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The Challenging Experience Questionnaire: Characterization of challenging experiences with psilocybin mushrooms
Open accessAbstract
Acute adverse psychological reactions to classic hallucinogens ("bad trips" or "challenging experiences"), while usually benign with proper screening, preparation, and support in controlled settings, remain a safety concern in uncontrolled settings (such as illicit use contexts). Anecdotal and case reports suggest potential adverse acute symptoms including affective (panic, depressed mood), cognitive (confusion, feelings of losing sanity), and somatic (nausea, heart palpitation) symptoms. Responses to items from several hallucinogen-sensitive questionnaires (Hallucinogen Rating Scale, the States of Consciousness Questionnaire, and the Five-Dimensional Altered States of Consciousness questionnaire) in an Internet survey of challenging experiences with the classic hallucinogen psilocybin were used to construct and validate a Challenging Experience Questionnaire. The stand-alone Challenging Experience Questionnaire was then validated in a separate sample. Seven Challenging Experience Questionnaire factors (grief, fear, death, insanity, isolation, physical distress, and paranoia) provide a phenomenological profile of challenging aspects of experiences with psilocybin. Factor scores were associated with difficulty, meaningfulness, spiritual significance, and change in well-being attributed to the challenging experiences. The factor structure did not differ based on gender or prior struggle with anxiety or depression. The Challenging Experience Questionnaire provides a basis for future investigation of predictors and outcomes of challenging experiences with classic hallucinogens.
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“Barrett et al. (2016) created the Challenging Experience Questionnaire (CEQ), which is designed to quantify challenging experiences under the influence of psychedelics (Barrett et al., 2016).”
From Assessment of the acute subjective psychedelic experience: A review of patient-reported outcome measures in clinical research on classical psychedelics (2024) · cites this paper as Barrett et al., 2016
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“The CEQ comprised of 26 items, each rated on a six-point Likert scale. Seven factors are assessed, including grief, fear, death, insanity, isolation, physical distress, and paranoia, to provide a phenomenological profile of challenging aspects of experiences with a classical psychedelic.”
From Assessment of the acute subjective psychedelic experience: A review of patient-reported outcome measures in clinical research on classical psychedelics (2024) · cites this paper as Barrett et al., 2016
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Meyer, T. D., Vale, L., Ibrahim, M., Olmos, C., Quevedo, J., & Soares, J. C. (2026) · BMJ Open · doi:10.1136/bmjopen-2026-118471
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“…Breakthrough Inventory (EBI; Roseman et al. 2019), the Psychological Insight Questionnaire (PIQ; Davis et al. 2021), the Challenging Experience Questionnaire (CEQ; Barrett et al. 2016), the Ego Dissolution Inventory (EDI; Nour et al. 2016), or the Watts Connectedness Scale (WCS; Watts et al. 2022).”
Self-citationPost-traumatic stress disorder symptoms following psychedelic use: a naturalistic survey study
Evens, R., Uyar, A., Gosslau, E., Dambeck, F., Repantis, D., Wolff, M., & Lueken, U. (2026) · Psychological Medicine · doi:10.1017/s0033291726103754
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InfluentialBaseline Mood and “Relational Triad” Predict Acute Qualities of Psychedelic Experience
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Psychedelic-Assisted Therapy (Pat): A New Frontier in Mental Health Treatment
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The psychedelic religion of mystical consciousnessReviews
Strassman, R. (2018) · Journal of Psychedelic Studies · doi:10.1556/2054.2018.003
Metadata
- Authors
- Barrett, F. S., Bradstreet, M. P., Leoutsakos, J.-M. S., Johnson, M. W., & Griffiths, R. R.
- Affiliations
- Johns Hopkins University (US)
- Corresponding author
- Barrett, Frederick S
- Venue
- Journal of Psychopharmacology
- Publisher
- SAGE Publications
- Published
- 2016-11-19
- Volume
- 30
- Issue
- 12
- Pages
- 1279-1295
- ISSN
- 0269-8811 (ISSN-L)
- 1461-7285
- PMC
- PMC5549781
- OpenAlex
- W2549202270
- Cited by
- 366
- References
- 73
- Citations by year
- 2026: 43 · 2025: 77 · 2024: 93 · 2023: 41 · 2022: 39 · 2021: 32 · 2020: 15 · 2019: 10 · 2018: 13 · 2017: 3
- FWCI
- 11.60
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Psychopharmacology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Drug Abuse (R01DA003889, T32DA007209)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Psychedelics and Drug Studies
- Social Sciences › Psychology › Social Psychology › Paranormal Experiences and Beliefs
- Social Sciences › Health › Religion, Spirituality, and Psychology
- Keywords
- psilocybin, challenging experiences, bad trips, questionnaire validation, grief, fear, death, paranoia, isolation, physical distress, altered states of consciousness, meaningfulness, spiritual meaning, well-being
- MeSH terms
- Adult, Affect, Agaricales, Anxiety, Depression, Emotions, Female, Hallucinogens, Humans, Male, Psilocybin, Surveys and Questionnaires
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