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Abstract

Background

Psilocybin-assisted psychotherapy has demonstrated significant promise as a treatment for depression, anxiety, and existential distress associated with serious medical illness and has generally been employed on an individual basis, which presents challenges for scaling and resource availability. There are also compelling theoretical reasons to suggest that group-based formats-if utilized in a thoughtful fashion-might offer unique or enhanced therapeutic benefits for certain conditions or populations. The HOPE trial is an IRB-approved open-label feasibility and safety pilot study of psilocybin enhanced group therapy in patients with a DSM-5 depressive disorder associated with a cancer diagnosis completed at the Huntsman Cancer Institute (HCI) in Salt Lake City, Utah (HOPE: A Pilot Study of Psilocybin Enhanced Group Psychotherapy in Patients with Cancer). We report here qualitative survey-based data, impressions, and suggestions for group-based psychedelic-assisted therapy interventions based on our observations to inform future studies.

Methods

Patients with a DSM-5 depressive disorder with an underlying cancer diagnosis were recruited from HCI by referral from oncology providers, palliative care, and social work. Following screening and consenting, 4-6 participants per cohort (with three total cohorts) were enrolled in a protocol involving 3 120 min group preparatory sessions, a single high-dose (25 mg) group psilocybin session, and 3 subsequent group integration sessions. Primary clinical outcomes are still in process of data collection and analysis. Qualitative data was gathered from patient written reports and a survey administered at 2 weeks post intervention. Qualitative reports were also gathered from the therapist team at a post-study group process session.

Findings

We report here results from a qualitative survey of participant experiences with group format study design, as well as impressions and guidelines for group format and group psychotherapeutic process to inform other studies pursuing group-based interventions in psychedelic therapy. Suggestions are provided for protocol design, screening processes, space considerations, therapist team structure, group process, music, timeline, as well as potential issues and challenges.

Open access

Abstract

Background and aims

Previous research has proposed that microdosing, i.e., the repeated use of sub-threshold doses of serotonergic hallucinogens, has an impact on mood by increasing emotional awareness. We propose that increased emotional awareness could translate into higher emodiversity, a balanced experience of emotions in which emotions are experienced with more similarity in intensity and duration. We examine the effect of microdosing, the day after, as well as the cumulative effect of microdosing on overall, positive and negative emodiversity.

Methods

We use data collected over a period of 28 days sampled between February to June 2020 from 18 users that already had an active practice of microdosing at the start of the data collection. We assessed emotional states using ESM methods, i.e., signal-contingent sampling with triggers sent 5 times a day. The working dataset has a number of 224 observations days. We used mixed effects models to test our hypotheses.

Results

When taking into account the level of average affect, we found that during microdosing days positive and overall emodiversity were significantly lower. No evidence was found for a mediating role of the level of average affect. Higher cumulative instances of microdosing were not related to any of the emodiversity indexes. Participants experienced more “awe, wonder, or amazement”, “ashamed, humiliated, or disgraced” as well as less “joyful, glad, or happy” emotions during microdosing days.

Conclusion

A microdosing practice may increase the centrality of certain emotions on microdosing days, resulting in a decrease in emotional diversity.

Open access

Abstract

This article reports on integration challenges that were experienced by nine individuals who attended a three-day legal psilocybin truffle retreat in the Netherlands. The study employed a qualitative phenomenological approach, using semi-structured interviews to gain an understanding of participants' (n = 30) psilocybin experiences and their after-effects. While the study did not actively seek to measure integration issues or unexpected side effects, nine out of thirty participants (30%) spontaneously reported a post-experience integration challenge. These challenges included: mood fluctuations, ‘post-ecstatic blues’, disconnection from community, re-experiencing symptoms, spiritual bypass and perceived lack of support. Integration challenges were transient; they occurred immediately after the psilocybin experience (once the main psychedelic effects had worn off) and in the days and weeks following the retreat, and resolved with time. Integration challenges were also correlated with positive after-effects including long-term remission of significant health conditions. The experiences related in this article align with existing literature that describes the ‘spiritual emergency’ phenomenon; that is, the potential challenges that can arise after ecstatic experiences and how these challenges may be integral to the transformative potential of such experiences. We discuss the implications for psychedelic integration and harm reduction practices and for future psychedelic research.

Open access

Abstract

Background and aims

Although large-scale population studies have linked the use of classic psychedelics (lysergic acid diethylamide, psilocybin, or mescaline) to reduced odds of physical health problems, mental health problems, and criminal behavior, the roughly 35 million adults in the United States who have used classic psychedelics are nonetheless stigmatized in the American job market. Various federal organizations in the United States automatically reject applicants on the sole basis of prior psychedelic use, thereby practicing an open form of legal discrimination against these applicants. The present study investigates whether this discrimination can be justified based on associations between lifetime classic psychedelic use and motivationally-based workplace absenteeism.

Methods

Using pooled cross-sectional data from the National Survey on Drug Use and Health (2013–2019) on 193,320 employed adults in the United States, this study tests whether lifetime classic psychedelic use predicts the number of workdays employees skipped in the last month (i.e., motivationally-based workplace absenteeism).

Results

After adjusting for sociodemographics, physical health indicators, and other substance use, no significant association between lifetime classic psychedelic use and motivationally-based workplace absenteeism is found.

Conclusion

This study builds on classic psychedelic research that is just beginning to take work-specific outcomes into account and offers empirical justification for the elimination of arbitrary drug-based recruitment policies in the workplace.

Open access
Journal of Psychedelic Studies
Authors:
Madeline Brendle
,
Anya Ragnhildstveit
,
Matthew Slayton
,
Leo Smart
,
Sarah Cunningham
,
Mackenzie H. Zimmerman
,
Paul Seli
,
Michael Santo Gaffrey
,
Lynnette Astrid Averill
, and
Reid Robison

Abstract

Background and Aims

Ketamine and esketamine have garnered interest in both psychiatric research and clinical practice for treatment-resistant depression (TRD). In this review, we examined registered trials investigating the therapeutic use of ketamine or esketamine for TRD, with the aim of characterizing emerging trends and knowledge gaps.

Methods

The ClinicalTrials.gov electronic registry and results database was queried from inception to February 5, 2022, adhering to elements of the PRISMA guideline, we evaluated trial eligibility in the qualitative synthesis. Data regarding study design, drug regimens, and measures were subsequently abstracted and descriptively analyzed.

Results

The search returned 86 records, of which 56 trials were included in the final review. The number of trials investigating ketamine and esketamine for TRD increased since 2008, with higher peaks observed in 2015 (n = 9) and 2021 (n = 9). Most trials were Phase 2 (13, 23.2%) or Phase 3 (11, 19.6%), gathering preliminary data on efficacy and/or further data on safety and efficacy with variant dosing and pharmacological approaches. By and large, trials examined ketamine and esketamine as individual versus combination treatments (45% and 25%, respectively). The Montgomery-Asberg Depression Rating Scale (MADRS) was most commonly used to assess clinical outcomes (75%).

Conclusions

There are increasingly large-scale and late-phase trials of esketamine over ketamine for TRD, coupled with efforts to centralize evidence on these medications. Yet several trials do not assess patient characteristics that may affect treatment response, such as age, sex, and race. By understanding these design limitations, scientists and clinicians can avoid research waste and funding bodies can judiciously direct support towards high priority research.

Open access

Abstract

Background and aims

Youth gambling research mainly focuses on the illegal use of age-restricted machines, but coin pusher and crane grab machines are gambling machines that can be used by people of any age in the UK, and are also in use internationally. Previous cross-sectional evidence has associated recollected childhood usage of these machines with adult gambling participation and levels of problem gambling amongst adult gamblers. We attempted to conceptually replicate the findings of one of these studies (Newall et al., 2021), while addressing some limitations of that study.

Methods

A cross-sectional survey of 2,000 UK-based and -born participants aged 19–24 years. The measures were participants' recollected usage of coin pusher and crane grab machines as a child, whether they had gambled in the past 12-months or not, and the PGSI for past 12-month gamblers.

Results

Overall, 5 of 7 tested associations were significant and in the hypothesized direction. Logistic regression models showed that adult gamblers were more likely to recollect using, and used at higher levels of frequency, coin pusher and crane grab machines, than non-gamblers. Then, negative binomial regression analysis showed that adults who recollected using crane grab machines at higher levels of frequency showed more gambling-related problems.

Discussion and Conclusions

These results suggest that childhood usage of coin pusher and crane grab machines may act as an underappreciated risk factor for the development of gambling-related harm across the lifespan. This information may be considered for further youth gambling research and policy.

Open access
Journal of Behavioral Addictions
Authors:
Simon Marmet
,
Matthias Wicki
,
Marc Dupuis
,
Stéphanie Baggio
,
Magali Dufour
,
Catherine Gatineau
,
Gerhard Gmel
, and
Joseph Studer

Abstract

Background

Video gaming is a popular activity among young people. Time spent with gaming was found to be only moderately associated with gaming disorder. However, patterns of binge gaming (playing more than 5 h consecutively) were rarely considered in research on gaming. This study explores how binge gaming frequency is related with gaming disorder and mental health.

Methods

The sample came from the Cohort study on substance use risk factors (C-SURF) and comprised 5,358 young men aged 28.26 years (SD = 1.27). ANCOVA was conducted to estimate the association between binge gaming frequency (gaming at least 5 h consecutively) and gaming disorder (measured with the Game Addiction Scale) as well as indicators of mental health.

Results

A total of 33.3% of the sample engaged in binge gaming at least once in the previous year, and 6.1% at least weekly. Frequency of binge gaming was associated with gaming disorder score in a linear dose-response relationship (linear trend = 2.30 [2.14, 2.46]) even if adjusted for time spent gaming (linear trend = 1.24 [1.03, 1.45). More frequent binge gaming was associated with lower life satisfaction and sleep quality, and with more major depression and social anxiety disorder symptoms.

Conclusions

Binge gaming patterns, especially daily or almost daily binge gaming, are important to consider with regard to gaming disorder and mental health. Asking about binge gaming may be a promising screening question for gaming related problems. Encouraging regular breaks from gaming may be a valuable prevention strategy to reduce negative outcomes of gaming.

Open access
Journal of Behavioral Addictions
Authors:
Elodie Hurel
,
Marie Grall-Bronnec
,
Elsa Thiabaud
,
Juliette Leboucher
,
Maxime Leroy
,
Bastien Perrot
, and
Gaëlle Challet-Bouju

Abstract

Background and aims

This research aimed to characterize social information processing abilities in a population of regular nondisordered poker players compared to controls.

Methods

Participants completed the Posner cueing paradigm task including social cues (faces) to assess attention allocation towards social stimuli, including the effect of the presentation time (subliminal vs supraliminal) and of the emotion displayed. The study included two groups of participants: 30 regular nondisordered poker players (those who played at least three times a week in Texas Hold'em poker games for at least three months) and 30 control participants (those who did not gamble or gambled less than once a month, whatever the game).

Results

The group of regular nondisordered poker players displayed an enhancement of the inhibition of return during the Posner cueing task. This means that in valid trials, they took longer to respond to the already processed localization in supraliminal conditions compared to controls. However, our results did not evidence any particular engagement or disengagement attention abilities toward specific types of emotion.

Discussion and Conclusions

These results suggest that regular nondisordered poker players displayed social information processing abilities, which may be due to the importance to efficiently process social information that can serve as tells in live poker. The observed enhancement of the inhibition of return may permit poker players to not process a localization that has already processed to save attentional resources. Further research regarding the establishment of the IOR in other forms of gambling and with non-social cues needs to be performed.

Open access

Abstract

Rationale

As a result of concerns about predominantly online behavioral addictions, an increasing number of systematic reviews and meta-analyses (SRMA) of treatment interventions for internet use disorders (IUD) are being recorded. This review was designed to (a) systematically identify the evidence base of SRMA and to (b) critically appraise the quality of reporting according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.

Methods

Four databases were searched until August 2022 to systematically identify SRMA. PRISMA indicators were evaluated on a three-level response format to obtain an overall score operationalizing the quality of reporting (score range: 0–84). Additionally, the percentage of adherence to the PRISMA indicators was calculated.

Results

Reporting quality of 23 SRMA, comprising 12 systematic reviews and 11 meta-analyses was evaluated. Quality scores ranged from 25 to 77 (M: 52.91; SD: 17.46). Results of the critical appraisal revealed deviations from the PRISMA indicators, including missing information on (a) registration of a study protocol, (b) statistical synthesis methods (c) evaluation of certainty of evidence, and (d) risk of bias assessment. Eleven (47.83%) of the SRMAs partially adhered, and twelve (52.17%) completely adhered to the PRISMA indicators.

Conclusion

This first critical appraisal on the reporting quality of SRMA on treatment interventions for IUD highlights limitations of the evidence base. Inadequate reporting compromises the practical utility and validity of SRMA and may complicate ongoing efforts of consensus on evidence-based interventions for IUD. Future research should focus on sufficient and transparent reporting of the methodological approach.

Open access