Investigating the potential of psychedelic-enhanced cognitive interventions for young people with self-harm behaviour: mechanisms, acceptability....

大约20%的年轻人在生活中经历过自我伤害行为。自残可能发生在不同的心理健康障碍中，并导致负面结果和自杀风险。目前可用的治疗方法通常时间长，成本高，并不适合每个人，因此必须研究替代治疗方法。与迷幻药相结合的治疗最近被证明对各种精神健康障碍有帮助，包括抑郁症和创伤后应激障碍。这项研究项目将探索一种新的心理干预结合低剂量的迷幻psilocybin，以针对年轻人的自我伤害行为（16-25岁）。该项目将与慈善组织药物科学合作，采用定量和定性方法，目的是：1）测试心理过程，通过这种心理过程，迷幻剂和治疗技术可以减少自我伤害行为（研究1）; 2）探索实施迷幻增强心理干预的可接受性和社会障碍（研究2）。我们之前的研究表明，自残的心理图像在自残者中很常见，并且会增加这种行为的冲动。第一项研究将检验亚致幻剂量的裸盖菇素与一种名为意象重写的认知行为治疗技术的结合是否能改变一些导致自残行为的思维方式，例如体验生动的心理图像。图像重写指导个体用另一种图像取代驱动自我伤害的心理图像，这种图像将阻止自我伤害并促进替代应对策略。在意象重写过程中，人们通常会害怕把负面的心理意象和情绪带到脑海中。这就是裸盖菇素可以发挥改变游戏规则的作用的地方。迷幻物质可以提高容忍困难情绪的能力，使思维方式更加灵活，个人更愿意改变。我们假设裸盖菇素可以促进面对在意象重写过程中出现的情绪，并使其更容易产生新的有用的心理意象。研究1将衡量意象重写pluspsilocybin是否可以减少最近有自我伤害行为的年轻人的心理意象，这些意象驱动自我伤害和相关的负面情绪，自我伤害是一种高度污名化的行为，这对寻求和获得支持的年轻人以及提供护理的临床医生产生了影响。迷幻药的滥用在年轻人中很常见，但他们对潜在治疗用途的态度尚不清楚，研究2将调查有自残经历的不同群体的年轻人和临床医生对迷幻药与心理治疗结合使用的期望、信念、恐惧和需求。基于药物科学在探索社会态度和传播有关药物证据方面的专业知识，我们将与年轻人进行焦点小组讨论，并采访临床医生，以了解存在哪些障碍以及实施这种新干预措施需要进行哪些调整。这些研究将把联合收割机实验心理学的发现与利益相关者的知识结合起来，为在某一领域开发高度创新的治疗方法铺平道路。年轻人对心理健康的需求日益增长。该项目旨在研究开发新的心理干预措施与迷幻药物相结合的潜力，以针对年轻人的自我伤害行为。大约20%的年轻人报告说在他们的生活中有过自我伤害（吉利斯等人，2018年）随着利率的增加（McManus等人，2019年）。

Approximately 20% of young people experience self-harm behaviour in their lives. Self-harm can occur across different mental health disorders and lead to negative outcomes and risk of suicide. Current available therapies are often long and costly and do not suit every individual, making it essential to research alternative treatments. Therapy combined with psychedelic drugs has recently been shown to be helpful in a variety of mental health disorders, including depression and post-traumatic stress disorder. This research project will explore a novel psychological intervention combined with a low dose of the psychedelic psilocybin to target self-harm behaviour in young people (aged 16-25).The project will use quantitative and qualitative methods in collaboration with the charity organisation Drug Science with the aim to:1) test the psychological processes by which combining psychedelics and therapy techniques may reduce self-harm behaviour (Study 1);2) explore the acceptability and societal barriers for the implementation of a psychedelic-enhanced psychological intervention (Study 2).Our previous research has shown that mental images of self-harm are common among individuals who self-harm and can increase the urge for this behaviour. Study 1 will examine if the combination of a sub-hallucinogenic dose ofpsilocybin with a cognitive-behavioural therapy technique called Imagery Re-Scripting can change some of the thinking styles that underly self-harm behaviour, such as experiencing vivid mental images.Imagery Re-Scripting guides an individual to replace mental imagery that drives self-harm with an alternative image that will instead discourage self-harm and promote alternative coping strategies. During Imagery Re-Scripting it is common for individuals to fear bringing negative mental images and emotions to mind. This is where psilocybin could play a game-changing role. Psychedelic substances can increase the ability to tolerate difficult emotions, make thinking styles more flexible and individuals more open to change. We hypothesise that psilocybin could facilitate confronting the emotions that arise during Imagery Re-Scripting, and make it easier to generate new helpful mental imagery.Study 1 will measure if Imagery Re-Scripting pluspsilocybin can reduce the mental images that drive self-harm and associated negative emotions in young people with recent self-harm behaviour, and if the effects are more pronounced and durable compared to Imagery Re-Scripting alone.Self-harm is a highly stigmatised behaviour, and this impacts on young people seeking and accessing support and clinicians delivering care. Recreational use of psychedelics is common among young people, but their attitudes toward potential therapeutic use are yet unknown.Study 2 will investigate what are the expectations, beliefs, fears and needs of a diverse group of young people with lived experience of self-harm and of clinicians around the use of psychedelics combined with a psychological therapy. Building on the expertise of Drug Science in exploring societal attitudes and disseminating evidence around drugs, we will conduct focus groups with young people and interview clinicians to understand what barriers are present and what adjustments would be needed to implement this novel intervention.Together, these studies will combine experimental psychology findings with stakeholder knowledge and pave the way for developing a highly innovative therapeutic in an area of growing mental health need for young people. This project aims to investigate the potential for developing novel psychological interventions combined with psychedelic drugs to target self-harm behaviour in young people. Around 20% of young people report having self-harmed in their life (Gillies et al., 2018) with rates increasing(McManus et al., 2019).