Clinically relevant acute subjective effects of psychedelics beyond mystical experience

Abstract

The administration of classic psychedelics has been associated with well-being and mental health benefits as well as risks and adverse events. The acute subjective effects of psychedelics might have a causal role in these risks and therapeutic benefits, but inconsistencies and limitations in the conceptualization and measurement of these acute subjective effects hinder research and clinical advances. In this Review, we outline current characterizations and psychometric examinations of the acute subjective effects of psychedelics, evaluate the construct validity of commonly used measures and describe findings showing that specific acute subjective effects predict certain outcomes. We discuss how to balance the limitations of existing measures with methodological advances in practice and elaborate on well-known methods and other psychological processes that can help inform the creation of new measures. We suggest actionable recommendations for how the field can transcend current conceptualizations and provide guidance on best practices until the next generation of measures is validated. The therapeutic benefits of psychedelics might be ascribed to their subjective effects, but methodological barriers limit interpretation of this association. In this Review, Yaden et al. balance the limitations of current assessments with research advances to inform the development of new measures and practices for understanding the clinical implications of psychedelics.