Prospective examination of the therapeutic role of psychological flexibility and cognitive reappraisal in the ceremonial use of ayahuasca

This survey study (n=261) assessed the role of psychological flexibility and emotion regulation processes in participants from Shipibo ayahuasca retreat centres. Participants reported significant reductions in negative mood after three months, as well as increases in positive mood and psychological flexibility. Increases in psychological flexibility statistically mediated the effects of acute psychological factors.

Abstract

Background: Evidence suggests that psychedelic-assisted therapy carries transdiagnostic efficacy in the treatment of mental health conditions characterized by low mood and the use of avoidance coping strategies.

Aims: While preliminary evidence suggests that psychological flexibility and emotion regulation processes play an important role within psychedelic therapy, this prospective study addressed methodological gaps in the literature and examined the ability of ayahuasca to stimulate acute states of cognitive reappraisal and long-term changes in psychological flexibility and mood. The study also explored whether moderating factors predisposed participants to experience therapeutic changes.

Methods: Participants (N = 261) were recruited from three Shipibo ayahuasca retreat centres in Central and South America and completed assessments on mood, psychological flexibility, and acute ceremonial factors. Expectancy, demand characteristics, and invalid responses were controlled for with several validity scales.

Results/Outcomes: Participants reported significant reductions in negative mood after three months, as well as increases in positive mood and psychological flexibility. Acute experiences of reappraisal during the ayahuasca ceremony exerted the strongest moderating effects on increases in positive mood and psychological flexibility. Increases in psychological flexibility statistically mediated the effects of acute psychological factors, including reappraisal, on changes in positive mood.

Conclusions/Interpretation: These results highlight the role of acute psychological processes, such as reappraisal, and post-acute increases in psychological flexibility as putative mechanisms underlying positive outcomes associated with psychedelics. These results also provide support for the integration of third-wave and mindfulness-based therapy approaches with psychedelic-assisted interventions.”

Authors: Gabrielle Agin-Liebes, Richard Zeifmann, Jason B. Luoma, Eric L. Garland, Keith Campbell & Brandon Weiss

Summary of Prospective examination of the therapeutic role of psychological flexibility and cognitive reappraisal in the ceremonial use of ayahuasca

Introduction

Mood disorders exert a substantial and devastating disease burden globally. Individuals with mood disorders tend to react negatively to their emotions and use maladaptive emotion regulation strategies, which amplify psychological distress and increase the frequency and intensity of negative emotions. Several empirically supported interventions have been developed to target maladaptive emotion regulation strategies, including third-wave contextual and mindfulness-based therapies and nondirective therapies involving classic psychedelics. These interventions have shown particular promise in enhancing outcomes with moderate-to-large effect sizes compared to control conditions.

There is recent interest in the integration of classic psychedelics with contextual-based therapies, focused on psychological flexibility processes, to treat disorders characterized by emotional avoidance and maladaptive emotion regulation. Several studies have suggested that psychological flexibility processes may be involved in psychedelic-induced changes. The studies included in this review used cross-sectional designs that inherently preclude analysis of process-level psychedelic changes, and included relatively brief follow-up periods.

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Institutes

Institutes associated with this publication

University of California San Francisco
At UCSF, there are two research teams dedicated to the study of psychedelics; the Neuroscape Psychedelic Division and the Translational Psychedelic Research Program.