Psilocybin can produce long-term changes in personality, personal values, and behavior. Although psilocybin-assisted therapy (PAT) is being actively studied for various psychiatric conditions, its effects on personal values in patients with alcohol use disorder (AUD) remain unexplored. This study examined the effects of PAT on personal values in patients with AUD and assessed relationships between value changes, acute psilocybin experiences, and drinking outcomes.
Methods:
In a phase II clinical trial (NCT02061293), 93 participants with AUD received 12 weeks of treatment, including manualized psychotherapy and two 8-h drug administration sessions with either psilocybin (n = 48) or active placebo (n = 45). Personal values were assessed before and after treatment using the Schwartz Value Survey (SVS), which includes 4 domain scores (Openness to Change, Self-Enhancement, Conservation, Self-Transcendence) and 10 subscales. The acute psychedelic experience was measured using the 30-item Mystical Experience Questionnaire (MEQ) and the 5-Dimensional Altered States of Consciousness Scale (5D-ASC). Treatment effects were assessed using univariate ANCOVAs, with baseline SVS values as covariates. Time effects within each group were evaluated using paired t-tests. Pearson correlations examined the relationship between value changes and acute effects, and also value changes and drinking outcomes.
Results:
Significant treatment effects were detected for the Conservation domain and its subscales “security” and “tradition.” No other domains or subscales showed significant treatment effects. Within the psilocybin group, time effects were significant only for conservation, and its subscales “tradition,” and “security”. No significant time effects were detected in the placebo group. In the psilocybin group, the MEQ subscale Ineffability was significantly associated with increases in Conservation, “security,” and “tradition” (r = 0.31–0.34). 5D-ASC subscale Vigilance Reduction was associated with Conservation (r = 0.31), but not its subscales. 5D-ASC subscale Dread of Ego Dissolution during the psilocybin sessions correlated with increases in “tradition” (r = 0.31). None of the value changes were significantly associated with drinking outcomes.
Conclusion:
PAT may alter value structure in patients with AUD patients by increasing Conservation. Although some associations were found between acute psychedelic effects and changes in Conservation, these value changes were not related to drinking outcomes.
Get full access to this article
View all access options for this article.
References
1.
ReiffCM, RichmanEE, NemeroffCB, et al.the Work Group on Biomarkers and Novel Treatments, a Division of the American Psychiatric Association Council of Research. Psychedelics and psychedelic-assisted psychotherapy. Am J Psychiatry, 2020; 177(5):391–410.
2.
SiegelAN, MeshkatS, BenitahK, et al.Registered clinical studies investigating psychedelic drugs for psychiatric disorders. J Psychiatr Res, 2021; 139:71–81.
3.
JohnsonM, RichardsW, GriffithsR. Human hallucinogen research: Guidelines for safety. J Psychopharmacol, 2008; 22(6):603–620; doi: 10.1177/0269881108093587
4.
Carhart-HarrisR, GiribaldiB, WattsR, et al.Trial of psilocybin versus escitalopram for depression. N Engl J Med, 2021; 384(15):1402–1411; doi: 10.1056/NEJMoa2032994
5.
Carhart-HarrisRL, BolstridgeM, RuckerJ, et al.Psilocybin with psychological support for treatment-resistant depression: An open-label feasibility study. Lancet Psychiatry, 2016; 3(7):619–627; doi: 10.1016/S2215-0366(16)30065-7
6.
DavisAK, BarrettFS, MayDG, et al.Effects of psilocybin-assisted therapy on major depressive disorder: A Randomized Clinical Trial. JAMA Psychiatry, 2021; 78(5):481–489.
7.
GoodwinGM, AaronsonST, AlvarezO, et al.Single-dose psilocybin for a treatment-resistant episode of major depression. N Engl J Med, 2022; 387(18):1637–1648; doi: 10.1056/NEJMoa2206443
8.
RaisonCL, SanacoraG, WoolleyJ, et al.Single-dose psilocybin treatment for major depressive disorder: A Randomized Clinical Trial. JAMA, 2023; 330(9):843–853; doi: 10.1001/jama.2023.14530
9.
BogenschutzMP, ForcehimesAA, PommyJA, et al.Psilocybin-assisted treatment for alcohol dependence: A Proof-of-Concept Study. J Psychopharmacol, 2015; 29(3):289–299.
10.
BogenschutzMP, RossS, BhattS, et al.Percentage of heavy drinking days following psilocybin-assisted psychotherapy vs placebo in the treatment of adult patients with alcohol use disorder: A Randomized Clinical Trial. JAMA Psychiatry, 2022; 79(10):953–962.
11.
JohnsonMW, Garcia-RomeuA, CosimanoMP, et al.Pilot study of the 5-HT2AR agonist psilocybin in the treatment of tobacco addiction. J Psychopharmacol, 2014; 28(11):983–992; doi: 10.1177/0269881114548296
12.
RossS, BossisA, GussJ, et al.Rapid and sustained symptom reduction following psilocybin treatment for anxiety and depression in patients with life-threatening cancer: A Randomized Controlled Trial. J Psychopharmacol, 2016; 30(12):1165–1180; doi: 10.1177/0269881116675512
13.
GriffithsRR, JohnsonMW, CarducciMA, et al.Psilocybin produces substantial and sustained decreases in depression and anxiety in patients with life-threatening cancer: A randomized double-blind trial. J Psychopharmacol, 2016; 30(12):1181–1197; doi: 10.1177/0269881116675513
14.
RokeachM. Understanding human values: Individual and societal. Free Press; New York, 2008, p.438.
15.
SchwartzSH. Universals in the content and structure of values: Theoretical advances and empirical tests in 20 countries. In Advances in Experimental Social Psychology. Elsevier; 1992, pp.1–65.
16.
SchwartzSH. An overview of the Schwartz theory of basic values. Online Readings Psychol Culture, 2012; 2(1):2307.
17.
SortheixFM, SchwartzSH. Values that underlie and undermine well–being: Variability across countries. Eur J Pers, 2017; 31(2):187–201; doi: 10.1002/per.2096
18.
SchwartzSH, MelechG, LehmannA, et al.Extending the cross-cultural validity of the theory of basic human values with a different method of measurement. J Cross-Cultural Psychol, 2001; 32(5):519–542; doi: 10.1177/0022022101032005001
19.
FischerR, BoerD. Motivational basis of personality traits: A meta-analysis of value-personality correlations. J Pers, 2015; 83(5):491–510; doi: 10.1111/jopy.12125
20.
SchwartzSH, CieciuchJ, VecchioneM, et al.Refining the theory of basic individual values. J Pers Soc Psychol, 2012; 103(4):663–688; doi: 10.1037/a0029393
21.
RudnevM, VauclairC-M. The link between personal values and frequency of drinking depends on cultural values: A cross-level interaction approach. Front Psychol, 2018; 9:1379; doi: 10.3389/fpsyg.2018.01379
22.
Morell-GomisR, Lloret IrlesD, MorianoJA, et al.Predicting cannabis use among adolescents in four European Countries: Combining personal values and the theory of planned behaviour. Addiction Res Theory, 2018; 26(6):498–506; doi: 10.1080/16066359.2018.1443214
23.
LiuH, YuS, CottrellL, et al.Personal values and involvement in problem behaviors among Bahamian early adolescents: A cross-sectional study. BMC Public Health, 2007; 7:135–20070702; doi: 10.1186/1471-2458-7-135
24.
BegottiT, BorcaG, RabagliettiE, et al.Fattori associati all’interruzione del consumo di sostanze psicoattive in adolescenza: Uno studio sui valori, l’uso del tempo libero, i modelli e gli atteggiamenti dei genitori. [Factors associated with quitting with psychoactive substances in adolescence: A study about values, leisure activities, parental models and attitudes. ] Psicologia Clinica Dello Sviluppo, 2011; 15:427–447.
25.
DanioniF, VillaniD, RanieriS. Personal values and substance use in adolescence and young adulthood: Risk or protective factors? Subst Use Misuse, 2023; 58(2):171–179; doi: 10.1080/10826084.2022.2151312
26.
SheppardME. Exploring personal values, attitudes, perceived injunctive and descriptive norms, and intrapersonal value-attitude relationships in relation to alcohol use and alcohol-related problems among college students. University of Alabama: Tuscaloosa, AL; 2011.
27.
LivazovićG, JukićR. Adolescent values and risk behavior: Predicting developmental paths in Youth. In: International Multidisciplinary Scientific Conference on Social Sciences & Arts SGEM. SGEM; 2017, pp.3–10.
28.
NordfjaernT, BrunborgGS. Associations between human values and alcohol consumption among Norwegians in the second half of life. Subst Use Misuse, 2015; 50(10):1284–1293.
29.
PikóB, BrassaiL. Values and health-related behaviour. Eur J Ment Health, 2007; 2:173–183.
30.
UngerJB, Ritt-OlsonA, TeranL, et al.Cultural values and substance use in a multiethnic sample of California adolescents. Addiction Res Theory, 2002; 10(3):257–279.
31.
AdayJS, MitzkovitzCM, BloeschEK, et al.Long-term effects of psychedelic drugs: A systematic review. Neurosci Biobehav Rev, 2020; 113:179–189; doi: 10.1016/j.neubiorev.2020.03.017
32.
KahonenJ. Psychedelic unselfing: Self-transcendence and change of values in psychedelic experiences. Front Psychol, 2023; 14:1104627; doi: 10.3389/fpsyg.2023.1104627
33.
BousoJC, Dos SantosRG, Alcazar-CorcolesMA, et al.Serotonergic psychedelics and personality: A systematic review of contemporary research. Neurosci Biobehav Rev, 2018; 87:118–132; doi: 10.1016/j.neubiorev.2018.02.004
34.
Garcia-RomeuA, DavisAK, ErowidE, et al.Persisting reductions in cannabis, opioid, and stimulant misuse after naturalistic psychedelic use: An Online Survey. Front Psychiatry, 2019; 10:955; doi: 10.3389/fpsyt.2019.00955
35.
JohnsonMW, Garcia-RomeuA, JohnsonPS, et al.An online survey of tobacco smoking cessation associated with naturalistic psychedelic use. J Psychopharmacol, 2017; 31(7):841–850.
36.
GriffithsRR, JohnsonMW, RichardsWA, et al.Psilocybin-occasioned mystical-type experience in combination with meditation and other spiritual practices produces enduring positive changes in psychological functioning and in trait measures of prosocial attitudes and behaviors. J Psychopharmacol, 2018; 32(1):49–69; doi: 10.1177/0269881117731279
37.
O’DonnellKC, MennengaSE, OwensLT, et al.Psilocybin for alcohol use disorder: Rationale and design considerations for a randomized controlled trial. Contemp Clin Trials, 2022; 123:106976–20221102; doi: 10.1016/j.cct.2022.106976
38.
FetvadjievVH, HeJ. The longitudinal links of personality traits, values, and well-being and self-esteem: A five-wave study of a nationally representative sample. J Pers Soc Psychol, 2019; 117(2):448–464.
39.
GroszMP, SchwartzSH, LechnerCM. The longitudinal interplay between personal values and subjective well-being: A registered report. Eur J Pers, 2021; 35(6):881–897; doi: 10.1177/08902070211012923
40.
VecchioneM, SchwartzSH, DavidovE, et al.Stability and change of basic personal values in early adolescence: A 2-year longitudinal study. J Pers, 2020; 88(3):447–463; doi: 10.1111/jopy.12502
41.
DittrichA. The standardized psychometric assessment of altered states of consciousness (ASCs) in humans. Pharmacopsychiatry, 1998; 31(Suppl 2):80–84; doi: 10.1055/s-2007-979351
42.
MacleanKA, LeoutsakosJM, JohnsonMW, et al.Factor analysis of the mystical experience questionnaire: A study of experiences occasioned by the hallucinogen psilocybin. J Sci Study Relig, 2012; 51(4):721–737; doi: 10.1111/j.1468-5906.2012.01685.x
43.
BarrettFS, JohnsonMW, GriffithsRR. Validation of the revised Mystical Experience Questionnaire in experimental sessions with psilocybin. J Psychopharmacol, 2015; 29(11):1182–1190; doi: 10.1177/0269881115609019
44.
SobellLC, BrownJ, LeoGI, et al.The reliability of the Alcohol Timeline Followback when administered by telephone and by computer. Drug Alcohol Depend, 1996; 42(1):49–54; doi: 10.1016/0376-8716(96)01263-x
MacLeanKA, JohnsonMW, GriffithsRR. Mystical experiences occasioned by the hallucinogen psilocybin lead to increases in the personality domain of openness. J Psychopharmacol, 2011; 25(11):1453–1461; doi: 10.1177/0269881111420188
56.
ErritzoeD, RosemanL, NourMM, et al.Effects of psilocybin therapy on personality structure. Acta Psychiatr Scand, 2018; 138(5):368–378; doi: 10.1111/acps.12904
57.
MadsenMK, FisherPM, StenbækDS, et al.A single psilocybin dose is associated with long-term increased mindfulness, preceded by a proportional change in neocortical 5-HT2A receptor binding. Eur Neuropsychopharmacol, 2020; 33:71–80; doi: 10.1016/j.euroneuro.2020.02.001
58.
CostaPTJr, McCraeRR. Neo Personality Inventory. American Psychological Association, 2000.
59.
KoK, KnightG, RuckerJJ, et al.Psychedelics, mystical experience, and therapeutic efficacy: A systematic review. Front Psychiatry, 2022; 13:917199; doi: 10.3389/fpsyt.2022.917199
60.
GoughHG, HeilbrunAB. The Adjective Check List Manual. Consulting Psychologists Press, 1983.
61.
RokeachM. The nature of human values. Free Press, 1973, p. x438.
62.
BardiA, GoodwinR. The dual route to value change: Individual processes and cultural moderators. Journal of Cross-Cultural Psychology, 2011; 42(2):271–287; doi: 10.1177/0022022110396916
63.
NourMM, EvansL, NuttD, et al.Ego-dissolution and psychedelics: Validation of the Ego-Dissolution Inventory (EDI). Front Hum Neurosci, 2016; 10:269; doi: 10.3389/fnhum.2016.00269
64.
HendricksPS. Awe: A putative mechanism underlying the effects of classic psychedelic-assisted psychotherapy. Int Rev Psychiatry, 2018; 30(4):331–342; doi: 10.1080/09540261.2018.1474185
