The Challenging Experience Questionnaire: Characterization of challenging experiences with psilocybin mushrooms

Abstract

Acute adverse psychological reactions to classic hallucinogens (“bad trips”, or “challenging experiences”), while usually benign with proper screening, preparation, and support in controlled settings, remain a safety concern in uncontrolled settings (such as illicit use contexts). Anecdotal and case reports suggest potential adverse acute symptoms including affective (panic, depressed mood), cognitive (confusion, feelings of losing sanity), and somatic (nausea, heart palpitation) symptoms. Responses to items from several hallucinogen-sensitive questionnaires (Hallucinogen Rating Scale, the States of Consciousness Questionnaire, and the 5-Dimensional Altered States of Consciousness questionnaire) in an internet survey of challenging experiences with the classic hallucinogen psilocybin were used to construct and validate a Challenging Experience Questionnaire (CEQ). The stand-alone CEQ was then validated in a separate sample. Seven CEQ factors (grief, fear, death, insanity, isolation, physical distress, and paranoia) provide a phenomenological profile of challenging aspects of experiences with psilocybin. Factor scores were associated with the difficulty, meaningfulness, spiritual significance, and change in well-being attributed to the challenging experiences. The factor structure did not differ based on gender or prior struggle with anxiety or depression. The CEQ provides a basis for future investigation of predictors and outcomes of challenging experiences with psilocybin, and should be explored as a measure of challenging experiences with the broad class of classic hallucinogens.

Neuroticism is associated with challenging experiences with psilocybin mushrooms

“…Responses from a total of 1993 participants who provided useable data for an online survey of challenging experiences with psilocybin (Barrett et al, 2016; Carbonaro et al, 2016) were included in the current analyses. Analysis of Study 1 data constitutes a secondary analysis of previously reported data (Barrett et al, 2016; Carbonaro et al, 2016).…”

“…Analysis of Study 1 data constitutes a secondary analysis of previously reported data (Barrett et al, 2016; Carbonaro et al, 2016). Participants were recruited to report on their single most psychologically difficult or challenging session or experience (worst “bad trip”) via internet advertisements (70.4% of respondents indicated that they became aware of the study through websites that are frequented by individuals interested in psychedelics such as Erowid, an online information library on psychoactive substances, www.erowid.com), email invitation via emails that were sent by study staff to email distribution lists related to websites and groups that are frequented by individuals interested in psychedelics (6.6% of respondents indicated that they received an email for the survey as a member of a large email distribution list, and 5.0% of respondents indicated that they received a personal email regarding the survey from a friend), and word of mouth (6.7% of respondents indicated that they became aware of the survey via personal communication other than email, and 0.9% of respondents indicated that they heard about the survey at a conference or public presentation).…”

“…Responses from a total of 981 participants who provided useable data for an online survey of challenging experiences with psilocybin mushrooms (Barrett et al, 2016) were included in the current analysis. Participants were recruited in a fashion similar to Study 1.…”

“…The strongest lines of evidence thus far point to the roles of set (the intentions and internal state of an individual), setting (the environment) (Leary, Litwin, & Metzner, 1963; Zinberg, 1986), and personality (Dittrich, 1994; Hemsley & Ward, 1985; Studerus, Gamma, Kometer, & Vollenweider, 2012) in predicting the effects of psychedelics. The current study investigates the association between traits in the Five Factor Model (FFM) of personality, and dimensions of challenging experiences (or “bad trips”) with psychedelics as measured using the Challenging Experiences Questionnaire (CEQ) (Barrett, Bradstreet, Leoutsakos, Johnson, & Griffiths, 2016). …”

“…The Challenging Experience Questionnaire (CEQ) is a self-report instrument that measures dimensions of challenging experience with psychedelics that are suggested by clinical and research literature (panic or fear, grief, isolation, feeling as though one is dying, feeling insane, physiological distress, and paranoia) (Barrett et al, 2016). The CEQ has advantages over other self-report measures of the subjective effects of psychedelics, when specifically considering challenging experiences.…”