Treatment-Resistant Depression (TRD)Depressive DisordersPTSDAnxiety DisordersSubstance Use Disorders (SUD)Palliative & End-of-Life DistressSet & SettingInterpersonal Functioning & Social ConnectednessMDMA

Set and setting predict psychopathology, wellbeing and meaningfulness of psychedelic experiences: a correlational study

This survey (n=1022) investigated the correlation between set and setting variables in psychedelic therapy with psychopathology, well-being, and personality. Findings suggest that growth motivations, natural settings, and the presence of significant others predict positive outcomes. In contrast, problematic motivations are associated with greater psychopathology and lower well-being.

Authors

  • Borkel, L. F.
  • Rojas-Hernández, J.
  • Henríquez-Hernández, L. A.

Published

Expert Review of Clinical Pharmacology
individual Study

Abstract

Background

In psychedelic therapy, the importance of set and setting is a fundamental but under-researched assumption. The aim of this study is to correlate variables of set (psychedelic use motivation) and setting (psychedelic use location and type of companion) with psychopathology, wellbeing and personality variables.Research design and methods: A sample of 1022 participants of the Spanish-speaking population was collected through an online survey. A novel instrument, the Psychedelic Use Scale (PUS), was developed to measure substance use variables of LSD, mescaline, psilocybin, DMT, 5-Meo-DMT, ketamine, Salvia divinorum, ibogaine and MDMA. Various personality, well-being and psychopathology instruments were implemented to measure outcome variables.

Results

Growth motivations, natural settings and presence of significant others predicted less psychopathology, greater wellbeing and meaningfulness of psychedelic experiences, whereas problematic motivations predicted greater psychopathology, lower wellbeing and did not predict meaningfulness of psychedelic experiences.

Conclusions

Based on these results, we suggest experimental hypotheses for future clinical trials and longitudinal studies with potential clinical implications.

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Research Summary of 'Set and setting predict psychopathology, wellbeing and meaningfulness of psychedelic experiences: a correlational study'

Introduction

Psychedelic substances produce marked alterations in perception, mood and cognition and are increasingly investigated for therapeutic uses across a range of psychiatric and neurological conditions. Earlier research has reported promising outcomes for substances such as psilocybin, LSD, DMT, MDMA and ketamine in disorders including treatment-resistant depression, PTSD, addiction and anxiety associated with life‑threatening illness, and has noted improvements in wellbeing and prosocial behaviour. Despite the growing evidence base, the longstanding clinical assumption that 'set' (the individual's mindset, personality and intentions) and 'setting' (the physical, social and cultural environment of use) shape the nature and therapeutic value of psychedelic experiences has received limited quantitative scrutiny, particularly with respect to how specific motivations, locations and companions relate to psychopathology, wellbeing and the meaningfulness of experiences. Borkel and colleagues set out to address this gap by examining associations between set and setting variables and outcome measures in a large Spanish‑language sample. The study aimed to determine whether distinct motives for use, locations where psychedelics were taken and types of companion present predict self‑reported meaningfulness of experiences, various wellbeing indices and measures of psychopathology, and to generate experimental hypotheses for future clinical and longitudinal studies.

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Study Details

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