Transdiagnostic Potential of Psychedelic-Assisted Therapy

Koçárová et al. (2021) proposed psychedelic-induced plasticity (pertaining to both the brain and the mind/psychological phenomena) as a primary transdiagnostic mechanism of change, when treatment occurs within the context of a supportive therapeutic environment and can address universally maladaptive behaviours of brain and mind.

As a reminder, neuroplasticity is where your brain becomes more malleable which can help to repair neural pathways and form new ones (de Vos et al., 2021). The figure below depicts acute-state effects of psychedelics on brain, behaviour, and mind in addition to related longer-term changes in transdiagnostically relevant constructs of psychological flexibility, cognitive flexibility, and mindfulness.

For this interactive, drag the vertical line to the left and right to see and compare both images. If you are using a keyboard, you can use the left and arrow keys.

Research Domain Criteria

The acute state and longer-term changes of psychedelics can also be mapped onto the RDoC framework.

RDOC mapped for psychedelic-assisted therapy. Social processing systmes see an increase in connectedness, empathy, pro-social behaviour, openness. Negative valence systems see altered fear and threat and a decrease in experiential/emotional avoidance, rumination, and rejection sensitivity. Arousal/Regulatory Systems see a decrease in circadian rhythms and sleep-wakefulness. Sensorimotor sees altered habit/agency/ownership. Cognitive systems see altered cognitive control and flexibility. Positive valence systems see an increase in responsiveness to reward, approach motivation, and reward learning. Self-processing systems see an increase in self/body boundaries, a decrease in self-focus, increase in unity, and decrease in self-referential processing/rumination.

While supportive of furthering our understanding of transdiagnostic factors amenable to psychedelic-assisted therapy intervention, the RDoC remains focused on individual biological targets and thus may perpetuate a decontextualized view that ignores socioecological factors and their impact on wellbeing, a previously noted criticism of the RDoC approach.

The Numinus Care Model encourages balancing multiple perspectives, maintaining TVIC and JEDI as orienting principles.

References

De Vos, C. M. H., Mason, N. L., and Kuypers, K. P. C. (2021). Psychedelics and Neuroplasticity: A Systematic Review Unraveling the Biological Underpinnings of Psychedelics. Frontiers in Psychiatry, 12(724606).

Kočárová, R., Horáček, J., and Carhart-Harris, R (2021). Does Psychedelic Therapy Have a Transdiagnostic Action and Prophylactic Potential? Frontiers in Psychiatry, 12(661233).