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Positive expectations predict improved mental-health outcomes linked to psychedelic microdosing
Open accessAbstract
Psychedelic microdosing describes the ingestion of near-threshold perceptible doses of classic psychedelic substances. Anecdotal reports and observational studies suggest that microdosing may promote positive mood and well-being, but recent placebo-controlled studies failed to find compelling evidence for this. The present study collected web-based mental health and related data using a prospective (before, during and after) design. Individuals planning a weekly microdosing regimen completed surveys at strategic timepoints, spanning a core four-week test period. Eighty-one participants completed the primary study endpoint. Results revealed increased self-reported psychological well-being, emotional stability and reductions in state anxiety and depressive symptoms at the four-week primary endpoint, plus increases in psychological resilience, social connectedness, agreeableness, nature relatedness and aspects of psychological flexibility. However, positive expectancy scores at baseline predicted subsequent improvements in well-being, suggestive of a significant placebo response. This study highlights a role for positive expectancy in predicting positive outcomes following psychedelic microdosing and cautions against zealous inferences on its putative therapeutic value.
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“Agreeableness and openness to experience did not change at all after MD compared to baseline in the current study, contrasting results from earlier MD studies (12, 28).”
From Trait mindfulness and personality characteristics in a microdosing ADHD sample: a naturalistic prospective survey study (2023) · cites this paper as [12]
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“Agreeableness was increased after MD in a general population sample (12)”
From Trait mindfulness and personality characteristics in a microdosing ADHD sample: a naturalistic prospective survey study (2023) · cites this paper as [12]
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“but other studies did not find this effect in a general population sample (12) and a general sample without individuals diagnosed with a mood, anxiety, substance use, psychotic or dissociative disorder (13).”
From Trait mindfulness and personality characteristics in a microdosing ADHD sample: a naturalistic prospective survey study (2023) · cites this paper as [12]
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“Neuroticism decreased after MD in healthy adults (29) and a general population sample (12)”
From Trait mindfulness and personality characteristics in a microdosing ADHD sample: a naturalistic prospective survey study (2023) · cites this paper as [12]
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“The decrease in neuroticism reported here is consistent with two previous prospective MD studies (12, 29).”
From Trait mindfulness and personality characteristics in a microdosing ADHD sample: a naturalistic prospective survey study (2023) · cites this paper as [12]
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“Kaertner et al. (2021) found that positive expectancy scores regarding the effects of microdosing at baseline predicted subsequent improvements in wellbeing.”
From Psychedelic Microdosing, Mindfulness, and Anxiety: A Cross-Sectional Mediation Study (2023) · cites this paper as Kaertner et al. (2021)
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A very brief measure of the Big-Five personality domains
Gosling, S. D., Rentfrow, P. J., & Swann, W. B. (2003) · Journal of Research in Personality · doi:10.1016/s0092-6566(03)00046-1 · Cited by 8,307
The brief resilience scale: Assessing the ability to bounce back
Smith, B. W., Dalen, J., Wiggins, K., Tooley, E., Christopher, P., & Bernard, J. (2008) · International Journal of Behavioral Medicine · doi:10.1080/10705500802222972 · Cited by 6,439
The Warwick-Edinburgh Mental Well-being Scale (WEMWBS): development and UK validation
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Marteau, T. M., & Bekker, H. (1992) · British Journal of Clinical Psychology · doi:10.1111/j.2044-8260.1992.tb00997.x · Cited by 3,238
Psychometric properties of the credibility/expectancy questionnaire
Devilly, G. J., & Borkovec, T. D. (2000) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/s0005-7916(00)00012-4 · Cited by 2,295
Griffiths, R. R., Johnson, M. W., Carducci, M. A., Umbricht, A., Richards, W. A., Richards, B. D., Cosimano, M. P., & Klinedinst, M. A. (2016) · Journal of Psychopharmacology · doi:10.1177/0269881116675513 · Cited by 2,201
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Ross, S., Bossis, A., Guss, J., Agin-Liebes, G., Malone, T., Cohen, B., Mennenga, S. E., Belser, A., Kalliontzi, K., Babb, J., et al. (2016) · Journal of Psychopharmacology · doi:10.1177/0269881116675512 · Cited by 1,698
Griffiths, R. R., Richards, W. A., McCann, U., & Jesse, R. (2006) · Psychopharmacology · doi:10.1007/s00213-006-0457-5 · Cited by 1,684
Cited by
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Blinding and expectancy confounds in psychedelic randomized controlled trials
Muthukumaraswamy, S. D., Forsyth, A., & Lumley, T. (2021) · Expert Review of Clinical Pharmacology · doi:10.1080/17512433.2021.1933434 · Cited by 324
Aday, J. S., Heifets, B. D., Pratscher, S. D., Bradley, E., Rosen, R., & Woolley, J. D. (2022) · Psychopharmacology · doi:10.1007/s00213-022-06123-7 · Cited by 237
de la Fuente Revenga, M., Zhu, B., Guevara, C. A., Naler, L. B., Saunders, J. M., Zhou, Z., Toneatti, R., Sierra, S., Wolstenholme, J. T., Beardsley, P. M., et al. (2021) · Cell Reports · doi:10.1016/j.celrep.2021.109836 · Cited by 224
Microdosing with psilocybin mushrooms: a double-blind placebo-controlled study
Cavanna, F., Muller, S. L., de la Fuente, L. A., Zamberlán, F., Palmucci, M., Janeckova, L., Kuchař, M., Pallavicini, C., & Tagliazucchi, E. (2022) · Translational Psychiatry · doi:10.1038/s41398-022-02039-0 · Cited by 157
Therapeutic effect of psilocybin in addiction: A systematic review
van der Meer, P. B., Fuentes, J. J., Kaptein, A. A., Schoones, J. W., de Waal, M. M., Goudriaan, A. E., Kramers, K., Schellekens, A., Somers, M., Bossong, M. G., et al. (2023) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2023.1134454 · Cited by 127
Metadata
- Authors
- Kaertner, L. S., Steinborn, M. B., Kettner, H., Spriggs, M. J., Roseman, L., Buchborn, T., Balaet, M., Timmermann, C., Erritzoe, D., & Carhart-Harris, R. L.
- Affiliations
- University of Würzburg (DE)
- Imperial College London (GB)
- ORCID
- Venue
- Scientific Reports
- Published
- 2021-01-21
- Volume
- 11
- Issue
- 1
- Pages
- 1941-1941
- ISSN
- 2045-2322 (ISSN-L)
- PMC
- PMC7820236
- OpenAlex
- W3122801192
- Cited by
- 145
- References
- 76
- Citations by year
- 2026: 6 · 2025: 26 · 2024: 34 · 2023: 37 · 2022: 24 · 2021: 18
- FWCI
- 19.24
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Scientific Reports (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, other-oa)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- eScholarship (California Digital Library) (submittedVersion, cc-by)
- Online Publication Service of Würzburg University (Würzburg University) (submittedVersion, cc-by)
- Spiral (Imperial College London) (submittedVersion, cc-by)
- Funders
- National Institute for Health and Care Research (ACF-2013-21-501, CL-2017-21-004)
- Academy of Medical Sciences (SGL019\1063)
- Imperial College London
- Topics
- Social Sciences › Psychology › Clinical Psychology › Psychedelics and Drug Studies
- Life Sciences › Neuroscience › Cognitive Neuroscience › Pain Management and Placebo Effect
- Social Sciences › Psychology › Social Psychology › Psychological Well-being and Life Satisfaction
- Keywords
- psychedelic microdosing, positive expectations, placebo response, psychological well-being, state anxiety, depressive symptoms, emotional stability, psychological resilience, social connectedness, agreeableness, nature relatedness, psychological flexibility, classic psychedelics
- MeSH terms
- Adult, Affect, Anxiety, Dose-Response Relationship, Drug, Emotions, Female, Hallucinogens, Humans, Lysergic Acid Diethylamide, Male, Mental Health, Middle Aged, Motivation, Psilocybin, Quality of Life, Placebo Effect, Outcome Assessment, Health Care
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