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TABLE OF CONTENTS

Abstract

Introduction

Materials and
Methods

Results

Discussion

Author
Contributions

Funding

Con ict of Interest


Statement

Footnotes

References

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TABLE OF CONTENTS
ORIGINAL RESEARCH ARTICLE
Front. Hum. Neurosci., 14 June 2016 | https://doi.org/10.3389/fnhum.2016.00269 (https://doi.org/10.3389/fnhum.2016.00269)
Abstract

Introduction

Materials and

Ego-Dissolution and Psychedelics: Validation of


Methods

Results

the Ego-Dissolution Inventory (EDI)


Discussion

Author
Matthew M. Nour (https://www.frontiersin.org/people/u/318688)1,2*,
Contributions Lisa Evans
(https://www.frontiersin.org/people/u/321573)3,
Funding David Nutt (https://www.frontiersin.org/people/u/41802)3
and Robin L. Carhart-Harris (https://www.frontiersin.org/people/u/31719)3
Con ict of Interest
Statement
1
Psychiatric Imaging Group, MRC Clinical Sciences Centre, Imperial College London, London, UK
2
Institute of Psychiatry Psychology and Neuroscience, King’s College London, London, UK
Footnotes
3
Faculty of Medicine, Centre for Neuropsychopharmacology, Division of Brain Sciences, Imperial College London, London, UK
References

Aims: The experience of a compromised sense of “self”, termed ego-dissolution, is a key feature of
the psychedelic experience. This study aimed to validate the Ego-Dissolution Inventory (EDI), a
new 8-item self-report scale designed to measure ego-dissolution. Additionally, we aimed to
investigate the specificity of the relationship between psychedelics and ego-dissolution.
Method: Sixteen items relating to altered ego-consciousness were included in an internet
questionnaire; eight relating to the experience of ego-dissolution (comprising the EDI), and eight
relating to the antithetical experience of increased self-assuredness, termed ego-inflation. Items
were rated using a visual analog scale. Participants answered the questionnaire for experiences
with classical psychedelic drugs, cocaine and/or alcohol. They also answered the seven questions
from the Mystical Experiences Questionnaire (MEQ) relating to the experience of unity with one’s
surroundings.

Results: Six hundred and ninety-one participants completed the questionnaire, providing data for
1828 drug experiences (1043 psychedelics, 377 cocaine, 408 alcohol). Exploratory factor analysis
demonstrated that the eight EDI items loaded exclusively onto a single common factor, which was
orthogonal to a second factor comprised of the items relating to ego-inflation (rho = −0.110),
demonstrating discriminant validity. The EDI correlated strongly with the MEQ-derived measure
of unitive experience (rho = 0.735), demonstrating convergent validity. EDI internal consistency
was excellent (Cronbach’s alpha 0.93). Three analyses confirmed the specificity of ego-dissolution
for experiences occasioned by psychedelic drugs. Firstly, EDI score correlated with drug-dose for
We use psychedelic drugsto(rho
cookies on this website = 0.371),
improve your userbut not for
experience. cocaine
Learn (rho = 0.115) or alcohol (rho = −0.055).
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Secondly, the linear regression line relating the subjective intensity of the experience
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to ego-
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dissolution was
(https://www.frontiersin.org) significantly steeper for psychedelics (unstandardized regression coefficient =
0.701) compared with cocaine (0.135) or alcohol (0.144). Ego-inflation, by contrast, was specifically
associated with cocaine experiences. Finally, a binary Support Vector Machine classifier identified
experiences occasioned by psychedelic drugs vs. cocaine or alcohol with over 85% accuracy using
ratings of ego-dissolution and ego-inflation alone.

Conclusion: Our results demonstrate the psychometric structure, internal consistency and
construct validity of the EDI. Moreover, we demonstrate the close relationship between ego-
dissolution and the psychedelic experience. The EDI will facilitate the study of the neuronal
correlates of ego-dissolution, which is relevant for psychedelic-assisted psychotherapy and our
understanding of psychosis.

Introduction
TABLE OF CONTENTS

Distortions
Abstract in the subjective experience of one’s “self”, or “ego”, are central to the psychedelic experience
(James, 1882; Huxley, 1954; Savage, 1955; Klee, 1963; Leary et al., 1964; Grof, 1976, 1980; Harrison, 2010;
Introduction
Carhart-Harris et al., 2014; Lebedev et al., 2015). Specifically, a reduction in the self-referential awareness
Materials and
that defines
Methods normal waking consciousness has been reported with all classical psychedelic drugs (5-HT2A
receptor
Results agonists), including psilocybin (Griffiths et al., 2008, 2011), lysergic acid diethylamide (LSD;
Goodman, 2002; Lyvers and Meester, 2012), and dimethyltryptamine (DMT; Trichter et al., 2009), as well as
Discussion
with other psychoactive substances such as nitrous oxide (James, 1882) and ketamine (Vollenweider and
Author
Kometer, 2010).
Contributions
The experience
Funding of a compromised sense of self occasioned by psychedelic drugs has been variously called
ego-death (Grof, 1980; Harrison, 2010), ego-loss (Leary et al., 1964), ego-disintegration (Muthukumaraswamy
Con ict of Interest
et al., 2013; Lebedev
Statement et al., 2015) and ego-dissolution (Klee, 1963; Studerus et al., 2010; Carhart-Harris et al.,
2014; Lebedev et al., 2015; Tagliazucchi et al., 2016). This experience has been interpreted from a
Footnotes
psychoanalytic perspective as a disruption of ego-boundaries, which results in a blurring of the distinction
References
between self-representation and object-representation, and precludes the synthesis of self-representations
into a coherent whole (Federn, 1952; Savage, 1955; Fischman, 1983).

It is likely that the prior “psychology” of the subject and the environmental setting in which they take a
psychedelic influences whether an ego-dissolution experience is welcomed and felt as something positive, or
feared and fought against (Eveloff, 1968; Fischman, 1983; Griffiths et al., 2008; Studerus et al., 2010, 2012). At
one extreme, ego-dissolution is closely related to blissful mystical experiences such as can be occasioned by
certain spiritual or religious practices (Stace, 1960; Hood, 1975; MacLean et al., 2012); indeed, loss-of-self was
identified by William James as being a cardinal feature of the mystical experience (James, 1985). These
experiences are characterized by a feeling of unity with one’s surroundings, which is explicitly related to
disturbed ego-boundaries and thus ego-dissolution. Moreover, the mystical experience is likely to be of
therapeutic benefit in psychedelic-assisted psychotherapy (Leary et al., 1964; Grof, 1980; Griffiths et al., 2008,
2011; Johnson et al., 2008, 2014). At the other extreme, it has been argued that self-disturbances and
disturbed ego-boundaries are a core phenomenological feature of psychosis and schizophrenia (Bleuler,
1950; Laing, 1959; Scharfetter, 1981; Fischman, 1983; Parnas, 2011; Sass et al., 2011; Northoff, 2014; Nour and
Barrera, 2015), although it remains unclear precisely how the self-disturbances specific to schizophrenia
relate to the experience of ego-dissolution under psychedelics.

Discussions of altered self-experience have been traditionally confined to philosophy or descriptive


psychopathology (Stace, 1960; Jaspers, 1997). In recent years, however, there has been increased interest in
the neurobiological correlates of the experience of self (Carhart-Harris and Friston, 2010; Qin and Northoff,
2011; Carhart-Harris et al., 2014). Psychedelic drugs may provide a fruitful avenue of research into the
neuronal correlates of normal and abnormal self-awareness or ego-consciousness (Carhart-Harris et al.,

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2013, 2014; Muthukumaraswamy et al., 2013; Roseman et al., 2014; Lebedev et al., 2015; Tagliazucchi et al.,
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2016). This research programme, however, is predicated on the existence of a validated self-report measure
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of the ego-dissolution experience.

There currently exist several measures that capture feelings related to alterations in self-experience (Strass-
man et al., 1994; Parnas et al., 2005; Studerus et al., 2010; MacLean et al., 2012). Dittrich’s APZ (Abnormal
Mental States) questionnaire, and its revised versions, OAV and 5D-ASC, have been used extensively to
characterize altered states of consciousness occasioned by psychedelic drugs (Dittrich, 1998; Studerus et al.,
2010). These questionnaires purport to capture both positive and negative experiences of depersonalization
and derealization (“oceanic boundlessness” and “dread of ego dissolution”, respectively), as well as
additional dimensions of “visionary restructuralization” (in APZ, OAV and 5D-ASC), “auditory alterations”
and “vigilance reductions” (both in 5D-ASC only; Dittrich, 1998; Hasler et al., 2004; Wittmann et al., 2007; Stu-
derus et al., 2010, 2011; Schmid et al., 2015). Recent psychometric evaluation of the OAV questionnaire,
however, reveals a more complex 11-factor structure, including factors relating to changes in cognition,
perception and mood, as well as to feelings of unity and disembodiment. At present, however, there are no
TABLE OF CONTENTS
validated scales that allow an easy, reliable and direct uni-dimensional measurement of ego-dissolution. This
presents
Abstract a barrier to this promising line of research.
Introduction
The primary aim of the present study was to develop and validate the “Ego-Dissolution Inventory” (EDI), a
new succinct
Materials and 8-item self-completed questionnaire designed to operationalize the experience of ego-
Methods
dissolution so that its construct validity can be tested and developed. In order to do this in an efficient way
Results
we chose to utilize online data collection via a large anonymous internet survey. A secondary aim was to
investigate
Discussion the specificity of the relationship between the experience of ego-dissolution and psychedelic
drugs, compared with cocaine and alcohol. These two comparator drugs were chosen because of their
Author
widespread
Contributions availability and use in Western societies. Finally, we aimed to test the hypothesis that
experiences occasioned by classical stimulant drugs, like cocaine, are in some respects antithetical to the
Funding
psychedelic experience, promoting ego-inflation rather than ego-dissolution.
Con ict of Interest
Statement

Footnotes
Materials and Methods
References

Survey Construction

Ego-Dissolution Inventory Item Selection

Sixteen novel statements relating to the experience of ego-consciousness were included in this study. Eight of
these were designed to capture the central phenomenon of ego-dissolution (and the associated feeling of
increased union with one’s surroundings, known as dissolved ego-boundaries), and particularly how it has
been characterized in the context of the psychedelic experience (Leary et al., 1964; Grof, 1980; Harrison,
2010). As well as referring to the existing literature on the psychedelic experience, we also sought the opinion
of six scientists working within the field of psychedelic neuroscience when choosing the final eight ego-
dissolution items, and sought consensus about the chosen items. The other eight items were designed to
reflect the distinct and largely antithetical experience of unusually elevated self-assuredness and confidence
(which we refer to as “ego-inflation”). The items from these two subscales were included in the final survey
in an interleaved manner with the intention of minimizing question “order” effects, and the potential
tendency for subjects to indiscriminately endorse any statement about altered consciousness when reflecting
on an experience with a psychoactive substance (particularly if that substance can have profound and
variegated psychological effects, as is the case with psychedelics). Items were rated using a visual analog
scale format (0–100, with incremental units of one) with zero defined as “No, not more than usually”, and 100
defined as “Yes, entirely or completely”, taking inspiration from a previous questionnaire on altered states of
consciousness developed by Dittrich (1998) as well as other self-constructed scales used internally by our
team (Carhart-Harris et al., 2012, 2015; Muthukumaraswamy et al., 2013). For the exact wording of the 16 ego-
consciousness items included in the survey see Table 1.
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TABLE 1

(https://www.frontiersin.org/files/Articles/190474/fnhum-10-00269-HTML/image_m/fnhum-10-00269-
t001.jpg)
Table 1. Factor loadings from exploratory factor analysis of item scores from 1828 drug experiences
(extraction method: principal axis factor; rotation method: promax with Kaiser normalization;
loadings taken from pattern matrix).

TABLE OF CONTENTS
Survey Structure
Abstract
Each subject
Introduction was asked to provide information on their age, sex and educational background. Subjects also
provided information on their lifetime use of psychedelic drugs and cocaine, as well as their weekly alcohol
Materials and
consumption
Methods (all possible answer options for educational attainment and drug and alcohol use are presented
in Table 2).
Results

Discussion

Author
TABLE 2
Contributions

Funding
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Con ict of Interest t002.jpg)
Statement Table 2. Demographic data for subjects who provided information for at least one drug experience.

Footnotes

References

After providing these demographic data, subjects were given the opportunity to answer questions on up to
four drug experiences: (1) their “most intense” psychedelic experience; (2) a “typical” psychedelic experience;
(3) a “typical” cocaine experience; and (4) a “typical” alcohol experience. For psychedelic experiences
subjects could further specify the drug taken (options were: LSD, psilocybin, mescaline, DMT and ayahuasca).
For each experience subjects were asked to provide information on how long ago the experience was
(options were: “Today”, “Last week”, “1–4 weeks” ago, “1–6 months” ago, “6–12 months” ago, “1–5 years” ago,
“6–10 years” ago, and “Over 10 years” ago). They were also asked how “intense” the experience was (for
psychedelic experiences), or how “energized/wired” or “inebriated/drunk” they felt (for cocaine and alcohol
experiences, respectively) on a visual analog scale from 0 to 100, with 0 = “Not at all” and 100 = “The most
intense/energized/inebriated imaginable”. The rationale for enquiring about a typical and most intense
experience with psychedelics was to collect a greater range of possible responses with regards to
psychedelics, which was our primary drug class of interest.

For each experience subjects were also asked to state the dose of the drug taken. For psychedelic drugs,
subjects were asked to provide a “rough/ballpark” estimate using an LSD-equivalent dose; available options
We use ranged from
cookies on “No more
this website than half
to improve a tab/50
your user micrograms
experience. of (//www.frontiersin.org/legal/list-of-cookies)
Learn more LSD” to “More than 3 tabs/300 micrograms of LSD”, CLOSE
split into 5 non-overlapping groups. This was done with the aim of providing a standard reference against
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which any non-LSD classical psychedelic could be compared. For cocaine, the dose options available ranged
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from: “less than 1/8 gram” to “More than 2 grams”, split into six non-overlapping groups. For alcohol, the
dose options ranged from: “Less than 3 units” to “Over 24 units”, split into nine non-overlapping groups.

For each drug experience, subjects answered the question “Do you believe that the experience [induced by
the relevant drug] and your contemplation of that experience have led to a change in your current sense of
personal well-being or life satisfaction?” using a 7-point rating scale (+3 = “increased very much”; +2 =
“increased moderately”; +1 = “increased slightly”; 0 = “no change”; −1 = “decreased slightly”; −2 = “decreased
moderately”; and −3 = “decreased very much”), taken from the persisting effects questionnaire as per Barrett
et al. (2015).

Subjects then answered the 16 ego-consciousness items (Table 1) relating to each specific drug experience in
question. For experiences occasioned by psychedelic drugs, subjects additionally answered seven questions
selected from the Mystical Experiences Questionnaire (MEQ; MacLean et al., 2012; Barrett et al., 2015). The
seven
TABLE OFquestions
CONTENTS selected have been shown to load onto a single common factor denoting “Mystical”
experiences (Barrett et al., 2015), and all relate to the so-called “unitive” experience, which is considered to
Abstract
be a fundamental feature of the mystical experiences (Stace, 1960; Hood, 1975; James, 1985). The unitive
Introduction
experience is related to the notion of dissolved ego-boundaries, and it has been hypothesized (although never
formally
Materials andinvestigated) that the phenomenology of the unitive experience overlaps with that of ego-
Methods
dissolution (James, 1882; Leary et al., 1964; Grof, 1980; Harrison, 2010). The inclusion of the relevant MEQ
Results
questions in this survey allowed us to explicitly test this hypothesis, and provided a means of measuring the
convergent
Discussion validity of the ego-dissolution construct.
Author
The specific MEQ questions included, and their relevant MEQ30 identifiers (Barrett et al., 2015), were as
Contributions
follows: “Freedom from the limitations of your personal self and feeling a unity or bond with what was felt to
Funding
be greater than your personal self” [MEQ30 Q14], “Experience of oneness in relation to an ‘inner world’
within”
Con [MEQ30 Q20], “Experience of the fusion of your personal self into a larger whole” [MEQ30 Q26],
ict of Interest
Statement
“Experience of unity with ultimate reality” [MEQ30 Q28], “Feeling that you experienced eternity or infinity”
[MEQ30
Footnotes Q05], “Experience of oneness or unity with objects and/or persons perceived in your surroundings”
[MEQ30 Q06] and “Experience of the insight that ‘all is One”’ [MEQ30 Q18]. Each item was rated on a 6-point
References
scale, where 0 = “none, not at all”; 1 = “so slight cannot decide”; 2 = “slight”; 3 = “moderate”; 4 = “strong
(equivalent in degree to any previous strong experience or expectation of this description)”; and 5 = “extreme
(more than ever before in my life and stronger than four)”. This is consistent with the standard procedure for
completion of the MEQ.

Dissemination of the Survey


This study was approved by the local ethics committee. The survey was implemented and hosted by the
online service Survey Gizmo1, and was estimated to take 38 min to complete. Survey Gizmo has
comprehensive privacy policies and security features that maintain the anonymity of responses in line with
ethics requirements.

Participants were recruited to take the online survey via web-link advertisements posted on Facebook
groups, Twitter pages, email newsletters, and online drug forums with a short request (“please participate in
our anonymous online questionnaire designed to learn more about experiences with classical psychedelics,
cocaine, and alcohol”). Recruitment targeted online communities interested in psychoactive substances and
altered states of consciousness (e.g., Psychedelic Society2, and Multidisciplinary Association for Psychedelic
Studies3), as well as websites visited by more diverse populations, (e.g., Reddit4, and Mumsnet5). The
collection of IP addresses and geographical locations of participants was disabled and participants were
informed of the anonymity of their responses. After reading a summary of the inclusion criteria and
instructions, participants provided informed consent by clicking “next” on the first page of the questionnaire.

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Inclusion criteria for participants were: (1) at least 18 years of age; and (2) had had at least one experience
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with a classical psychedelic (LSD, psilocybin, DMT, ayahuasca or mescaline), cocaine, and/or alcohol. Data
(https://www.frontiersin.org)
collection occurred over a 4-week period.

Statistical Analysis

Factor Analysis and De nition of Ego-Dissolution Inventory

We defined a completed form as one in which the subject had answered all 16 ego-consciousness items
relating to at least one drug experience, and also provided information about the dose of drug taken, the
subjective intensity of the experience, and the effect on well-being.

Scores for the 16 ego-consciousness items for each complete form were subjected to an exploratory factor
analysis using the iterated principle axis factor method and an oblique (promax) rotation, which allowed
common factors to be correlated (Budaev, 2010). The appropriate number of factors to be extracted was
TABLE OF CONTENTS
determined by parallel analysis of principal components using 1000 random draws (Horn, 1965; O’Connor,
Abstract
2000) and Cattell’s scree plot criterion (Cattell, 1966). Based on the factor loadings (from the pattern matrix),
the 16 ego-consciousness
Introduction items could be easily separated into two 8-item scales reflecting “ego-dissolution”
and “ego-inflation”
Materials and experiences (full details in “Results” Section). The mean item scores for both the ego-
Methods
dissolution and ego-inflation scales were used as a measure of ego-dissolution and ego-inflation for all
subsequent
Results analysis.
Discussion
Reliability and Construct Validity
Author
Contributions
Internal consistency of the scales was assessed with Cronbach’s alpha (Cronbach, 1951). Convergent validity
Funding
of the ego-dissolution scale was assessed using the correlation with our MEQ-derived measure of unitive
experience
Con for psychedelic experiences. Discriminant validity was demonstrated firstly by the ability of an
ict of Interest
Statement
exploratory factor analysis to separate the eight ego-dissolution items from the eight ego-inflation items, and
secondly
Footnotes by demonstrating the specificity of ego-dissolution for the psychedelic experience over alcohol or
cocaine experiences (see “Relationship of Ego-Dissolution to Psychedelic Drugs and Persisting Effects”
References
Section).

Relationship of Ego-Dissolution to Psychedelic Drugs and Persisting E ects

The specificity of the relationship between ego-dissolution and experiences occasioned by classical
psychedelics was tested in three ways. Firstly we investigated the correlation between reported drug dose
and both ego-dissolution and ego-inflation for each drug class separately (where drug dose was defined as
the central value for the selected dose range for each experience). For each drug class the null hypothesis
that the dose-ego-dissolution and dose-ego-inflation correlations were equal was tested using a 2-tailed t-test
of the differences between dependent correlation coefficients (Field, 2013).

Secondly, we investigated the relationship between the reported subjective intensity of the experience and
ego-dissolution. Correlations between experience intensity and ego-experiences within a drug class were
investigated in an identical manner to the dose-response relationships. As ratings of subjective experience
intensity are theoretically comparable across drug classes (unlike drug doses) we were able to test the
hypothesis that the linear relationship between subjective intensity and ego-dissolution (or ego-inflation) was
different between psychedelic, cocaine and alcohol experiences by testing whether the slope of the linear
regression line relating subjective intensity (independent variable) to ego-dissolution or ego-inflation
(dependent variables) is significantly different between drug classes (using MATLAB’s aoctool [Analysis of
covariance (ANCOVA)] function [MATLAB 2015b, Mathworks]).

Finally, a Support Vector Machine (SVM) classifier (a common supervised machine learning algorithm) was
trained to distinguish between typical experiences with psychedelics, cocaine and alcohol using only the ego-
dissolution and ego-inflation score for each experience, in three binary one-v-one classification tasks
We use (psychedelic vs. cocaine,
cookies on this website psychedelics
to improve vs. alcohol,
your user experience. cocaine
Learn vs. alcohol). Only “typical” psychedelic
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were included in this analysis to avoid classification problems associated with numerically imbalanced
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classes (He and Garcia, 2009). The SVM classifier was implemented in MATLAB 2015b (Mathworks), as part of
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the Classification Learner application, with the following settings: 5-fold cross-validation, linear kernel,
standard normalization transformation applied to data before entering into SVM classifier.

The correlation between ego-dissolution or ego-inflation and reported changes in personal well-being was
compared both between and within drug classes using Fisher’s r-to-z transform and 2-tailed t-test,
respectively (Field, 2013).

Spearman’s rho was used to quantify all bivariate correlations. Statistical significance is defined as p < 0.05
(two-tailed). Multiple statistical comparisons were performed when analyzing the correlation between ego-
dissolution or ego-inflation and variables of interest (e.g., drug dose, experience intensity, or change in well-
being) separately for the three drug classes. In these instances, we applied Bonferroni correction for multiple
comparisons (specifically, six simultaneous comparisons) such that differences are deemed statistically
significant for p < 0.008. 95% confidence intervals were calculated using the bias corrected and accelerated
bootstrap
TABLE method
OF CONTENTS (1000 samples). All statistical analysis was performed using SPSS Statistics (IBM, Version
22), and MATLAB (MathWorks, Version 2015b including Statistics and Machine Learning Toolbox).
Abstract

Introduction
Results
Materials and
Methods

Results
Baseline Demographics of Survey Responders
Discussion
Six-hundred and ninety-one subjects completed the online survey. Table 2 summarizes the demographic
Author
information for these subjects. Each subject answered questions for a mean of 2.65 drug experiences (SD
Contributions
1.18), providing data for 1828 complete drug experiences for analysis (1043 were with psychedelic drugs: 584
Funding
relating to the most intense psychedelic experience and 459 relating to a typical psychedelic experience,
Con ict of Interest
occurring a median of 1–5 years and 6–12 months prior to survey completion, respectively. 377 were with
Statement
cocaine, occurring a median of 1–5 years prior to survey completion. 408 were with alcohol, occurring a
Footnotes
median of 1–4 weeks prior to survey completion).
References

Ego-Dissolution Inventory: Factor Structure and Internal Consistency


To investigate the factor structure of the 16 ego-consciousness items in a hypothesis-free manner, all
questions were submitted to an exploratory factor analysis. The Kaiser–Meyer–Olkin measure of sampling
adequacy was 0.918 and Bartlett’s test of sphericity was highly significant (χ2(120) = 22441.7, p < 0.001)
confirming that the data were indeed suitable for factor analysis (Budaev, 2010).

Both parallel analysis for principle components (Horn, 1965; O’Connor, 2000) and inspection of the scree plot
using Cattell’s criterion (Cattell, 1966) supported a model with two factors or components (parallel analysis
observed and 95% confidence interval simulated eigenvalues for the 3rd component were 1.04 and 1.12,
respectively). The first component explained 36.6% of the variance in the sample, and the second component
explained 29.5% of the variance in the sample. All other components explained <7% of the variance in the
sample.

The data were therefore subjected to an exploratory factor analysis to extract two common factors. Factor 1
comprised of the eight items relating to the experience of “ego-dissolution” whilst Factor 2 comprised of the
eight items relating to the experience of “ego-inflation”. Communality values (the proportion of an item’s
variance that can be explained by the extracted common factors) ranged from 39% to 82%. Every item loaded
strongly and exclusively onto either Factor 1 or Factor 2, demonstrating a simple and easily interpretable
factor structure (Table 1).

Guided by the results of the exploratory factor analysis, two 8-item scales were derived, one reflecting the
experience of “ego-dissolution”, and one reflecting the experience of “ego-inflation” (Table 1). Both scales had
excellent internal consistency (Cronbach’s alpha = 0.93 and 0.91, respectively; Cronbach, 1951). The mean
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and ego-inflation scale were almost perfectly correlated with the CLOSE
factor scores calculated using the regression method from the exploratory factor analysis output (both rho >
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0.99, p < 0.001). For ease of interpretability and replication, the mean item scores from the two scales were
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used as a measure of ego-dissolution and ego-inflation for all subsequent analysis.

Construct Validity
For experiences with psychedelic drugs, the score for the MEQ-derived measure of unitive experience
correlated strongly with ego-dissolution (rho = 0.735 [95% CI 0.704, 0.763], p < 0.001) providing a clear
demonstration of convergent validity. This measure of unitive experience also correlated positively with ego-
inflation (rho = 0.274 [0.219, 0.332], p < 0.001) but the strength of this correlation was significantly weaker
than that between unitive experience and ego-dissolution (t(1040) = 17.8, p < 0.001). In the exploratory factor
analysis, Factor 1 (“ego-dissolution”) and Factor 2 (“ego-inflation”) were essentially orthogonal (rho = −0.11),
demonstrating the discriminant validity of ego-dissolution and ego-inflation subscales.

Speci city of Ego-Dissolution for Psychedelic Drugs


TABLE OF CONTENTS

Abstract

Dose-Response
Introduction Relationship
Materials and
For experiences with psychedelic drugs, there was a significant positive correlation between reported drug
Methods
dose and ego-dissolution (rho = 0.371 [0.317, 0.427], p < 0.001), and only a weak correlation between reported
Results
drug dose and ego-inflation (rho = 0.063 [0.003, 0.127], p = 0.043), which did not survive correction for
Discussion
multiple comparisons (Figure 1A). The difference between these two correlations was significant (t(1040) =
8.55, p < 0.001).
Author Conversely, for cocaine, there was a significant and strong positive correlation between
Contributions
reported drug dose and ego-inflation (rho = 0.385 [0.390, 0.477], p < 0.001) but only a weak correlation
Funding
between drug dose and ego-dissolution (rho = 0.115 [0.012, 0.211], p = 0.026), which also did not survive
correction
Con for
ict of Interest multiple comparisons (Figure 1B). Again, the difference between these two correlations was
Statement
significant (t = 4.88, p < 0.001). For alcohol there was no dose-response relationship with either ego-
(374)
dissolution
Footnotes (rho = −0.055 [−0.150, 0.048], p = 0.266) or ego-inflation (rho = −0.054 [−0.148, 0.037], p = 0.328), and
no difference between these correlations (t(405) = 0.031, p = 0.488; Figure 1C).
References

FIGURE 1

(https://www.frontiersin.org/files/Articles/190474/fnhum-10-00269-HTML/image_m/fnhum-10-00269-
g001.jpg)
Figure 1. Relationship between drug dose and scores for ego-dissolution (blue circles, solid line) and
ego-inflation (red squares, dashed line) for experiences occasioned by different drug classes. (A)
Psychedelic experiences (n = 1043). (B) Cocaine experiences (n = 377). (C) Alcohol experiences (n = 408).
Lines represent linear regression lines of best fit, with corresponding R2 and p-value. Error bars represent
±1 SEM.

Intensity-Response Relationship

For experiences with psychedelic drugs, the subjective intensity of the experience was positively correlated
with both ego-dissolution (rho = 0.577 [0.529, 0.621], p < 0.001) and ego-inflation (rho = 0.099 [0.040, 0.159], p =
0.001), although the correlation with ego-dissolution was significantly stronger than that with ego-inflation
(t(1040) = 15.1, p < 0.001). The opposite pattern was observed for cocaine and alcohol experiences however,
where there was a significantly stronger correlation between the subjective intensity of these drug
experiences and ego-inflation (Cocaine: rho = 0.545 [0.464, 0.625], p < 0.001. Alcohol: rho = 0.502 [0.410, 0.582],
p < 0.001) than ego-dissolution (Cocaine: rho = 0.279 [0.180, 0.378], p < 0.001. Alcohol: rho = 0.334 [0.237,
0.421], p < 0.001); (t(374) = 5.33, p < 0.001, and t(405) = 4.03, p < 0.001, for cocaine and alcohol respectively).

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ANCOVA analysis was used to fit separate regression lines relating subjective intensity (predictor variable) to
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ego-dissolution or ego-inflation (dependent variables), for each drug class separately. This analysis confirmed
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that ego-dissolution experiences were significantly predicted by experience intensity (F(1,1822) = 528.4, MSE =
165132.7, p < 0.001), drug class (F(2,1822) = 636.39, MSE = 198863.7, p < 0.001), and the interaction between
subjective intensity and drug class (F(2,1822) = 116.29, MSE = 36338, p < 0.001). Follow-up multiple comparison
tests (Tukey’s HSD criterion) demonstrated that the slope of the regression line relating experience intensity
to ego-dissolution was significantly steeper for psychedelics (unstandardized regression coefficient = 0.701
[0.640, 0.762]), than for cocaine (0.135 [0.088, 0.182]) or alcohol (0.144 [0.098, 0.191], both p < 0.001). There
was no difference between the slopes of the regression lines relating experience intensity to ego-dissolution
for alcohol vs. cocaine (p = 0.984; Figure 2A).

FIGURE 2

TABLE OF CONTENTS
(https://www.frontiersin.org/files/Articles/190474/fnhum-10-00269-HTML/image_m/fnhum-10-00269-
g002.jpg)
Abstract
Figure 2. Relationship between experience intensity and ego-consciousness. (A) Linear regression lines
Introduction of best fit for relationship between reported subjective intensity and ego-dissolution for experiences
occasioned by psychedelic drugs (blue solid line, R2 = 0.328, p < 0.001), cocaine (red coarsely-broken line, R2
Materials and = 0.078, p < 0.001) or alcohol (black finely-broken line, R2 = 0.084, p < 0.001). (B) Linear regression lines of
Methods
best fit for relationship between reported subjective intensity and ego-inflation for experiences occasioned by psychedelic drugs (blue
solid line, R2 = 0.012, p < 0.001), cocaine (red coarsely-broken line, R2 = 0.318, p < 0.001) or alcohol (black finely-broken line, R2 = 0.213,
Results
p < 0.001).

Discussion

Author
Contributions
Ego-inflation experiences were also significantly predicted by subjective intensity (F(1,1822) = 229.16, MSE =
Funding
89120.9, p < 0.001), drug class (F(2,1822) = 278.5, MSE = 108309.5, p < 0.001) and the interaction between drug
Con ict of Interest
class and intensity (F(2,1822) = 61.16, MSE = 23785.8, p < 0.001). The slope of the regression line relating
Statement
experience intensity to ego-inflation, was, however, significantly shallower for psychedelics (0.096 [0.043,
Footnotes
0.149]) compared with cocaine (0.632 [0.538, 0.726], p < 0.001) and alcohol (0.439 [0.357, 0.521], p < 0.001), and
References
was steeper for cocaine than for alcohol experiences (p = 0.003; Figure 2B).

Support Vector Machine Classi er

As a final demonstration of the specificity of the ego-dissolution experience for psychedelic drugs, we trained
a SVM binary classifier to distinguish between typical psychedelic (n = 459), cocaine (n = 377) and alcohol (n =
408) drug experiences using only the ego-dissolution and ego-inflation scores. This classifier achieved an
accuracy of 90.1% when distinguishing between psychedelic vs. cocaine experiences (receiver-operator
characteristic (ROC) area under the curve (AUC) = 0.958), and 85.2% accuracy when distinguishing between
psychedelic and alcohol experiences (ROC AUC = 0.927). By contrast, it performed poorly when distinguishing
cocaine from alcohol experiences (63.4% accuracy, ROC AUC = 0.685). Classification at chance level is
equivalent to 50% accuracy and ROC AUC = 0.5. Figure 3 illustrates the relationship between ego-dissolution
and ego-inflation for experiences occasioned by different drugs.

FIGURE 3

(https://www.frontiersin.org/files/Articles/190474/fnhum-10-00269-HTML/image_m/fnhum-10-00269-
g003.jpg)
Figure 3. The relationship between ego-dissolution and ego-inflation for experiences occasioned by
classical psychedelics (blue crosses), cocaine (red circles) and alcohol (green triangles).

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Ego-Dissolution and Well-Being
As a final exploratory analysis, we sought to investigate the relationship between ego-experiences and the
extent to which the experience in question changed subjects’ current sense of personal well-being or life
satisfaction. For psychedelic drugs, the median response on the 7-point rating scale (with possible answers
from −3 to +3) was +2 (+2 = “Increased moderately”, interquartile range = 2, skewness = −0.769, median time
elapsed since experience = 1–5 years), which was significantly greater than the median response for cocaine
(0 = “No change”, interquartile range = 0, skewness −0.135, median time elapsed since experience = 1–5 years)
or alcohol (0 = “No change”, interquartile range = 0, skewness = −0.220, median time elapsed since experience
= 1–4 weeks; p < 0.001 for both comparisons, Wilcoxon rank sum test). The difference between the mean
change in well-being between cocaine and alcohol was not significant (p = 0.260, Wilcoxon rank sum test).

There was a trend for a positive correlation between ego-dissolution score and improvement in well-being
across
TABLE OF all drug classes,
CONTENTS with this effect reaching statistical significance after correction for multiple
comparisons only for experiences occasioned by psychedelic drugs (psychedelic: rho = 0.392 [0.342, 0.442], p
Abstract
< 0.001, cocaine: rho = 0.103 [−0.006, 0.204], p = 0.045; alcohol: rho = 0.084 [−0.009, 0.181], p = 0.091). This
Introduction
correlation was significantly stronger for psychedelic drugs compared with either cocaine (Z = 5.15, p < 0.001)
or alcohol
Materials and (Z = 5.63, p < 0.001), but did not differ between cocaine and alcohol drug experiences (Z = 0.267, p =
Methods
0.789).
Results
Ego-inflation was positively correlated with improvement in well-being for psychedelic drugs (rho = 0.198
Discussion
[0.135, 0.263], p < 0.001). There was a trend for a negative correlation between ego-inflation and well-being
Author
for experiences with cocaine and alcohol however, although these correlations were non-significant after
Contributions
correction for multiple comparisons (Cocaine: rho = −0.083 [−0.198, 0.027], p = 0.107. Alcohol: rho = −0.112
Funding
[−0.216, −0.014], p = 0.024). Whilst the correlation between ego-inflation and well-being was significantly
different
Con for psychedelic drugs compared with both cocaine (Z = 4.71, p < 0.001) and alcohol
ict of Interest (Z = 5.53, p <
Statement
0.001), it was not significantly different between cocaine and alcohol (Z = 0.408, p = 0.683).
Footnotes
For psychedelic experiences, the positive correlation between ego-dissolution and increase in well-being was
References
stronger than between ego-inflation and change in well-being (t(1040) = 5.48, p < 0.001). For both cocaine and
alcohol experiences, the negative correlation between ego-inflation and change in well-being was stronger
than the correlation between ego-dissolution and change in well-being (Cocaine: t(374) = 3.14, p = 0.001.
Alcohol: t(405) = 4.13, p < 0.001).

Discussion
The results presented in this study demonstrate the internal consistency, single-factor psychometric structure
and construct validity the EDI, a new 8-item self-report questionnaire designed to measure the experience of
ego-dissolution. Additionally, our results demonstrate that ego-dissolution positively correlates with drug
dose and experience intensity specifically for psychedelic drugs, compared with cocaine or alcohol
experiences. This result mirrors the previously demonstrated positive relationship between psilocybin dose
and altered states of consciousness, including “oceanic boundlessness” and “dread of ego dissolution” (as
measured by the 5D-ASC questionnaire; Hasler et al., 2004; Wittmann et al., 2007; Studerus et al., 2011) and
the mystical experience (Griffiths et al., 2011). Indeed, we also found a positive correlation between
psychedelic dose and unitive experience (rho = 0.307, p < 0.001).

The experience of a coherent and well-circumscribed self is a cardinal feature of adult human waking
consciousness (Carhart-Harris and Friston, 2010; Carhart-Harris et al., 2014). Conversely, the experience of
ego-dissolution is unfamiliar to most people, and is related to relatively rare altered states of consciousness,
such as the psychedelic experience (Huxley, 1954; Leary et al., 1964; Grof, 1980; Harrison, 2010; Carhart-Har-
ris et al., 2014; Lebedev et al., 2015) and the mystical experience (Stace, 1960; James, 1985). Despite the
relative rarity of the ego-dissolution experience, a fuller understanding of its neurobiological correlates may
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inform our understanding of the therapeutic mechanism of action of psychedelic drugs (Grof, 1980; Griffiths
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et al., 2008, 2011) and human consciousness more generally (Carhart-Harris et al., 2014). The development
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and validation of the EDI is an important contribution to this research programme.

An understanding of the neurobiological correlates of self-experience is also of great importance to a number


of mental health conditions, where the sense of self is disrupted or compromised (Northoff, 2014). A
disrupted sense of self has long been considered to be a core phenomenological feature of acute psychosis
(Federn, 1952; Laing, 1959; Fischman, 1983; Jaspers, 1997; Scharfetter, 1981; Nour and Barrera, 2015).
Recently this idea has been extended by Sass and Parnas (2003), who propose that the core
phenomenological alteration in schizophrenia is an “instability of pre-reflective self-awareness”, which has
been termed an “ipseity-disorder” or “self-disorder” (Sass et al., 2011). They argue that saturating all
subjective experience is a pre-reflective awareness of self as the unified subject of experience (Sass and
Parnas, 2003). This notion is closely related to the feeling of inhabiting a living body embedded in the world
(Stanghellini, 2009). As the pre-reflective sense of self is related to a feeling of immersion in a social world,
ipseity disturbance may also result in the deficits in social cognition seen in patients (Parnas and Bovet, 1991;
TABLE OF CONTENTS
Stanghellini, 2001, 2009; Nelson et al., 2009; Nordgaard and Parnas, 2014; Nour and Barrera, 2015). Further
research
Abstract is required to clarify the relationship between the self-disturbances seen in schizophrenia and
psychedelic states, as well as the relationship between other features of the psychedelic state and psychosis
Introduction
(Corlett et al., 2009).
Materials and
Methods
Our results represent a necessary step in the demonstration of the construct validity of ego-dissolution.
Results
Construct validity can be decomposed into discriminant and convergent validity. Discriminant validity of the
EDI was
Discussion demonstrated by the fact that items relating to ego-dissolution and those relating to ego-inflation
loaded onto two orthogonal factors in the exploratory factor analysis. Convergent validity of the EDI was
Author
demonstrated
Contributions by the strong positive correlation between EDI and our (MEQ-based) measure of the unitive
experience. This suggests that experiences of ego-dissolution, unity and dissolved ego-boundaries may be
Funding
conceptually inseparable (Federn, 1952; Savage, 1955; Fischman, 1983), occurring together during “peak”
Con ict of Interest
psychedelic experiences.
Statement Consistent with this hypothesis, the item “I felt at one with the universe” loaded
particularly strongly on the “ego-dissolution” factor (0.830), together with items explicitly referring to
Footnotes
“dissolution” and “disintegration” of self or ego (0.883 and 0.897, respectively).
References
Our measure of ego-inflation, in contrast to ego-dissolution, showed a significant dose-response relationship
with cocaine, but not psychedelics or alcohol. Although all three drug classes showed a positive correlation
between ego-inflation and experience intensity, this relationship was strongest for cocaine and weakest for
psychedelic drugs. These results suggest that experiences occasioned by cocaine are in some sense
antithetical to the psychedelic experience; with cocaine seeming to promote self-centeredness rather than the
selflessness associated with psychedelics.

Consistent with this hypothesis, a binary SVM classifier was able to identify experiences occasioned by
psychedelic drugs vs. cocaine or alcohol with over 85% accuracy using the ego-dissolution and ego-inflation
scores alone. This machine-learning approach may be usefully applied in a number of contexts. For example,
it may help to inform debates over whether hybrid compounds such as 3,4-
methylenedioxymethamphetamine (MDMA) should be classed as “ego-dissolving” psychedelic-like agents,
“ego-inflating” stimulant-like agents, both, or neither. Moreover, used in conjunction with neurobiological
measures, such as neuroimaging, these tools may help us to identify key (defining) properties of different
psychoactive drugs, as well as non-drug-induced states, in a data-driven manner, and may inform novel
hypotheses concerning the endogenous role of 5-HT2A receptors. This may help us to address questions
regarding the similarities and differences of different altered states of consciousness such as dreaming,
psychosis and the psychedelic state (Carhart-Harris, 2007). More generally, our results suggest that the
specific way in which a drug disturbs ego-consciousness may inform a novel phenomenologically-based
classification system for psychoactive substances.

Subjects in the present study reported that on average their reported experiences with psychedelic drugs had
a positive and lasting impact on their well-being, which correlated positively with the degree of ego-
dissolution experienced (rho = 0.392). This is consistent with previous work, which has established that
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mystical (or “peak”) experiences occasioned by psilocybin correlate positively with increases in “openness”
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(MacLean et al., 2011), well-being (Barrett et al., 2015), and the meaningfulness/spiritual significance of the
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experience (Griffiths et al., 2008). Similarly, one influential model of LSD therapy states that the experience of
“ego death and … loss of boundaries between the subject and the objective world, with ensuing feelings of
unity” is of great therapeutic benefit (Grof, 1980). Moreover, lifetime psychedelic use has been associated
with reduced odds ratio of psychological distress, suicidality and certain mental health problems in large
population samples (Krebs and Johansen, 2013; Hendricks et al., 2015; Johansen and Krebs, 2015).

Regarding the neurobiology of the psychedelic state, previous work has indicated that psychedelics disrupt
the integrity of the default-mode network (DMN), a normally well-integrated network of (mostly cortical)
brain regions that display high metabolic demands, “connector-hub” status and appear to be involved in
high-level functions such as the processing of self-specific information (Qin and Northoff, 2011; Buckner,
2013; Speth et al., 2016). Psilocybin and DMT-containing ayahuasca decrease functional connectivity between
key DMN hub regions (Carhart-Harris et al., 2012; Muthukumaraswamy et al., 2013; Palhano-Fontes et al.,
2015). Psilocybin and LSD also disrupt the functional segregation between usually well-demarcated brain
TABLE OF CONTENTS
networks, promoting increased global integration (Carhart-Harris et al., 2013; Roseman et al., 2014), which
correlates
Abstract with ego-dissolution (Tagliazucchi et al., 2016). Disrupted integrity of the DMN and reduced
anticorrelation between DMN and task-positive network activity may facilitate a less constrained style of
Introduction
cognition and a weakening of the feeling of a well-circumscribed self. This may be a psychological
Materials and
consequence
Methods of a less constrained (more entropic) style of brain activity and a “collapse” in the normal
hierarchical
Results organization of cortical circuits, which normally functions to finesse perception and cognition
by minimizing uncertainty (Hohwy, 2007; Carhart-Harris and Friston, 2010; Friston, 2010; Carhart-Harris et
Discussion
al., 2014; Roseman et al., 2014; Tagliazucchi et al., 2014; Nour and Nour, 2015).
Author
These previous
Contributions experimental findings suggest that the integrity of the DMN may be important for normal
self-experience (Qin and Northoff, 2011; Carhart-Harris et al., 2014). Relatively few studies have explicitly
Funding
investigated the neural correlates of ego-dissolution experiences occasioned by psychedelic drugs. Muthuku-
Con ict of Interest
maraswamy et
Statement al. (2013) found that the experience of ego-disintegration occasioned by psilocybin correlated
with decreased alpha power in the posterior cingulate cortex, a DMN hub region, using
Footnotes
magnetoencephalography (MEG). Lebedev et al. (2015) by contrast, found that ego-dissolution correlated with
References
decreased functional connectivity between the anterior parahippocampal cortex and higher-level cortical
DMN regions as well as decreased (within-network) integrity of the salience network, and reduced inter-
hemispheric communication.

A recent study found that the degree of ego-dissolution occasioned by LSD was correlated with global
functional connectivity (“Functional Connectivity Density”, as measured by functional magnetic resonance
imaging (fMRI)) in bilateral temporo-parietal junction (angular gyrus) and bilateral insular cortex (Tagliazuc-
chi et al., 2016). More generally, this study reported that LSD induced increases in global connectivity in more
widespread high-level association cortices, which overlap substantially with the default mode network. A
separate analysis of the same fMRI data further revealed that ego-dissolution showed a strong inverse
correlation with DMN network integrity (measured as within-network resting state functional connectivity),
and functional connectivity between the parahippocampus and retrosplenial cortex (Carhart-Harris et al.,
2016). Moreover, significant relationships were found between ego-dissolution and decreased delta and
alpha power (e.g., in posterior cingulate cortex) as measured by MEG (Carhart-Harris et al., 2016), replicating
previous findings with psilocybin (Muthukumaraswamy et al., 2013).

One limitation of these studies is that they either used a single-item measure of ego-dissolution (Muthuku-
maraswamy et al., 2013; Carhart-Harris et al., 2016; Tagliazucchi et al., 2016), or principle component analysis
loadings from an (as yet) unvalidated questionnaire which included items indirectly related to ego-
dissolution (e.g., perceptual abnormalities; Lebedev et al., 2015). Thus, the validated EDI allows for a more
rigorous study of the neural correlates of ego-dissolution experienced in a number of altered states of
consciousness, including those associated with psychedelic drugs and spiritual practice.

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The present study has some limitations. Firstly, the population sampled was fairly homogenous, which limits
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the study’s external validity, and thus our ability to extrapolate to a broader demographic. Specifically, most
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of our subjects were male, under the age of 30, and had at least some university education. Over half the
subjects had used classical psychedelic drugs on over 10 occasions. This also raises the possibility that our
subjects’ responses were biased by their familiarity with reports about paradigmatic features of the
psychedelic experience, such as ego-dissolution. Moreover, we did not collect information on the setting in
which the psychedelic experiences took place, which is known to influence the quality of the experience
(Leary et al., 1964; Grof, 1976; Fischman, 1983). Another important limitation of our study is its retrospective
design, which introduces potential inaccuracies in experience recall. We employed an anonymous internet
questionnaire design to facilitate the collection of a large data sample of subjects from around the world.
Although this approach has its strengths, it is impossible to verify that the experiences attributed to
psychedelics were indeed caused by these substances. Finally, we asked subjects to estimate the dose of
psychedelic ingested using “LSD-equivalent” doses, so as to more easily investigate dose-response
relationships across different classical psychedelics. The inaccuracy introduced by this approach, however, is
likelyOFtoCONTENTS
TABLE have weakened, rather than strengthened, any observed dose-response relationship between
psychedelics and ego-dissolution.
Abstract
Given these
Introduction limitations, future studies should include a more heterogeneous sampling population, perhaps
by intentionally recruiting subjects from different cultural and religious backgrounds, to explore the
Materials and
influence of
Methods these factors on ego-dissolution. It would also be of interest to investigate the relationship
between
Results responses on the EDI and other validated scales, for example the 5D-ASC (Studerus et al., 2010).
Finally, experimental studies in which a range of psychedelic drug doses are administered to subjects in a
Discussion
blinded manner would be able to assess how subject-specific factors influence the relationship between dose
Author
and subjective effects, whilst controlling for recall effects and the effect of setting.
Contributions
In conclusion,
Funding the present study offers initial-phase validation of the EDI, and adds to the growing evidence
that ego-dissolution is a key phenomenological feature of the psychedelic experience, which may be studied
Con ict of Interest
experimentally.
Statement The existence of the EDI will facilitate future research into the neural correlates of this
experience, which is of relevance for psychedelic-assisted psychotherapy and the phenomenology of certain
Footnotes
psychiatric conditions.
References

Author Contributions
MMN and RLC-H conceived of and designed this study and interpreted the results; contributed to drafting the
work and revised it critically for important intellectual content. All authors approved the final version of this
manuscript to be published and agreed to be accountable for all aspects of the work in ensuring that
questions related to the accuracy or integrity of any part of the work be appropriately investigated and
resolved. MMN and LE undertook statistical analysis of the data. LE managed the implementation of the
questionnaire and subsequent data collection. MMN wrote the article, with editing from RLC-H.

Funding
MMN is funded by the Medical Research Council, UK. RLC-H is funded by Mosley Foundation. DN is funded by
Safra Foundation.

Con ict of Interest Statement


The authors declare that the research was conducted in the absence of any commercial or financial
relationships that could be construed as a potential conflict of interest.

Footnotes
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1. ^ www.surveygizmo.eu/ (http://www.surveygizmo.eu/)
2. ^ www.psychedelicsociety.org.uk (http://www.psychedelicsociety.org.uk)
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3. ^ www.maps.org (http://www.maps.org)
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4. ^ https://www.reddit.com/ (https://www.reddit.com/)
5. ^ www.mumsnet.com/ (http://www.mumsnet.com/)

References
Barrett, F. S., Johnson, M. W., and Griffiths, R. R. (2015). Validation of the revised mystical experience questionnaire in experimental sessions
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Con ict of Interest
el+of+the+mind&author=Carhart-Harris+R.&publication_year=2007&journal=Neuropsychoanal.&volume=9&pages=183-211)
Statement
Carhart-Harris, R. L., Erritzoe, D., Williams, T., Stone, J. M., Reed, L. J., Colasanti, A., et al. (2012). Neural correlates of the psychedelic state as
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TABLE OF CONTENTS

Krebs, T. S., and Johansen, P.-Ø. (2013). Psychedelics and mental health: a population study. PLoS One 8:e63972. doi:
Abstract
10.1371/journal.pone.0063972

Introduction
PubMed Abstract (http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=23976938) | CrossRef Full
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Materials and
title=Psychedelics+and+mental+health%3A+a+population+study&author=Krebs+T.+S.&author=Johansen+P.-
Methods
Ø.&publication_year=2013&journal=PLoS+One&volume=8&pages=e63972)

Results
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Discussion
Classics.
Author
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Funding
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Con ict of Interest
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Statement
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Keywords: ego dissolution, ego disintegration, ego death, psychedelic, self disturbance, ego boundaries, mystical experience, hallucinogen

Citation: Nour MM, Evans L, Nutt D and Carhart-Harris RL (2016) Ego-Dissolution and Psychedelics: Validation of the Ego-Dissolution Inventory (EDI). Front.
Hum. Neurosci. 10:269. doi: 10.3389/fnhum.2016.00269

Received: 18 February 2016; Accepted: 20 May 2016;


Published: 14 June 2016.

Edited by:
Isadora Olivé (https://loop.frontiersin.org/people/40336/overview), Université Vincennes Saint Denis Paris 8, France

Reviewed by:
Philip R. Corlett (https://loop.frontiersin.org/people/4515/overview), Yale University, USA
Matthew W. Johnson (https://loop.frontiersin.org/people/337263/overview), Johns Hopkins University, USA

Copyright © 2016 Nour, Evans, Nutt and Carhart-Harris. This is an open-access article distributed under the terms of the Creative Commons Attribution Li-
cense (CC BY) (http://creativecommons.org/licenses/by/4.0/). The use, distribution and reproduction in other forums is permitted, provided the original
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