Acute subjective effects of psychedelics in naturalistic group settings prospectively predict longitudinal improvements in trauma symptoms, trait shame, and connectedness among adults with childhood maltreatment histories

Abstract

Studies of psychedelic use in naturalistic and clinical settings have suggested safety and mental health benefits for adults with histories of childhood maltreatment. Acute psychological mechanisms that predict therapeutic benefits in this population, however, have yet to be determined. Two common group settings of naturalistic psychedelic use – organized ceremonies and raves or other electronic dance music events – might facilitate therapeutic psychedelic effects because of the unique psychosocial environments they comprise. This prospective, longitudinal study sought to investigate 2 primary questions: first, whether adults with maltreatment histories planning to use psychedelic drugs with therapeutic intent at ceremonies or raves would see enduring psychological benefits after their experiences; and second, whether subjective dimensions of the acute psychedelic experience would be associated with lasting psychological benefits. Eighty-five participants completed self-report measures in the month before, within 2 days after, and approximately 2 months after a planned psychedelic experience with therapeutic intent at a ceremony or rave assessing childhood maltreatment history; trauma symptoms, internalized (trait) shame, and connectedness at baseline and follow-up; and various dimensions of the acute subjective psychedelic experience. Mean scores in posttraumatic stress disorder (PTSD) symptoms, complex PTSD symptoms, trait shame, social connectedness, and general connectedness significantly improved from baseline to 2-month follow-up (ds = 0.73–1.12). Longitudinal changes in outcomes significantly correlated with acute subjective effects of the psychedelic experience. These findings have implications regarding both the potential clinical benefit of psychedelic use among adults with childhood maltreatment histories as well as the psychological mechanisms of therapeutic action of psychedelics.