Ayahuasca's Antidepressant Effects Covary with Behavioral Activation as Well as Mindfulness.

Ayahuasca, a plant-based hallucinogen that serves as a spiritual medicine in South America, has improved depression in at least one placebo-controlled clinical trial. Case studies suggest that dramatic behavioral changes often follow the Ayahuasca ceremony, but most explanations of antidepressant effects focus on changes in mindfulness. This study investigated whether both mindfulness and behavioral activation might contribute to these anti-depressant effects. We surveyed individuals (N = 152) about their changes in depressive symptoms, behavioral activation, and mindfulness after an Ayahuasca experience. Mindfulness was strongly associated with reduced depression severity (r = - .670, p < .001), while behavioral activation was moderately linked (r = - .474, p < .001). Changes in depressive symptoms (Center for Epidemiological Sciences Depression Short Form [CES-D-10]) covaried with subscales from the Five Facet Mindfulness Questionnaire [FFMQ] and Experiences Questionnaire [EQ], confirming previous findings (ß = -.57, 95% CI -5.70, -3.25), p < .001). In addition, a modification of the Behavioral Activation for Depression Scale-Short Form [BADS-SF] accounted for significant unique variance in the improvements in depression (ß = - .16, 95% CI -6.32, -0.08), p < .05). Changes in behavioral activation likely serve as a mechanism underlying Ayahuasca's antidepressant effects. Future clinical trials could benefit from tracking behavioral activation.

Cannabis Expectancies for Sleep.

Up to 35% of adults in the United States suffer from sleep disturbances, which covary with a host of negative mental and physical health outcomes. Previous research suggests that cannabis' sedative effects may be associated with improved sleep. The present study examined the self-reported effect of cannabis use on individual's sleep-related problems. Participants included 311 individuals recruited online, who reported both sleep-related problems and cannabis use. Analyses revealed that participants expected cannabis to decrease the incidence of sleep-related problems, including allowing participants to have an earlier bedtime, to fall asleep more quickly, and to have a longer night's sleep. Moreover, expectancies about the influence of cannabis on sleep negatively covaried with cannabis-related problems. These findings suggest that individuals believe using cannabis might positively influence their sleep quality and believing so may be protective against cannabis problems. Randomized control trials of cannabis for insomnia appear justified.

Cannabis-induced Koro in Americans.

AIMS: Koro, an acute panic reaction related to the perception of penile retraction, was once considered limited to specific cultures. The disorder has appeared as part of a panic response to cannabis, but only in citizens of India. This study looked for cannabis-induced Koro in Americans. DESIGN: Given the relative rarity of cannabis-induced Koro, this work focused on individual case studies. PARTICIPANTS: Over 70 men responded by phone to report negative reactions to cannabis. Three of them (Caucasians aged 22-26 with years of experience with cannabis) spontaneously mentioned experiencing symptoms of Koro after smoking marijuana. FINDINGS: All three cases occurred after participants had heard about cannabis-induced Koro and used the drug in a novel setting or atypical way. Two of the men had body dysmorphia, which may have contributed to symptoms. All three decreased their cannabis consumption after the Koro experience. CONCLUSIONS: Koro, particularly cannabis-induced Koro, is not limited to Eastern cultures. Several factors may interact to create symptoms. These include previous knowledge of cannabis-induced Koro, the use of marijuana in a way that might heighten a panic reaction, and poor body image. In addition, these cases confirm previous work that shows that negative reactions to drugs can attenuate their use.

Polydrug use in an inpatient treatment sample of problem drinkers.

Over the past 30 years in the United States, there have been marked secular increases in polydrug use. Alcohol and other substance use disorders are highly comorbid. Yet, little research has characterized patterns of polydrug use in persons with alcohol dependence. In particular, little is known about this population's use of alcohol and other drugs in combination or on the same day, which is termed simultaneous polydrug use (SPU). This research assessed patterns of SPU in 212 problem drinkers who participated in an alcohol treatment outcome study. Subjects were given a Time-Line Follow-Back interview that assessed the use of alcohol and nine other drug classes for each day of the 120 days before treatment entry. A majority of subjects (61%) reported SPU during this assessment interval. Subjects who reported SPU were disproportionately younger, male, and unmarried, compared with those who did not report SPU. The most common alcohol/drug combinations were alcohol with cocaine (60% of subjects who reported SPU), alcohol with marijuana (51% of SPU subjects), and alcohol with sedatives (31% of SPU subjects). The most common three-drug combination was alcohol, cocaine, and marijuana (23% of SPU subjects). Alcohol use and drug use were associated at the event level, significantly more than association predicted by the base rates of the individual behaviors. Time-Line Follow-Back data correlated highly with a questionnaire measure of SPU. Results indicate that polydrug use is an important focus for assessment and intervention in alcohol treatment programs.