Formal Treatment Research Articles

Identifying Causal Effects Under Functional Dependencies

We study the identification of causal effects, motivated by two improvements to identifiability that can be attained if one knows that some variables in a causal graph are functionally determined by their parents (without needing to know the specific functions). First, an unidentifiable causal effect may become identifiable when certain variables are functional. Secondly, certain functional variables can be excluded from being observed without affecting the identifiability of a causal effect, which may significantly reduce the number of needed variables in observational data. Our results are largely based on an elimination procedure that removes functional variables from a causal graph while preserving key properties in the resulting causal graph, including the identifiability of causal effects. Our treatment of functional dependencies in this context mandates a formal, systematic, and general treatment of positivity assumptions, which are prevalent in the literature on causal effect identifiability and which interact with functional dependencies, leading to another contribution of the presented work.

Screening and Following Up Harmful Alcohol Use "… is Not Necessarily Your Primary Focus": A Qualitative Study Exploring Health Professionals' Experiences Addressing Harmful Alcohol Use in a Norwegian Hospital.

Alcohol use remains a leading cause of excess mortality and morbidity worldwide, and identifying and following up harmful alcohol use represents a key component of alcohol harm reduction policies. This article explores health professionals' experiences implementing these policies in a Norwegian hospital. To explore health professionals' views and experiences of systematic screening and tailored follow-up of harmful and hazardous alcohol use in a Norwegian hospital. We conducted semi-structured interviews with 13 specialty registrars and nurses working in the emergency department and observation ward of a hospital in Oslo, Norway. Interviews were carried out between May and December 2022, coded using NVivo v.14 and analyzed thematically. We identified three themes: (i) standardized and clinical assessment, referring to tensions between standardized and clinical alcohol risk assessment; (ii) formal and informal treatment guidelines, encompassing the informal patient care practices enacted in the emergency department and on the wards, and; (iii) training delivery and barriers to implementation, referring to the training penetration rate and identified need for "clear and simple" alcohol treatment guidelines. This study highlights tensions between alcohol-related harm and alcohol-related norms as these pertain to screening and following up harmful and hazardous alcohol use in a Norwegian hospital. Results suggest training should focus on zero alcohol recommendations, the use of assessment tools, the acceptability of screening to patients and "clear and simple" patient follow-up procedures.

The Unmet Treatment Need for Eating Disorders: What Has Changed in More Than 10 Years? An Updated Systematic Review and Meta-Analysis.

A minority of individuals with eating disorders seek help from health professionals qualified to provide eating disorder care. This review assessed the proportion of individuals with eating disorders who had sought help or received treatment, as an update to an earlier review conducted more than a decade ago. Three databases were searched for studies that: (1) included a community sample of help-seekers and non-help seekers, (2) used a standardized eating disorder screening instrument, and (3) assessed the percentage of participants who had sought help specifically for eating disorder concerns. Of 972 articles, 21 studies met inclusion criteria, representing 37,423 participants. The pooled proportion reporting help-seeking from any source (e.g., helpline, support groups, chat rooms as well as health professionals) was 30% and the pooled proportion reporting formal treatment seeking from health professionals (e.g., psychologist) specifically for eating disorder concerns was 32%. However, there was evidence of publication bias across studies. These rates suggest little to no improvement in the unmet need for treatment since the last review with studies continuing to focus on white adult women. Help-seeking rates among other populations remain unclear and there is an urgent need to understand reasons for overall low help-seeking rates. Clear definitions and measures of help-seeking with appropriate distinctions between sources of help are needed to improve our understanding of help-seeking pathways and identify solutions to facilitate help-seeking. Better visibility of health professionals qualified to provide safe and effective eating disorder care could help reduce the substantial treatment gap.

Craspedia blepharia (Compositae/Asteraceae, Gnaphalieae), a new species from Garibaldi Ridge in Nelson/Tasman, South Island of New Zealand

ABSTRACT Craspedia G.Forst., a genus of tribe Gnaphalieae (Compositae/Asteraceae), is confined to Australia and New Zealand. Twelve species, including Craspedia blepharia Breitw. & Courtney, which we are describing here, are now recognised in New Zealand. Craspedia blepharia is known only from Garibaldi Ridge in Nelson/Tasman, South Island of New Zealand. It is a strong calcicole, confined to exposed, vertical surfaces of limestone cliffs and dolines and quartzose sandstone cliffs which receive calcium-rich seep-water. Its rosettes grow either individually or in dense clumps on cliff faces, thus allowing the plants to receive water from surface water flow. It is distinguished from other New Zealand Craspedia by its rosette leaves clad with a hispid adaxially very dense and abaxially sparse indumentum of very long (2.2–3 mm), usually curved, uniseriate, multiseptate, usually slightly brown or colourless, translucent trichomes that may have a very thin curly, flagellate tip, and leaf margins with a thin white rim formed by the flagellate tips of these long, curved trichomes. We are providing the formal taxonomic treatment together with illustrations and descriptions of its morphology, distribution, habitat, ecology, phenology, and etymology, as well as an assessment of its conservation status.

Public perceptions of opioid misuse recovery and related resources in a nationally representative sample of United States adults.

To understand how the US public defines recovery from opioid misuse and the recovery-related resources it views as most helpful, and to compare differences by opioid misuse history and demographic characteristics. Observational study of data from the nationally representative AmeriSpeak® Panel survey administered in October/November 2021. United States. 6515 adults (≥ 18 years). Respondents ranked 10 definitions of recovery (religious in nature; spiritual in nature; physical/mental in nature; contributing to society; enhanced quality of life; seeking professional help; having a sense of purpose; moderate/controlled substance use; no drug use; abstaining from all substance use) and 9 resources that might contribute to recovery (primary care physician; intensive inpatient program; residential rehabilitation program; self-help group; therapist/psychologist/social worker; prescribed medication; talking to family/friends; spiritual/natural healer; faith-based organization). We explored differences in rankings by opioid misuse history (personal vs. family/friend vs. no history) and demographic characteristics (race, sex, age) using multivariable ordinal logistic regression. Seeking professional help was the most endorsed recovery definition overall [mean (M) = 6.97, standard error (SE) = 0.03]. Those with personal opioid misuse history ranked enhanced quality of life (B = 0.16, P = 0.049) and having a sense of purpose (B = 0.16, P = 0.029) significantly higher, and ranked abstaining from substance use (B = -0.20, P = 0.009) significantly lower as recovery definitions than those without a history of opioid misuse. Compared with White respondents, Black (B = 0.60, P < 0.001) and Hispanic (B = 0.55, P < 0.001) respondents defined recovery as more religious in nature. Residential rehabilitation program was identified as the most helpful resource for recovery (M = 7.16, SE = 0.02), while prescribed medication received a relatively low ranking overall (M = 4.05, SE = 0.03). Those with family/friend opioid misuse history ranked prescribed medication as less helpful than others (B = -0.14, P = 0.003). The general US public's views around recovery from opioid misuse appear to focus on abstinence and formal treatment receipt, while people with a history of opioid misuse place less emphasis on abstinence and greater emphasis on other aspects of well-being.

The integrated behavioral model of mental health help seeking (IBM-HS): A health services utilization theory of planned behavior for accessing care.

This article introduces the integrated behavioral model of mental health help seeking (IBM-HS), a theoretical model for understanding the constructs (e.g., systemic, predisposing, and enabling factors; mental health literacy; illness perceptions; perceived need; stigma; shame; perceived benefits, motivation) that influence people's decision making around seeking professional mental health care and their ultimate access to formal treatment. The IBM-HS is a help-seeking-specific adaptation of the empirically supported integrated behavioral model and integrative model, which are themselves evolutions of the theory of planned behavior and theory of reasoned action. The IBM-HS posits that help-seeking determinants (e.g., structural forces; cultural influences; past help-seeking experience; evaluated need; mental health perceptions, knowledge, and skills; social support) influence help-seeking beliefs (i.e., outcome beliefs, experiential beliefs, beliefs about others' expectations, beliefs about others' behavior, logistical beliefs), which in turn determine their respective help-seeking mechanisms (i.e., attitude, perceived norm, personal agency). These mechanisms collectively influence help-seeking intention, which drives prospective help-seeking behavior, subject to the moderating effects of determinants. Finally, prospective behavior has reciprocal feedback loop effects on certain determinants and beliefs. This article describes the need for the IBM-HS, the model's constructs and their interrelations, measurement considerations, and how the model can be used by scholarly and applied users to systematically understand people's intention to seek professional mental health care services and what helps or hinders them from utilizing this care. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Are continuous stop-and-go mixnets provably secure?

This work formally analyzes the anonymity guarantees of continuous stop-and-go mixnets and attempts to answer the titular question. Existing mixnet based anonymous communication protocols that aim to provide provable anonymity guarantees rely on round-based communication models, which requires synchronization among all the nodes and clients that is difficult to achieve in practice. Continuous stop-and-go mixnets (e.g., Loopix and Nym) provide a nice alternative by adding a random delay for each message on every hop independent of all other hops and all other messages. The core anonymization technique of continuous mixnets combined with the fact that the messages are sent by the clients to the mixnet at different times makes it a difficult problem to formally prove security for such mixnet protocols; existing end-to-end analyses for such designs provide only experimental evaluations for anonymity and were lacking a comprehensive formal treatment. We are the first to close that gap and provide a formal analysis. We provide two indistinguishability based definitions (of sender anonymity), namely pairwise unlinkability and user unlinkability, tuned specifically for continuous stop-and-go mixnets. We derive the adversarial advantage as a function of the protocol parameters for the two definitions. We show that there is a fundamental lower bound on the adversarial advantage $\delta$ for pairwise unlinkability; however, strong user unlinkability (negligible adversarial advantage) can be achieved if the users message rate ($\lambda_u$) is proportional to message processing rate ($\lambda$) on the nodes.

Statistical Mechanical Theories of Membrane Permeability.

A popular theoretical framework to compute the permeability coefficient of a molecule is provided by the classic Smoluchowski-Kramers treatment of the steady-state diffusive flux across a free-energy barrier. Within this framework, commonly termed "inhomogeneous solubility-diffusion" (ISD), the permeability, P, is expressed in closed form in terms of the potential of mean force and position-dependent diffusivity of the molecule of interest along the membrane normal. In principle, both quantities can be calculated from all-atom MD simulations. Although several methods exist for calculating the position-dependent diffusivity, each of these is at best an estimate. In addition, the ISD model does not account for memory effects along the chosen reaction coordinate. For these reasons, it is important to seek alternative theoretical formulations to determine the permeability coefficient that are able to account for the factors ignored by the ISD approximation. Using Green-Kubo linear response theory, we establish the familiar constitutive relation between the flux density across the membrane and the difference in the concentration of a permeant molecule, j = PΔC. On this basis, we derive a time-correlation function expression for the nonequilibrium flux across a membrane that is reminiscent of the transmission coefficient in the reactive flux formalism treatment of transition rates. An analysis based on the transition path theory framework is exploited to derive alternative expressions for the permeability coefficient. The different strategies are illustrated with stochastic simulations based on the generalized Langevin equation in addition to unbiased molecular dynamics simulations of water permeation of a lipid bilayer.

The Role of Addiction Treatment in Building Recovery Capital: Findings From 2022 Life in Recovery Survey in Flanders, Belgium

Introduction: This paper examines life experiences before and during addiction recovery in a large sample of treated and untreated persons in Flanders (Belgium). Methods: A total of 343 participants in recovery from alcohol and/or illicit drug problems (≥3 months) completed the 2022 ‘Life in Recovery’ survey online. Participants were categorized into four groups based on their engagement with treatment services: (1) unassisted recovery, (2) mutual aid support only, (3) formal treatment only, and (4) formal treatment and mutual aid support. The questionnaire was supplemented with open-ended questions about facilitators and barriers to recovery. Findings: Group comparisons revealed significant differences in the severity of dependence and living conditions (recovery strengths and barriers, SABRS) during addiction between those in recovery without treatment and the treatment groups. However, similarities in strengths, barriers, and quality of life during recovery were observed across all groups. Differences in barriers during recovery were attributed to variations in initial conditions rather than treatment engagement. The complementary qualitative analysis revealed that the four clusters experienced similar factors as facilitating and hindering recovery. Discussion: These findings suggest that while various pathways can lead to recovery, those involving formal treatment and mutual aid support may be particularly valuable for individuals facing greater initial barriers and fewer strengths during addiction, highlighting treatment as an important but not universally necessary source of recovery capital.

Accepting and committing to caregiving for schizophrenia—a mixed method pilot study

BackgroundEnd of traditional institutionalized psychiatric care, diagnostic complexities, and associated stigma often negatively impact the social networks of caregivers, making them experience social isolation. Not the “identified patients”, caregiver perspectives are typically overlooked further adding to anticipatory stigma resulting in social death among them. Caregiving experience results in developing coping skills, preventing carers from responding to the nuances of the context, and identifying the useful rules— “Experiential Avoidance”. Psycho-education is typically combined with other formal treatment programs for case conceptualization, and to provide a clear rationale for the treatment approach but less as a distinct psychotherapy. Borrowing the philosophy of Functional Contextualism, the present study developed a “Present-Moment Awareness” guided psychoeducational intervention. The aim was to reduce schizophrenia caregiver burden and anticipatory stigma and promote the value of caregiver participation as ‘experts by experience’.MethodFive family caregivers of remitted schizophrenia patients were recruited using purposive sampling. Pre-post measure was taken on caregiver burden, caregiving experience, sense of personal mastery, and caregiving competence. Results were analysed quantitatively and qualitatively.ResultsA significant decrease in caregiver burden, stigma, and negative effects on the family in post-intervention was observed. Self-compassion led to a rise in a sense of empowerment.ConclusionA caregiver-centred “Present-Moment Awareness” guided psycho-education for schizophrenia caregivers can be considered a possible means to address perceived stigma in caregivers and to reduce associated distress of carers.

The lived experience of gambling-related harm in natural language.

Gambling-related harms can have a significant negative impact on disordered gamblers, lower risk gamblers, and affected others. Yet, most disordered and lower risk gamblers will never seek formal treatment, often due to the stigma and shame surrounding gambling. Online self-help forums are a popular alternative way for gamblers to anonymously seek help from others. Analysis of these interactions can provide a deeper understanding of gambling than more commonly used research methodologies. In the present study, we leverage recent developments in natural language processing to analyze posts on a U.K.-based online self-help gambling forum. Using correlated topic modeling, we canvass the various types of discussions among forum members. We also combine this approach with semantic similarity analysis based on sentence embeddings, to map first the posts, and then the 10 topics, onto six previously established gambling-related harm domains. The topic modeling revealed a cluster of discussions of many negative emotions, a topic regarding the positive emotions underlying the potential for change, a distinct topic regarding gambling's relationship harms, and numerous environmental factors that contributed to harm. Emotional/psychological and health harms were most strongly associated with users' posts, illustrating the multidimensionality of severe gambling-related harm. Our results reveal the co-occurrence of different harms, such as the frequent mentions of financial harms and concomitant emotional/psychological harms. The analysis of the lived experiences of gambling-related harm in natural language represents a useful tool for gambling research and can provide a different perspective to inform policy. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Ideological and methodological foundations of the «idea of law» by Gustav Radbruch

The famous German legal philosopher G. Radbruch has gone through a complex scientific path which influenced both his worldview and methodological foundations of the concepts proposed by him. The study traces the evolution of Radbruch’s philosophy of law, which was formed under the influence of representatives of neo-Kantianism, in particular G. Simmel, H. Rickert, E. Lask and the school of «free law” – G. Kantorovich, as well as historical events – the domination of Nazism in Germany. The authors reveal the peculiarities of G. Radbruch’s methodology; his position is based on the neo-Kantian methodology of distinguishing between “what is” and “what ought to be”, on the methodology of the philosophy of values and the principle that it is logically impossible from what is to derive what is valuable, what is right, what ought to be. G. Radbruch viewed law as a cultural phenomenon, a value fact that differs from other normative systems by a special value that is important for the realization of justice. The law as a phenomenon has a positive form ( statute, custom, international agreement) and social significance (regulates human behaviour and relations). But law also has a normative character (it is an evaluation and a requirement for reality), it also has a social purpose (which is to achieve the public good), it has an individual purpose (which is to realise and ensure human rights) and a nature of universality, and therefore equality and it should embody justice. The authors examine the well-known and fundamental concept of the “idea of law” which is fundamental to Radbruch’s philosophy and consists of three elements: justice, expediency (sustability), and legal certainty. The idea of law is an essential requirement for positive law; it legitimizes it, makes it “correct law” and “lawfull law (statute)”. Legislation that does not embody the idea of law essentially loses its legal nature. Justice is the formal equal treatment of equals and unequal treatment of unequals. Legal certainty reflects the social and individual purpose of law and justifies human freedom, equality and uniqueness on the basis of human value. Expediency (sustability) is the clarity, certainty, and comprehensibility of the law and should be understood as a basis for ensuring justice. G. Radbruch’s concept of the “idea of law” is essentially a modern theory of the legitimation of positive law.

Development of a Mental Health Apps Recommender Platform.

The aim of the paper is to establish the requirements and methodology for the development and implementation of a recommender system for mental health apps to support patients in self-managing their mental health while awaiting formal treatment. The system was developed using an algorithm-based approach, including: (1) user needs assessment through literature review and interviews with various stakeholders, (2) software modelling and prototype creation, and (3) bench testing of the prototype with health experts and users. Based on initial exploration of users' requirements, relevant standards and regulations, a library of trusted mental health apps was compiled and a recommendation engine was built to generate accurate user profiles and deliver personalised health recommendations, which will be further tested to ensure quality. Developing a constructive mental health recommendation system requires the establishment of clear and comprehensive requirements, as well as a robust methodology adressing concerns related to data security, confidentiality, safety, and reliability. Subsequent research may compare various indicators of mental health outcomes at the start and end of patients' waiting period to gain more insights into how the recommender system could be further improved to enhance user experience and their overall well-being.

Social License to Operate for NIMBY Infrastructures: The Mechanism of the Four Components of Procedural Justice

The key to obtaining the Social License to Operate (SLO) for businesses in the not-in-my-backyard (NIMBY) infrastructure projects is the justice of the process. The study constructs a model to analyze the effect of the four components of procedural justice (procedural regulations and the behavior and attitudes of the government and construction enterprises) on the SLO. A large-scale questionnaire survey is conducted to assess the role and the extent of the influence of these four components in obtaining the SLO for NIMBY infrastructures. The results of Structural Equation Modeling (SEM) and mediation effects tests show that procedural justice significantly influences the SLO for NIMBY infrastructure projects. All four components significantly improve community trust and social acceptance of the project. The construction enterprise’s informal treatment of the public’s behavior and attitudes has the largest influence, whereas the government’s formal treatment of the public’s behavior and attitudes has the least influence. The findings provide theoretical and practical guidance for improving the SLO for NIMBY infrastructure projects and promoting the sustainable development of these projects.

Comorbidity of bipolar disorder and borderline personality disorder: Phenomenology, course, and treatment considerations.

Bipolar disorder (BD) and borderline personality disorder (BPD) are both serious psychiatric conditions that elevate the risk for harmful outcomes. Although these conditions represent distinct diagnostic entities, existing research suggests that approximately 20% of individuals with BD meet the criteria for comorbid BPD. Individuals with comorbid BD/BPD appear to have a markedly more severe and phenomenologically distinct clinical course when compared with those with BD alone. However, treatments have generally not been tested in this specific population, and currently, no formal treatment guidelines exist for this subgroup of patients. In the current paper, we review the epidemiological and descriptive research characterizing those with comorbid BD/BPD and discuss the impact of this comorbidity on psychosocial treatment. We also review current findings on evidence-based treatments for BD and BPD that show promise in treating those with comorbid BD/BPD. In our review of the literature, we highlight the importance of recognizing this comorbidity and discuss avenues for developing and integrating evidence-based treatment approaches for this understudied clinical population. Although formal trials of interventions targeted to comorbid BD/BPD are limited, there is promising evidence regarding the possibility of using or integrating existing evidence-based approaches for this population. There are also several areas of clinical practice improvement and future research directions that stem from this literature.

Unsupervised Imputation of Non-Ignorably Missing Data Using Importance-Weighted Autoencoders

Deep Learning (DL) methods have dramatically increased in popularity in recent years. While its initial success was demonstrated in the classification and manipulation of image data, there has been significant growth in the application of DL methods to problems in the biomedical sciences. However, the greater prevalence and complexity of missing data in biomedical datasets present significant challenges for DL methods. Here, we provide a formal treatment of missing data in the context of Variational Autoencoders (VAEs), a popular unsupervised DL architecture commonly used for dimension reduction, imputation, and learning latent representations of complex data. We propose a new VAE architecture, NIMIWAE, that is one of the first to flexibly account for both ignorable and non-ignorable patterns of missingness in input features at training time. Following training, samples can be drawn from the approximate posterior distribution of the missing data can be used for multiple imputation, facilitating downstream analyses on high dimensional incomplete datasets. We demonstrate through statistical simulation that our method outperforms existing approaches for unsupervised learning tasks and imputation accuracy. We conclude with a case study of an EHR dataset pertaining to 12,000 ICU patients containing a large number of diagnostic measurements and clinical outcomes, where many features are only partially observed.

Leveraging Life Cycle Assessment and System Dynamics Model Analysis for an Integrated Household E-Waste Management System in Yaoundé, Cameroon

Electronic waste (E-waste) is a global environmental issue and a contemporary challenge in developing countries, where implementing sustainable E-waste management policies is required to mitigate the adverse impacts of inappropriate treatment and disposal. This study assesses the environmental and human health impacts of the current E-waste management system in Yaoundé. The study then proposes an integrated E-waste management system (IEMS) with policy instruments for increased formal E-waste collection and reduced environmental impacts from informal E-waste treatment. Life cycle assessment (LCA) was utilized to identify high-impact contributing processes within the current E-waste management system (EMS) and to determine the optimum scenario for an integrated system. The system dynamics model (SDM) analysis ascertained the efficiency of the E-waste policy under the IEMS. Results show that the IEMS can reduce global warming potential, fine particulate matter formation, and human carcinogenic toxicity from one ton of E-waste treatment by 27%, 16.3%, and 34%, respectively. Regarding the policy efficiency simulation for the IEMS, the policy instrument (Policy 1), with levies on electronic appliance producers, proved environmentally efficient in reducing the quantity of informal recycling. It was also more economically viable for the recycling fund to increase formal E-waste collection and subsidize formal treatment within the context of the IEMS. The study outcome is informative for E-waste management policy planning in developing economies.

Geographic and Racial/Ethnic Differences in Access to Methamphetamine Detoxification Services, United States, 2021.

Methamphetamine detoxification before entering formal and longer term treatment may have a positive impact on treatment retention and success. Understanding geographic distribution of methamphetamine specialty detox services and differential access by race/ethnicity is critical for establishing policies that ensure equitable access across populations. We used the Mental health and Addiction Treatment Tracking Repository to identify treatment facilities that offered any substance use detoxification in 2021 (N=2346) as well as the census block group in which they were located. We sourced data from the US Census Bureau to identify the percentage of a census block group that was White, Black, and Hispanic. We used logistic regression to model the availability of methamphetamine-specific detox, predicted by the percentage of a block group that was Black and Hispanic. We adjusted for relevant covariates and defined state as a random effect. We calculated model-based predicted probabilities. Over half (60%) of detox facilities offered additional detox services specifically for methamphetamine. Sixteen states had <10 methamphetamine-specific detox facilities. The predicted probability of methamphetamine-specific detox availability was 60% in census block groups with 0%-9% Black residents versus only 46% in census block groups with 90%-100% Black residents, and was 61% in census block groups with 0%-9% Hispanic residents versus 30% in census block groups with 90%-100% Hispanic residents. During an unprecedented national methamphetamine crisis, access to a critical health care service was disproportionately lower in communities that were predominately Black and Hispanic. We orient our findings around a discussion of health disparities, residential segregation, and the upstream causes of the systematic exclusion of minoritized communities from health care.

Latest Intestinal Ultrasound Advancements In Inflammatory Bowel Disease

Inflammatory bowel disease (IBD) treatment has evolved from monitoring clinical symptoms to targeting objective measurements of mucosal healing with endoscopic and radiologic imaging. It is well known that clinical symptoms do not match disease severity. Frequent evaluation with radiologic imaging is now the standard of care. Although Selecting Therapeutic Targets in Inflammatory Bowel Disease (STRIDE-II) recommendations do not list radiographic targets as an endpoint due to the “limited ability of the currently available treatments to achieve transmural healing,” this will likely evolve over time particularly with the rapidly growing uptake of intestinal ultrasound (IUS) in clinical trials. For the time being, imaging is considered as an “adjuvant assessment rather than a formal treatment target.”

Minorities’ Diminished Psychedelic Returns: Gender, Perceived Stigma, and Distress

Because psychedelics have been found to increase psychological traits like openness, mental flexibility, and interpersonal perceptiveness, some researchers believe that psychedelics could help individuals cope with the psychological effects of discrimination. However, it is still unclear whether psychedelic use can help manage the internalized stigma that deters formal mental health treatment. This study investigates the impact of six measures of psychedelic use (MDMA, psilocybin, DMT, ayahuasca, peyote/mescaline, and LSD) on psychological distress (Kessler Psychological Distress Scale) and internalized stigma. The study used data from the National Survey of Drug Use and Health (NSDUH) from 2008 to 2019, with a sample size of 458,372 participants. Ordinary least square regression models were conducted using Stata 18. Gender analysis found that among men, ayahuasca use was linked to reduced stigma perception associated with higher distress. For women, DMT use was linked to reduced stigma perceptions when experiencing higher distress. However, results find that individuals who have used MDMA and psilocybin reported heightened perceptions of stigma associated with increased psychological distress. Among women, MDMA and psilocybin use was associated with a higher perception of stigma when they experienced distress. These findings suggest that, overall, psychedelics may not reduce the impact of distress on the perception of stigma, especially for women.