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Cited by 106Psychedelics and Drug StudiesMindfulness and Compassion InterventionsPsychotherapy Techniques and Applications

Post-Psychedelic Reductions in Experiential Avoidance Are Associated With Decreases in Depression Severity and Suicidal Ideation

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Zeifman, Richard J., Wagner, Anne C., Watts, Ros, Kettner, Hannes, Mertens, Lea J., Carhart-Harris, Robin L.·2020·Frontiers in Psychiatry
DOI 10.3389/fpsyt.2020.00782PMC PMC7438781
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Abstract

Psychedelic therapy shows promise as a novel intervention for a wide range of mental health concerns but its therapeutic action is incompletely understood. In line with acceptance and commitment therapy’s (ACT’s) transdiagnostic model, qualitative research has suggested that reductions in experiential avoidance are an important component of therapeutic outcomes associated with psychedelics. However, limited research has quantitatively explored the association between decreases in experiential avoidance and therapeutic outcomes associated with psychedelics. Therefore, in two prospective studies, using convenience samples of individuals with plans to use a psychedelic, we explored the impact of psychedelic use on experiential avoidance, depression severity, and suicidal ideation, as well as relationships between changes in these outcomes. Participants (Study 1, N=104; Study 2 N=254) completed self-report questionnaires of depression severity, suicidal ideation, and experiential avoidance: 1) before using a psychedelic (in ceremonial and non-ceremonial contexts), as well as 2) 2-weeks and 3) 4-weeks after psychedelic use. Across both studies, repeated measures ANOVAs indicated significant decreases in experiential avoidance, depression severity, and suicidal ideation after psychedelic use. Furthermore, decreases in experiential avoidance were significantly associated with decreases in depression severity and suicidal ideation. These results suggest that psychedelics may lead to significant decreases in experiential avoidance, depression severity, and suicidal ideation. Additionally, these findings imply that reduced experiential avoidance may be a transdiagnostic mechanism mediating treatment success within psychedelic therapy. We conclude that integrating psychedelics with psychotherapeutic interventions that target experiential avoidance (e.g. ACT) may enhance therapeutic outcomes.

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Crossref · 10.3389/fpsyt.2020.00782

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  • Two prospective studies used naturalistic volunteer samples with high attrition (>50%), which may have introduced self-selection and sample biases limiting generalizability.

    “Second, although two of these studies employed prospective designs, their use of naturalistic, volunteer samples with high rates of attrition (> 50%) may have contributed self-selection and sample biases that limit generalizability (Close et al., 2020; Zeifman et al., 2020).”

    From Prospective examination of the therapeutic role of psychological flexibility and cognitive reappraisal in the ceremonial use of ayahuasca (2022) · cites this paper as Zeifman et al., 2020

    The Methods (Study 1 and Study 2, Procedures and Participants; page unavailable) describe prospective studies with volunteer recruitment, and the Discussion (Limitations and Future Research; page unavailable) identifies possible completer/attrition bias. But the reported follow-up nonresponse was 97 of 279 enrollees in Study 1 and 206 of 478 in Study 2—neither exceeds 50%. The claim’s >50% attrition figure is therefore not supported as stated by this paper. (LLM, conf=0.87)

    Experimental — accuracy not yet measured

  • Across three prospective samples, psychological flexibility increased and covaried over time with clinical outcomes such as depression and suicidality.

    “In particular, across three prospective samples, psychological flexibility showed signs of increasing and covarying over time with clinical outcomes including depression and suicidality (Close et al., 2020; Zeifman et al., 2020).”

    From Prospective examination of the therapeutic role of psychological flexibility and cognitive reappraisal in the ceremonial use of ayahuasca (2022) · cites this paper as Zeifman et al., 2020

  • These therapies are proposed to work by stimulating psychological flexibility, reducing emotional avoidance, and increasing approach-oriented coping.

    “It has been proposed that they exert their effects through the stimulation of psychological flexibility processes that decrease emotional avoidance and increase approach-oriented emotional coping (Davis et al., 2020; Kashdan et al., 2020; Zeifman et al., 2020)”

    From Prospective examination of the therapeutic role of psychological flexibility and cognitive reappraisal in the ceremonial use of ayahuasca (2022) · cites this paper as Zeifman et al., 2020

  • Recent prospective studies indicate psychological flexibility is a key component in outcomes following psychedelic use.

    “A few recent studies, including three prospective studies, have suggested that psychological flexibility is a key component in psychedelic-induced outcomes (Close et al., 2020; Davis et al., 2020; Zeifman et al., 2020).”

    From Prospective examination of the therapeutic role of psychological flexibility and cognitive reappraisal in the ceremonial use of ayahuasca (2022) · cites this paper as Zeifman et al., 2020

  • Reductions in experiential avoidance were significantly associated with decreases in depression and suicidality scores.

    “Reductions in experiential avoidance were significantly associated with decreases in depression and suicidality scores [55].”

    From The psychological processes of classic psychedelics in the treatment of depression: a systematic review protocol (2022) · cites this paper as [55]

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Research works printed but not linked: 1

  1. [31]Hayes SC Content, context, and the types of psychological acceptance. In: Hayes SC Jacobson NS Follette VM Dougher MJ, editors. Acceptance and change: Content and context in psychotherapy. Reno, Nevada: Context Press (1994). p. 13– 32.

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Authors
Zeifman, R. J., Wagner, A. C., Watts, R., Kettner, H., Mertens, L. J., & Carhart-Harris, R. L.
Affiliations
  • Imperial College London (GB)
  • Heidelberg University (DE)
Corresponding author
Zeifman, Richard J.
ORCID
Venue
Frontiers in Psychiatry
Publisher
Frontiers Media SA
Published
2020-08-07
Volume
11
Pages
782-782
ISSN
1664-0640 (ISSN-L)
DOI
10.3389/fpsyt.2020.00782
PMC
PMC7438781
OpenAlex
W3047886920
Cited by
106
References
98
Citations by year
2026: 13 · 2025: 17 · 2024: 17 · 2023: 17 · 2022: 18 · 2021: 20 · 2020: 4
FWCI
5.90
Type
journal article
Language
en
Open access
Licence
Locations
  • Frontiers in Psychiatry (publishedVersion, cc-by)
  • 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)
  • Spiral (Imperial College London) (submittedVersion, cc-by)
Funders
Canadian Institutes of Health Research
Topics
  • Social Sciences › Psychology › Clinical Psychology › Psychedelics and Drug Studies
  • Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
  • Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
Keywords
psychedelics, experiential avoidance, depression severity, suicidal ideation, acceptance and commitment therapy, transdiagnostic mechanisms, psychedelic therapy, treatment outcomes

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