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

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

Journal of psychopharmacology (Oxford, England) August 1, 2017 DOI: 10.1177/0269881117711712 (opens in new tab)

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Study at a glance

AI-extracted from the abstract
Characteristics Randomized controlled trial Peer reviewed
Population Adults with chronic, treatment-resistant PTSD
Intervention MDMA-assisted psychotherapy
Duration Long-term follow-up
Topics MDMA Psychedelic-assisted therapy
Keywords Neo personality Openness Pharmacotherapy Lasting Positive personality changes Enduring recovery Neuroticism Positive treatment outcome Reduced PTSD Symptoms Symptom relief This psychotherapy Recent investigation Randomized trial
Citations 163
Key findings Changes in openness, but not neuroticism, moderated the relationship between reduced PTSD symptoms and MDMA-assisted psychotherapy, with increased openness and decreased neuroticism observed at long-term follow-up.

Abstract

A growing body of research suggests that traumatic events lead to persisting personality change characterized by increased neuroticism. Relevantly, enduring improvements in Post-Traumatic Stress Disorder (PTSD) symptoms have been found in response to 3,4-methylenedioxymethamphetamine (MDMA)-assisted psychotherapy. There is evidence that lasting changes in the personality feature of "openness" occur in response to hallucinogens, and that this may potentially act as a therapeutic mechanism of change. The present study investigated whether heightened Openness and decreased Neuroticism served as a mechanism of change within a randomized trial of MDMA-assisted psychotherapy for chronic, treatment-resistant PTSD. The Clinician-Administered PTSD Scale (CAPS) Global Scores and NEO PI-R Personality Inventory (NEO) Openness and Neuroticism Scales served as outcome measures. Results indicated that changes in Openness but not Neuroticism played a moderating role in the relationship between reduced PTSD symptoms and MDMA treatment. Following MDMA-assisted psychotherapy, increased Openness and decreased Neuroticism when comparing baseline personality traits with long-term follow-up traits also were found. These preliminary findings suggest that the effect of MDMA-assisted psychotherapy extends beyond specific PTSD symptomatology and fundamentally alters personality structure, resulting in long-term persisting personality change. Results are discussed in terms of possible mechanisms of psychotherapeutic change.

In the evidence

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Comparable studies

Other randomized controlled trials on MDMA and psychedelic-assisted therapy, most cited first.

Study Year Design Participants
The safety and efficacy of {+/-}3,4-methylenedioxymethamphetamine-assisted psychotherapy in subjects with chronic, treatment-resistant posttraumatic stress disorder: the first randomized controlled pilot study. Patients with chronic post-traumatic stress disorder refractory to both psychotherapy... 2010 Randomized controlled trial n = 20
3,4-methylenedioxymethamphetamine (MDMA)-assisted psychotherapy for post-traumatic stress disorder in military veterans, firefighters, and police officers: a randomised, double-blind, dose-response, phase 2 clinical trial. Military veterans and first responders aged 18 or older with chronic PTSD lasting 6... 2018 Randomized, double-blind, dose-response, phase 2 clinical trial n = 26
A randomized, controlled pilot study of MDMA (±3,4-Methylenedioxymethamphetamine)-assisted psychotherapy for treatment of resistant, chronic Post-Traumatic Stress Disorder (PTSD) Patients with treatment-resistant PTSD 2012 Randomized controlled trial n = 12
Reduction in social anxiety after MDMA-assisted psychotherapy with autistic adults: a randomized, double-blind, placebo-controlled pilot study. Autistic adults with marked to very severe social anxiety 2018 Randomized controlled trial n = 12
3,4-Methylenedioxymethamphetamine-assisted psychotherapy for treatment of chronic posttraumatic stress disorder: A randomized phase 2 controlled trial. People with chronic posttraumatic stress disorder 2018 Randomized controlled trial n = 28

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