Abstract
Background
Research suggests that mindfulness-based interventions may improve mindfulness-related capacities (e.g., decentering, non-judging, and non-reacting) and emotion regulation. Previously, our group reported that ayahuasca could be a potential analogue of mindfulness practice. The main aim of the current study was to examine the effects of ayahuasca on emotional regulation and mindfulness-related capacities. Secondarily, we sought to explore the effects of ayahuasca on individuals with borderline personality disorder (BPD) traits.
Method
This is an observational study of 45 volunteers who participated in an ayahuasca session. The volunteers completed various self-report instruments designed to measure emotional dysregulation (Difficulties in Emotion Regulation Scale (DERS)) and mindfulness traits (Five Facet Mindfulness Questionnaire (FFMQ)–Short Form and Experiences Questionnaire (EQ)) prior to and 24 h after the ayahuasca session. The volunteers were divided into two subgroups based on their score on the McLean Screening Instrument for BPD (MSI-BPD). Twelve participants were grouped into the BPD-like traits subgroup while the rest of them were included in the non-BPD-like subgroup. We performed within-subjects and between-group analyses.
Results
Overall, the participants showed significant improvements on the FFMQ subscales observing, acting with awareness, non-judging, and non-reacting and also significantly improved on decentering (EQ scale) and on the DERS subscales emotional non-acceptance, emotional interference, and lack of control. The BPD-like subgroup also showed significant improvements on the DERS subscales emotional interference and lack of control but not in mindfulness capacities.
Conclusions
These findings suggest a potential therapeutic effect for ayahuasca in emotion regulation and mindfulness capacities (including decentering, acceptance, awareness, and sensitivity to meditation practice). Based on these results, we believe that ayahuasca therapy could be of value in clinical populations, such as individuals with BPD, affected by emotion dysregulation.
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References
André JA, Verschuere B, Lobbestael J (2015) Diagnostic value of the Dutch version of the McLean Screening Instrument for BPD (MSI-BPD). J Personal Disord 29(1):71–78. https://doi.org/10.1521/pedi_2014_28_148
Baer RA, Sauer SE (2011) Relationships between depressive rumination, anger rumination, and borderline personality features. Personal Disord 2(2):142–150. https://doi.org/10.1037/a0019478
Baer RA, Smith GT, Hopkins J, Krietemeyer J, Toney L (2006) Using self-report assessment methods to explore facets of mindfulness. Assessment 13:27–45. https://doi.org/10.1177/1073191105283504
Barbosa PC, Giglio JS, Dalgalarrondo P (2005) Altered states of consciousness and short-term psychological after-effects induced by the first time ritual use of ayahuasca in an urban context in Brazil. J Psychoactive Drugs 37(2):193–201. https://doi.org/10.1080/02791072.2005.10399801
Barkley RA (2010) Deficient emotional self-regulation is a core component of attention-deficit/hyperactivity disorder. J ADHD Relat Disord 1:5–37
Bradley B, DeFife JA, Guarnaccia C, Phifer J, Fani N, Ressler KJ, Westen D (2011) Emotion dysregulation and negative affect: association with psychiatric symptoms. J Clin Psychiatry 72:685–691. https://doi.org/10.4088/JCP.10m06409blu
Britton WB, Shahar B, Szepsenwol O, Jacobs WJ (2012) Mindfulness-based cognitive therapy improves emotional reactivity to social stress: results from a randomized controlled trial. Behav Ther 43:365–380. https://doi.org/10.1016/j.beth.2011.08.006
Carmody J, Baer R (2008) Relationships between mindfulness practice and levels of mindfulness, medical and psychological symptoms and well-being in a mindfulness-based stress reduction program. J Behav Med 31:23–33. https://doi.org/10.1007/s10865-007-9130-7
Cebolla A, García-Palacios A, Soler J, Guillén V, Baños R, Botella C (2012) Psychometric properties of the Spanish validation of the five facets of mindfulness questionnaire (FFMQ). Eur J Psychiatry 26:118–126. https://doi.org/10.4321/S0213-61632012000200005
Chanen AM, Jovev M, Djaja D, McDougall E, Yuen HP, Rawlings D, Jackson HJ (2008) Screening for borderline personality disorder in outpatient youth. J Personal Disord 22(4):353–364. https://doi.org/10.1521/pedi.2008.22.4.353
Chu UB, Ruoho AE (2016) Biochemical pharmacology of the sigma-1 receptor. Mol Pharmacol 89(1):142–153. https://doi.org/10.1124/mol.115.101170
Crowell SE, Beauchaine TP, Linehan MM (2009) A biosocial developmental model of borderline personality: elaborating and extending Linehan’s theory. Psychol Bull 135:495–510. https://doi.org/10.1037/a0015616
Domínguez-Clavé E, Soler J, Elices M, Pascual JC, Álvarez E, de la Fuente-Revenga M, Friedlander P, Feilding A, Riba J (2016) Ayahuasca: pharmacology, neuroscience and therapeutic potential. Brain Res Bull 126:89–101. https://doi.org/10.1016/j.brainresbull.2016.03.002
Dos Santos RG, Grasa E, Valle M, Ballester MR, Bouso JC, Nomdedéu JF, Homs R, Barbanoj MJ, Riba J (2012) Pharmacology of ayahuasca administered in two repeated doses. Psychopharmacology 219:1039–1053. https://doi.org/10.1007/s00213-011-2434-x
Dos Santos RG, Valle M, Bouso JC, Nomdedéu JF, Rodríguez-Espinosa J, McIlhenny EH, Barker SA, Barbanoj MJ, Riba J (2011) Autonomic, neuroendocrine, and immunological effects of ayahuasca. J Clin Psychopharmacol 31(6):717–726. https://doi.org/10.1097/JCP.0b013e31823607f6
Eisenlohr-Moul T, Peters JR, Chamberlain KD, Rodriguez M (2016a) Weekly fluctuations in nonjudging predict borderline personality disorder feature expression in women. J Psychopathol Behav Assess 38(1):149–157. https://doi.org/10.1007/s10862-015-9505-y
Eisenlohr-Moul TA, Peters JR, Pond RS, DeWall CN (2016b) Both trait and state mindfulness predict lower aggressiveness via anger rumination: a multilevel mediation analysis. Mindfulness (N Y) 7(3):713–726. https://doi.org/10.1007/s12671-016-0508-x
Fabregas JM, Gonzalez D, Fondevila S, Cutchet M, Fernandez X, Barbosa PCR, Alcazar-Corcoles MA, Barbanoj MJ, Riba J, Bouso JC (2010) Assessment ofaddiction severity among ritual users of ayahuasca. Drug Alcohol Depend 111(3):257–261. https://doi.org/10.1016/j.drugalcdep.2010.03.024
Feigenbaum J (2007) Dialectical behaviour therapy: an increasing evidence base. J Ment Health 16(1):51–68. https://doi.org/10.1080/09638230601182094
Feliu-Soler A, Pascual JC, Borràs X, Portella MJ, Martín-Blanco A, Armario A, Alvarez E, Pérez V, Soler J (2014) Effects of dialectical behaviour therapy-mindfulness training on emotional reactivity in borderline personality disorder: preliminary results. Clin Psychol Psychother 21(4):363–370. https://doi.org/10.1002/cpp.1837
Fontanilla D, Johannessen M, Hajipour AR, Cozzi NV, Jackson MB, Ruoho AE (2009) The hallucinogen N,N-dimethyltryptamine (DMT) is an endogenoussigma-1 receptor regulator. Science 323(5916):934–937. https://doi.org/10.1126/science.1166127
Franquesa A, Sainz-Cort A, Gandyd S, Soler J, Alcázar-Córcoles MA, Bouso JC (2018) Psychological variables implied in the therapeutic effect of ayahuasca: a contextual approach. Psychiatry Res 264:334–339. https://doi.org/10.1016/j.psychres.2018.04.012
Frecska E, Bokor P, Winkelman M (2016) The therapeutic potentials of ayahuasca: possible effects against various diseases of civilization. Front Pharmacol 7(35). https://doi.org/10.3389/fphar.2016.00035
Fresco DM, Moore MT, van Dulmen MH, Segal ZV, Ma SH, Teasdale JD, Williams JM (2007) Initial psychometric properties of the experiences questionnaire: validation of a self-report measure of decentering. Behav Ther 38(3):234–246. https://doi.org/10.1016/j.beth.2006.08.003
Frood A (2015) Ayahuasca psychedelic tested for depression. Nature:391. https://doi.org/10.1038/nature.2015.17252
Fruzzetti AE (2002) Dialectical behavior therapy for borderline personality and related disorders. In: Kaslow FW & Patterson T (eds) Comprehensive handbook of psychotherapy: cognitive-behavioral approaches, Vol. 2, John Wiley & Sons Inc, Hoboken, NJ, pp 215–240
Glenn C, Klonsky ED (2009) Emotion dysregulation as a core feature of borderline personality disorder. J Personal Disord 23(1):20–28. https://doi.org/10.1521/pedi.2009.23.1.20
Gonzalez-Maeso J, Sealfon SC (2009) Agonist-trafficking and hallucinogens. Curr Med Chem 16(8):1017–1027. https://doi.org/10.2174/092986709787581851
Gratz KL, Roemer L (2004) Multidimensional assessment of emotion regulation and dysregulation: development, factor structure, and initial validation of the Difficulties in Emotion Regulation Scale. J Psychopathol Behav Assess 26:41–54. https://doi.org/10.1023/B:JOBA.0000007455.08539.94
Gratz KL, Rosenthal MZ, Tull MT, Lejuez CW, Gunderson JG (2006) An experimental investigation of emotion dysregulation in borderline personality disorder. J Abnorm Psychol 115:850–855. https://doi.org/10.1037/0021-843X.115.4.850
Grob CS, McKenna DJ, Callaway JC, Brito GS, Neves ES, Oberlaender G, Saide OL, Labigalini E, Tacla C, Miranda CT, Strassman RJ, Boone KB (1996) Human psychopharmacology of hoasca, a plant hallucinogen used in ritual context in Brazil. J Nerv Ment Dis 184(2):86–94. https://doi.org/10.1097/00005053-199602000-00004
Gross JJ, Thompson RA (2007) Emotion regulation: conceptual foundations. In: Gross JJ (ed) Handbook of emotion regulation. Guilford Press, New York, pp 3–25
Halpern JH, Sherwood AR, Passie T, Blackwell KC, Ruttenber AJ (2008) Evidence of health and safety in american members of a religion who use a hallucinogenic sacrament. Med Sci Monit 14(8):SR15–SR22
Hervás G, Jódar R (2008) Adaptación al castellano de la Escala de Dificultades en la Regulación Emocional. Clínica y Salud. http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1130-52742008000200001&lng=es
Hölzel BK, Lazar SW, Gard T, Schuman-Olivier Z, Vago DR, Ott U (2011) How does mindfulness meditation work? Proposing mechanisms of action from a conceptual and neural perspective. Perspect Psychol Sci 6:537–559. https://doi.org/10.1177/1745691611419671
Leichsenring F, Leibing E, Kruse J, New AS, Leweke F (2011) Borderline personality disorder. Lancet 377(9759):74–84. https://doi.org/10.1016/S0140-6736(10)61422-5
Linehan M (1993) Cognitive-behavioral treatment of borderline personality disorder. Guilford press, New York
Loizaga-Velder A (2013) A psychotherapeutic view on the therapeutic effects of ritual ayahuasca use in the treatment of addiction. MAPS Bull Spec Ed 23(1):36–40 Retrieved from http://www.maps.org/news/bulletin/articles/3549-special-edition-psychedelicspsychology
Martín-Blanco A, Ancoechea A, Soler J, Elices M, Carmona C, Pascual JC (2017) Changes over the last 15 years on psychopharmacological management of subjects with borderline personality disorder. Acta Psychiatr Scand 136:323–331. https://doi.org/10.1111/acps.12767
McKenna DJ, Towers GH, Abbott F (1984) Monoamine oxidase inhibitors in South American hallucinogenic plants: tryptamine and beta-carboline constituents of ayahuasca. J Ethnopharmacol 10:195–223
Neacsiu AD, Eberle JW, Kramer R, Wiesmann T, Linehan MM (2014) Dialectical behavior therapy skills for transdiagnostic emotion dysregulation: a pilot randomized controlled trial. Behav Res Ther 59:40–51. https://doi.org/10.1016/j.brat.2014.05.005
Noblin JL, Venta A, Sharp C (2014) The validity of the MSI-BPD among inpatient adolescents. Assessment 21(2):210–217. https://doi.org/10.1177/1073191112473177
Osorio Fde L, Sanches RF, Macedo LR, Santos RG, Maia-de-Oliveira JP, Wichert-Ana L, Araujo DB, Riba J, Crippa JA, Hallak JE (2015) Antidepressant effects of a single dose of ayahuasca in patients with recurrent depression: a preliminary report. Rev Bras Psiquiatr (Sao Paulo Brazil) 37(1):13–20. https://doi.org/10.1590/1516-4446-2014-1496
Ott J (1999) Pharmahuasca: human pharmacology of oral DMT plus harmine. J Psychoactive Drugs 31:171–177. https://doi.org/10.1080/02791072.1999.10471741
Renna ME, Quintero JM, Fresco DM, Mennin DS (2017) Emotion regulation therapy: a mechanism-targeted treatment for disorders of distress. Front Psychol 8(98). https://doi.org/10.3389/fpsyg.2017.00098
Riba J, Rodríguez-Fornells A, Urbano G, Morte A, Antonijoan R, Montero M, Callaway J, Barbanoj MJ (2001) Subjective effects and tolerability of the South American psychoactive beverage ayahuasca in healthy volunteers. Psychopharmacology 154:85–95. https://doi.org/10.1007/s002130000606
Riba J, Valle M, Urbano G, Yritia M, Morte A, Barbanoj MJ (2003) Human pharmacology of ayahuasca: subjective and cardiovascular effects, monoamine metabolite excretion, and pharmacokinetics. J Pharmacol Exper Ther 306(1):73–83. https://doi.org/10.1124/jpet.103.049882
Rivier L, Lindgren JE (1972) “Ayahuasca”, the South American hallucinogenic drink: an ethnobotanical and chemical investigation. Econ Bot 26:101–129 Retrieved from http://www.jstor.org/stable/4253328
Sampedro F, de la Fuente Revenga M, Valle M, Roberto N, Domínguez-Clavé E, Elices M, Luna LE, Crippa JAS, Hallak JEC, de Araujo DB, Friedlander P, Barker SA, Álvarez E, Soler J, Pascual JC, Feilding A, Riba J (2017) Assessing the psychedelic “after-glow” in ayahuasca users: post-acute neurometabolic and functional connectivity changes are associated with enhanced mindfulness capacities. Int J Neuropsychopharmacol 20(9):698–711. https://doi.org/10.1093/ijnp/pyx036
Sanches RF, de Lima Osório F, Dos Santos RG, Macedo LR, Maia-de-Oliveira JP, Wichert-Ana L, de Araujo DB, Riba J, Crippa JA, Hallak JE (2016) Antidepressant effects of a single dose of ayahuasca in patients with recurrent depression: a SPECT study. J Clin Psychopharmacol 36:77–81. https://doi.org/10.1097/JCP.0000000000000436
Santos RG, Landeira-Fernandez J, Strassman RJ, Motta V, Cruz AP (2007) Effects of ayahuasca on psychometric measures of anxiety, panic-like and hopelessness in Santo Daime membres. J Ethnopharmacol 112(3):507–513. https://doi.org/10.1016/j.jep.2007.04.012
Shanon B (2003) Altered states and the study of consciousness: the case of ayahuasca. J Mind Behav 24(2):125–153 Retrieved from http://www.jstor.org/stable/43853997
Soler J, Cebolla A, Feliu-Soler A, Demarzo MM, Pascual JC, Baños R, García-Campayo J (2014a) Relationship between meditative practice and self-reported mindfulness: the MINDSENS composite index. PLoS One 9:e86622. https://doi.org/10.1371/journal.pone.0086622
Soler J, Franquesa A, Feliu-Soler A, Cebolla A, García-Campayo J, Tejedor R, Demarzo M, Baños R, Pascual JC, Portella MJ (2014b) Assessing decentering: validation, psychometric properties, and clinical usefulness of the Experiences Questionnaire in a Spanish sample. Behav Ther 45(6):863–871. https://doi.org/10.1016/j.beth.2014.05.004
Soler J, Elices M, Dominguez-Clave E, Pascual JC, Feilding A, Navarro-Gil M, García-Campayo J, Riba J (2018) Four weekly ayahuasca sessions lead to increases in “acceptance” capacities: a comparison study with a standard 8-week mindfulness training program. Front Pharmacol 9(224). https://doi.org/10.3389/fphar.2018.00224
Soler J, Domínguez-Clavé E, García-Rizo C, Vega D, Elices M, Martín-Blanco A, Feliu-Soler A, Carmona C, Pascual JC (2016a) Validation of the Spanish version of the McLean Screening Instrument for Borderline Personality Disorder. Rev Psiquiatr Salud Ment (Barc.) 9(4):195–202. https://doi.org/10.1016/j.rpsm.2016.03.002
Soler J, Elices M, Franquesa A, Barker S, Friedlander P, Feilding A, JC P, Riba J (2016b) Exploring the therapeutic potential of ayahuasca: acute intake increases mindfulness-related capacities. Psychopharmacology 233:823–829. https://doi.org/10.1007/s00213-015-4162-0
Soler J, Pascual JC, Tiana T, Cebrià A, Barrachina J, Campins MJ, Gich I, Alvarez E, Pérez V (2009) Dialectical behaviour therapy skills training compared to standard group therapy in borderline personality disorder: a 3-month randomised controlled clinical trial. Behav Res Ther 47(5):353–358. https://doi.org/10.1016/j.brat.2009.01.013
Thomas G, Lucas P, Capler NR, Tupper KW, Martin G (2013) Ayahuasca-assisted therapy for addiction: results from a preliminary observational study in Canada. Curr Drug Abuse Rev 6:30–42. https://doi.org/10.2174/15733998113099990003
Tsai SY, Hayashi T, Harvey BK, Wang Y, Wu WW, Shen RF, Zhang Y, Becker KG, Hoffer BJ, Su TP (2009) Sigma-1 receptors regulate hippocampal dendritic spine formation via a free radical-sensitive mechanism involving Rac1xGTP pathway. Proc Natl Acad Sci U S A 106:22468–22473. https://doi.org/10.1073/pnas.0909089106
Tupper KW (2008) The globalization of ayahuasca: harm reduction or benefit maximization? Int J Drug Policy 19:297–303. https://doi.org/10.1016/j.drugpo.2006.11.001
Vega D, Torrubia R, Soto À, Ribas J, Soler J, Pascual JC, Rodríguez-Fornells A, Marco-Pallarés J (2017) Exploring the relationship between non suicidal self-injury and borderline personality traits in young adults. Psychiatry Res 256:403–411. https://doi.org/10.1016/j.psychres.2017.07.008
Zanarini MC, Vujanovic AA, Parachini EA, Boulanger JL, Frankenburg FR, Hennen J (2003) A screening measure for BPD: the McLean Screening Instrument for Borderline Personality Disorder (MSI-BPD). J Personal Disord 17(6):568–573. https://doi.org/10.1521/pedi.17.6.568.25355
Acknowledgments
The authors would like to thank the individuals from Santo Daime, La Encantada, and La Maloka who voluntarily participated in the study. We thank Bradley Londres for editing the manuscript.
Funding
This study was funded by a FIS grant from the Spanish Ministry of Economics and Competitivity - Instituto de Salud Carlos III, under contract PI16/00078 (IP: Enric Alvarez and Jordi Riba), in collaboration with Institut de Recerca de l’Hospital de la Santa Creu i Sant Pau, Barcelona. Elisabet Domínguez is supported by a PFIS grant linked to the aforementioned project.
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Participation was voluntary and written informed consent was obtained from all participants prior to enrollment. The study was conducted in accordance with the Declaration of Helsinki and was approved by the Sant Pau Hospital Ethics Committee.
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The authors declare that they have no conflict of interest.
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Domínguez-Clavé, E., Soler, J., Pascual, J.C. et al. Ayahuasca improves emotion dysregulation in a community sample and in individuals with borderline-like traits. Psychopharmacology 236, 573–580 (2019). https://doi.org/10.1007/s00213-018-5085-3
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DOI: https://doi.org/10.1007/s00213-018-5085-3