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Expectancies for Subjective and Antidepressant Effects in Psilocybin Users

Mitch Earleywine, Maha N. Mian, Joseph A. de Leo

Journal of Humanistic Psychology September 22, 2023 DOI: 10.1177/00221678231194798 (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Cross-sectional survey Peer reviewed
Sample size 500
Population Psilocybin-using individuals
Topics Anxiety Psilocybin
Keywords Expectancy theory Hallucinogen Antidepressant Clinical psychology Depressive symptoms Depression economics Cognition
Citations 5
Key findings Expectancies about antidepressant effects of psilocybin are associated with ego dissolution and emotional breakthrough, but not with mystical experiences, and may influence treatment outcomes.

Abstract

Expectancy effects for many psychoactive substances appear to play a role in consumption, problematic use, subjective responses to acute administration, and subsequent effects. Expectancies of psychedelics have received little attention in published research despite their reputation for creating dramatic changes in subjective state. Psilocybin-assisted treatment (PAT) improves depression, but details of associated expected effects remain incomplete. Previous work suggests that PAT-induced changes in depression and other forms of well-being covary with specific subjective effects of psilocybin. Self-reports from over 500 psilocybin-using individuals revealed correlations with relevant subjective effects that appeared to mediate antidepressant effects in previous work (e.g., Mystical Experiences, Ego dissolution, and Emotional Breakthrough). Correlations with demographic variables, current depressive symptoms, and general hallucinogen involvement were markedly smaller. Expectancies on specific depressive symptoms also paralleled retrospective reports of other psychedelic-induced antidepressant effects. Regression revealed that current depressive symptoms, ego dissolution, and emotional breakthroughs accounted for unique variance in expected antidepressant effects, but expectancies on mystical effects did not. Although limitations suggest cautious interpretation, psilocybin-using individuals appear to hold relevant expectancies about subjective and antidepressant effects, which might play a role in treatment outcomes worthy of monitoring in clinical trials.

Comparable studies

Other cross-sectional and survey studies on psilocybin for anxiety, most cited first.

Study Year Design Participants
The Challenging Experience Questionnaire: Characterization of challenging experiences with psilocybin mushrooms Internet survey respondents reporting challenging experiences with psilocybin 2016 Questionnaire development and validation
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

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