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Clinically relevant acute subjective effects of psychedelics beyond mystical experience

Nature Reviews Psychology volume 3, pages 606–621 (2024)Cite this article

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Abstract

The administration of classic psychedelics has been associated with well-being and mental health benefits as well as risks and adverse events. The acute subjective effects of psychedelics might have a causal role in these risks and therapeutic benefits, but inconsistencies and limitations in the conceptualization and measurement of these acute subjective effects hinder research and clinical advances. In this Review, we outline current characterizations and psychometric examinations of the acute subjective effects of psychedelics, evaluate the construct validity of commonly used measures and describe findings showing that specific acute subjective effects predict certain outcomes. We discuss how to balance the limitations of existing measures with methodological advances in practice and elaborate on well-known methods and other psychological processes that can help inform the creation of new measures. We suggest actionable recommendations for how the field can transcend current conceptualizations and provide guidance on best practices until the next generation of measures is validated.

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Fig. 1: Possible overlaps between the factors assessed in existing scales of subjective effects of psychedelics.

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Acknowledgements

The authors thank M. van Elk, S. Nayak, S. Kangaslami, R. Ehrenkranz, P. Tiwari and M. Graziosi for their comments and K. Klein for her assistance. This article is dedicated to the memory of Roland R. Griffiths, who passed away on 16 October 2023 after accepting a terminal cancer diagnosis with inspiring grace and gratitude for life. Roland was a beloved friend, colleague and mentor. He was an exemplar of scientific curiosity across a range of topics in psychopharmacology and beyond. He was among those primarily responsible for the restart of rigorous scientific work on sychedelic substances such as psilocybin, which is now a global field of scientific research.

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  1. Deceased: Roland R. Griffiths.

Authors and Affiliations

  1. Department of Psychiatry and Behavioral Sciences, Center for Psychedelic and Consciousness Research, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    David B. Yaden, Sean P. Goldy, Brandon Weiss & Roland R. Griffiths

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  1. David B. Yaden
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Contributions

All authors wrote the article and contributed substantially to the discussion of the content. D.B.Y. and R.R.G. conceived the paper. D.B.Y., S.P.G., B.W. and R.R.G. researched data for the article. D.B.Y., S.P.G., R.R.G. and B.W reviewed and edited the manuscript before submission.

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Correspondence to David B. Yaden.

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Competing interests

Support for D.B.Y., S.P.G., B.W. and R.R.G. through the Johns Hopkins Center for Psychedelic and Consciousness Research was provided by Tim Ferriss, Matt Mullenweg, Blake Mycoskie, Craig Nerenberg, and the Steven and Alexandra Cohen Foundation. R.R.G. reported grants from the Riverstyx Foundation, a crowdsourced funding campaign organized by Tim Ferris, and the National Institute on Drug Abuse (grant R01DA03889) for research support outside the submitted work; personal fees from the Heffter Research Institute (HRI) to cover travel costs as a member of the board of directors of HRI outside the submitted work; and was site principal investigator for a multisite trial of psilocybin-facilitated treatment of major depressive disorder sponsored by the Usona Institute. B.W. owns Axial Therapeutic Research, Inc., a company investigating the safety and effectiveness of alternative treatments for military veteran health.

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Yaden, D.B., Goldy, S.P., Weiss, B. et al. Clinically relevant acute subjective effects of psychedelics beyond mystical experience. Nat Rev Psychol 3, 606–621 (2024). https://doi.org/10.1038/s44159-024-00345-6

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