Philip Gerrans, Hugh Mgovern, Jakob Hohwy et al.
1 citation
preprint
Complex post-traumatic stress disorder (C-PTSD) involves additional symptoms beyond those of PTSD, including emotional instability, negative self-concept, and interpersonal difficulties, often from prolonged trauma like childhood maltreatment or domestic violence. A novel model based on active inference and self-modelling explains these differences and identifies the insula's role in affective regulation. The model suggests that MDMA-assisted therapy may help recalibrate emotional regulation and strengthen self-model, offering a potential treatment avenue. Theoretical and clinical implications are discussed, with emphasis on further empirical research.
European journal of psychotraumatology
December 1, 2026
Philip Gerrans, Hugh McGovern, Jakob Hohwy et al.
Complex post-traumatic stress disorder (C-PTSD) involves lasting difficulties with emotions, self-concept, and relationships, beyond typical PTSD symptoms. This review proposes a neurocognitive explanation based on predictive processing and self-modelling, focusing on how the brain's insula integrates bodily signals, emotions, and self-awareness. The authors suggest that C-PTSD arises from maladaptive predictions shaped by prolonged interpersonal trauma, leading to unstable self-regulation. They examine MDMA-assisted psychotherapy as one intervention that may temporarily alter emotional salience, trust, and self-related thinking. The framework generates testable hypotheses about self-modelling in C-PTSD and offers guidance for developing treatments that target affective regulation and self-referential processing.
Brain and behavior
July 1, 2026
Lena K L Oestreich, Nathalie M Rieser
Psychedelic and substance-assisted therapies show promise for mental health disorders like treatment-resistant depression, PTSD, and substance use disorders, but major questions remain as the field moves toward clinical implementation. This editorial introduces a special issue that brings together empirical studies, reviews, and commentaries on these emerging priorities. A central theme is that psychedelic therapy cannot be understood as a pharmacological intervention alone; therapeutic relationships, preparation, integration, music, touch, peer support, cultural context, and patient expectations all shape outcomes. Subjective meaning-making and altered states are potentially central to therapeutic change. Implementation challenges include models of care for veterans, global mental health equity, and culturally responsive access. The field requires greater conceptual precision, attention to safety and consent, and frameworks prioritizing equity and cultural appropriateness.