Therapeutic effect of increased openness: Investigating mechanism of action in MDMA-assisted psychotherapy

Wagner, Mark T.; Mithoefer, Michael C.; Mithoefer, Ann T; MacAulay, Rebecca K.; Jerome, Lisa; Yazar‐Klosinski, Berra; Doblin, Rick

doi:10.1177/0269881117711712

Cited by 130 publications

(69 citation statements)

References 53 publications

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“…Other reports suggest that MDMA positively biases interpretation of emotional facial expressions, either by enhancing identification of positive expressions, interfering with identification of negative expressions, or both (Bedi et al, 2009;Hysek et al, 2012a;Kirkpatrick et al, 2014b;Wardle and de Wit, 2014a). Negative processing bias has been observed in multiple psychiatric disorders (Bishop, 2007;Rude et al, 2002), including PTSD (Litz et al, 2000), and the positive-biasing effects of MDMA we report here may underlie its effectiveness in a therapeutic context (Mithoefer et al, 2013;Mithoefer et al, 2011;Oehen et al, 2013;Wagner et al, 2017).…”

Section: Discussionsupporting

confidence: 50%

Effects of MDMA on attention to positive social cues and pleasantness of affective touch

Bershad

Mayo

Hedger³

et al. 2019

Neuropsychopharmacol.

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Effects of MDMA on attention to positive social cues and pleasantness of affective touch. http://researchonline.ljmu.ac.uk/id/eprint/10667/ Article LJMU has developed LJMU Research Online for users to access the research output of the University more effectively. AbstractThe psychostimulant drug ± 3,4-methylenedioxymethamphetamine (MDMA) reportedly produces distinctive feelings of empathy and closeness with others. MDMA increases social behavior in animal models and has shown promise in psychiatric disorders such as autism spectrum disorder (ASD) and post-traumatic stress disorder (PTSD). How it produces these prosocial effects is not known. This behavioral and psychophysiological study examined the effects of MDMA, compared to the prototypical stimulant methamphetamine (MA), on two measures of social behavior in healthy young adults: i) responses to socially relevant, "affective" touch, and ii) visual attention to emotional faces. Men and women (N=36) attended four sessions in which they received MDMA (0.75 or 1.5mg/kg), MA (20mg), or a placebo in randomized order under double-blind conditions. Responses to experienced and observed affective touch (i.e., being touched or watching others being touched) were assessed using facial electromyography (EMG), a proxy of affective state. Responses to emotional faces were assessed using electrooculography (EOG) in a measure of attentional bias. Subjective ratings were also included. We hypothesized that MDMA, but not MA, would enhance ratings of pleasantness and psychophysiological responses to affective touch and increase attentional bias toward positive facial expressions. Consistent with this, we found that MDMA, but not MA, selectively enhanced ratings of pleasantness of experienced affective touch. Neither drug altered ratings of pleasantness of observed touch. On the EOG measure of attentional bias, MDMA, but not MA, increased attention toward happy faces. These results provide new evidence that MDMA can enhance the experience of positive social interactions; in this case pleasantness of physical touch and attentional bias toward positive facial expressions. The findings are consistent with evidence that the prosocial effects are unique to MDMA relative to another stimulant. Understanding the

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Section: Discussionsupporting

confidence: 50%

Effects of MDMA on attention to positive social cues and pleasantness of affective touch

Bershad

Mayo

Hedger³

et al. 2019

Neuropsychopharmacol.

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“…Increases in Openness have been shown 2 weeks after administration of LSD in healthy individuals ( Lebedev et al, 2016 ). Another study showed that increases in Openness predicted greater reduction in post-traumatic stress disorder symptoms among individuals receiving MDMA-assisted psychotherapy ( Wagner et al, 2017 ). The failure to observe significant increases in Openness in the current study may be attributable to engagement in the program of spiritual practices or to some other aspect of the study design.…”

Section: Discussionmentioning

confidence: 99%

Psilocybin-occasioned mystical-type experience in combination with meditation and other spiritual practices produces enduring positive changes in psychological functioning and in trait measures of prosocial attitudes and behaviors

et al. 2017

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Psilocybin can occasion mystical-type experiences with participant-attributed increases in well-being. However, little research has examined enduring changes in traits. This study administered psilocybin to participants who undertook a program of meditation/spiritual practices. Healthy participants were randomized to three groups (25 each): (1) very low-dose (1 mg/70 kg on sessions 1 and 2) with moderate-level (“standard”) support for spiritual-practice (LD-SS); (2) high-dose (20 and 30 mg/70 kg on sessions 1 and 2, respectively) with standard support (HD-SS); and (3) high-dose (20 and 30 mg/70kg on sessions 1 and 2, respectively) with high support for spiritual practice (HD-HS). Psilocybin was administered double-blind and instructions to participants/staff minimized expectancy confounds. Psilocybin was administered 1 and 2 months after spiritual-practice initiation. Outcomes at 6 months included rates of spiritual practice and persisting effects of psilocybin. Compared with low-dose, high-dose psilocybin produced greater acute and persisting effects. At 6 months, compared with LD-SS, both high-dose groups showed large significant positive changes on longitudinal measures of interpersonal closeness, gratitude, life meaning/purpose, forgiveness, death transcendence, daily spiritual experiences, religious faith and coping, and community observer ratings. Determinants of enduring effects were psilocybin-occasioned mystical-type experience and rates of meditation/spiritual practices. Psilocybin can occasion enduring trait-level increases in prosocial attitudes/behaviors and in healthy psychological functioning. Trial Registration ClinicalTrials.gov Identifier NCT00802282

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“…Similarly, administration of LSD in a brain imaging setting led to discrete increases in Openness scores in healthy volunteers assessed at 2 weeks after the LSD session although this was not replicated in a recent LSD study with longer postsession follow‐up time points (1 month and 12 months) . Recently, administration of the entactogen, 3,4‐methylenedioxy‐methamphetamine (MDMA), in conjunction with psychotherapy has been shown to lead to increases in Openness , as well as decreases in Neuroticism , in patients being treated for post‐traumatic stress disorder . Regular ceremonial use of the psychedelic brew, ayahuasca, was associated with higher Openness scores when compared with matched non‐ayahuasca using controls and self‐reported lifetime recreational psychedelic use correlated positively with Openness scores in a large online survey , as well as in a separate brain imaging trial (D. Erritzoe, under review).…”

Section: Discussionmentioning

confidence: 99%

Effects of psilocybin therapy on personality structure

Erritzoe

Roseman

Nour

et al. 2018

Acta Psychiatr Scand

210

164

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ObjectiveTo explore whether psilocybin with psychological support modulates personality parameters in patients suffering from treatment‐resistant depression (TRD).MethodTwenty patients with moderate or severe, unipolar, TRD received oral psilocybin (10 and 25 mg, one week apart) in a supportive setting. Personality was assessed at baseline and at 3‐month follow‐up using the Revised NEO Personality Inventory (NEO‐PI‐R), the subjective psilocybin experience with Altered State of Consciousness (ASC) scale, and depressive symptoms with QIDS‐SR16.Results Neuroticism scores significantly decreased while Extraversion increased following psilocybin therapy. These changes were in the direction of the normative NEO‐PI‐R data and were both predicted, in an exploratory analysis, by the degree of insightfulness experienced during the psilocybin session. Openness scores also significantly increased following psilocybin, whereas Conscientiousness showed trend‐level increases, and Agreeableness did not change.ConclusionOur observation of changes in personality measures after psilocybin therapy was mostly consistent with reports of personality change in relation to conventional antidepressant treatment, although the pronounced increases in Extraversion and Openness might constitute an effect more specific to psychedelic therapy. This needs further exploration in future controlled studies, as do the brain mechanisms of postpsychedelic personality change.

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Therapeutic effect of increased openness: Investigating mechanism of action in MDMA-assisted psychotherapy

Cited by 130 publications

References 53 publications

Effects of MDMA on attention to positive social cues and pleasantness of affective touch

Effects of MDMA on attention to positive social cues and pleasantness of affective touch

Psilocybin-occasioned mystical-type experience in combination with meditation and other spiritual practices produces enduring positive changes in psychological functioning and in trait measures of prosocial attitudes and behaviors

Effects of psilocybin therapy on personality structure

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