Naturalistic use of psychedelics is related to emotional reactivity and self-consciousness: The mediating role of ego-dissolution and mystical experiences

Classic psychedelics such as psilocybin, LSD and DMT act primarily via 5-HT2A receptor activation and produce robust acute changes in perception, emotion and cognition. Prior work has shown that even single experimental or therapeutic doses can produce lasting improvements in well-being, reductions in depression and anxiety symptoms, and personality changes such as increased openness. At the same time, naturalistic use of psychedelics may produce different outcomes than controlled clinical administration and can be associated both with reported benefits and with a minority of prolonged adverse reactions. Whether repeated, naturalistic use is related to persistent, trait-level differences in emotional reactivity and modes of self-consciousness remains unclear. Orłowski and colleagues used a large online cross-sectional survey to test three linked hypotheses. First, they predicted that greater lifetime use of psychedelics would be associated with higher trait positive emotional reactivity and lower trait negative emotional reactivity. Second, they expected more frequent use to relate to a more adaptive pattern of self-consciousness, operationalised as lower public self-consciousness and rumination but higher reflective thinking and internal state awareness. Third, the investigators hypothesised that retrospective reports of the intensity of ego-dissolution and mystical experiences would mediate the relationships between lifetime psychedelics use and the psychological outcomes of interest. The study therefore aimed to examine persistent individual-differences correlates of naturalistic psychedelic use and the possible mediating role of core subjective aspects of psychedelic experiences.

Data were collected via an anonymous Polish-language online survey implemented in LimeSurvey and distributed through social media channels affiliated with Polish research institutions and harm-reduction organisations. Participants provided informed electronic consent and the full survey took about 30 minutes. After quality-control exclusions, the analytic sample comprised 2,561 participants; 1,661 reported lifetime use of classic psychedelics and completed retrospective measures of ego-dissolution and mystical experience. Exclusions (N = 712) were made for failed attention checks, implausible or careless reporting of use, a self-reported diagnosis of substance dependence, non-binary gender reporting (excluded here for the purposes of modelling gender as a predictor), and extremely low within-subject response variability on key questionnaires. The survey collected demographics (age, sex, education, place of residence, self-reported mental and physical health and financial situation), detailed lifetime and past-year counts of use for several classic psychedelics (LSD, psilocybin mushrooms, synthetic psilocybin, DMT, changa, ayahuasca, mescaline and derivatives) and counts for other psychoactive substance classes. Participants were instructed not to count microdosing occasions. Psychological measures included the Perth Emotional Reactivity Scale – Short Form (PERS-S) to index trait positive and negative emotional reactivity, the Self-Consciousness Scale (SCS) which the investigators re-factor analysed to retrieve four factors (public self, social anxiety, internal state awareness, self-reflectiveness), the Reflection–Rumination Questionnaire (RRQ) for reflective and ruminative self-focus, the Ego-Dissolution Inventory (EDI) and an abridged Hood Mysticism Scale (HMS) for retrospective intensity of ego-dissolution and mystical experience (the latter two completed only by psychedelics users). A short three-item Polish AUDIT subset measured problematic alcohol use. The main predictor was a factored lifetime psychedelics-use variable: investigators summed reported lifetime administrations across psychedelic classes and converted the resulting distribution into four categories — non-users (baseline) plus tertiles among users (occasional, moderate, frequent). Other exposures (lifetime use of other substance classes), lifetime meditation hours, age and education were likewise transformed into categorical factors to address extreme skewness. Analyses used robust linear regression (KS2014 estimator) to examine associations between factored lifetime psychedelic use and psychological outcomes while controlling for age, sex, education, lifetime meditation hours, lifetime uses of other drug classes and alcohol use. Mediation analyses were conducted among psychedelics users only using the PyProcessMacro package; EDI and HMS scores were entered as mediators between the categorical levels of lifetime use and the psychological outcomes. Indirect effects were estimated with 5,000-sample bootstrapping and HC3 heteroscedasticity-consistent covariance corrections. The authors report that data and analysis scripts are publicly available.

Sample sizes and data quality filters are reported: 2,561 participants were analysed overall and 1,661 completed retrospective EDI and HMS measures. Lifetime reports of psychedelic administrations summed to 34,186 occasions across substances, with LSD and psilocybin predominating. Robust regression analyses indicated that factored lifetime psychedelics use was associated with several psychological outcomes. Lifetime use predicted lower negative emotional reactivity (F(3, 2523) = 3.64, p = 0.012) and higher internal state awareness (F(3, 2523) = 6.72, p < 0.001). Lifetime psychedelics use was also associated with lower rumination (F(3, 2523) = 6.15, p < 0.001) and higher reflective thinking (F(3, 2523) = 6.69, p < 0.001). Self-reflectiveness (a distinct SCS factor) was not significantly predicted by lifetime psychedelics use (F(3, 2523) = 0.99, p = 0.399). The investigators report positive emotional reactivity was higher among more frequent users (reported elsewhere in the results and summary materials), while analyses of public-self and social-anxiety factors indicated reductions in projected public self-consciousness among users. Several covariates showed significant associations with the outcomes: male sex and greater lifetime meditation hours were linked to less negative emotional reactivity, whereas lifetime benzodiazepine, opioid and higher alcohol use were associated with greater negative reactivity. Internal state awareness was also positively associated with education, lifetime meditation hours and benzodiazepine use, and negatively associated with male sex, older age and alcohol use. Rumination and reflection showed expected relations with age, education, meditation hours and other substance-use covariates. For subjective acute effects, lifetime psychedelic use (F(3, 1624) = 30.09, p < 0.001) and meditation hours (F(3, 1624) = 29.38, p < 0.001) were associated with higher reported mystical-experience scores on the HMS; male sex and alcohol use were associated with lower mystical scores. Analyses of ego-dissolution predictors revealed significant associations for some covariates but non-monotonic relationships across use levels. Mediation analyses showed that retrospective reports of ego-dissolution (EDI) and mystical experience (HMS) statistically mediated most of the observed relations between factored lifetime psychedelics use and psychological variables. Specifically, the indirect effect via ego-dissolution accounted for increases in internal state awareness, reflection and positive reactivity and for decreases in public self, rumination and negative reactivity. The size of indirect effects generally increased with higher use frequency (T2 to T3). When lifetime meditation hours were added as a covariate, the pattern of mediation remained largely unchanged, although the magnitude of indirect effects was reduced by about 20.2%–39.9% for significant pathways, indicating some shared variance with meditation practice. The investigators note that some relationships involving cannabis and ego-dissolution were non-monotonic; full coefficient tables and confidence intervals are reported in supplementary materials.

Orłowski and colleagues interpret their findings as evidence that repeated naturalistic use of classic psychedelics is associated with an adaptive pattern of trait-level emotional reactivity and aspects of self-consciousness. They highlight three principal observations: (1) more frequent lifetime use related to greater positive and lower negative emotional reactivity; (2) use was associated with diminished public self-consciousness, greater internal state awareness, reduced rumination and increased reflective self-focus; and (3) the majority of these relationships were statistically mediated by retrospective reports of ego-dissolution and mystical aspects of psychedelic experiences. The authors situate these cross-sectional results within prior experimental and clinical literature, noting consistency with acute-state findings that psychedelics bias responses away from negative and toward positive stimuli, and with therapeutic studies where intensity of subjective experience predicted longer-term outcomes. They also discuss a plausible neurobiological account linking repeated acute deactivation of default mode network processes under psychedelics to more persistent alterations in self-related processing and reduced sensitivity to external evaluation. The investigators acknowledge important limitations. Foremost is the cross-sectional, retrospective design, which precludes causal inference: pre-existing personality or emotional profiles might predispose individuals to use psychedelics, rather than use causing trait change. They argue, however, that several aspects of the data (a monotonic relation with number of uses, consistency after controlling for demographics, other substance use and meditation, and a distinct pattern compared with other drug classes) reduce the likelihood that simple selection effects fully explain the results. Additional limitations include self-selection and expectancy biases inherent to online surveys, potential memory inaccuracies in retrospective reporting, and the inability of mediation analysis to establish directionality among subjective experience and trait outcomes. The authors also note that dose effects and unmeasured subjective components (for example awe or emotional breakthrough) may confound the observed mediation by mystical or ego-dissolution scores, since dose increases the likelihood of intense subjective experiences. For future research, the authors recommend longitudinal designs with repeated measures in users and non-users to clarify causality and to disentangle the roles of dose, specific subjective experience components and non-pharmacological practices such as meditation.

The study concludes that more frequent naturalistic use of classic psychedelics is associated with a profile of more positive emotional reactivity and adaptive self-consciousness traits, and that retrospective reports of ego-dissolution and mystical experiences account for most of these associations. The authors recommend longitudinal research to determine whether these cross-sectional associations reflect causal effects of regular psychedelic intake.