B-56Investigation of Personality Change Following MDMA-Assisted Psychotherapy for Post Traumatic Stress Disorder
Michael Wagner, Michael C. Mithoefer, Ann T. Mithoefer, Rebecca K. MacAulay, Lisa Jerome, B Bazaar-Klosinski, Rick Doblin
Archives of Clinical Neuropsychology August 31, 2016 DOI: 10.1093/arclin/acw043.131 via OpenAlex
Summary
In a Phase II clinical trial of MDMA-assisted psychotherapy for chronic, treatment-resistant PTSD, increases in Openness and decreases in Neuroticism personality traits were linked to greater symptom reduction, regardless of treatment condition. Participants receiving MDMA showed the largest gains in Openness, which predicted lower PTSD severity. The authors propose that MDMA, combined with psychotherapy, may facilitate a reorganization of mental experience through altered brain pathways, rather than through psychological learning alone.
Study at a glance
| Characteristics | Randomized controlled trial Peer reviewed |
|---|---|
| Sample size | 20 |
| Population | Subjects with treatment-refractory PTSD |
| Intervention | MDMA-assisted psychotherapy |
| Dose | 125 mg |
| Topics | MDMA PTSD |
| Keywords | Psychotherapist Clinical psychology Borderline personality disorder |
| Citations | 1 |
| Key finding | Increases in Openness and decreases in Neuroticism predicted lower PTSD severity, with MDMA-treated participants showing the greatest increase in Openness. |
Abstract
Objective: New data from a previously published randomized blinded Phase II clinical trial (Mithoefer, et al., 2011) is presented here to test whether psychological change mediates the effect of 3,4-methylenedioxymethamphetamine (MDMA)-assisted psychotherapy for chronic, treatment-resistant PTSD. Method: Twenty-three (23) subjects with treatment-refractory PTSD were randomized to either a placebo or experimental condition. Subjects received 2-3 experimental sessions of 125 mg MDMA-assisted psychotherapy (N = 12) or inactive placebo and psychotherapy (N = 8) according to FDA/IRB approved protocol. The CAPS and NEO PI-R were primary outcome measures. Results: There was a significant main effect of decreased CAPS scores, independent of treatment condition when Openness F(1, 17) = 40.60 p < .001 or Neuroticism F(1, 17) = 20.48, p < .001 were used as covariates. Significant interactions showed that experimental subjects experienced the greatest increase in Openness, concomitantly demonstrating greater decreases in CAPS score, F(1, 17) = 5.68, p = .029; also decreases in Neuroticism were associated with a decreased CAPS score, F(1, 17) = 18.83, p < .001. Change score of increased Openness predicted a lower CAPS score, r = .525, p = .031; while decreases in Neuroticism predicted lower CAPS score, r = .492, p = .028. Conclusion: Psychological learning models do not seem to fit these data. With psychotherapeutic priming and MDMA, resolution of PTSD with associated change in personality trait, was conceptualized as involving a transient alteration in the temporal/cingulate, amygdala, and ventromedial frontal pathways of the brain resulting in an “aha” type reorganization of mental experience.