المؤلفون: Weiss, Brandon, Ginige, Induni, Shannon, Lu, Giribaldi, Bruna, Murphy-Beiner, Ashleigh, Murphy, Roberta, Baker-Jones, Michelle, Martell, Jonny, Nutt, David, Carhart-Harris, Robin, Erritzoe, David

المصدر: Psychological Medicine. 54(1)

مصطلحات موضوعية: Absorption, escitalopram, five-factor model, impulsivity, personality, personality change, psilocybin therapy, Humans, Psilocybin, Escitalopram, Depressive Disorder, Major, Depression, Personality, Neuroticism

الوصف: BACKGROUND: Psilocybin Therapy (PT) is being increasingly studied as a psychiatric intervention. Personality relates to mental health and can be used to probe the nature of PTs therapeutic action. METHODS: In a phase 2, double-blind, randomized, active comparator controlled trial involving patients with moderate-to-severe major depressive disorder, we compared psilocybin with escitalopram, over a core 6-week trial period. Five-Factor model personality domains, Big Five Aspect Scale Openness aspects, Absorption, and Impulsivity were measured at Baseline, Week 6, and Month 6 follow-up. RESULTS: PT was associated with decreases in neuroticism (B = -0.63), introversion (B = -0.38), disagreeableness (B = -0.47), impulsivity (B = -0.40), and increases in absorption (B = 0.32), conscientiousness (B = 0.30), and openness (B = 0.23) at week 6, with neuroticism (B = -0.47) and disagreeableness (B = -0.41) remaining decreased at month 6. Escitalopram Treatment (ET) was associated with decreases in neuroticism (B = -0.38), disagreeableness (B = -0.26), impulsivity (B = -0.35), and increases in openness (B = 0.28) at week 6, with neuroticism (B = -0.46) remaining decreased at month 6. No significant between-condition differences were observed. CONCLUSIONS: Personality changes across both conditions were in a direction consistent with improved mental health. With the possible exception of trait absorption, there were no compelling between-condition differences warranting conclusions regarding a selective action of PT (v. ET) on personality; however, post-ET changes in personality were significantly moderated by pre-trial positive expectancy for escitalopram, whereas expectancy did not moderate response to PT.

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/0d31j1djTest
https://escholarship.org/content/qt0d31j1dj/qt0d31j1dj.pdfTest

المؤلفون: Oliver C. Robinson, Jules Evans, David Luke, Rosalind McAlpine, Aneta Sahely, Amy Fisher, Stian Sundeman, Eirini Ketzitzidou Argyri, Ashleigh Murphy-Beiner, Katrina Michelle, Ed Prideaux

المصدر: Frontiers in Psychology, Vol 15 (2024)

مصطلحات موضوعية: psychedelics, challenging experiences, adverse effects, qualitative, Structured Tabular Thematic Analysis, extended difficulties, Psychology, BF1-990

الوصف: IntroductionA growing body of literature is investigating the difficulties that some individuals encounter after psychedelic experiences. Existing research has explored the nature and predictors of these difficulties; however, a research gap exists in understanding how individuals endeavour to cope with such difficulties.MethodsThe current study collected data from an international cohort of 608 participants who reported experiencing difficulties that persisted for at least one day after a psychedelic experience. They provided written data on how they used coping strategies to alleviate these difficulties. The qualitative analysis of the written data on coping was conducted using Structured Tabular Thematic Analysis.ResultsA wide range of individual and social coping strategies were employed that were found helpful. The most common individual strategies were meditation and prayer, followed by self-educational activities such as reading and journaling. The most prevalent forms of social coping involved seeking support from friends or family members, followed by obtaining assistance from a therapist or coach. Features of social coping that were reported to be helpful included feeling heard/accepted, a non-judgemental attitude and sharing similar experiences.DiscussionOur findings hold potential for informing the design of therapeutic interventions and educational resources aimed at enhancing positive outcomes for those experiencing extended difficulties after psychedelic use.

وصف الملف: electronic resource

العلاقة: https://www.frontiersin.org/articles/10.3389/fpsyg.2024.1369715/fullTest; https://doaj.org/toc/1664-1078Test

الوصول الحر: https://doaj.org/article/78e6c10da76048ff8aed462d278ada9cTest

المؤلفون: Murphy, Roberta, Kettner, Hannes, Zeifman, Rick, Giribaldi, Bruna, Kartner, Laura, Martell, Jonny, Read, Tim, Murphy-Beiner, Ashleigh, Baker-Jones, Michelle, Nutt, David, Erritzoe, David, Watts, Rosalind, Carhart-Harris, Robin

مصطلحات موضوعية: Biomedical and Clinical Sciences, Clinical Sciences, Depression, Mental Health, Clinical Trials and Supportive Activities, Clinical Research, Mental health, Good Health and Well Being, acute psychedelic experience, depression, emotional breakthrough, mystical experience, psilocybin, psychedelic assisted therapy, therapeutic alliance, therapeutic relationship, Pharmacology and Pharmaceutical Sciences, Pharmacology and pharmaceutical sciences

الوصف: 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, R 2 = 0.42 for EBIMax; β = -0.19, R 2 = 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.govTest, identifier (NCT03429075).

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/9g16b1k1Test

المؤلفون: Meg J. Spriggs, Ashleigh Murphy-Beiner, Roberta Murphy, Julia Bornemann, Hannah Thurgur, Anne K. Schlag

المصدر: Frontiers in Psychology, Vol 14 (2023)

مصطلحات موضوعية: psychedelic assisted therapy (PAT), ethics, equity, co-design, psychotherapy, Psychology, BF1-990

الوصف: The field of psychedelic assisted therapy (PAT) is growing at an unprecedented pace. The immense pressures this places on those working in this burgeoning field have already begun to raise important questions about risk and responsibility. It is imperative that the development of an ethical and equitable infrastructure for psychedelic care is prioritized to support this rapid expansion of PAT in research and clinical settings. Here we present Access, Reciprocity and Conduct (ARC); a framework for a culturally informed ethical infrastructure for ARC in psychedelic therapies. These three parallel yet interdependent pillars of ARC provide the bedrock for a sustainable psychedelic infrastructure which prioritized equal access to PAT for those in need of mental health treatment (Access), promotes the safety of those delivering and receiving PAT in clinical contexts (Conduct), and respects the traditional and spiritual uses of psychedelic medicines which often precede their clinical use (Reciprocity). In the development of ARC, we are taking a novel dual-phase co-design approach. The first phase involves co-development of an ethics statement for each arm with stakeholders from research, industry, therapy, community, and indigenous settings. A second phase will further disseminate the statements for collaborative review to a wider audience from these different stakeholder communities within the psychedelic therapy field to invite feedback and further refinement. By presenting ARC at this early stage, we hope to draw upon the collective wisdom of the wider psychedelic community and inspire the open dialogue and collaboration upon which the process of co-design depends. We aim to offer a framework through which psychedelic researchers, therapists and other stakeholders, may begin tackling the complex ethical questions arising within their own organizations and individual practice of PAT.

وصف الملف: electronic resource

العلاقة: https://www.frontiersin.org/articles/10.3389/fpsyg.2023.1119115/fullTest; https://doaj.org/toc/1664-1078Test

الوصول الحر: https://doaj.org/article/a0e84df006e74fdfa6794b70a9a0e402Test

المؤلفون: Jules Evans, Oliver C Robinson, Eirini Ketzitzidou Argyri, Shayam Suseelan, Ashleigh Murphy-Beiner, Rosalind McAlpine, David Luke, Katrina Michelle, Ed Prideaux

المصدر: PLoS ONE, Vol 18, Iss 10, p e0293349 (2023)

مصطلحات موضوعية: Medicine, Science

الوصف: Long-term adverse experiences following psychedelic use can persist for weeks, months, or even years, and are relatively unexplored in psychedelic research. Our convergent mixed-method study gained quantitative and qualitative data from 608 participants who reported extended difficulties following psychedelic experiences. Data was gathered on the context of use, the nature and duration of the challenges they experienced (including a written description of these), plus a range of possible risk factors and perceived causes. The most common forms of extended difficulty were feelings of anxiety and fear, existential struggle, social disconnection, depersonalization and derealization. For approximately one-third of the participants, problems persisted for over a year, and for a sixth, they endured for more than three years. It was found that a shorter duration of difficulties was predicted by knowledge of dose, drug type and lower levels of difficulty reported during the psychoactive experience, while a narrower range of difficulties was predicted by taking the drug in a guided setting. Implications for psychedelic harm reduction are discussed.

وصف الملف: electronic resource

العلاقة: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0293349&type=printableTest; https://doaj.org/toc/1932-6203Test

الوصول الحر: https://doaj.org/article/f7b1edfd02a24d2fb3d1fc872c79a674Test

المؤلفون: Evans, Jules, Robinson, Oliver, Argyri, Eirini, Suseelan, Shayam, Murphy-Beiner, Ashleigh, McAlpine, Rosalind, Luke, David, Michelle, Katrina, Prideaux, Ed

مصطلحات موضوعية: BF Psychology, RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry, RS Pharmacy and materia medica

الوصف: Long-term adverse experiences following psychedelic use can persist for weeks, months, or even years, and are relatively unexplored in psychedelic research. Our convergent mixed-method study gained quantitative and qualitative data from 608 participants who reported extended difficulties following psychedelic experiences. Data was gathered on the context of use, the nature and duration of the challenges they experienced (including a written description of these), plus a range of possible risk factors and perceived causes. The most common forms of extended difficulty were feelings of anxiety and fear, existential struggle, social disconnection, depersonalization and derealization. For approximately one-third of the participants, problems persisted for over a year, and for a sixth, they endured for more than three years. It was found that a shorter duration of difficulties was predicted by knowledge of dose, drug type and lower levels of difficulty reported during the psychoactive experience, while a narrower range of difficulties was predicted by taking the drug in a guided setting. Implications for psychedelic harm reduction are discussed.

وصف الملف: application/pdf

العلاقة: http://gala.gre.ac.uk/id/eprint/44668/7/44668_LUKE_%20Extended_difficulties_following_the_use_of_psychedelic_drugs_A_mixed_methods_study.pdfTest; Evans, Jules, Robinson, Oliver orcid:0000-0002-6758-2223 , Argyri, Eirini, Suseelan, Shayam, Murphy-Beiner, Ashleigh, McAlpine, Rosalind, Luke, David orcid:0000-0003-2141-2453 , Michelle, Katrina and Prideaux, Ed (2023) Extended difficulties following the use of psychedelic drugs: a mixed methods study. PLoS ONE, 18 (10):e0293349. pp. 1-24. ISSN 1932-6203 (Online) (doi:https://doi.org/10.1371/journal.pone.0293349Test )

الإتاحة: https://doi.org/10.1371/journal.pone.0293349Test
http://gala.gre.ac.uk/id/eprint/44668Test/
http://gala.gre.ac.uk/id/eprint/44668/7/44668_LUKE_%20Extended_difficulties_following_the_use_of_psychedelic_drugs_A_mixed_methods_study.pdfTest

المؤلفون: Jacobs, E, Murphy-Beiner, A, Rouiller, I, Nutt, D, Spriggs, MJ

الوصف: The ethical value—and to some scholars, necessity—of providing trial patients with post-trial access (PTA) to an investigational drug has been subject to significant attention in the field of research ethics. Although no consensus has emerged, it seems clear that, in some trial contexts, various factors make PTA particularly appropriate. We outline the atypical aspects of psychedelic clinical trials that support the case for introducing the provision of PTA within research in this field, including the broader legal status of psychedelics, the nature of the researcher-therapist/participant relationship, and the extended time-frame of the full therapeutic process. As is increasingly understood, the efficacy of psychedelic-assisted psychotherapy is driven as much by extrapharmacological elements and the cultural therapeutic container as by the drug itself. As such, we also advocate for a refocusing of attention from post-trial access to a broader concept encompassing other elements of post-trial care. We provide an overview of some of the potential post-trial care provisions that may be appropriate in psychedelic clinical trials. Although the World Medical Association’s Declaration of Helsinki calls on researchers, sponsors, and governments to make provisions for post-trial access, such provision may feel impracticable or out-of-reach within psychedelic trials that are already constrained by a high resource demand and significant bureaucratic burden. We show how conceiving of post-trial provision as an integral site of the research process, and an appropriate destination for research funding, will serve to develop the infrastructure necessary for the post-legalisation psychedelic medicine ecosystem.

العلاقة: https://ora.ox.ac.uk/objects/uuid:0d468a8d-e520-47db-962f-cdbeecb12d43Test; https://doi.org/10.1007/s12152-023-09536-zTest

الإتاحة: https://doi.org/10.1007/s12152-023-09536-zTest
https://ora.ox.ac.uk/objects/uuid:0d468a8d-e520-47db-962f-cdbeecb12d43Test

المؤلفون: Weiss, B, Ginige, I, Shannon, L, Giribaldi, B, Murphy-Beiner, A, Murphy, R, Baker-Jones, M, Martell, J, Nutt, DJ, Carhart-Harris, RL, Erritzoe, D

الوصف: Background: Psilocybin Therapy (PT) is being increasingly studied as a psychiatric intervention. Personality relates to mental health and can be used to probe the nature of PT's therapeutic action. Methods: In a phase 2, double-blind, randomized, active comparator controlled trial involving patients with moderate-to-severe major depressive disorder, we compared psilocybin with escitalopram, over a core 6-week trial period. Five-Factor model personality domains, Big Five Aspect Scale Openness aspects, Absorption, and Impulsivity were measured at Baseline, Week 6, and Month 6 follow-up. Results: PT was associated with decreases in neuroticism (B = −0.63), introversion (B = −0.38), disagreeableness (B = −0.47), impulsivity (B = −0.40), and increases in absorption (B = 0.32), conscientiousness (B = 0.30), and openness (B = 0.23) at week 6, with neuroticism (B = −0.47) and disagreeableness (B = −0.41) remaining decreased at month 6. Escitalopram Treatment (ET) was associated with decreases in neuroticism (B = −0.38), disagreeableness (B = −0.26), impulsivity (B = −0.35), and increases in openness (B = 0.28) at week 6, with neuroticism (B = −0.46) remaining decreased at month 6. No significant between-condition differences were observed. Conclusions: Personality changes across both conditions were in a direction consistent with improved mental health. With the possible exception of trait absorption, there were no compelling between-condition differences warranting conclusions regarding a selective action of PT (v. ET) on personality; however, post-ET changes in personality were significantly moderated by pre-trial positive expectancy for escitalopram, whereas expectancy did not moderate response to PT.

العلاقة: Psychological Medicine; http://hdl.handle.net/10044/1/104385Test

الإتاحة: https://doi.org/10.1017/S0033291723001514Test
http://hdl.handle.net/10044/1/104385Test

المؤلفون: Spriggs, M, Bornemann, J, Murphy-Beiner, A, Murphy, R, Thurgur, H, Schlag, AK

المصدر: 8 ; 1

الوصف: The field of psychedelic assisted therapy (PAT) is growing at an unprecedented pace. The immense pressures this places on those working in this burgeoning field have already begun to raise important questions about risk and responsibility. It is imperative that the development of an ethical and equitable infrastructure for psychedelic care is prioritized to support this rapid expansion of PAT in research and clinical settings. Here we present Access, Reciprocity and Conduct (ARC); a framework for a culturally informed ethical infrastructure for ARC in psychedelic therapies. These three parallel yet interdependent pillars of ARC provide the bedrock for a sustainable psychedelic infrastructure which prioritized equal access to PAT for those in need of mental health treatment (Access), promotes the safety of those delivering and receiving PAT in clinical contexts (Conduct), and respects the traditional and spiritual uses of psychedelic medicines which often precede their clinical use (Reciprocity). In the development of ARC, we are taking a novel dual-phase co-design approach. The first phase involves co-development of an ethics statement for each arm with stakeholders from research, industry, therapy, community, and indigenous settings. A second phase will further disseminate the statements for collaborative review to a wider audience from these different stakeholder communities within the psychedelic therapy field to invite feedback and further refinement. By presenting ARC at this early stage, we hope to draw upon the collective wisdom of the wider psychedelic community and inspire the open dialogue and collaboration upon which the process of co-design depends. We aim to offer a framework through which psychedelic researchers, therapists and other stakeholders, may begin tackling the complex ethical questions arising within their own organizations and individual practice of PAT.

العلاقة: Frontiers in Psychology; http://hdl.handle.net/10044/1/103729Test

الإتاحة: https://doi.org/10.3389/fpsyg.2023.1119115Test
http://hdl.handle.net/10044/1/103729Test

المؤلفون: Weiss, Brandon, Ginige, Induni, Shannon, Lu, Giribaldi, Bruna, Murphy-Beiner, Ashleigh, Murphy, Roberta, Baker-Jones, Michelle, Martell, Jonny, Nutt, David J., Carhart-Harris, Robin L., Erritzoe, David

المصدر: Psychological Medicine ; volume 54, issue 1, page 217-217 ; ISSN 0033-2917 1469-8978

الإتاحة: https://doi.org/10.1017/s0033291723002039Test
https://www.cambridge.org/core/services/aop-cambridge-core/content/view/S0033291723002039Test