Investigating the Role of Self-Compassion in MDMA-Assisted Therapy for Social Anxiety Disorder

Self-compassion is theorized to play a central role in promoting mental health and wellbeing, including for individuals with social anxiety disorder (SAD). One proposed mechanism of MDMA-assisted therapy (MDMA-AT) for SAD is the cultivation of self-compassion. Across five aims, we will characterize self-compassion experiences during MDMA-AT and evaluate its role as a potential mechanism of therapeutic change. Specifically, we will examine whether trait self-compassion increases over the course of treatment and whether state self-compassion experienced during MDMA dosing sessions contributes to these changes and to clinical outcomes: Aim 1 establishes whether trait self-compassion significantly increases over treatment and explores its trajectory of change. Aim 2 examines whether state self-compassion experienced during dosing sessions translates to enduring changes in trait self-compassion over the course of MDMA-AT. Aims 3 and 4 evaluate whether changes in trait self-compassion (Aim 3) and levels of state self-compassion during dosing (Aim 4) are associated with changes in mental health, wellbeing and functional outcomes, including: (a) social anxiety symptoms, (b) global functional impairment, (c) depressive symptoms, (d) internalized shame, and (e) sense of belonging. Aim 5 evaluates whether the intensity of state self-compassion differs across the two MDMA dosing sessions.