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Amada N, Shane J. Self-Actualization and the Integration of Psychedelic Experience: The Mediating Role of Perceived Benefits to Narrative Self-Functioning. JOURNAL OF HUMANISTIC PSYCHOLOGY 2022. [DOI: 10.1177/00221678221099680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
There is a growing need in the field of psychedelic science for a unifying perspective of overall well-being to join seemingly disparate findings across clinical and non-clinical populations, and account for the unique role of post-psychedelic integration for promoting benefits. According to the eudaimonic perspective of well-being, the stories we create about who we are (self-insight) and who we can become (personal development) are key aspects of narrative self-functioning that either constrain or facilitate well-being. The present paper draws upon this perspective to investigate the relationship between extent of post-psychedelic integration and optimal well-being ( self-actualization), with perceived benefits to narrative self-functioning ( self-insight and personal development) as a mediator. The data for testing this model was collected from roughly 750 participants recruited from websites and social media forums. Because the sample contained clinical and non-clinical individuals, the model was able to be tested with mental health condition as a moderator. Results indicated that perceived benefits to narrative self-functioning is one pathway through which integration of psychedelic experience may promote optimal well-being for both clinical and non-clinical populations. Exploratory analyses indicated that integration techniques that are more self-referential in nature are the ones that indirectly relate to optimal well-being via perceived benefits. The results of the present study should be interpreted as a preliminary model for future longitudinal research to test, as our cross-sectional methods preclude any causal inferences to be made from these mediation analyses.
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Affiliation(s)
- Nicole Amada
- The City University of New York, New York City, USA
| | - Jacob Shane
- The City University of New York, New York City, USA
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202
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Murray CH, Huang Z, Lee R, de Wit H. Adolescents are more sensitive than adults to acute behavioral and cognitive effects of THC. Neuropsychopharmacology 2022; 47:1331-1338. [PMID: 35110688 PMCID: PMC9117219 DOI: 10.1038/s41386-022-01281-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 01/16/2022] [Accepted: 01/19/2022] [Indexed: 11/09/2022]
Abstract
Increased cannabis availability has contributed to increased use with concomitant incidence of adverse effects. One risk factor for adverse drug reactions may be age. There is preclinical evidence that acute effects of delta-9-tetrahydrocannabinol (THC), the primary active constituent of cannabis, are greater during adolescence, but this has not been fully studied in humans. The present study sought to determine whether adolescent men and women are more sensitive than adults to acute THC. Adolescents aged 18-20 (N = 12) and adults aged 30-40 (N = 12), with less than 20 total lifetime uses of THC-containing products, received capsules of THC (7.5, 15 mg) and placebo across three study sessions in randomized order under double blind conditions. During each session, subjective, cardiovascular, behavioral, and EEG measures were obtained. Behavioral measures included Simple Reaction Time, Stop Task, Time Production and N-back and EEG measures included P300 amplitudes during an auditory oddball task and eyes-closed resting state. THC affected subjective state and heart rate similarly in both age groups. However, adolescents were more sensitive to performance impairing effects, exhibiting dose-dependent impairments on reaction time, response accuracy, and time perception. On EEG measures, THC dose-dependently decreased P300 amplitude in adolescents but not adults. Adolescents were more sensitive to behavioral and cognitive effects of THC, but not to cardiovascular effects or subjective measures. Thus, at doses that produce comparable ratings of intoxication, adolescents may exhibit greater cognitive impairment and alterations in brain function.
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Affiliation(s)
- Conor H. Murray
- grid.170205.10000 0004 1936 7822Department of Psychiatry and Behavioral Neuroscience, University of Chicago, 5841 S Maryland Ave, Chicago, IL 60637 USA
| | - Zhengyi Huang
- grid.170205.10000 0004 1936 7822Department of Psychiatry and Behavioral Neuroscience, University of Chicago, 5841 S Maryland Ave, Chicago, IL 60637 USA
| | - Royce Lee
- grid.170205.10000 0004 1936 7822Department of Psychiatry and Behavioral Neuroscience, University of Chicago, 5841 S Maryland Ave, Chicago, IL 60637 USA
| | - Harriet de Wit
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, 5841 S Maryland Ave, Chicago, IL, 60637, USA.
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203
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Murray CH, Tare I, Perry CM, Malina M, Lee R, de Wit H. Low doses of LSD reduce broadband oscillatory power and modulate event-related potentials in healthy adults. Psychopharmacology (Berl) 2022; 239:1735-1747. [PMID: 34613430 PMCID: PMC9847217 DOI: 10.1007/s00213-021-05991-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 09/20/2021] [Indexed: 01/21/2023]
Abstract
RATIONALE Classical psychedelics, including psilocybin and lysergic acid diethylamide (LSD), are under investigation as potential therapeutic agents in psychiatry. Whereas most studies utilize relatively high doses, there are also reports of beneficial effects of "microdosing," or repeated use of very low doses of these drugs. The behavioral and neural effects of these low doses are not fully understood. OBJECTIVES To examine the effects of LSD (13 μg and 26 μg) versus placebo on resting-state electroencephalography (EEG) and event-related potential (ERP) responses in healthy adults. METHODS Twenty-two healthy men and women, 18 to 35 years old, participated in 3 EEG sessions in which they received placebo or LSD (13 μg and 26 μg) under double-blind conditions. During each session, participants completed drug effect and mood questionnaires at hourly intervals, and physiological measures were recorded. During expected peak drug effect, EEG recordings were obtained, including resting-state neural oscillations in scalp electrodes over default mode network (DMN) regions and P300, N170, and P100 ERPs evoked during a visual oddball paradigm. RESULTS LSD dose-dependently reduced oscillatory power across delta, theta, alpha, beta, and gamma frequency bands during both eyes closed and eyes open resting conditions. During the oddball task, LSD dose-dependently reduced ERP amplitudes for P300 and N170 components and increased P100 latency. LSD also produced dose-related increases in positive mood, elation, energy, and anxiety and increased heart rate and blood pressure. On a measure of altered states of consciousness, LSD dose-dependently increased Blissful State, but not other indices of perceptual or sensory effects typical of psychedelic drugs. The subjective effects of the drug were not correlated with the EEG measures. CONCLUSIONS Low doses of LSD produced broadband cortical desynchronization over the DMN during resting state and reduced P300 and N170 amplitudes, patterns similar to those reported with higher doses of psychedelics. Notably, these neurophysiological effects raise the possibility that very low doses of LSD may produce subtle behavioral and perhaps therapeutic effects that do not rely on the full psychedelic experience.
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Affiliation(s)
- Conor H Murray
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, 5841 S Maryland Ave MC3077, Chicago, IL, 60637, USA
| | - Ilaria Tare
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, 5841 S Maryland Ave MC3077, Chicago, IL, 60637, USA
| | - Claire M Perry
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, 5841 S Maryland Ave MC3077, Chicago, IL, 60637, USA
| | - Michael Malina
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, 5841 S Maryland Ave MC3077, Chicago, IL, 60637, USA
| | - Royce Lee
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, 5841 S Maryland Ave MC3077, Chicago, IL, 60637, USA
| | - Harriet de Wit
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, 5841 S Maryland Ave MC3077, Chicago, IL, 60637, USA.
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204
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McGovern HT, Leptourgos P, Hutchinson BT, Corlett PR. Do psychedelics change beliefs? Psychopharmacology (Berl) 2022; 239:1809-1821. [PMID: 35507071 DOI: 10.1007/s00213-022-06153-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 04/19/2022] [Indexed: 01/29/2023]
Abstract
Renewed interest in psychedelics has reignited the debate about whether and how they change human beliefs. In both the clinical and social-cognitive domains, psychedelic consumption may be accompanied by profound, and sometimes lasting, belief changes. We review these changes and their possible underlying mechanisms. Rather than inducing de novo beliefs, we argue psychedelics may instead change the impact of affect and of others' suggestions on how beliefs are imputed. Critically, we find that baseline beliefs (in the possible effects of psychedelics, for example) might color the acute effects of psychedelics as well as longer-term changes. If we are to harness the apparent potential of psychedelics in the clinic and for human flourishing more generally, these possibilities must be addressed empirically.
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Affiliation(s)
- H T McGovern
- School of Psychology, The University of Queensland, Brisbane, QLD, Australia
| | - P Leptourgos
- Department of Psychiatry, Yale University, New Haven, CT, USA
| | - B T Hutchinson
- Research School of Psychology, The Australian National University, Canberra, ACT, Australia
| | - P R Corlett
- Department of Psychiatry, Yale University, New Haven, CT, USA.
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205
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Affiliation(s)
- Awais Aftab
- Department of Psychiatry, Case Western Reserve University, Cleveland, Ohio
| | - Dan J Stein
- South African Medical Research Council Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry, University of Cape Town, Cape Town, South Africa
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206
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Lawn T, Dipasquale O, Vamvakas A, Tsougos I, Mehta MA, Howard MA. Differential contributions of serotonergic and dopaminergic functional connectivity to the phenomenology of LSD. Psychopharmacology (Berl) 2022; 239:1797-1808. [PMID: 35322297 PMCID: PMC9166846 DOI: 10.1007/s00213-022-06117-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 03/11/2022] [Indexed: 02/25/2023]
Abstract
RATIONALE LSD is the prototypical psychedelic. Despite a clear central role of the 5HT2a receptor in its mechanism of action, the contributions of additional receptors for which it shows affinity and agonist activity remain unclear. OBJECTIVES We employed receptor-enriched analysis of functional connectivity by targets (REACT) to explore differences in functional connectivity (FC) associated with the distributions of the primary targets of LSD-the 5HT1a, 5HT1b, 5HT2a, D1 and D2 receptors. METHODS We performed secondary analyses of an openly available dataset (N = 15) to estimate the LSD-induced alterations in receptor-enriched FC maps associated with these systems. Principal component analysis (PCA) was employed as a dimension reduction strategy for subjective experiences associated with LSD captured by the Altered States of Consciousness (ASC) questionnaire. Correlations between these principal components as well as VAS ratings of subjective effects with receptor-enriched FC were explored. RESULTS Compared to placebo, LSD produced differences in FC when the analysis was enriched with each of the primary serotonergic and dopaminergic receptors. Altered receptor-enriched FC showed relationships with the subjective effects of LSD on conscious experience, with serotonergic and dopaminergic systems being predominantly associated with perceptual effects and perceived selfhood as well as cognition respectively. These relationships were dissociable, with different receptors showing the same relationships within, but not between, the serotonergic and dopaminergic systems. CONCLUSIONS These exploratory findings provide new insights into the pharmacology of LSD and highlight the need for additional investigation of non-5HT2a-mediated mechanisms.
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Affiliation(s)
- Timothy Lawn
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Ottavia Dipasquale
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Alexandros Vamvakas
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
- Medical Physics Department, School of Medicine, University of Thessaly, Larissa, Greece
| | - Ioannis Tsougos
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
- Medical Physics Department, School of Medicine, University of Thessaly, Larissa, Greece
| | - Mitul A. Mehta
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Matthew A. Howard
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
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207
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Group VR experiences can produce ego attenuation and connectedness comparable to psychedelics. Sci Rep 2022; 12:8995. [PMID: 35637199 PMCID: PMC9149675 DOI: 10.1038/s41598-022-12637-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 05/12/2022] [Indexed: 11/09/2022] Open
Abstract
AbstractWith a growing body of research highlighting the therapeutic potential of experiential phenomenology which diminishes egoic identity and increases one’s sense of connectedness, there is significant interest in how to elicit such ‘self-transcendent experiences’ (STEs) in laboratory contexts. Psychedelic drugs (YDs) have proven particularly effective in this respect, producing subjective phenomenology which reliably elicits intense STEs. With virtual reality (VR) emerging as a powerful tool for constructing new perceptual environments, we describe a VR framework called ‘Isness-distributed’ (Isness-D) which harnesses the unique affordances of distributed multi-person VR to blur conventional self-other boundaries. Within Isness-D, groups of participants co-habit a shared virtual space, collectively experiencing their bodies as luminous energetic essences with diffuse spatial boundaries. It enables moments of ‘energetic coalescence’, a new class of embodied intersubjective experience where bodies can fluidly merge, enabling participants to include multiple others within their self-representation. To evaluate Isness-D, we adopted a citizen science approach, coordinating an international network of Isness-D 'nodes'. We analyzed the results (N = 58) using 4 different self-report scales previously applied to analyze subjective YD phenomenology (the inclusion of community in self scale, ego-dissolution inventory, communitas scale, and the MEQ30 mystical experience questionnaire). Despite the complexities associated with a distributed experiment like this, the Isness-D scores on all 4 scales were statistically indistinguishable from recently published YD studies, demonstrating that distributed VR can be used to design intersubjective STEs where people dissolve their sense of self in the connection to others.
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208
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Henner RL, Keshavan MS, Hill KP. Review of potential psychedelic treatments for PTSD. J Neurol Sci 2022; 439:120302. [DOI: 10.1016/j.jns.2022.120302] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 04/27/2022] [Accepted: 05/24/2022] [Indexed: 12/20/2022]
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209
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Girn M, Roseman L, Bernhardt B, Smallwood J, Carhart-Harris R, Nathan Spreng R. Serotonergic psychedelic drugs LSD and psilocybin reduce the hierarchical differentiation of unimodal and transmodal cortex. Neuroimage 2022; 256:119220. [PMID: 35483649 DOI: 10.1016/j.neuroimage.2022.119220] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 04/03/2022] [Accepted: 04/15/2022] [Indexed: 12/20/2022] Open
Abstract
Lysergic acid diethylamide (LSD) and psilocybin are serotonergic psychedelic compounds with potential in the treatment of mental health disorders. Past neuroimaging investigations have revealed that both compounds can elicit significant changes to whole-brain functional organization and dynamics. A recent proposal linked past findings into a unified model and hypothesized reduced whole-brain hierarchical organization as a key mechanism underlying the psychedelic state, but this has yet to be directly tested. We applied a non-linear dimensionality reduction technique previously used to map hierarchical connectivity gradients to assess cortical organization in the LSD and psilocybin state from two previously published pharmacological resting-state fMRI datasets (N = 15 and 9, respectively). Results supported our primary hypothesis: The principal gradient of cortical connectivity, describing a hierarchy from unimodal to transmodal cortex, was significantly flattened under both drugs relative to their respective placebo conditions. Between-condition contrasts revealed that this was driven by a reduction of functional differentiation at both hierarchical extremes - default and frontoparietal networks at the upper end, and somatomotor at the lower. Gradient-based connectivity mapping indicated that this was underpinned by a disruption of modular unimodal connectivity and increased unimodal-transmodal crosstalk. Results involving the second and third gradient, which, respectively represent axes of sensory and executive differentiation, also showed significant alterations across both drugs. These findings provide support for a recent mechanistic model of the psychedelic state relevant to therapeutic applications of psychedelics. More fundamentally, we provide the first evidence that macroscale connectivity gradients are sensitive to an acute pharmacological manipulation, supporting a role for psychedelics as scientific tools to perturb cortical functional organization.
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Affiliation(s)
- Manesh Girn
- Department of Neurology and Neurosurgery, Montreal Neurological Institute, McGill University, 3801 Rue Université, Montreal, QC H3A 2B4, Canada.
| | - Leor Roseman
- Centre for Psychedelic Research, Department of Brain Sciences, Imperial College London, London, United Kingdom
| | - Boris Bernhardt
- Department of Neurology and Neurosurgery, Montreal Neurological Institute, McGill University, 3801 Rue Université, Montreal, QC H3A 2B4, Canada
| | | | - Robin Carhart-Harris
- Neuroscape Psychedelics Division, Department of Neurology, University of California San Francisco, San Francisco, CA, United States
| | - R Nathan Spreng
- Department of Neurology and Neurosurgery, Montreal Neurological Institute, McGill University, 3801 Rue Université, Montreal, QC H3A 2B4, Canada; Departments of Psychiatry and Psychology, McGill University, Montreal, QC, Canada; Douglas Mental Health University Institute, Verdun, QC, Canada; McConnell Brain Imaging Centre, McGill University, Montreal, QC, Canada
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210
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Doss MK, Madden MB, Gaddis A, Nebel MB, Griffiths RR, Mathur BN, Barrett FS. Models of psychedelic drug action: modulation of cortical-subcortical circuits. Brain 2022; 145:441-456. [PMID: 34897383 PMCID: PMC9014750 DOI: 10.1093/brain/awab406] [Citation(s) in RCA: 51] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 08/10/2021] [Accepted: 10/05/2021] [Indexed: 12/15/2022] Open
Abstract
Classic psychedelic drugs such as psilocybin and lysergic acid diethylamide (LSD) have recaptured the imagination of both science and popular culture, and may have efficacy in treating a wide range of psychiatric disorders. Human and animal studies of psychedelic drug action in the brain have demonstrated the involvement of the serotonin 2A (5-HT2A) receptor and the cerebral cortex in acute psychedelic drug action, but different models have evolved to try to explain the impact of 5-HT2A activation on neural systems. Two prominent models of psychedelic drug action (the cortico-striatal thalamo-cortical, or CSTC, model and relaxed beliefs under psychedelics, or REBUS, model) have emphasized the role of different subcortical structures as crucial in mediating psychedelic drug effects. We describe these models and discuss gaps in knowledge, inconsistencies in the literature and extensions of both models. We then introduce a third circuit-level model involving the claustrum, a thin strip of grey matter between the insula and the external capsule that densely expresses 5-HT2A receptors (the cortico-claustro-cortical, or CCC, model). In this model, we propose that the claustrum entrains canonical cortical network states, and that psychedelic drugs disrupt 5-HT2A-mediated network coupling between the claustrum and the cortex, leading to attenuation of canonical cortical networks during psychedelic drug effects. Together, these three models may explain many phenomena of the psychedelic experience, and using this framework, future research may help to delineate the functional specificity of each circuit to the action of both serotonergic and non-serotonergic hallucinogens.
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Affiliation(s)
- Manoj K Doss
- Center for Psychedelic and Consciousness Research, Johns Hopkins University School of Medicine, Baltimore, MD, 21224, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, 21224, USA
| | - Maxwell B Madden
- Department of Pharmacology, University of Maryland School of Medicine, Baltimore, MD, 21201, USA
| | - Andrew Gaddis
- Center for Psychedelic and Consciousness Research, Johns Hopkins University School of Medicine, Baltimore, MD, 21224, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, 21224, USA
| | - Mary Beth Nebel
- Center for Neurodevelopmental and Imaging Research, Kennedy Krieger Institute, Baltimore, MD, 21205, USA
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Roland R Griffiths
- Center for Psychedelic and Consciousness Research, Johns Hopkins University School of Medicine, Baltimore, MD, 21224, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, 21224, USA
- Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Brian N Mathur
- Department of Pharmacology, University of Maryland School of Medicine, Baltimore, MD, 21201, USA
| | - Frederick S Barrett
- Center for Psychedelic and Consciousness Research, Johns Hopkins University School of Medicine, Baltimore, MD, 21224, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, 21224, USA
- Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
- Department of Psychological and Brain Sciences, Johns Hopkins University, Baltimore, MD 21218, USA
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211
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Daws RE, Timmermann C, Giribaldi B, Sexton JD, Wall MB, Erritzoe D, Roseman L, Nutt D, Carhart-Harris R. Increased global integration in the brain after psilocybin therapy for depression. Nat Med 2022; 28:844-851. [DOI: 10.1038/s41591-022-01744-z] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 02/14/2022] [Indexed: 12/13/2022]
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212
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Leptourgos P, Bouttier V, Denève S, Jardri R. From hallucinations to synaesthesia: A circular inference account of unimodal and multimodal erroneous percepts in clinical and drug-induced psychosis. Neurosci Biobehav Rev 2022; 135:104593. [PMID: 35217108 DOI: 10.1016/j.neubiorev.2022.104593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 02/15/2022] [Accepted: 02/21/2022] [Indexed: 10/19/2022]
Abstract
Psychedelics distort perception and induce visual and multimodal hallucinations as well as synaesthesia. This is in contradiction with the high prevalence of distressing voices in schizophrenia. Here we introduce a unifying account of unimodal and multimodal erroneous percepts based on circular inference. We show that amplification of top-down predictions (descending loops) leads to an excessive reliance on priors and aberrant levels of integration of the sensory representations, resulting in crossmodal percepts and stronger illusions. By contrast, amplification of bottom-up information (ascending loops) results in overinterpretation of unreliable sensory inputs and high levels of segregation between sensory modalities, bringing about unimodal hallucinations and reduced vulnerability to illusions. We delineate a canonical microcircuit in which layer-specific inhibition controls the propagation of information across hierarchical levels: inhibitory interneurons in the deep layers exert control over priors, removing descending loops. Conversely, inhibition in the supragranular layers counterbalances the effects of the ascending loops. Overall, we put forward a multiscale and transnosographic account of erroneous percepts with important theoretical, conceptual and clinical implications.
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Affiliation(s)
- Pantelis Leptourgos
- Department of Psychiatry, Connecticut Mental Health Center, Yale University, New Haven, CT, USA; Laboratoire de Neurosciences Cognitives & Computationnelles (LNC²), ENS, INSERM U-960, PSL Research University, Paris, France.
| | - Vincent Bouttier
- Laboratoire de Neurosciences Cognitives & Computationnelles (LNC²), ENS, INSERM U-960, PSL Research University, Paris, France; Univ Lille, INSERM U-1172, Lille Neurosciences & Cognition Centre, Plasticity and Subjectivity Team, & CHU Lille, Fontan Hospital, CURE Platform, Lille, France
| | - Sophie Denève
- Laboratoire de Neurosciences Cognitives & Computationnelles (LNC²), ENS, INSERM U-960, PSL Research University, Paris, France
| | - Renaud Jardri
- Laboratoire de Neurosciences Cognitives & Computationnelles (LNC²), ENS, INSERM U-960, PSL Research University, Paris, France; Univ Lille, INSERM U-1172, Lille Neurosciences & Cognition Centre, Plasticity and Subjectivity Team, & CHU Lille, Fontan Hospital, CURE Platform, Lille, France.
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213
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Murphy R, Kettner H, Zeifman R, Giribaldi B, Kartner L, Martell J, Read T, Murphy-Beiner A, Baker-Jones M, Nutt D, Erritzoe D, Watts R, Carhart-Harris R. Therapeutic Alliance and Rapport Modulate Responses to Psilocybin Assisted Therapy for Depression. Front Pharmacol 2022; 12:788155. [PMID: 35431912 PMCID: PMC9009076 DOI: 10.3389/fphar.2021.788155] [Citation(s) in RCA: 47] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 12/07/2021] [Indexed: 01/30/2023] Open
Abstract
Background: Across psychotherapeutic frameworks, the strength of the therapeutic alliance has been found to correlate with treatment outcomes; however, its role has never been formally assessed in a trial of psychedelic-assisted therapy. We aimed to investigate the relationships between therapeutic alliance and rapport, the quality of the acute psychedelic experience and treatment outcomes. Methods: This 2-arm double-blind randomized controlled trial compared escitalopram with psychedelic-assisted therapy for moderate-severe depressive disorder (N = 59). This analysis focused on the psilocybin condition (n = 30), who received two oral doses of 25 mg psilocybin, 3-weeks apart, with psychological preparation, in-session support, and integration therapy. A new psychedelic therapy model, called “Accept-Connect-Embody” (ACE), was developed in this trial. The primary outcome was depression severity 6 weeks post treatment (Quick Inventory of Depressive Symptomatology, QIDS-SR-16). Path analyses tested the hypothesis that therapeutic alliance (Scale To Assess the Therapeutic Relationship Patient Version, STAR-P) would predict depression outcomes via its influence on the acute psychedelic experience, specifically emotional-breakthrough (EBI) and mystical-type experiences (MEQ). The same analysis was performed on the escitalopram arm to test specificity. Results: The strength of therapeutic alliance predicted pre-session rapport, greater emotional-breakthrough and mystical-type experience (maximum EBI and MEQ scores across the two psilocybin sessions) and final QIDS scores (β = −0.22, R2 = 0.42 for EBIMax; β = −0.19, R2 = 0.32 for MEQMax). Exploratory path models revealed that final depression outcomes were more strongly affected by emotional breakthrough during the first, and mystical experience during the second session. Emotional breakthrough, but not mystical experience, during the first session had a positive effect on therapeutic alliance ahead of the second session (β = 0.79, p < 0.0001). Therapeutic alliance ahead of the second session had a direct impact on final depression scores, not mediated by the acute experience, with a weaker alliance ahead of the second psilocybin session predicting higher absolute depression scores at endpoint (β = −0.49, p < 0.001) Discussion: Future research could consider therapist training and characteristics; specific participant factors, e.g., attachment style or interpersonal trauma, which may underlie the quality of the therapeutic relationship, the psychedelic experience and clinical outcomes; and consider how therapeutic approaches might adapt in cases of weaker therapeutic alliance. Clinical Trial Registration: This trial is registered at http://clinicaltrials.gov, identifier (NCT03429075).
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Affiliation(s)
- Roberta Murphy
- Department of Brain Sciences, Centre for Psychedelic Research, Imperial College London, Faculty of Medicine, London, United Kingdom
- Medical Psychotherapy, South West London and St. Georges NHS Trust, London, United Kingdom
- *Correspondence: Roberta Murphy,
| | - Hannes Kettner
- Department of Brain Sciences, Centre for Psychedelic Research, Imperial College London, Faculty of Medicine, London, United Kingdom
| | - Rick Zeifman
- Department of Brain Sciences, Centre for Psychedelic Research, Imperial College London, Faculty of Medicine, London, United Kingdom
- Department of Psychology, Ryerson University, Toronto, ON, Canada
| | - Bruna Giribaldi
- Department of Brain Sciences, Centre for Psychedelic Research, Imperial College London, Faculty of Medicine, London, United Kingdom
| | - Laura Kartner
- Department of Brain Sciences, Centre for Psychedelic Research, Imperial College London, Faculty of Medicine, London, United Kingdom
| | - Jonny Martell
- Department of Brain Sciences, Centre for Psychedelic Research, Imperial College London, Faculty of Medicine, London, United Kingdom
- Medical Psychotherapy and General Adult Psychiatry, Devon Partnership NHS Trust, Exeter, United Kingdom
| | - Tim Read
- Department of Brain Sciences, Centre for Psychedelic Research, Imperial College London, Faculty of Medicine, London, United Kingdom
| | - Ashleigh Murphy-Beiner
- Department of Brain Sciences, Centre for Psychedelic Research, Imperial College London, Faculty of Medicine, London, United Kingdom
- Department of Psychology, Royal Holloway University, Surrey, United Kingdom
| | - Michelle Baker-Jones
- Department of Brain Sciences, Centre for Psychedelic Research, Imperial College London, Faculty of Medicine, London, United Kingdom
| | - David Nutt
- Department of Brain Sciences, Centre for Psychedelic Research, Imperial College London, Faculty of Medicine, London, United Kingdom
| | - David Erritzoe
- Department of Brain Sciences, Centre for Psychedelic Research, Imperial College London, Faculty of Medicine, London, United Kingdom
| | - Rosalind Watts
- Department of Brain Sciences, Centre for Psychedelic Research, Imperial College London, Faculty of Medicine, London, United Kingdom
| | - Robin Carhart-Harris
- Department of Brain Sciences, Centre for Psychedelic Research, Imperial College London, Faculty of Medicine, London, United Kingdom
- Psychedelics Division Neuroscape, Department of Neurology, University of California, San Francisco, San Francisco, CA, United States
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214
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Kirkham N, Letheby C. Psychedelics and environmental virtues. PHILOSOPHICAL PSYCHOLOGY 2022. [DOI: 10.1080/09515089.2022.2057290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Nin Kirkham
- Department of Philosophy, The University of Western Australia, Perth, Western Australia, Australia
| | - Chris Letheby
- Department of Philosophy, The University of Western Australia, Perth, Western Australia, Australia
- Department of Philosophy, The University of Adelaide, Adelaide, South Australia, Australia
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215
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Coppola P, Spindler LRB, Luppi AI, Adapa R, Naci L, Allanson J, Finoia P, Williams GB, Pickard JD, Owen AM, Menon DK, Stamatakis EA. Network dynamics scale with levels of awareness. Neuroimage 2022; 254:119128. [PMID: 35331869 DOI: 10.1016/j.neuroimage.2022.119128] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 02/10/2022] [Accepted: 03/20/2022] [Indexed: 02/04/2023] Open
Abstract
Small world topologies are thought to provide a valuable insight into human brain organisation and consciousness. However, functional magnetic resonance imaging studies in consciousness have not yielded consistent results. Given the importance of dynamics for both consciousness and cognition, here we investigate how the diversity of small world dynamics (quantified by sample entropy; dSW-E1) scales with decreasing levels of awareness (i.e., sedation and disorders of consciousness). Paying particular attention to result reproducibility, we show that dSW-E is a consistent predictor of levels of awareness even when controlling for the underlying functional connectivity dynamics. We find that dSW-E of subcortical and cortical areas are predictive, with the former showing higher and more robust effect sizes across analyses. We find that the network dynamics of intermodular communication in the cerebellum also have unique predictive power for levels of awareness. Consequently, we propose that the dynamic reorganisation of the functional information architecture, in particular of the subcortex, is a characteristic that emerges with awareness and has explanatory power beyond that of the complexity of dynamic functional connectivity.
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Affiliation(s)
- Peter Coppola
- Division of Anaesthesia, School of Clinical Medicine, Addenbrooke's Hospital, University of Cambridge, Hills Rd., Cambridge CB2 0QQ, UK; Department of Clinical Neurosciences, School of Clinical Medicine, Addenbrooke's Hospital, University of Cambridge, Hills Rd., Cambridge CB2 0QQ, UK
| | - Lennart R B Spindler
- Division of Anaesthesia, School of Clinical Medicine, Addenbrooke's Hospital, University of Cambridge, Hills Rd., Cambridge CB2 0QQ, UK; Department of Clinical Neurosciences, School of Clinical Medicine, Addenbrooke's Hospital, University of Cambridge, Hills Rd., Cambridge CB2 0QQ, UK
| | - Andrea I Luppi
- Division of Anaesthesia, School of Clinical Medicine, Addenbrooke's Hospital, University of Cambridge, Hills Rd., Cambridge CB2 0QQ, UK; Department of Clinical Neurosciences, School of Clinical Medicine, Addenbrooke's Hospital, University of Cambridge, Hills Rd., Cambridge CB2 0QQ, UK
| | - Ram Adapa
- Division of Anaesthesia, School of Clinical Medicine, Addenbrooke's Hospital, University of Cambridge, Hills Rd., Cambridge CB2 0QQ, UK; Division of Neurosurgery, School of Clinical Medicine, Addenbrooke's Hospital, University of Cambridge, Hills Rd., Cambridge CB2 0QQ, UK
| | - Lorina Naci
- Trinity College Institute of Neuroscience, School of Psychology, Trinity College Dublin, Lloyd Building, Dublin 2, Ireland
| | - Judith Allanson
- Department of Clinical Neurosciences, School of Clinical Medicine, Addenbrooke's Hospital, University of Cambridge, Hills Rd., Cambridge CB2 0QQ, UK; Department of Neurosciences, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation, Hills Rd., Cambridge, CB2 0QQ, UK
| | - Paola Finoia
- Division of Anaesthesia, School of Clinical Medicine, Addenbrooke's Hospital, University of Cambridge, Hills Rd., Cambridge CB2 0QQ, UK; Division of Neurosurgery, School of Clinical Medicine, Addenbrooke's Hospital, University of Cambridge, Hills Rd., Cambridge CB2 0QQ, UK
| | - Guy B Williams
- Department of Clinical Neurosciences, School of Clinical Medicine, Addenbrooke's Hospital, University of Cambridge, Hills Rd., Cambridge CB2 0QQ, UK; Wolfson Brain Imaging Centre, University of Cambridge, Cambridge Biomedical Campus (Box 65), Cambridge CB2 0QQ, UK
| | - John D Pickard
- Department of Clinical Neurosciences, School of Clinical Medicine, Addenbrooke's Hospital, University of Cambridge, Hills Rd., Cambridge CB2 0QQ, UK; Division of Neurosurgery, School of Clinical Medicine, Addenbrooke's Hospital, University of Cambridge, Hills Rd., Cambridge CB2 0QQ, UK; Wolfson Brain Imaging Centre, University of Cambridge, Cambridge Biomedical Campus (Box 65), Cambridge CB2 0QQ, UK
| | - Adrian M Owen
- The Brain and Mind Institute, Western Interdisciplinary Research Building, University of Western Ontario, London, ON N6A 5B7, Canada
| | - David K Menon
- Division of Anaesthesia, School of Clinical Medicine, Addenbrooke's Hospital, University of Cambridge, Hills Rd., Cambridge CB2 0QQ, UK; Wolfson Brain Imaging Centre, University of Cambridge, Cambridge Biomedical Campus (Box 65), Cambridge CB2 0QQ, UK
| | - Emmanuel A Stamatakis
- Division of Anaesthesia, School of Clinical Medicine, Addenbrooke's Hospital, University of Cambridge, Hills Rd., Cambridge CB2 0QQ, UK; Department of Clinical Neurosciences, School of Clinical Medicine, Addenbrooke's Hospital, University of Cambridge, Hills Rd., Cambridge CB2 0QQ, UK.
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216
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Ballentine G, Friedman SF, Bzdok D. Trips and neurotransmitters: Discovering principled patterns across 6850 hallucinogenic experiences. SCIENCE ADVANCES 2022; 8:eabl6989. [PMID: 35294242 PMCID: PMC8926331 DOI: 10.1126/sciadv.abl6989] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 12/17/2021] [Indexed: 05/06/2023]
Abstract
Psychedelics probably alter states of consciousness by disrupting how the higher association cortex governs bottom-up sensory signals. Individual hallucinogenic drugs are usually studied in participants in controlled laboratory settings. Here, we have explored word usage in 6850 free-form testimonials about 27 drugs through the prism of 40 neurotransmitter receptor subtypes, which were then mapped to three-dimensional coordinates in the brain via their gene transcription levels from invasive tissue probes. Despite high interindividual variability, our pattern-learning approach delineated how drug-induced changes of conscious awareness are linked to cortex-wide anatomical distributions of receptor density proxies. Each discovered receptor-experience factor spanned between a higher-level association pole and a sensory input pole, which may relate to the previously reported collapse of hierarchical order among large-scale networks. Coanalyzing many psychoactive molecules and thousands of natural language descriptions of drug experiences, our analytical framework finds the underlying semantic structure and maps it directly to the brain.
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Affiliation(s)
- Galen Ballentine
- Department of Psychiatry, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | | | - Danilo Bzdok
- Department of Biomedical Engineering, McConnell Brain Imaging Centre (BIC), Montreal Neurological Institute (MNI), Faculty of Medicine, School of Computer Science, McGill University, Montreal, Canada
- Mila—Quebec Artificial Intelligence Institute, Montreal, Canada
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217
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Stoliker D, Egan GF, Razi A. Reduced Precision Underwrites Ego Dissolution and Therapeutic Outcomes Under Psychedelics. Front Neurosci 2022; 16:827400. [PMID: 35368271 PMCID: PMC8968396 DOI: 10.3389/fnins.2022.827400] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 02/02/2022] [Indexed: 01/02/2023] Open
Abstract
Evidence suggests classic psychedelics reduce the precision of belief updating and enable access to a range of alternate hypotheses that underwrite how we make sense of the world. This process, in the higher cortices, has been postulated to explain the therapeutic efficacy of psychedelics for the treatment of internalizing disorders. We argue reduced precision also underpins change to consciousness, known as “ego dissolution,” and that alterations to consciousness and attention under psychedelics have a common mechanism of reduced precision of Bayesian belief updating. Evidence, connecting the role of serotonergic receptors to large-scale connectivity changes in the cortex, suggests the precision of Bayesian belief updating may be a mechanism to modify and investigate consciousness and attention.
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Affiliation(s)
- Devon Stoliker
- Turner Institute for Brain and Mental Health, Monash University, Clayton, VIC, Australia
- *Correspondence: Devon Stoliker,
| | - Gary F. Egan
- Turner Institute for Brain and Mental Health, Monash University, Clayton, VIC, Australia
- Monash Biomedical Imaging, Monash University, Clayton, VIC, Australia
| | - Adeel Razi
- Turner Institute for Brain and Mental Health, Monash University, Clayton, VIC, Australia
- Monash Biomedical Imaging, Monash University, Clayton, VIC, Australia
- Wellcome Centre for Human Neuroimaging, University College London (UCL), London, United Kingdom
- CIFAR Azrieli Global Scholars Programs, Canadian Institute for Advanced Research (CIFAR), Toronto, ON, Canada
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218
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Duerler P, Vollenweider FX, Preller KH. A neurobiological perspective on social influence: Serotonin and social adaptation. J Neurochem 2022; 162:60-79. [PMID: 35274296 PMCID: PMC9322456 DOI: 10.1111/jnc.15607] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 02/26/2022] [Accepted: 03/02/2022] [Indexed: 01/09/2023]
Abstract
Humans are inherently social beings. Being suggestible to each other's expectations enables pro-social skills that are crucial for social learning and adaptation. Despite its high relevance for psychiatry, the neurobiological mechanisms underlying social adaptation are still not well understood. This review therefore provides a conceptual framework covering various distinct mechanisms underlying social adaptation and explores the neuropharmacology - in particular the role of the serotonin (5-HT) system - modulating these mechanisms. This article therefore reviews empirical results on social influence processing and reconciles them with recent findings from psychedelic research on social processing to elucidate neurobiological and neuropharmacological underpinnings of social adaptation. Various computational, neurobiological, and neurochemical processes are involved in distinct mechanisms underlying social adaptation such as the multisensory process of social information integration that is crucial for the forming of self-representation and representations of social norms. This is again associated with self- and other-perception during social interactions as well as value-based decision making that guides our behaviour in daily interactions. We highlight the critical role of 5-HT in these processes and suggest that 5-HT can facilitate social learning and may represent an important target for treating psychiatric disorders characterized by impairments in social functioning. This framework also has important implications for psychedelic-assisted therapy as well as for the development of novel treatment approaches and future research directions.
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Affiliation(s)
- Patricia Duerler
- Neuropsychopharmacology and Brain Imaging, Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital for Psychiatry Zurich, Lenggstr. 31, Zurich, Switzerland
| | - Franz X Vollenweider
- Neuropsychopharmacology and Brain Imaging, Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital for Psychiatry Zurich, Lenggstr. 31, Zurich, Switzerland
| | - Katrin H Preller
- Neuropsychopharmacology and Brain Imaging, Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital for Psychiatry Zurich, Lenggstr. 31, Zurich, Switzerland
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219
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Simulated visual hallucinations in virtual reality enhance cognitive flexibility. Sci Rep 2022; 12:4027. [PMID: 35256740 PMCID: PMC8901713 DOI: 10.1038/s41598-022-08047-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 02/24/2022] [Indexed: 11/09/2022] Open
Abstract
Historically, psychedelic drugs are known to modulate cognitive flexibility, a central aspect of cognition permitting adaptation to changing environmental demands. Despite proof suggesting phenomenological similarities between artificially-induced and actual psychedelic altered perception, experimental evidence is still lacking about whether the former is also able to modulate cognitive flexibility. To address this, we measure participants' cognitive flexibility through behavioral tasks after the exposure to virtual reality panoramic videos and their hallucinatory-like counterparts generated by the DeepDream algorithm. Results show that the estimated semantic network has a flexible structure when preceded by altered videos. Crucially, following the simulated psychedelic exposure, individuals also show an attenuated contribution of the automatic process and chaotic dynamics underlying the decision process. This suggests that simulated altered perceptual phenomenology enhances cognitive flexibility, presumably due to a reorganization in the cognitive dynamics that facilitates the exploration of uncommon decision strategies and inhibits automated choices.
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220
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Agin-Liebes G, Zeifman R, Luoma JB, Garland EL, Campbell WK, Weiss B. Prospective examination of the therapeutic role of psychological flexibility and cognitive reappraisal in the ceremonial use of ayahuasca. J Psychopharmacol 2022; 36:295-308. [PMID: 35253514 PMCID: PMC10074827 DOI: 10.1177/02698811221080165] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Evidence suggests that psychedelic-assisted therapy carries transdiagnostic efficacy in the treatment of mental health conditions characterized by low mood and the use of avoidance coping strategies. AIMS While preliminary evidence suggests that psychological flexibility and emotion regulation processes play an important role within psychedelic therapy, this prospective study addressed methodological gaps in the literature and examined the ability of ayahuasca to stimulate acute states of cognitive reappraisal and long-term changes in psychological flexibility and mood. The study also explored whether moderating factors predisposed participants to experience therapeutic changes. METHODS Participants (N = 261) were recruited from three Shipibo ayahuasca retreat centers in Central and South America and completed assessments on mood, psychological flexibility, and acute ceremonial factors. Expectancy, demand characteristics, and invalid responding were controlled for with several validity scales. RESULTS/OUTCOMES Participants reported significant reductions in negative mood after three months, as well as increases in positive mood and psychological flexibility. Acute experiences of reappraisal during the ayahuasca ceremony exerted the strongest moderating effects on increases in positive mood and psychological flexibility. Increases in psychological flexibility statistically mediated the effects of acute psychological factors, including reappraisal, on changes in positive mood. CONCLUSIONS/INTERPRETATION These results highlight the role of acute psychological processes, such as reappraisal, and post-acute increases in psychological flexibility as putative mechanisms underlying positive outcomes associated with psychedelics. These results also provide support for the integration of third-wave and mindfulness-based therapy approaches with psychedelic-assisted interventions.
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Affiliation(s)
- Gabrielle Agin-Liebes
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, USA.,Neuroscape, Sandler Neurosciences Center, University of California, San Francisco, San Francisco, CA, USA
| | - Richard Zeifman
- Department of Psychology, Ryerson University, Toronto, ON, Canada
| | - Jason B Luoma
- Research and Training Center, Portland Psychotherapy Clinic, Portland, OR, USA
| | - Eric L Garland
- College of Social Work, University of Utah, Salt Lake City, UT, USA
| | - W Keith Campbell
- Department of Psychology, University of Georgia, Athens, GA, USA
| | - Brandon Weiss
- Department of Psychology, University of Georgia, Athens, GA, USA
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221
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Wolff M, Mertens LJ, Walter M, Enge S, Evens R. The Acceptance/Avoidance-Promoting Experiences Questionnaire (APEQ): A theory-based approach to psychedelic drugs' effects on psychological flexibility. J Psychopharmacol 2022; 36:387-408. [PMID: 35253518 PMCID: PMC8902683 DOI: 10.1177/02698811211073758] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
BACKGROUND Many benefits and some harms associated with psychedelic use could be attributable to these drugs' acceptance/avoidance-promoting effects and corresponding changes in psychological flexibility. Underlying psychological mechanisms are insufficiently understood. AIM The purpose of this study was the validation of a psychological model of acceptance/avoidance-promoting psychedelic experiences, which included the development of a theory-based self-report instrument: the Acceptance/Avoidance-Promoting Experiences Questionnaire (APEQ). Its two main scales, acceptance-related experience (ACE) and avoidance-related experience (AVE), represent the theorized model's core constructs. We aimed to test the model's central assumptions of complementarity (ACE and AVE may occur alternatingly but not simultaneously, and are therefore empirically independent), intertwinedness (subaspects within ACE and AVE are mutually contingent and therefore highly inter-correlated), context-dependence (ACE and AVE depend on context factors) and interaction (longer-term outcomes depend on the interplay between ACE and AVE). METHOD A bilingual retrospective online survey including 997 English- and 836 German-speaking participants. Each participant reported on one psychedelic experience occasioned by lysergic acid diethylamide (LSD), psilocybin, mescaline, or ayahuasca. RESULTS Whereas ACE and AVE were found to be relatively independent aspects of participants' reported psychedelic experiences (complementarity), their subaspects were mostly distinguishable but strongly correlated among each other (intertwinedness). Therapeutic, escapist, and hedonic use motives were differentially associated with ACE and AVE (context-dependence), which were in turn associated with retrospective changes in psychological flexibility following participants' reported experiences. The positive association between ACE and increased psychological flexibility was significantly moderated by AVE (interaction). CONCLUSION These results provide an initial validation of the APEQ and its underlying theoretical model, suggesting the two can help clarify the psychological mechanisms of psychedelic-induced benefits and harms. Both should be further investigated in prospective-longitudinal and clinical studies.
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Affiliation(s)
- Max Wolff
- MIND Foundation, Berlin, Germany
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Berlin, Germany
- Faculty of Psychology, Dresden University of Technology, Dresden, Germany
- Max Wolff, MIND Foundation, 10245 Berlin, Germany.
| | - Lea J Mertens
- Department of Molecular Neuroimaging, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Marie Walter
- Department of Psychology, University of Mainz, Mainz, Germany
| | - Sören Enge
- Department of Psychology, MSB Medical School Berlin, Berlin, Germany
| | - Ricarda Evens
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Berlin, Germany
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222
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Petranker R, Kim J, Anderson T. Microdosing as a Response to the Meaning Crisis: A Qualitative Analysis. JOURNAL OF HUMANISTIC PSYCHOLOGY 2022. [DOI: 10.1177/00221678221075076] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The use of psychedelic substances in both humanistic and mainstream clinical research has been increasing in the last decade. In particular, the practice of microdosing—ingesting sub-hallucinogenic doses of psychedelics—has been increasing in popularity, but large-scale qualitative analyses are still uncommon. This study attempted to recognize emergent themes in qualitative reports regarding the experience of microdosing to enrich the theoretical landscape in psychedelic research and propose future research directions for both basic and clinical research. Participants were people who reported microdosing at least once in the last year; they described their experiences using an online survey. Data from 118 informative responses suggested four main emergent themes: reasons for microdosing, the practice of microdosing itself, outcomes linked to microdosing, and meta-commentary about microdosing. We use meaning-making theory and propose that, even at low doses, psychedelic substances can provide a sense of meaning. Our results suggest that many of the reported benefits occur regardless of motivation to microdose and are likely due to the enhanced psychological flexibility and a sense of connectedness made possible due to the use of psychedelics. Double-blind, placebo-controlled experiments are required to substantiate these reports.
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223
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Varley TF, Sporns O. Network Analysis of Time Series: Novel Approaches to Network Neuroscience. Front Neurosci 2022; 15:787068. [PMID: 35221887 PMCID: PMC8874015 DOI: 10.3389/fnins.2021.787068] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 12/20/2021] [Indexed: 12/12/2022] Open
Abstract
In the last two decades, there has been an explosion of interest in modeling the brain as a network, where nodes correspond variously to brain regions or neurons, and edges correspond to structural or statistical dependencies between them. This kind of network construction, which preserves spatial, or structural, information while collapsing across time, has become broadly known as "network neuroscience." In this work, we provide an alternative application of network science to neural data: network-based analysis of non-linear time series and review applications of these methods to neural data. Instead of preserving spatial information and collapsing across time, network analysis of time series does the reverse: it collapses spatial information, instead preserving temporally extended dynamics, typically corresponding to evolution through some kind of phase/state-space. This allows researchers to infer a, possibly low-dimensional, "intrinsic manifold" from empirical brain data. We will discuss three methods of constructing networks from nonlinear time series, and how to interpret them in the context of neural data: recurrence networks, visibility networks, and ordinal partition networks. By capturing typically continuous, non-linear dynamics in the form of discrete networks, we show how techniques from network science, non-linear dynamics, and information theory can extract meaningful information distinct from what is normally accessible in standard network neuroscience approaches.
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Affiliation(s)
- Thomas F. Varley
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN, United States
- School of Informatics, Computing, and Engineering, Indiana University, Bloomington, IN, United States
| | - Olaf Sporns
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN, United States
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224
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Northoff G, Zilio F. Temporo-spatial Theory of Consciousness (TTC) - Bridging the gap of neuronal activity and phenomenal states. Behav Brain Res 2022; 424:113788. [PMID: 35149122 DOI: 10.1016/j.bbr.2022.113788] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Revised: 02/04/2022] [Accepted: 02/04/2022] [Indexed: 01/22/2023]
Abstract
Consciousness and its neural mechanisms remain a mystery. Current neuroscientific theories focus predominantly on the external input/stimulus and the associated stimulus-related activity during conscious contents. Despite all progress, we encounter two gaps: (i) a gap between spontaneous and stimulus-related activity; (ii) a gap between neuronal and phenomenal features. A novel, different, and unique approach, Temporo-spatial theory of consciousness (TTC) aims to bridge both gaps. The TTC focuses on the brain's spontaneous activity and how its spatial topography and temporal dynamic shape stimulus-related activity and resurface in the corresponding spatial and temporal features of consciousness, i.e., 'common currency'. The TTC introduces four temporo-spatial mechanisms: expansion, globalization, alignment, and nestedness. These are associated with distinct dimensions of consciousness including phenomenal content, access, form/structure, and level/state, respectively. Following up on the first introduction of the TTC in 2017, we review updates, further develop these temporo-spatial mechanisms, and postulate specific neurophenomenal hypotheses. We conclude that the TTC offers a viable approach for (i) linking spontaneous and stimulus-related activity in conscious states; (ii) determining specific neuronal and neurophenomenal mechanisms for the distinct dimensions of consciousness; (iii) an integrative and unifying framework of different neuroscientific theories of consciousness; and (iv) offers novel empirically grounded conceptual assumptions about the biological and ontological nature of consciousness and its relation to the brain.
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Affiliation(s)
- Georg Northoff
- Mind, Brain Imaging and Neuroethics Research Unit, Institute of Mental Health Research, The Royal Ottawa Mental Health Centre and University of Ottawa, Ottawa, Canada; Centre for Cognition and Brain Disorders, Hangzhou Normal University, Hangzhou, China; Mental Health Centre, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
| | - Federico Zilio
- Department of Philosophy, Sociology, Education and Applied Psychology, University of Padua, Padua, Italy.
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225
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Connolly P. Instability and Uncertainty Are Critical for Psychotherapy: How the Therapeutic Alliance Opens Us Up. Front Psychol 2022; 12:784295. [PMID: 35069367 PMCID: PMC8777103 DOI: 10.3389/fpsyg.2021.784295] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 12/06/2021] [Indexed: 01/04/2023] Open
Abstract
Tschacher and Haken have recently applied a systems-based approach to modeling psychotherapy process in terms of potentially beneficial tendencies toward deterministic as well as chaotic forms of change in the client's behavioral, cognitive and affective experience during the course of therapy. A chaotic change process refers to a greater exploration of the states that a client can be in, and it may have a potential positive role to play in their development. A distinction is made between on the one hand, specific instances of instability which are due to techniques employed by the therapist, and on the other, a more general instability which is due to the therapeutic relationship, and a key, necessary result of a successful therapeutic alliance. Drawing on Friston's systems-based model of free energy minimization and predictive coding, it is proposed here that the increase in the instability of a client's functioning due to therapy can be conceptualized as a reduction in the precisions (certainty) with which the client's prior beliefs about themselves and their world, are held. It is shown how a good therapeutic alliance (characterized by successful interpersonal synchrony of the sort described by Friston and Frith) results in the emergence of a new hierarchical level in the client's generative model of themselves and their relationship with the world. The emergence of this new level of functioning permits the reduction of the precisions of the client's priors, which allows the client to 'open up': to experience thoughts, emotions and experiences they did not have before. It is proposed that this process is a necessary precursor to change due to psychotherapy. A good consilience can be found between this approach to understanding the role of the therapeutic alliance, and the role of epistemic trust in psychotherapy as described by Fonagy and Allison. It is suggested that beneficial forms of instability in clients are an underappreciated influence on psychotherapy process, and thoughts about the implications, as well as situations in which instability may not be beneficial (or potentially harmful) for therapy, are considered.
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Affiliation(s)
- Patrick Connolly
- Counselling and Psychology Department, Hong Kong Shue Yan University, North Point, Hong Kong SAR, China
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226
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Vollenweider FX, Smallridge JW. Classic Psychedelic Drugs: Update on Biological
Mechanisms. PHARMACOPSYCHIATRY 2022; 55:121-138. [PMID: 35079988 PMCID: PMC9110100 DOI: 10.1055/a-1721-2914] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Renewed interest in the effects of psychedelics in the treatment of psychiatric
disorders warrants a better understanding of the neurobiological mechanisms
underlying the effects of these substances. During the past two decades,
state-of-the-art studies of animals and humans have yielded new important
insights into the molecular, cellular, and systems-level actions of psychedelic
drugs. These efforts have revealed that psychedelics affect primarily
serotonergic receptor subtypes located in cortico-thalamic and cortico-cortical
feedback circuits of information processing. Psychedelic drugs modulate
excitatory-inhibitory balance in these circuits and can participate in
neuroplasticity within brain structures critical for the integration of
information relevant to sensation, cognition, emotions, and the narrative of
self. Neuroimaging studies showed that characteristic dimensions of the
psychedelic experience obtained through subjective questionnaires as well as
alterations in self-referential processing and emotion regulation obtained
through neuropsychological tasks are associated with distinct changes in brain
activity and connectivity patterns at multiple-system levels. These recent
results suggest that changes in self-experience, emotional processing, and
social cognition may contribute to the potential therapeutic effects of
psychedelics.
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Affiliation(s)
- Franz X. Vollenweider
- Neuropsychopharmacology and Brain Imaging, Department of Psychiatry,
Psychotherapy and Psychosomatics, University Hospital for Psychiatry Zurich,
Zurich, Switzerland
| | - John W. Smallridge
- Neuropsychopharmacology and Brain Imaging, Department of Psychiatry,
Psychotherapy and Psychosomatics, University Hospital for Psychiatry Zurich,
Zurich, Switzerland
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227
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Letheby C, Mattu J. Philosophy and classic psychedelics: A review of some emerging themes. JOURNAL OF PSYCHEDELIC STUDIES 2022. [DOI: 10.1556/2054.2021.00191] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Abstract
Serotonergic (or “classic”) psychedelics have struck many researchers as raising significant philosophical questions that, until recently, were largely unexplored by academic philosophers. This paper provides an overview of four emerging lines of research at the intersection of academic philosophy and psychedelic science that have gained considerable traction in the last decade: selfless consciousness, psychedelic epistemology, psychedelic ethics, and spiritual/religious naturalism. In this paper, we highlight philosophical questions concerning (i) psychedelics, self-consciousness, and phenomenal consciousness, (ii) the epistemic profile of the psychedelic experience; (iii) ethical concerns about the appropriate use of psychedelics; and (iv) whether spiritual or religious dimensions of psychedelic use are compatible with a naturalistic worldview.
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Affiliation(s)
- Chris Letheby
- Department of Philosophy, University of Western Australia, 35 Stirling Hwy, Crawley WA 6009, Australia
- Department of Philosophy, University of Adelaide, North Terrace, Adelaide SA 5005, Australia
| | - Jaipreet Mattu
- Department of Philosophy, Rotman Institute of Philosophy, Western University, 7170 Western Interdisciplinary Research Building, 1151 Richmond St., London, Ontario, N6A 5B8, Canada
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228
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Davey CG, Harrison BJ. The self on its axis: a framework for understanding depression. Transl Psychiatry 2022; 12:23. [PMID: 35042843 PMCID: PMC8766552 DOI: 10.1038/s41398-022-01790-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 12/24/2021] [Accepted: 01/10/2022] [Indexed: 12/12/2022] Open
Abstract
The self is experienced differently in depression. It is infused with pervasive low mood, and structured by negative self-related thoughts. The concept of the self has been difficult to define-one of the reasons it is now infrequently an object of enquiry for psychiatry-but findings from functional brain imaging and other neuroscience studies have provided new insights. They have elucidated how the self is supported by complex, hierarchical brain processes. Bodily sensations rise through the spinal cord, brainstem, and subcortical regions through to cortical networks, with the default mode network sitting at the apex, integrating interoceptive signals with information about the extended social environment. We discuss how this forms a "self axis", and demonstrate how this axis is set awry by depression. Our self-axis model of depression establishes a new perspective on the disorder. It emphasises the multi-level nature of depression, and how impacts made at different explanatory levels influence others along the axis. It suggests that diverse treatments might be effective for depression, from lifestyle interventions to psychotherapies to medications: they target different aspects of the self, but changes at one level of the self axis can affect others along it. Our framework for depression establishes a central role for the self, which might again become a useful focus of investigation.
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Affiliation(s)
- Christopher G. Davey
- grid.1008.90000 0001 2179 088XDepartment of Psychiatry, The University of Melbourne, Melbourne, VIC Australia
| | - Ben J. Harrison
- grid.1008.90000 0001 2179 088XDepartment of Psychiatry, The University of Melbourne, Melbourne, VIC Australia
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229
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Abstract
PURPOSE OF REVIEW Few treatments are available for patients with mood disorders or post-traumatic stress disorder (PTSD) who have already failed multiple interventions. After several decades when research into psychedelics was effectively halted by federal legislation, the past several years have shown the re-emergence of thoughtful investigations studying the utility of compounds such as 3,4-methylenedioxymethamphetamine (MDMA) and psilocybin. RECENT FINDINGS Several studies have coupled the safe administration of psychedelic compounds in a controlled environment after several hours of preparation of study participants and followed by multiple sessions to integrate the psychedelic experience. The improvement participants experience appear related to the often profound perspective changes experienced and seem unlike the improvements seen in the currently available care paradigms. Studies cited include treatment resistant depression, end of life despair, and PTSD. Psychedelic psychotherapy, a unique remarriage of biological therapy and psychotherapy, has the potential to transform mental health care.
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Affiliation(s)
- Gregory S. Barber
- grid.413036.30000 0004 0434 0002Department of Psychiatry, University of Maryland Medical Center, Baltimore, MD USA
| | - Scott T. Aaronson
- grid.415693.c0000 0004 0373 4931Institute for Advanced Diagnostics and Therapeutics, Sheppard Pratt Health System, 6501 N. Charles Street, Towson, MD USA
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230
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Petranker R, Anderson T, Maier LJ, Barratt MJ, Ferris JA, Winstock AR. Microdosing psychedelics: Subjective benefits and challenges, substance testing behavior, and the relevance of intention. J Psychopharmacol 2022; 36:85-96. [PMID: 33591231 DOI: 10.1177/0269881120953994] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
BACKGROUND Microdosing psychedelics is the practice of taking small, sub-hallucinogenic doses of lysergic acid diethylamide or psilocybin-containing mushrooms. Despite its surging popularity, little is known about the specific intentions to start microdosing and the effects of this practice. AIMS First, we aimed to replicate previous findings regarding the subjective benefits and challenges reported for microdosing. Second, we assessed whether people who microdose test their substances before consumption. Third, we examined whether having an approach-intention to microdosing was predictive of more reported benefits. METHODS The Global Drug Survey runs the world's largest online drug survey. Participants who reported last year use of lysergic acid diethylamide or psilocybin in the Global Drug Survey 2019 were offered the opportunity to answer a sub-section on microdosing. RESULTS Data from 6753 people who reported microdosing at least once in the last 12 months were used for analyses. Our results suggest a partial replication of previously reported benefits and challenges among the present sample often reporting enhanced mood, creativity, focus and sociability. Counter to our prediction, the most common challenge participants associated with microdosing was 'None'. As predicted, most participants reported not testing their substances. Counter to our hypothesis, approach-intention - microdosing to approach a desired goal - predicted less rather than more benefits. We discuss alternate frameworks that may better capture the reasons people microdose. CONCLUSION Our results suggest the perceived benefits associated with microdosing greatly outweigh the challenges. Microdosing may have utility for a variety of uses while having minimal side effects. Double-blind, placebo-controlled experiments are required to substantiate these reports.
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Affiliation(s)
- Rotem Petranker
- Clinical Psychology, York University, Toronto, Canada.,Psychedelic Studies Research Program, University of Toronto Mississauga, Mississauga, Canada
| | - Thomas Anderson
- Psychedelic Studies Research Program, University of Toronto Mississauga, Mississauga, Canada.,Department of Psychology, University of Toronto, Toronto, Canada
| | - Larissa J Maier
- Department of Psychiatry and Weill Institute for Neurosciences, University of California, San Francisco, United States of America.,Early Postdoc Mobility Grantee (P2ZHP1_17812), Swiss National Science Foundation, Bern, Switzerland
| | - Monica J Barratt
- Social and Global Studies Centre, RMIT University, Melbourne, Australia.,National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Jason A Ferris
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - Adam R Winstock
- University College London, Gower Street, London, United Kingdom.,Global Drug Survey Ltd, London, United Kingdom
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231
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Hayes C, Wahba M, Watson S. Will psilocybin lose its magic in the clinical setting? Ther Adv Psychopharmacol 2022; 12:20451253221090822. [PMID: 35480296 PMCID: PMC9036342 DOI: 10.1177/20451253221090822] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 03/01/2022] [Indexed: 12/13/2022] Open
Abstract
Psilocybin as a novel treatment for depression is garnering a lot of attention from both the mainstream media and the academic community. Although phase 3 trials are only just beginning, we feel that it is important for clinicians to consider what psilocybin-assisted psychotherapy might look like in the clinical setting. In this narrative review article we have considered the difficulties that may arise as psilocybin emerges from the research setting, which may hamper its progress towards becoming a licenced medication. Psilocybin has its own unique challenges: the expectation patients come to dosing with having read overwhelmingly positive media; patient suggestibility under the influence of psilocybin and requirement for specialised therapists to name a few. We have also made some recommendations for measures that should be taken in both the phase 3 trials and with clinicians to try and minimise some of the issues raised. In doing so our hope is that psilocybin will continue towards becoming a licenced medication that suitable patients are able to access with relative ease. Practicing psychiatrists need to have an awareness of the potential pitfalls of psilocybin as they will be responsible for prescribing it in the future.
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Affiliation(s)
- Caroline Hayes
- Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, St Nicholas Hospital, Jubilee Road, Newcastle upon Tyne NE3 3XT, UK
| | - Mourad Wahba
- Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Stuart Watson
- Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
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232
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McCulloch DEW, Madsen MK, Stenbæk DS, Kristiansen S, Ozenne B, Jensen PS, Knudsen GM, Fisher PM. Lasting effects of a single psilocybin dose on resting-state functional connectivity in healthy individuals. J Psychopharmacol 2022; 36:74-84. [PMID: 34189985 PMCID: PMC8801642 DOI: 10.1177/02698811211026454] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
BACKGROUND Psilocybin is a psychedelic drug that has shown lasting positive effects on clinical symptoms and self-reported well-being following a single dose. There has been little research into the long-term effects of psilocybin on brain connectivity in humans. AIM Evaluate changes in resting-state functional connectivity (RSFC) at 1 week and 3 months after one psilocybin dose in 10 healthy psychedelic-naïve volunteers and explore associations between change in RSFC and related measures. METHODS Participants received 0.2-0.3 mg/kg psilocybin in a controlled setting. Participants completed resting-state functional magnetic resonance imaging (fMRI) scans at baseline, 1-week and 3-month post-administration and [11C]Cimbi-36 PET scans at baseline and 1 week. We examined changes in within-network, between-network and region-to-region RSFC. We explored associations between changes in RSFC and psilocybin-induced phenomenology as well as changes in psychological measures and neocortex serotonin 2A receptor binding. RESULTS Psilocybin was well tolerated and produced positive changes in well-being. At 1 week only, executive control network (ECN) RSFC was significantly decreased (Cohen's d = -1.73, pFWE = 0.010). We observed no other significant changes in RSFC at 1 week or 3 months, nor changes in region-to-region RSFC. Exploratory analyses indicated that decreased ECN RSFC at 1 week predicted increased mindfulness at 3 months (r = -0.65). CONCLUSIONS These findings in a small cohort indicate that psilocybin affects ECN function within the psychedelic 'afterglow' period. Our findings implicate ECN modulation as mediating psilocybin-induced, long-lasting increases in mindfulness. Although our findings implicate a neural pathway mediating lasting psilocybin effects, it is notable that changes in neuroimaging measures at 3 months, when personality changes are observed, remain to be identified.
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Affiliation(s)
| | - Martin Korsbak Madsen
- Neurobiology Research Unit and NeuroPharm, Rigshospitalet, Copenhagen, Denmark,Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Dea Siggaard Stenbæk
- Neurobiology Research Unit and NeuroPharm, Rigshospitalet, Copenhagen, Denmark,Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Sara Kristiansen
- Neurobiology Research Unit and NeuroPharm, Rigshospitalet, Copenhagen, Denmark
| | - Brice Ozenne
- Neurobiology Research Unit and NeuroPharm, Rigshospitalet, Copenhagen, Denmark,Section of Biostatistics, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Peter Steen Jensen
- Neurobiology Research Unit and NeuroPharm, Rigshospitalet, Copenhagen, Denmark
| | - Gitte Moos Knudsen
- Neurobiology Research Unit and NeuroPharm, Rigshospitalet, Copenhagen, Denmark,Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Patrick MacDonald Fisher
- Neurobiology Research Unit and NeuroPharm, Rigshospitalet, Copenhagen, Denmark,Patrick MacDonald Fisher, Neurobiology Research Unit, Rigshospitalet Building 8057, 8 Inge Lehmanns Vej, Copenhagen 2100, Denmark.
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233
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Fischman LG. Knowing and being known: Psychedelic-assisted psychotherapy and the sense of authenticity. Front Psychiatry 2022; 13:933495. [PMID: 36203843 PMCID: PMC9530638 DOI: 10.3389/fpsyt.2022.933495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 09/02/2022] [Indexed: 11/16/2022] Open
Abstract
Participants in MDMA- and psychedelic-assisted psychotherapy often emerge from these treatments with new beliefs about themselves and the world. Studies have linked changed beliefs with mystical experiences reported by some participants during drug sessions. While there has been some debate about the epistemic value of drug-induced mystical experiences, and about the need for consent to treatments that may alter metaphysical beliefs, less attention has been given to the sense of authenticity that attends these experiences. In this paper, I consider the intersubjective context in which these changed beliefs arise. I suggest that the sense of authenticity people experience with MDMA- and psychedelic-assisted psychotherapy derives from a simultaneous feeling of knowing and being known. The medications used in these treatments reduce the defensive barriers which ordinarily prevent powerful feelings from being intersubjectively shared, allowing the subject to experience knowing and being known with the therapist and/or internalized or imagined others. In explaining this thesis, I discuss Ratcliffe's "existential feeling;" ipseity in incipient psychosis and psychedelic states; Winnicott's notions of the True Self, omnipotence, creativity, and transitional phenomena; implicit relational knowing and moments of meeting; infant-mother dyad research; predictive processing and the relaxed beliefs model of psychedelic action; the role of the "partner in thought" in knowing and feeling known. I propose that a "transitional space" model of MDMA- and psychedelic-assisted psychotherapy is well-suited for working through "not-me" or dissociated experience.
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Affiliation(s)
- Lawrence G Fischman
- Department of Psychiatry, School of Medicine, Tufts University, Boston, MA, United States
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234
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Carhart-Harris RL, Wagner AC, Agrawal M, Kettner H, Rosenbaum JF, Gazzaley A, Nutt DJ, Erritzoe D. Can pragmatic research, real-world data and digital technologies aid the development of psychedelic medicine? J Psychopharmacol 2022; 36:6-11. [PMID: 33888025 PMCID: PMC8801625 DOI: 10.1177/02698811211008567] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Favourable regulatory assessments, liberal policy changes, new research centres and substantial commercial investment signal that psychedelic therapy is making a major comeback. Positive findings from modern trials are catalysing developments, but it is questionable whether current confirmatory trials are sufficient for advancing our understanding of safety and best practice. Here we suggest supplementing traditional confirmatory trials with pragmatic trials, real-world data initiatives and digital health solutions to better support the discovery of optimal and personalised treatment protocols and parameters. These recommendations are intended to help support the development of safe, effective and cost-efficient psychedelic therapy, which, given its history, is vulnerable to excesses of hype and regulation.
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Affiliation(s)
- Robin L Carhart-Harris
- Centre for Psychedelic Research, Imperial College London, London, UK,Robin L Carhart-Harris, Centre for Psychedelic Research, Imperial College London, Burlington Danes Building, London W12 0NN, UK.
| | - Anne C Wagner
- Remedy, Toronto, Canada,Department of Psychology, Ryerson University, Toronto, Canada
| | - Manish Agrawal
- Maryland Oncology and Hematology, Rockville, USA,Aquilino Cancer Center, Rockville, USA
| | - Hannes Kettner
- Centre for Psychedelic Research, Imperial College London, London, UK
| | | | - Adam Gazzaley
- Neuroscape, Department of Neurology, Physiology and Psychiatry, University of California San Francisco, San Francisco, USA
| | - David J Nutt
- Centre for Psychedelic Research, Imperial College London, London, UK
| | - David Erritzoe
- Centre for Psychedelic Research, Imperial College London, London, UK
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235
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Zamani A, Carhart-Harris R, Christoff K. Prefrontal contributions to the stability and variability of thought and conscious experience. Neuropsychopharmacology 2022; 47:329-348. [PMID: 34545195 PMCID: PMC8616944 DOI: 10.1038/s41386-021-01147-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 08/02/2021] [Accepted: 08/03/2021] [Indexed: 02/08/2023]
Abstract
The human prefrontal cortex is a structurally and functionally heterogenous brain region, including multiple subregions that have been linked to different large-scale brain networks. It contributes to a broad range of mental phenomena, from goal-directed thought and executive functions to mind-wandering and psychedelic experience. Here we review what is known about the functions of different prefrontal subregions and their affiliations with large-scale brain networks to examine how they may differentially contribute to the diversity of mental phenomena associated with prefrontal function. An important dimension that distinguishes across different kinds of conscious experience is the stability or variability of mental states across time. This dimension is a central feature of two recently introduced theoretical frameworks-the dynamic framework of thought (DFT) and the relaxed beliefs under psychedelics (REBUS) model-that treat neurocognitive dynamics as central to understanding and distinguishing between different mental phenomena. Here, we bring these two frameworks together to provide a synthesis of how prefrontal subregions may differentially contribute to the stability and variability of thought and conscious experience. We close by considering future directions for this work.
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Affiliation(s)
- Andre Zamani
- Department of Psychology, University of British Columbia, 2136 West Mall, Vancouver, BC, Canada.
| | - Robin Carhart-Harris
- Centre for Psychedelic Research, Department of Brain Sciences, Imperial College London, London, UK
| | - Kalina Christoff
- Department of Psychology, University of British Columbia, 2136 West Mall, Vancouver, BC, Canada
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236
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Sarris J, Pinzon Rubiano D, Day K, Galvão-Coelho NL, Perkins D. Psychedelic medicines for mood disorders: current evidence and clinical considerations. Curr Opin Psychiatry 2022; 35:22-29. [PMID: 34855694 DOI: 10.1097/yco.0000000000000759] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
PURPOSE OF REVIEW Despite advances in treatment modalities for mood disorders over recent decades, further therapeutic options are still required. Increased research is occurring, with the pursuit of psychedelic-based pharmacotherapies for a range of mood disorders and other conditions. RECENT FINDINGS Serotonergic psychedelics have been found to modulate brain networks underlying various psychiatric disorders, as well promoting neurogenesis and neuroplasticity. Randomized placebo-controlled trials have found psilocybin with psychological support effective at treating depression, including treatment-resistant depression; with emergent research also signalling N,N-dimethyltryptamine/ayahuasca also as a potential option for the treatment of depression. Lysergic acid diethylamide has been found to have anxiolytic effects, whereas 3,4-methylenedioxymethamphetamine (MDMA) has been used effectively to treat post-traumatic stress disorder (PTSD), with Phase III clinical trial evidence. Microdosing of psychedelics is a growing phenomenon that has shown benefits in some preclinical data; however, a recent self-directed controlled trial reported no evidence of improved mood. SUMMARY Current research with medicinal psychedelics, usually as an adjunct to psychotherapy, has shown encouraging results in treating mood disorders. However, there are challenges regarding blinding and sample sizes remain small, and there have been no definitive Phase III studies (aside from MDMA for PTSD). Further work exploring novel formulations, interface with pharmacogenomics and the microbiome, and inflammatory pathways can be advised.
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Affiliation(s)
- Jerome Sarris
- Psychae Institute, Melbourne, Victoria
- NICM Health Research Institute, Western Sydney University, Westmead, New South Wales
- Florey Institute of Neuroscience and Mental Health, Parkville
- The Melbourne Clinic Professorial Unit, Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia
| | | | | | - Nicole L Galvão-Coelho
- NICM Health Research Institute, Western Sydney University, Westmead, New South Wales
- Laboratory of Hormone Measurement, Department of Physiology and Behavior
- Postgraduate Program in Psychobiology and Department of Physiology and Behavior, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Daniel Perkins
- Psychae Institute, Melbourne, Victoria
- University of Melbourne
- Centre for Mental Health, Swinburne University of Technology, Melbourne, Victoria, Australia
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237
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Lu Y, Rodriguez-Larios J. Nonlinear EEG signatures of mind wandering during breath focus meditation. CURRENT RESEARCH IN NEUROBIOLOGY 2022; 3:100056. [DOI: 10.1016/j.crneur.2022.100056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 08/31/2022] [Accepted: 09/07/2022] [Indexed: 11/17/2022] Open
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238
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Teixeira PJ, Johnson MW, Timmermann C, Watts R, Erritzoe D, Douglass H, Kettner H, Carhart-Harris RL. Psychedelics and health behaviour change. J Psychopharmacol 2022; 36:12-19. [PMID: 34053342 PMCID: PMC8801670 DOI: 10.1177/02698811211008554] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Healthful behaviours such as maintaining a balanced diet, being physically active and refraining from smoking have major impacts on the risk of developing cancer, diabetes, cardiovascular diseases and other serious conditions. The burden of the so-called 'lifestyle diseases'-in personal suffering, premature mortality and public health costs-is considerable. Consequently, interventions designed to promote healthy behaviours are increasingly being studied, e.g., using psychobiological models of behavioural regulation and change. In this article, we explore the notion that psychedelic substances such as psilocybin could be used to assist in promoting positive lifestyle change conducive to good overall health. Psilocybin has a low toxicity, is non-addictive and has been shown to predict favourable changes in patients with depression, anxiety and other conditions marked by rigid behavioural patterns, including substance (mis)use. While it is still early days for modern psychedelic science, research is advancing fast and results are promising. Here we describe psychedelics' proposed mechanisms of action and research findings pertinent to health behaviour change science, hoping to generate discussion and new research hypotheses linking the two areas. Therapeutic models including psychedelic experiences and common behaviour change methods (e.g., Cognitive Behaviour Therapy, Motivational Interviewing) are already being tested for addiction and eating disorders. We believe this research may soon be extended to help promote improved diet, exercise, nature exposure and also mindfulness or stress reduction practices, all of which can contribute to physical and psychological health and well-being.
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Affiliation(s)
- Pedro J Teixeira
- CIPER - Faculty of Human Kinetics, University of Lisbon, Cruz Quebrada, Portugal,The Synthesis Institute B.V, Amsterdam, The Netherlands,Pedro J Teixeira, Faculty of Human Kinetics, University of Lisbon, Estrada da Costa, Cruz Quebrada 1499-002, Portugal.
| | - Matthew W Johnson
- Center for Psychedelic and Consciousness Research, Johns Hopkins University, Baltimore, USA
| | | | | | - David Erritzoe
- Imperial College London Psychedelic Research Group, London, UK
| | - Hannah Douglass
- Imperial College London Psychedelic Research Group, London, UK
| | - Hannes Kettner
- Imperial College London Psychedelic Research Group, London, UK
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239
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Villiger D. How Psychedelic-Assisted Treatment Works in the Bayesian Brain. Front Psychiatry 2022; 13:812180. [PMID: 35360137 PMCID: PMC8963812 DOI: 10.3389/fpsyt.2022.812180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 02/11/2022] [Indexed: 11/25/2022] Open
Abstract
Psychedelics are experiencing a renaissance in clinical research. In recent years, an increasing number of studies on psychedelic-assisted treatment have been conducted. So far, the results are promising, suggesting that this new (or rather, rediscovered) form of therapy has great potential. One particular reason for that appears to be the synergistic combination of the pharmacological and psychotherapeutic interventions in psychedelic-assisted treatment. But how exactly do these two interventions complement each other? This paper provides the first account of the interaction between pharmacological and psychological effects in psychedelic-assisted treatment. Building on the relaxed beliefs under psychedelics (REBUS) hypothesis of Carhart-Harris and Friston and the contextual model of Wampold, it argues that psychedelics amplify the common factors and thereby the remedial effects of psychotherapy. More precisely, psychedelics are assumed to attenuate the precision of high-level predictions, making them more revisable by bottom-up input. Psychotherapy constitutes an important source of such input. At best, it signalizes a safe and supportive environment (cf. setting) and induces remedial expectations (cf. set). During treatment, these signals should become incorporated when high-level predictions are revised: a process that is hypothesized to occur as a matter of course in psychotherapy but to get reinforced and accelerated under psychedelics. Ultimately, these revisions should lead to a relief of symptoms.
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Affiliation(s)
- Daniel Villiger
- Department of Psychosomatics and Psychotherapy, Psychiatric University Hospital Basel, University of Basel, Basel, Switzerland.,Institute of Philosophy, University of Zurich, Zurich, Switzerland
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240
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van den Berg M, Magaraggia I, Schreiber R, Hillhouse TM, Porter JH. How to account for hallucinations in the interpretation of the antidepressant effects of psychedelics: a translational framework. Psychopharmacology (Berl) 2022; 239:1853-1879. [PMID: 35348806 PMCID: PMC9166823 DOI: 10.1007/s00213-022-06106-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 02/24/2022] [Indexed: 01/02/2023]
Abstract
RATIONALE Recent trials with psychedelics in major depressive disorder and treatment-resistant depression showed remarkable improvements in depressive symptoms that can last for up to several months after even a single administration. The lack of an appropriate placebo control group-as patients are often able to discriminate the subjective effects of the drug-and an incomplete understanding of the role of the hallucinogenic and mystical experience, hampers the interpretation of these therapeutic effects. OBJECTIVES To control for these factors, we developed a translational framework based on establishing pharmacokinetic/pharmacodynamic (PK/PD) relationships in rodents and humans for hallucinogenic (i.e., discriminative stimulus effects in rodents and humans; head twitch responses in rodents; questionnaires in humans) and therapeutic effects. For the latter, we selected the pattern separation and attentional set-shifting tasks as measures for cognitive flexibility because of their high translational value. We predict that these PK/PD analyses will lead to a more objective evaluation of improvements in patients compared to relying only on the currently used self-reported questionnaires. We hypothesize that-if the role of the hallucinogenic experience is not central in the antidepressant effects of psychedelics-the ED50's for the therapeutic effects will be significantly lower than for the hallucinogenic and mystical effects. CONCLUSION Our framework will help to inform future studies that aim at the elucidation of the mechanism(s) of action of psychedelics in depression, and the role of the acute subjective and/or hallucinogenic experience in their effects.
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Affiliation(s)
- Manon van den Berg
- Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands ,Faculty of Psychology and Neuroscience, Section Neuropsychology & Psychopharmacology, Maastricht University, Maastricht, The Netherlands
| | - Igor Magaraggia
- Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands ,Faculty of Psychology and Neuroscience, Section Neuropsychology & Psychopharmacology, Maastricht University, Maastricht, The Netherlands
| | - Rudy Schreiber
- Faculty of Psychology and Neuroscience, Section Neuropsychology & Psychopharmacology, Maastricht University, Maastricht, The Netherlands.
| | - Todd M. Hillhouse
- Department of Psychology, University of Wisconsin Green Bay, Green Bay, WI USA
| | - Joseph H. Porter
- Department of Psychology, Virginia Commonwealth University, Richmond, USA
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Kelly JR, Gillan CM, Prenderville J, Kelly C, Harkin A, Clarke G, O'Keane V. Psychedelic Therapy's Transdiagnostic Effects: A Research Domain Criteria (RDoC) Perspective. Front Psychiatry 2021; 12:800072. [PMID: 34975593 PMCID: PMC8718877 DOI: 10.3389/fpsyt.2021.800072] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 11/19/2021] [Indexed: 12/12/2022] Open
Abstract
Accumulating clinical evidence shows that psychedelic therapy, by synergistically combining psychopharmacology and psychological support, offers a promising transdiagnostic treatment strategy for a range of disorders with restricted and/or maladaptive habitual patterns of emotion, cognition and behavior, notably, depression (MDD), treatment resistant depression (TRD) and addiction disorders, but perhaps also anxiety disorders, obsessive-compulsive disorder (OCD), Post-Traumatic Stress Disorder (PTSD) and eating disorders. Despite the emergent transdiagnostic evidence, the specific clinical dimensions that psychedelics are efficacious for, and associated underlying neurobiological pathways, remain to be well-characterized. To this end, this review focuses on pre-clinical and clinical evidence of the acute and sustained therapeutic potential of psychedelic therapy in the context of a transdiagnostic dimensional systems framework. Focusing on the Research Domain Criteria (RDoC) as a template, we will describe the multimodal mechanisms underlying the transdiagnostic therapeutic effects of psychedelic therapy, traversing molecular, cellular and network levels. These levels will be mapped to the RDoC constructs of negative and positive valence systems, arousal regulation, social processing, cognitive and sensorimotor systems. In summarizing this literature and framing it transdiagnostically, we hope we can assist the field in moving toward a mechanistic understanding of how psychedelics work for patients and eventually toward a precise-personalized psychedelic therapy paradigm.
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Affiliation(s)
- John R. Kelly
- Department of Psychiatry, Trinity College, Dublin, Ireland
- Department of Psychiatry, Tallaght University Hospital, Dublin, Ireland
| | - Claire M. Gillan
- Trinity College Institute of Neuroscience, Trinity College, Dublin, Ireland
- School of Psychology, Trinity College, Dublin, Ireland
- Global Brain Health Institute, Trinity College, Dublin, Ireland
| | - Jack Prenderville
- Transpharmation Ireland Ltd, Institute of Neuroscience, Trinity College, Dublin, Ireland
- Discipline of Physiology, School of Medicine, Trinity College, Dublin, Ireland
| | - Clare Kelly
- Department of Psychiatry, Trinity College, Dublin, Ireland
- Trinity College Institute of Neuroscience, Trinity College, Dublin, Ireland
- School of Psychology, Trinity College, Dublin, Ireland
| | - Andrew Harkin
- Trinity College Institute of Neuroscience, Trinity College, Dublin, Ireland
- School of Pharmacy and Pharmaceutical Sciences, Trinity College, Dublin, Ireland
| | - Gerard Clarke
- Department of Psychiatry and Neurobehavioral Science, University College Cork, Cork, Ireland
- APC Microbiome Ireland, University College Cork, Cork, Ireland
| | - Veronica O'Keane
- Department of Psychiatry, Trinity College, Dublin, Ireland
- Department of Psychiatry, Tallaght University Hospital, Dublin, Ireland
- Trinity College Institute of Neuroscience, Trinity College, Dublin, Ireland
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242
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Sousa TR, Rema J, Machado S, Novais F. Psychedelics and hallucinogens in Psychiatry: finding new pharmacological targets. Curr Top Med Chem 2021; 22:1250-1260. [PMID: 34852736 DOI: 10.2174/1568026621666211201145800] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Revised: 10/31/2021] [Accepted: 11/01/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND The therapeutic options for neurobehavioral disorders are still limited, and in many cases, they lack a satisfactory balance between efficacy and side effects. OBJECTIVE This work aims to review current evidence regarding the potential contribution of psychedelics and hallucinogens to the discovery of new drugs for treating different psychiatric disorders. DISCUSSION Ayahuasca/N,N-dimethyltryptamine (DMT), lysergic acid diethylamide (LSD), and psilocybin have evidence supporting their use in depression, and psilocybin and ayahuasca have also shown good results in treatment-resistant depression. In randomized controlled trials (RCTs) conducted with anxious patients, there were symptomatic improvements with psilocybin and LSD. Psilocybin diminished Yale-Brown Obsessive Compulsive Scale (Y-BOCS) scores in a small obsessive-compulsive disorder (OCD) sample. The evidence is less robust regarding substance use disorders, but it suggests a possible role for LSD and psilocybin in alcohol use disorders and for psilocybin in tobacco addiction. In a clinical setting, these substances seem to be safe and well-tolerated. Their mechanisms of action are not fully elucidated, but there seems to be a preponderant role of 5-hydroxytryptamine (5HT) 2A agonism, as well as connectivity changes within the default mode network (DMN) and amygdala and some other molecular modifications. CONCLUSION The studies underlying the conclusions have small samples and are heterogeneous in their methods. However, the results suggest that the use of psychedelics and hallucinogens could be considered in some disorders. More studies are needed to reinforce their evidence as potential new drugs.
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Affiliation(s)
- Teresa Reynolds Sousa
- Psychiatry and Mental Health Department, North Lisbon Hospital Centre, Lisbon. Portugal
| | - João Rema
- Psychiatry and Mental Health Department, North Lisbon Hospital Centre, Lisbon. Portugal
| | - Sergio Machado
- Department of Sports Methods and Techniques, Federal University of Santa Maria, Santa Maria. Brazil
| | - Filipa Novais
- Psychiatry and Mental Health Department, North Lisbon Hospital Centre, Lisbon. Portugal
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243
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Psychedelic Epistemology: William James and the “Noetic Quality” of Mystical Experience. RELIGIONS 2021. [DOI: 10.3390/rel12121058] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
William James proposed in 1902 that states of mystical experience, central to his idea of religious experience, can be identified based on their ineffability and their noetic quality. The epistemological category of the noetic quality, modified by W. T. Stace in 1960, plays a central but somewhat confounding role in today’s biomedical research involving psychedelic drugs such as psilocybin and LSD. Using scales based on James, it can be shown that psychedelics “reliably occasion” intense subjective states of experience or mystical states. It is debated whether these states are necessary for the wide range of possible mental health therapeutic benefits that appear to follow. This paper reviews what James said about the noetic quality and its relationship to religious experience, epistemology, and states of mystical experience. It explores how the noetic quality is measured in today’s research, addressing a growing list of concerns that psychedelic science can be epistemologically biased, that it is hostile to atheistic or physicalist views, that it injects religion unduly into science, or that it needs to find ways to eliminate the mystical element, if not the entire intense subjective experience altogether.
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244
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Timmermann C, Kettner H, Letheby C, Roseman L, Rosas FE, Carhart-Harris RL. Psychedelics alter metaphysical beliefs. Sci Rep 2021; 11:22166. [PMID: 34815421 PMCID: PMC8611059 DOI: 10.1038/s41598-021-01209-2] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 10/19/2021] [Indexed: 02/06/2023] Open
Abstract
Can the use of psychedelic drugs induce lasting changes in metaphysical beliefs? While it is popularly believed that they can, this question has never been formally tested. Here we exploited a large sample derived from prospective online surveying to determine whether and how beliefs concerning the nature of reality, consciousness, and free-will, change after psychedelic use. Results revealed significant shifts away from 'physicalist' or 'materialist' views, and towards panpsychism and fatalism, post use. With the exception of fatalism, these changes endured for at least 6 months, and were positively correlated with the extent of past psychedelic-use and improved mental-health outcomes. Path modelling suggested that the belief-shifts were moderated by impressionability at baseline and mediated by perceived emotional synchrony with others during the psychedelic experience. The observed belief-shifts post-psychedelic-use were consolidated by data from an independent controlled clinical trial. Together, these findings imply that psychedelic-use may causally influence metaphysical beliefs-shifting them away from 'hard materialism'. We discuss whether these apparent effects are contextually independent.
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Affiliation(s)
- Christopher Timmermann
- Division of Psychiatry, Department of Brain Sciences, Centre for Psychedelic Research, Imperial College London, London, UK.
| | - Hannes Kettner
- Division of Psychiatry, Department of Brain Sciences, Centre for Psychedelic Research, Imperial College London, London, UK
| | - Chris Letheby
- Department of Philosophy, The University of Western Australia, Perth, Australia
- Department of Philosophy, The University of Adelaide, Adelaide, Australia
| | - Leor Roseman
- Division of Psychiatry, Department of Brain Sciences, Centre for Psychedelic Research, Imperial College London, London, UK
| | - Fernando E Rosas
- Division of Psychiatry, Department of Brain Sciences, Centre for Psychedelic Research, Imperial College London, London, UK
- Data Science Institute, Imperial College London, London, UK
- Centre for Complexity Science, Imperial College London, London, UK
| | - Robin L Carhart-Harris
- Division of Psychiatry, Department of Brain Sciences, Centre for Psychedelic Research, Imperial College London, London, UK
- Psychedelics Division, Neuroscape, Department of Neurology, University of California, San Francisco, USA
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245
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Dupuis D. Psychedelics as Tools for Belief Transmission. Set, Setting, Suggestibility, and Persuasion in the Ritual Use of Hallucinogens. Front Psychol 2021; 12:730031. [PMID: 34887799 PMCID: PMC8651242 DOI: 10.3389/fpsyg.2021.730031] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 11/01/2021] [Indexed: 12/04/2022] Open
Abstract
The use of psychedelics in the collective rituals of numerous indigenous groups suggests that these substances are powerful catalysts of social affiliation, enculturation, and belief transmission. This feature has recently been highlighted as part of the renewed interest in psychedelics in Euro-American societies, and seen as a previously underestimated vector of their therapeutic properties. The property of psychedelics to increase feelings of collective belonging and transmission of specific cultural values or beliefs raise, however, complex ethical questions in the context of the globalization of these substances. In the past decades, this property has been perceived as problematic by anticult movements and public authorities of some European countries, claiming that these substances could be used for "mental manipulation." Despite the fact that this notion has been widely criticized by the scientific community, alternative perspectives on how psychedelic experience supports enculturation and social affiliation have been yet little explored. Beyond the political issues that underlie it, the re-emergence of the concept of "psychedelic brainwashing" can then be read as the consequence of the fact that the dynamic through which psychedelic experience supports persuasion is still poorly understood. Beyond the unscientific and politically controversed notion of brainwashing, how to think the role of psychedelics in the dynamics of transmission of belief and its ethical stakes? Drawing on data collected in a shamanic center in the Peruvian Amazon, this article addresses this question through an ethnographic case-study. Proposing the state of hypersuggestibility induced by psychedelics as the main factor making the substances powerful tools for belief transmission, I show that it is also paradoxically in its capacity to produce doubt, ambivalence, and reflexivity that psychedelics support enculturation. I argue that, far from the brainwashing model, this dynamic is giving a central place to the agency of the recipient, showing that it is ultimately on the recipient's efforts to test the object of belief through an experiential verification process that the dynamic of psychedelic enculturation relies on. Finally, I explore the permanence and the conditions of sustainability of the social affiliation emerging from these practices and outline the ethical stakes of these observations.
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Affiliation(s)
- David Dupuis
- Research Department, Quai Branly Museum, Paris, France
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246
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Hong CCH, Fallon JH, Friston KJ. fMRI Evidence for Default Mode Network Deactivation Associated with Rapid Eye Movements in Sleep. Brain Sci 2021; 11:brainsci11111528. [PMID: 34827529 PMCID: PMC8615877 DOI: 10.3390/brainsci11111528] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 11/12/2021] [Accepted: 11/16/2021] [Indexed: 11/25/2022] Open
Abstract
System-specific brain responses—time-locked to rapid eye movements (REMs) in sleep—are characteristically widespread, with robust and clear activation in the primary visual cortex and other structures involved in multisensory integration. This pattern suggests that REMs underwrite hierarchical processing of visual information in a time-locked manner, where REMs index the generation and scanning of virtual-world models, through multisensory integration in dreaming—as in awake states. Default mode network (DMN) activity increases during rest and reduces during various tasks including visual perception. The implicit anticorrelation between the DMN and task-positive network (TPN)—that persists in REM sleep—prompted us to focus on DMN responses to temporally-precise REM events. We timed REMs during sleep from the video recordings and quantified the neural correlates of REMs—using functional MRI (fMRI)—in 24 independent studies of 11 healthy participants. A reanalysis of these data revealed that the cortical areas exempt from widespread REM-locked brain activation were restricted to the DMN. Furthermore, our analysis revealed a modest temporally-precise REM-locked decrease—phasic deactivation—in key DMN nodes, in a subset of independent studies. These results are consistent with hierarchical predictive coding; namely, permissive deactivation of DMN at the top of the hierarchy (leading to the widespread cortical activation at lower levels; especially the primary visual cortex). Additional findings indicate REM-locked cerebral vasodilation and suggest putative mechanisms for dream forgetting.
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Affiliation(s)
- Charles Chong-Hwa Hong
- Patuxent Institution, Correctional Mental Health Center—Jessup, Jessup, MD 20794, USA
- Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University, Baltimore, MD 21205, USA
- Correspondence: ; Tel.: +1-410-596-1956
| | - James H. Fallon
- Department of Anatomy and Neurobiology, University of California, Irvine, CA 92697, USA;
- Department of Psychiatry and Human Behavior, University of California, Irvine, CA 92697, USA
| | - Karl J. Friston
- The Well Come Centre for Human Neuroimaging, Institute of Neurology, University College London, London WC1N 3AR, UK;
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Ehrmann K, Allen JJB, Moreno FA. Psilocybin for the Treatment of Obsessive-Compulsive Disorders. Curr Top Behav Neurosci 2021; 56:247-259. [PMID: 34784024 DOI: 10.1007/7854_2021_279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Obsessive-compulsive disorder (OCD) is a highly prevalent and disabling condition for which currently available treatments are insufficiently effective and alternatives merit priority attention. Psilocybin may represent a safe and effective avenue for treatment of individuals affected by this condition. In this chapter we briefly introduce OCD symptoms, epidemiology, as well as relevant hypotheses on the mechanism of disease that may inform treatment interventions. We briefly describe currently available treatments, mechanisms of action, and efficacy limitations, as preamble to the potential use of psilocybin and perhaps similar compounds in the treatment of OCD and related conditions. Although much is reviewed throughout this book about the mechanisms of action of psychedelic agents, a focused discussion of psilocybin effects as they pertain to OCD is also included. Our experience with incidental observation, prospective research, and current explorations of psilocybin in OCD are also described.
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248
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Luppi AI, Mediano PAM, Rosas FE, Harrison DJ, Carhart-Harris RL, Bor D, Stamatakis EA. What it is like to be a bit: an integrated information decomposition account of emergent mental phenomena. Neurosci Conscious 2021; 2021:niab027. [PMID: 34804593 PMCID: PMC8600547 DOI: 10.1093/nc/niab027] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 06/24/2021] [Accepted: 08/12/2021] [Indexed: 01/08/2023] Open
Abstract
A central question in neuroscience concerns the relationship between consciousness and its physical substrate. Here, we argue that a richer characterization of consciousness can be obtained by viewing it as constituted of distinct information-theoretic elements. In other words, we propose a shift from quantification of consciousness-viewed as integrated information-to its decomposition. Through this approach, termed Integrated Information Decomposition (ΦID), we lay out a formal argument that whether the consciousness of a given system is an emergent phenomenon depends on its information-theoretic composition-providing a principled answer to the long-standing dispute on the relationship between consciousness and emergence. Furthermore, we show that two organisms may attain the same amount of integrated information, yet differ in their information-theoretic composition. Building on ΦID's revised understanding of integrated information, termed ΦR, we also introduce the notion of ΦR-ing ratio to quantify how efficiently an entity uses information for conscious processing. A combination of ΦR and ΦR-ing ratio may provide an important way to compare the neural basis of different aspects of consciousness. Decomposition of consciousness enables us to identify qualitatively different 'modes of consciousness', establishing a common space for mapping the phenomenology of different conscious states. We outline both theoretical and empirical avenues to carry out such mapping between phenomenology and information-theoretic modes, starting from a central feature of everyday consciousness: selfhood. Overall, ΦID yields rich new ways to explore the relationship between information, consciousness, and its emergence from neural dynamics.
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Affiliation(s)
- Andrea I Luppi
- Division of Anaesthesia, School of Clinical Medicine, University of Cambridge, Cambridge CB2 0QQ, UK
- Department of Clinical Neurosciences, University of Cambridge, Cambridge CB2 0QQ, UK
- Leverhulme Centre for the Future of Intelligence, University of Cambridge, Cambridge CB2 1SB, UK
| | - Pedro A M Mediano
- Department of Psychology, University of Cambridge, Cambridge CB2 3EB, UK
| | - Fernando E Rosas
- Center for Psychedelic Research, Department of Brain Science, Imperial College London, London W12 0NN, UK
- Data Science Institute, Imperial College London, London SW7 2AZ, UK
- Centre for Complexity Science, Imperial College London, London SW7 2AZ, UK
| | - David J Harrison
- Leverhulme Centre for the Future of Intelligence, University of Cambridge, Cambridge CB2 1SB, UK
- Department of History and Philosophy of Science, University of Cambridge, Cambridge CB2 3RH, UK
| | - Robin L Carhart-Harris
- Center for Psychedelic Research, Department of Brain Science, Imperial College London, London W12 0NN, UK
| | - Daniel Bor
- Department of Psychology, University of Cambridge, Cambridge CB2 3EB, UK
| | - Emmanuel A Stamatakis
- Division of Anaesthesia, School of Clinical Medicine, University of Cambridge, Cambridge CB2 0QQ, UK
- Department of Clinical Neurosciences, University of Cambridge, Cambridge CB2 0QQ, UK
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249
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Koslowski M, Johnson MW, Gründer G, Betzler F. Novel Treatment Approaches for Substance Use Disorders: Therapeutic Use of Psychedelics and the Role of Psychotherapy. CURRENT ADDICTION REPORTS 2021. [DOI: 10.1007/s40429-021-00401-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Abstract
Purpose of Review
The use of psychedelics in a therapeutical setting has been reported for the treatment of various diagnoses in recent years. However, as psychedelic substances are still commonly known for their (illicit) recreational use, it may seem counterintuitive to use psychedelic therapy to treat substance use disorders. This review aims to discuss how psychedelics can promote and intensify psychotherapeutic key processes, in different approaches like psychodynamic and cognitive behavioral therapy, with a spotlight on the treatment of substance use disorders (SUD).
Recent Findings
There is promising evidence of feasibility, safety, and efficacy of psychedelic therapy in SUD. In the whole process of former and current psychedelic therapy regimes that have shown to be safe and efficacious, various psychotherapeutic elements, both psychodynamic and behavioral as well as other approaches, can be identified, while a substantial part of the assumed mechanism of action, the individual psychedelic experience, cannot be distinctly classified to just one approach.
Summary
Psychedelic therapy consists of a complex interaction of pharmacological and psychological processes. When administered in well-defined conditions, psychedelics can serve as augmentation of different psychotherapy interventions in the treatment of SUD and other mental disorders, regardless of their theoretical origin.
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250
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Spriggs MJ, Douglass HM, Park RJ, Read T, Danby JL, de Magalhães FJC, Alderton KL, Williams TM, Blemings A, Lafrance A, Nicholls DE, Erritzoe D, Nutt DJ, Carhart-Harris RL. Study Protocol for "Psilocybin as a Treatment for Anorexia Nervosa: A Pilot Study". Front Psychiatry 2021; 12:735523. [PMID: 34744825 PMCID: PMC8563607 DOI: 10.3389/fpsyt.2021.735523] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 09/15/2021] [Indexed: 01/14/2023] Open
Abstract
Background: Anorexia nervosa (AN) is a serious and life-threatening psychiatric condition. With a paucity of approved treatments, there is a desperate need for novel treatment avenues to be explored. Here, we present (1) an overview of the ways through which Public Patient Involvement (PPI) has informed a trial of psilocybin-assisted therapy for AN and (2) a protocol for a pilot study of psilocybin-assisted therapy in AN currently underway at Imperial College London. The study aims to assess the feasibility, brain mechanisms and preliminary outcomes of treating anorexia nervosa with psilocybin. Methods: (1) PPI: Across two online focus groups, eleven individuals with lived experience of AN were presented with an overview of the protocol. Their feedback not only identified solutions to possible barriers for future participants, but also helped the research team to better understand the concept of "recovery" from the perspective of those with lived experience. (2) Protocol: Twenty female participants [21-65 years old, body mass index (BMI) 15 kg/m2 or above] will receive three oral doses of psilocybin (up to 25 mg) over a 6-week period delivered in a therapeutic environment and enveloped by psychological preparation and integration. We will work with participant support networks (care teams and an identified support person) throughout and there will be an extended remote follow-up period of 12 months. Our two-fold primary outcomes are (1) psychopathology (Eating Disorder Examination) across the 6-month follow-up and (2) readiness and motivation to engage in recovery (Readiness and Motivation Questionnaire) across the 6-week trial period. Neurophysiological outcome measures will be: (1) functional magnetic resonance imaging (fMRI) brain changes from baseline to 6-week endpoint and (2) post-acute changes in electroencephalography (EEG) activity, including an electrophysiological marker of neuronal plasticity. Discussion: The results of this pilot study will not only shed light on the acceptability, brain mechanisms, and impression of the potential efficacy of psilocybin as an adjunct treatment for AN but will be essential in shaping a subsequent Randomised Control Trial (RCT) that would test this treatment against a suitable control condition. Clinical Trial Registration: identifier: NCT04505189.
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Affiliation(s)
- Meg J. Spriggs
- Centre for Psychedelic Research, Department of Brain Sciences, Imperial College London, London, United Kingdom
| | - Hannah M. Douglass
- Centre for Psychedelic Research, Department of Brain Sciences, Imperial College London, London, United Kingdom
| | - Rebecca J. Park
- OxBREaD Research Group, Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - Tim Read
- Centre for Psychedelic Research, Department of Brain Sciences, Imperial College London, London, United Kingdom
| | - Jennifer L. Danby
- Centre for Psychedelic Research, Department of Brain Sciences, Imperial College London, London, United Kingdom
| | | | - Kirsty L. Alderton
- Centre for Psychedelic Research, Department of Brain Sciences, Imperial College London, London, United Kingdom
| | - Tim M. Williams
- Centre for Psychedelic Research, Department of Brain Sciences, Imperial College London, London, United Kingdom
| | - Allan Blemings
- Centre for Psychedelic Research, Department of Brain Sciences, Imperial College London, London, United Kingdom
| | - Adele Lafrance
- School of Rural and Northern Health, Laurentian University, Sudbury, ON, Canada
| | - Dasha E. Nicholls
- Division of Psychiatry, Department of Brain Sciences, Imperial College London, London, United Kingdom
| | - David Erritzoe
- Centre for Psychedelic Research, Department of Brain Sciences, Imperial College London, London, United Kingdom
| | - David J. Nutt
- Centre for Psychedelic Research, Department of Brain Sciences, Imperial College London, London, United Kingdom
| | - Robin L. Carhart-Harris
- Centre for Psychedelic Research, Department of Brain Sciences, Imperial College London, London, United Kingdom
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