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Psychiatric risks for worsened mental health after psychedelic use

Marrocu, Alessia; Kettner, Hannes; Weiss, Brandon; Zeifman, Richard J; Erritzoe, David; Carhart-Harris, Robin L
BACKGROUND/UNASSIGNED:Resurgent psychedelic research has largely supported the safety and efficacy of psychedelic therapy for the treatment of various psychiatric disorders. As psychedelic use and therapy increase in prevalence, so does the importance of understanding associated risks. Cases of prolonged negative psychological responses to psychedelic therapy seem to be rare; however, studies are limited by biases and small sample sizes. The current analytical approach was motivated by the question of whether rare but significant adverse effects have been under-sampled in psychedelic research studies. METHODS/UNASSIGNED: = 807). We define "negative response" by a clinically meaningful decline in a generic index of mental health, that is, one standard error from the mean decrease in psychological well-being 4 weeks post-psychedelic use (vs pre-use baseline). We then assessed whether a history of diagnosed mental illness can predict negative responses. RESULTS/UNASSIGNED: < 0.05). CONCLUSION/UNASSIGNED:We infer that the presence of a personality disorder may represent an elevated risk for psychedelic use and hypothesize that the importance of psychological support and good therapeutic alliance may be increased in this population.
PMCID:10944581
PMID: 38491857
ISSN: 1461-7285
CID: 5639872

Preliminary evidence for the importance of therapeutic alliance in MDMA-assisted psychotherapy for posttraumatic stress disorder

Zeifman, Richard J; Kettner, Hannes; Ross, Stephen; Weiss, Brandon; Mithoefer, Michael C; Mithoefer, Ann T; Wagner, Anne C
PMCID:10769553
PMID: 38174611
ISSN: 2000-8066
CID: 5626092

Canalization and plasticity in psychopathology

Carhart-Harris, R L; Chandaria, S; Erritzoe, D E; Gazzaley, A; Girn, M; Kettner, H; Mediano, P A M; Nutt, D J; Rosas, F E; Roseman, L; Timmermann, C; Weiss, B; Zeifman, R J; Friston, K J
This theoretical article revives a classical bridging construct, canalization, to describe a new model of a general factor of psychopathology. To achieve this, we have distinguished between two types of plasticity, an early one that we call 'TEMP' for 'Temperature or Entropy Mediated Plasticity', and another, we call 'canalization', which is close to Hebbian plasticity. These two forms of plasticity can be most easily distinguished by their relationship to 'precision' or inverse variance; TEMP relates to increased model variance or decreased precision, whereas the opposite is true for canalization. TEMP also subsumes increased learning rate, (Ising) temperature and entropy. Dictionary definitions of 'plasticity' describe it as the property of being easily shaped or molded; TEMP is the better match for this. Importantly, we propose that 'pathological' phenotypes develop via mechanisms of canalization or increased model precision, as a defensive response to adversity and associated distress or dysphoria. Our model states that canalization entrenches in psychopathology, narrowing the phenotypic state-space as the agent develops expertise in their pathology. We suggest that TEMP - combined with gently guiding psychological support - can counter canalization. We address questions of whether and when canalization is adaptive versus maladaptive, furnish our model with references to basic and human neuroscience, and offer concrete experiments and measures to test its main hypotheses and implications. This article is part of the Special Issue on "National Institutes of Health Psilocybin Research Speaker Series".
PMID: 36584883
ISSN: 1873-7064
CID: 5433432

Prospective examination of the therapeutic role of psychological flexibility and cognitive reappraisal in the ceremonial use of ayahuasca

Agin-Liebes, Gabrielle; Zeifman, Richard; Luoma, Jason B; Garland, Eric L; Campbell, W Keith; Weiss, Brandon
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/OBJECTIVE: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: = 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/RESULTS: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/CONCLUSIONS: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.
PMID: 35253514
ISSN: 1461-7285
CID: 5304132

Evaluating the Instantiation of Narcissism Components in Contemporary Measures of Psychopathy

Weiss, Brandon; Sleep, Chelsea E; Lynam, Donald R; Miller, Joshua D
Narcissistic traits figure prominently in classical conceptualizations of psychopathy and bear substantial empirical overlap with components of psychopathy. Yet the degree to which various widely used self-report measures of psychopathy include relevant narcissistic content has not been evaluated, especially in relation to new, multidimensional models of narcissism. Using a large undergraduate sample (N = 432) and self- and informant-ratings of narcissism, the present study examined narcissism's instantiation in several commonly used self-report psychopathy measures. A modern conceptualization of narcissism at three levels of hierarchical organization (i.e., Trifurcated Model of Narcissism) was applied to comprehensively evaluate narcissism's instantiation in these psychopathy measures. Although narcissistic traits related to self-centered antagonism were well-instantiated across psychopathy self-report measures, narcissistic traits related to agentic extraversion were represented more modestly by most (i.e., Triarchic Psychopathy Measure, Self-Report Psychopathy Scale: Version III, Levenson Self-Report Psychopathy Scale), but not all (i.e., Elemental Psychopathy Assessment [EPA]) psychopathy measures. Only the EPA contained substantial representation of all narcissism components. Given the theoretical and empirical overlap between psychopathy and narcissism, it behooves researchers to be aware of the degree to which psychopathy measures capture narcissistic content.
PMID: 33371746
ISSN: 1552-3489
CID: 5304102

Examining Psychedelic-Induced Changes in Social Functioning and Connectedness in a Naturalistic Online Sample Using the Five-Factor Model of Personality

Weiss, Brandon; Nygart, Victoria; Pommerencke, Lis Marie; Carhart-Harris, Robin L; Erritzoe, David
The present study examines prospective changes in personality traits relevant to social functioning as well as perceived social connectedness in relation to the naturalistic use of psychedelic compounds in an online volunteer sample. The study also examined the degree to which demographic characteristics, social setting, baseline personality, and acute subjective factors (e.g., emotional breakthrough experiences) influenced trajectories of personality and perceived social connectedness. Participants recruited online completed self-report measures of personality and social connectedness at three timepoints (baseline, 2weeks post-experience, 4weeks post-experience). Linear mixed models were used to examine changes in outcomes and the moderation of these outcomes by covariates. The most substantive changes were reductions in the personality domains Neuroticism, and increases in Agreeableness and social connectedness. Notably, reductions in Neuroticism and increases in Agreeableness covaried over time, which may be suggestive of common processes involving emotion regulation. Preliminary evidence was found for a specific effect on a component of Agreeableness involving a critical and quarrelsome interpersonal style. Although moderation by demographic characteristics, social setting, baseline personality, and acute factors generally found limited support, baseline standing on Neuroticism, perspective taking, and social connectedness showed tentative signs of amplifying adaptive effects on each trait, respectively. Our findings hold implications for the potential use of psychedelics for treating interpersonal elements of personality pathology as well as loneliness.
PMCID:8655335
PMID: 34899488
ISSN: 1664-1078
CID: 5304122

Investigating the neural substrates of Antagonistic Externalizing and social-cognitive Theory of Mind: an fMRI examination of functional activity and synchrony

Weiss, Brandon; Jahn, Andrew; Hyatt, Courtland S; Owens, Max M; Carter, Nathan T; Sweet, Lawrence H; Miller, Joshua D; Haas, Brian W
Recently developed quantitative models of psychopathology (i.e., Hierarchical Taxonomy of Psychopathology) identify an Antagonistic Externalizing spectrum that captures the psychological disposition toward criminal and antisocial behavior. The purpose of the present study was to examine relations between Antagonistic psychopathology (and associated Five-Factor model Antagonism/Agreeableness) and neural functioning related to social-cognitive Theory of Mind using a large sample (N = 973) collected as part of the Human Connectome Project (Van Essen et al., 2013a). No meaningful relations between Antagonism/Antagonistic Externalizing and Theory of Mind-related neural activity or synchrony were observed (p < .005). We conclude by outlining methodological considerations (e.g., validity of social cognition task and low test-retest reliability of functional biomarkers) that may account for these null results, and present recommendations for future research.
PMCID:8057509
PMID: 33954274
ISSN: 2513-9886
CID: 5304112

A Randomized Controlled Trial of Brief Skills Training in Affective and Interpersonal Regulation (STAIR) for Veterans in Primary Care

Jain, Shaili; Ortigo, Kile; Gimeno, Julia; Baldor, Denine A; Weiss, Brandon J; Cloitre, Marylène
This randomized controlled trial assessed the efficacy of a five-session version of Skills Training in Affective and Interpersonal Regulation (STAIR) among veterans obtaining treatment in primary care. Veterans who screened positive for either posttraumatic stress disorder (PTSD) or depression (N = 26) were enrolled and randomized into either five-session STAIR or treatment as usual (TAU). Assessments of PTSD symptoms (PTSD Checklist for DSM-5; PCL-5), depression (Beck Depression Inventory-II; BDI-II), emotion regulation (Difficulties in Emotion Regulation Scale; DERS), and social engagement difficulties (World Health Organization Disability Assessment 2.0; WHODAS-2) were assessed at pretreatment, posttreatment, and 3-month follow-up assessments. Participants assigned to the five-session STAIR condition reported significant improvements on all measures, whereas those assigned to TAU showed no change. Group × Treatment interactions were significant for all outcomes, and effect sizes for the interactions ranged from moderate to large, Hedge's gs = 0.81 for the PCL-5, 1.15 for the BDI-II, 0.75 for the DERS, and 0.81 for the WHODAS-2. The results indicate that five-session STAIR, a brief, skills-focused treatment, may be effective in reducing a range of symptoms and in improving social functioning among veterans treated in primary care settings.
PMID: 32506563
ISSN: 1573-6598
CID: 4477662

The DSM-5 section III personality disorder criterion a in relation to both pathological and general personality traits

Sleep, Chelsea E; Weiss, Brandon; Lynam, Donald R; Miller, Joshua D
Following the introduction of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), section III alternative model of personality disorder, much of the empirical attention has been directed toward testing the performance of Criterion B (i.e., pathological traits). Much more recently, with the development of assessment tools related to Criterion A (i.e., personality impairment), a burgeoning literature base is forming for it as well. A closer look at the Criterion A component, however, reveals disagreements around its structure, discriminant validity, ability to distinguish between personality-based and nonpersonality-based forms of psychopathology, overlap between the two criteria, and incremental validity. The goal of the current study (N = 365 undergraduates) was to test Criterion A in relation to both pathological personality traits, as specified in the DSM-5, and general personality traits, as some scholars suggested that might be more appropriate. The results suggest that impairment domains overlap substantially with pathological and general traits, and these traits account for considerable variance in impairment domains. Most importantly, the findings suggest that general and pathological traits functioned in nearly identical ways, as evidenced by the similar relations that they evinced with traditional DSM-5 personality disorder constructs. In line with previous work, the present findings demonstrate limited discriminant validity among impairment domains and an inability to distinguish between Axis I and II symptoms. Further research on the alternative model of personality disorder is needed to test the necessity and sufficiency of its constituent components. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
PMID: 31804130
ISSN: 1949-2723
CID: 5304082

Examining the Contribution of Perfectionistic Traits to the Construct Validity of the DSM-5 Alternative Model of Personality Disorder

Hemmati, Azad; Weiss, Brandon; Mirani, Atefeh; Rezaei, Farzin; Miller, Joshua D
Scholars of perfectionism have proposed significant modifications to DSM-5's alternative model of personality disorders (AMPD), such that (1) perfectionism be expanded beyond the inclusion of a singular trait-rigid perfectionism-and (2) perfectionistic traits be specified as trait descriptors of personality disorders (PDs) other than obsessive-compulsive PD. In this study, we evaluate these proposals by examining the degree to which (a) perfectionistic traits are already instantiated in Section II and Section III models of personality pathology; and (b) perfectionistic traits meaningfully augment the construct validity of AMPD PDs. We conducted these approaches in a large sample (N =3D 435) from an Iranian undergraduate population that is atypically found in the literature. Results showed that perfectionistic traits are already fairly well instantiated in Section III Criterion B. Perfectionistic traits minimally improved the construct validity of OCPD, but did not meaningfully do so for other PDs. Future investigation into the clinical utility of perfectionistic traits is needed.
PMID: 32250207
ISSN: 1943-2763
CID: 5304092