The Challenging Experience Questionnaire: Characterization of challenging experiences with psilocybin mushrooms
Frederick S. Barrett, Matthew P. Bradstreet, Jeannie‐marie Leoutsakos, Matthew W. Johnson, Roland R. Griffiths
Journal of Psychopharmacology November 18, 2016 DOI: 10.1177/0269881116678781 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Questionnaire development and validation Peer reviewed |
|---|---|
| Population | Internet survey respondents reporting challenging experiences with psilocybin |
| Intervention | psilocybin |
| Topics | Anxiety Psilocybin |
| Keywords | Hallucinogen Distress Clinical psychology Paranoia Mood Feeling |
| Citations | 364 |
| Key points | Seven distinct factors (grief, fear, death, insanity, isolation, physical distress, and paranoia) characterize challenging psilocybin experiences, and these factors correlate with difficulty, meaningfulness, spiritual significance, and changes in well-being. |
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 Five-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. The stand-alone Challenging Experience Questionnaire was then validated in a separate sample. Seven Challenging Experience Questionnaire 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 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 Challenging Experience Questionnaire provides a basis for future investigation of predictors and outcomes of challenging experiences with classic hallucinogens.
In the evidence
This study is part of the evidence base for a synthesis in the library. Here is how each one recorded it.
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Identified seven factors of challenging psilocybin experiences, including fear, that were associated with difficulty and changes in well-being, with factor structure not differing by prior anxiety or depression.
Synthesized
Comparable studies
Other cross-sectional and survey studies on psilocybin for anxiety, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Psychedelics and Mental Health: A Population Study Adult population in the United States | 2013 | Cross-sectional survey | n = 130,152 |
| Microdosing psychedelics: Motivations, subjective effects and harm reduction People aged 16 years or older who had used psychedelics and could comprehend written... | 2019 | Cross-sectional survey | n = 525 |
| People of color in North America report improvements in racial trauma and mental health symptoms following psychedelic experiences Black, Indigenous, and people of color (BIPOC) in the US and Canada | 2020 | Cross-sectional survey | n = 313 |
| Naturalistic psilocybin use is associated with persisting improvements in mental health and wellbeing: results from a prospective, longitudinal survey Adults planning to take psilocybin outside clinical research, primarily... | 2023 | Prospective longitudinal survey | n = 2,833 |
| Psychedelic perceptions: mental health service user attitudes to psilocybin therapy Mental health service users | 2021 | Cross-sectional survey | n = 99 |
Citations in the library
Cited by 336
- Quality of Acute Psychedelic Experience Predicts Therapeutic Efficacy of Psilocybin for Treatment-Resistant Depression Frontiers in Pharmacology January 17, 2018
- Psychedelics and the essential importance of context. Journal of Psychopharmacology February 15, 2018
- Predicting Responses to Psychedelics: A Prospective Study Frontiers in Pharmacology November 2, 2018
- Emotional breakthrough and psychedelics: Validation of the Emotional Breakthrough Inventory. Journal of Psychopharmacology July 11, 2019
- Psychological flexibility mediates the relations between acute psychedelic effects and subjective decreases in depression and anxiety. Journal of Contextual Behavioral Science 2020
and 331 more in the library
Cites 49
- Psilocybin produces substantial and sustained decreases in depression and anxiety in patients with life-threatening cancer: A randomized double-blind trial Journal of Psychopharmacology November 30, 2016
- Rapid and sustained symptom reduction following psilocybin treatment for anxiety and depression in patients with life-threatening cancer: a randomized controlled trial Journal of Psychopharmacology November 30, 2016
- Psilocybin can occasion mystical-type experiences having substantial and sustained personal meaning and spiritual significance Psychopharmacology July 7, 2006
- Psilocybin with psychological support for treatment-resistant depression: an open-label feasibility study. The Lancet Psychiatry May 17, 2016
- The entropic brain: a theory of conscious states informed by neuroimaging research with psychedelic drugs Frontiers in Human Neuroscience 2014
and 44 more in the library