Scoping Review of Experiential Measures from Psychedelic Research and Clinical Trials.

Subjective responses to psychedelic drugs, such as mystical experiences and oceanic boundlessness, often correlate with therapeutic improvements in conditions like treatment-resistant depression, end-of-life anxiety, and substance use disorders. Measuring these responses is challenging; several scales show good reliability and factor structure, but samples are often small and self-selected. This review examines the psychometric properties of widely used scales and their links to treatment outcomes. Challenging experiences, psychological insight, and emotional breakthroughs also show promise, though replication is needed. A collaborative approach to data collection on subjective reactions in therapeutic settings could help predict improvement across conditions.

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Abstract

Subjective responses to psychoactive drugs have served as intriguing windows into consciousness as well as useful predictors. Subjective reactions to psychedelic molecules are particularly interesting given how they covary with subsequent improvements associated with psychedelic-assisted treatments. Although links between subjective reactions and decreases in treatment-resistant clinical depression, end-of-life anxiety, and maladaptive consumption of alcohol and nicotine appear in the empirical literature, the measurement of these subjective responses has proven difficult. Several scales developed over many decades show reasonable internal consistency. Studies suggest that many have a replicable factor structure and other good psychometric properties, but samples are often small and self-selected. We review the psychometric properties of some of the most widely used scales and detail their links to improvement in response to psychedelic-assisted treatments. Generally, assessments of mystical experiences or oceanic boundlessness correlate with improvements. Challenging subjective experiences, psychological insight, and emotional breakthroughs also show considerable promise, though replication would strengthen conclusions. We suggest a collaborative approach where investigators can focus on key responses to ensure that the field will eventually have data from many participants who report their subjective reactions to psychedelic molecules in a therapeutic setting. This may aid in predicting improvement amongst targeted conditions and wellbeing.