裸盖菇素试验中使用的研究材料的全领域综述与分析：二十年研究评估
A Field-Wide Review and Analysis of Study Materials Used in Psilocybin Trials: Assessment of Two Decades of Research.
作者信息
Yaden David B, Graziosi Marianna, Owen Alexa M, Agin-Liebes Gabrielle, Aaronson Scott T, Allen Katja Ehrmann, Barrett Frederick S, Bogenschutz Michael P, Carhart-Harris Robin, Ching Terence H W, Cosimano Mary P, Danforth Alicia, Davis Alan K, Garcia-Romeu Albert, Griffiths Roland, Grob Charles S, Gründer Gerhard, Gukasyan Natalie, Heinzerling Keith G, Hendricks Peter S, Holze Friederike, Horton David M, Johnson Matthew W, Kelmendi Benjamin, Knatz Peck Stephanie, Koslowski Michael, Liechti Matthias E, Mertens Lea J, Moreno Francisco A, Nayak Sandeep M, Nicholas Christopher R, Preller Katrin H, Rieser Nathalie M, Ross Stephen, Sergi Karina, Sloshower Jordan, Smigielski Lukasz, Stenbæk Dea Siggaard, Vollenweider Franz X, Weiss Brandon, Wolff Max, Yaden Mary Elizabeth
机构信息
Center for Psychedelic and Consciousness Research, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Department of Clinical Psychology, Hofstra University, Hempstead, New York, USA.
出版信息
Psychedelic Med (New Rochelle). 2025 Feb 27;3(1):1-18. doi: 10.1089/psymed.2024.0019. eCollection 2025 Mar.
INTRODUCTION
Serotonergic psychedelics, serotonin 2A receptor agonists such as psilocybin that can result in substantially altered states of consciousness, are used in recreational and research settings. The safety of psychedelic experiences in research settings is supported by controlled physical environments, presence of clinical and medical staff to address emergent issues, screening for personal and family history of potential contraindications, and psychoeducational preparation with psychological support. Research settings typically provide psychoeducation to participants verbally and in writing (e.g., informed consent), and such documents and conversations can provide safety-related information-but may also introduce a wide range of expectancies. Such expectancies might involve the specific character of the acute subjective effects of psychedelics, possible side effects, and anticipated outcomes.
METHODS
To better understand the content of this psychoeducation, we gathered study materials from many psilocybin studies conducted in the past two decades in healthy and therapeutic populations. We conducted a reflexive thematic analysis to better understand these documents.
RESULTS
While these documents varied substantially between studies, we identified themes intended to lower levels of risk and optimize therapeutic effects from psychedelic treatments. The most frequently coded themes related to (1) biological and physical safety, (2) psychological safety and well-being, (3) aspects of setting, and (4) potential for expectancies. Prioritizing biological and psychological safety was evident in the materials from all sites. Furthermore, we identify potential contributors to expectancy unrelated to safety and suggest that these extrapharmacological elements be studied systematically in future research.
CONCLUSIONS
Ideally, future research should strive to maximize safety while attempting to minimize extraneous expectancies.
引言
血清素能致幻剂，如裸盖菇素这类血清素2A受体激动剂，可导致意识状态大幅改变，被用于娱乐和研究场景。研究场景中致幻体验的安全性有可控的物理环境、临床和医务人员在场以应对突发问题、筛查个人及家族潜在禁忌病史以及提供心理支持的心理教育准备等方面的保障。研究场景通常会以口头和书面形式（如知情同意书）向参与者提供心理教育，此类文件和对话可提供与安全相关的信息，但也可能引发各种各样的预期。这些预期可能涉及致幻剂急性主观效应的具体特征、可能的副作用以及预期结果。
方法
为了更好地理解这种心理教育的内容，我们收集了过去二十年里在健康人群和治疗人群中进行的许多裸盖菇素研究的研究材料。我们进行了反思性主题分析，以更好地理解这些文件。
结果
虽然这些文件在不同研究之间差异很大，但我们确定了旨在降低风险水平并优化致幻治疗效果的主题。编码最频繁的主题涉及：（1）生物和身体安全；（2）心理安全与幸福感；（3）场景方面；（4）预期可能性。在所有研究地点的材料中，优先考虑生物和心理安全是很明显的。此外，我们确定了与安全无关的预期的潜在影响因素，并建议在未来研究中对这些非药理学因素进行系统研究。
结论
理想情况下，未来的研究应在努力将无关预期降至最低的同时，最大限度地提高安全性。
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