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Ceremonial Psychedelic Experiences and Changes in Mental Health Outcomes in Those with Adverse Childhood Experiences

M. Mehmood, Rebecka Bremler, M. Spriggs, Hannes Kettner, Leor Roseman, Lasse Damgaard, Robin Carhart-Harris, David Erritzoe, Rick Zeifman

Psychedelic Medicine December 15, 2025 DOI: 10.1177/28314425251392251 via Semantic Scholar

Summary

People who experienced more adverse childhood experiences (ACEs) showed greater improvements in mental well-being, reductions in experiential avoidance, and lower trait anxiety after participating in psychedelic ceremonies compared to those with fewer ACEs. Higher ACE scores were also linked to stronger emotional breakthrough and mystical experiences during the psychedelic session. Among individuals with four or more ACEs, those who reported stronger mystical or emotional breakthrough experiences had better well-being at two and four weeks afterward, and mystical experiences were linked to less experiential avoidance while emotional breakthrough was linked to less anxiety at four weeks. However, the acute experiences did not significantly change how ACEs affected mental health outcomes overall.

Study at a glance

Characteristics Prospective observational survey Peer reviewed
Sample size 570
Population Individuals who participated in psychedelic ceremonies
Intervention Psychedelic ceremonies
Duration 4-week follow-up
Keywords Psychology Medicine
Key finding Adverse childhood experiences significantly moderated the relationship between time and mental health outcomes, with higher ACEs associated with greater improvements in mental health across time.

Abstract

Background:Adverse childhood experiences (ACEs) are known to contribute to mental health issues and interfere with response to mental health interventions. Psychedelics have been found to improve mental health outcomes; however, the exploration of the effects of psychedelics on mental health in those with higher ACEs remains limited. The present study aimed to examine mental health outcomes and acute subjective effects of ceremonial psychedelic use across the spectrum of ACE severity. Method:Prospective observational survey data were collected from a convenience sample (N = 570) of individuals who participated in psychedelic ceremonies. ACE severity was measured at baseline using the validated ACE-Questionnaire. Acute psychedelic experiences (mystical, emotional breakthrough, and challenging experiences) were assessed 1-day postpsychedelic use. Validated measures of mental well-being, experiential avoidance, and trait anxiety were obtained before, and 2- and 4-weeks postpsychedelic experience. Results:A regression analysis found that ACEs significantly moderated the relationship between time and mental health outcomes. Relative to lower ACEs, higher ACEs were associated with greater improvements in mental health across time, corrected for baseline. Spearman’s correlation showed that ACEs were significantly positively correlated with emotional breakthrough (rs = 0.15) and mystical experiences (rs =.12). Among individuals with ACEs ≥4, mystical and emotional breakthrough experiences were positively associated with well-being 2 (adj. r2 = 0.576 and 0.526) and 4 weeks (adj. r2 = 0.438 and 0.463, respectively) postpsychedelic experience (controlling for baseline well-being). Mystical experiences were negatively associated with experiential avoidance (adj. r2 = 0.716), and emotional breakthrough experiences were negatively associated with anxiety, 4 weeks postpsychedelic experience (adj. r2 = 0.401), controlling for baseline. Acute experiences did not significantly moderate the association between ACEs and mental health outcomes. Discussion:ACEs were associated with improvements in mental health following psychedelic experiences. ACEs were positively correlated with emotional breakthrough and mystical experiences, which were associated with improved longer term mental health. Study limitations include the use of a convenience sample and noncontrolled design. This study’s findings tentatively inform the development of psychedelic therapy in those reporting ACEs.

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