A systematic review of 40 studies with 6941 participants found a moderate association between developmental trauma (abuse or neglect before age 18) and dissociation in people with psychosis. Sexual and emotional abuse showed the strongest links to dissociation. Dissociation partially explained the connection between developmental trauma and positive psychotic symptoms, especially hallucinations, and also contributed to paranoia and delusional ideas. Individuals with psychosis and developmental trauma reported more dissociation than those without trauma. The review recommends screening for psychotic and dissociative symptoms in trauma survivors and managing dissociation, while calling for more longitudinal, qualitative, and experimental research.
MDMA-assisted psychotherapy shows promise for treating PTSD, but the psychological mechanisms behind its effects are not well understood. This qualitative study will have approximately 25 experienced psychodynamic psychotherapists receive two doses of MDMA (80-120 mg, oral) in an open-label design. Participants will complete interviews before, during, and after MDMA sessions, plus daily journals. Researchers will use phenomenological and thematic analysis, along with grounded theory, to develop a model of MDMA's psychological mechanisms of action. The study treats therapists as expert observers of their own psychological processes, aiming to generate insights that can inform future treatment models and offer a framework for qualitative mechanistic research on psychedelics.