Stauffer Christopher S, Anderson Brian T, Ortigo Kile M, Woolley Joshua
Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, California 94143, United States.
San Francisco Veterans Affairs Medical Center Mental Health, San Francisco, California 94121, United States.
ACS Pharmacol Transl Sci. 2020 Dec 9;4(2):526-532. doi: 10.1021/acsptsci.0c00169. eCollection 2021 Apr 9.
Attachment insecurity is determined early in life, is a risk factor for psychopathology, and can be measured on two separate continuous dimensions: attachment anxiety and attachment avoidance. Therapeutic changes toward more secure attachment correlate with reduction in psychiatric symptoms. Psilocybin-assisted psychotherapy has demonstrated promise in the treatment of psychopathology, such as treatment-resistant depression and substance use disorders. We hypothesized that psilocybin-assisted psychotherapy would reduce attachment anxiety and attachment avoidance, thus increasing attachment security. We also hypothesized that baseline measures of attachment insecurity, which can reflect a diminished capacity for trust and exploration, would inform the quality of the psilocybin session. Participants were male long-term AIDS survivors with moderate-severe demoralization ( = 18). Using the Experiences in Close Relationships scale, we measured attachment insecurity at baseline as well as immediately, and 3 months, after completion of a brief group therapy course, which included a single midtreatment open-label psilocybin session conducted individually. Clinically important aspects of the psilocybin session were assessed using the revised Mystical Experience Questionnaire and the Challenging Experience Questionnaire the day following psilocybin administration. Self-reported ratings of attachment anxiety decreased significantly from baseline to 3-months post-intervention, (16) = -2.2; = 0.045; = 0.45; 95% CI 0.01, 0.87. Attachment avoidance did not change significantly. Baseline attachment anxiety was strongly correlated with psilocybin-occasioned mystical-type experiences, (15) = 0.53, = 0.029, and baseline attachment avoidance was strongly correlated with psilocybin-related challenging experiences, (16) = 0.62, = 0.006. These findings have important implications for the general treatment of psychopathology as well as optimizing psilocybin-assisted psychotherapy as a broadly applicable treatment modality.
依恋不安全感在生命早期就已确定，是精神病理学的一个风险因素，并且可以在两个独立的连续维度上进行测量：依恋焦虑和依恋回避。向更安全依恋的治疗性改变与精神症状的减轻相关。裸盖菇素辅助心理治疗已在治疗精神病理学方面展现出前景，如难治性抑郁症和物质使用障碍。我们假设裸盖菇素辅助心理治疗会减少依恋焦虑和依恋回避，从而增加依恋安全性。我们还假设，能够反映信任和探索能力减弱的依恋不安全感基线测量值，会为裸盖菇素治疗环节的质量提供信息。参与者为患有中度至重度士气低落的男性长期艾滋病幸存者（ = 18）。使用亲密关系经历量表，我们在基线时以及在完成一个简短的团体治疗课程后立即、3个月时测量了依恋不安全感，该团体治疗课程包括一次单独进行的治疗中期开放标签裸盖菇素治疗环节。在裸盖菇素给药后的第二天，使用修订后的神秘体验问卷和挑战性体验问卷评估了裸盖菇素治疗环节的临床重要方面。自我报告的依恋焦虑评分从基线到干预后3个月显著降低，(16) = -2.2； = 0.045； = 0.45；95% CI 0.01, 0.87。依恋回避没有显著变化。基线依恋焦虑与裸盖菇素引发的神秘类型体验密切相关，(15) = 0.53， = 0.029，并且基线依恋回避与裸盖菇素相关的挑战性体验密切相关，(16) = 0.62， = 0.006。这些发现对精神病理学的一般治疗以及优化裸盖菇素辅助心理治疗作为一种广泛适用的治疗方式具有重要意义。
