other good psychometric properties, but samples are often small and self-selected. We review the psychometric properties of some of the most widely used scales and detail their links to improvement in response to psychedelic-assisted treatments. Generally, assessments of mystical experiences or oceanic boundlessness correlate with improvements. Challenging subjective experiences, psychological insight, and emotional breakthroughs also show considerable promise, though replication would strengthen conclusions. We suggest a collaborative approach where investigators can focus on key responses to ensure that the field will eventually have data from many participants who report their subjective reactions to psychedelic molecules in a therapeutic setting. This may aid in predicting improvement amongst targeted conditions and wellbeing.
Research Summary of 'Scoping Review of Experiential Measures from Psychedelic Research and Clinical Trials'
Introduction
Psychiatry has seen renewed interest in classical psychedelics for a range of mental health conditions including major depressive disorder, alcohol and tobacco use disorders, obsessive–compulsive disorder, and cancer-related depression and anxiety. These compounds (for example, psilocybin, LSD, DMT, and 5-MeO-DMT) act primarily as serotonin 2A (5-HT2A) receptor agonists and produce dose-dependent alterations in perception, emotion and cognition. Prior work has developed numerous psychometric scales to quantify these subjective experiences, and several studies report associations between specific subjective phenomena (notably mystical-type experiences and oceanic boundlessness) and clinical improvements following psychedelic-assisted interventions. However, scale selection varies widely across investigators and institutions, sample sizes tend to be small or self-selected, and psychometric evidence is scattered, leaving uncertainty about which instruments are most robust and clinically informative. Do and colleagues conducted a scoping review to map the field of experiential measurement in psychedelic research. Their stated aims were to identify the most commonly used scales, describe the attributes of each instrument, and summarise available psychometric properties for measures employed with classical psychedelics (psilocybin, LSD, 5-MeO-DMT, ayahuasca, and DMT). The authors framed this work as preparatory for greater standardisation and collaborative data collection that could improve measurement of subjective mediators in future clinical trials and mechanistic studies.
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Herrmann, Z., Earleywine, M., De Leo, J., Slabaugh, S., Kenny, T., & Rush, A. J. (2023). Scoping Review of Experiential Measures from Psychedelic Research and Clinical Trials. Journal of Psychoactive Drugs, 55(4), 501-517. https://doi.org/10.1080/02791072.2022.2125467
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