Background: The classical psychedelics, psilocybin, peyote, ayahuasca/ N,N-dimethyltryptamine, and lysergic acid diethylamide are considered promising new treatments for psychiatric illnesses, such as depression, anxiety, addiction, and obsessive-compulsive disorders. However, their profound and characteristic subjective effects raise concern for distinctive biases in randomized clinical trials. Methods: We performed a systematic literature search to identify all clinical trials on classical psychedelics with patient populations to examine descriptive data and determine the risk of bias. Two independent reviewers searched three databases (PubMed, Embase, and APA PsycNet) and extracted information on study design, study population, use of active or inactive placebo, dropouts, evaluation of blinding of intervention, and reporting of expectancy and therapeutic alliance. Results: We included 10 papers reporting on 10 unique trials. The trials generally included populations that were predominantly white and highly educated. The trials had small samples and considerable dropout. Blinding was either unsuccessful or not reported regardless of type of placebo. Few trials published protocols, statistical analysis plans (SAPs), and outcomes relating to psychotherapy fidelity. All trials but one were rated as high risk of bias. Conclusion: Successful blinding of intervention is a significant challenge in this field. To better accommodate this, we suggest that future trials use a parallel-group design and utilize an active placebo on a psychedelic-naïve population. Future trials should publish trial protocol and SAPs, use clinician-rated outcomes accessed by a blinded rater, evaluate blinding of intervention, and consider measuring expectancy and therapeutic fidelity.
As adults, not only do we choose what we prefer, we also tend to adapt our preferences according to our previous choices. We do this even when our choices were blind and we could not have had any previous preference for the option we chose. These blind choice-induced preferences are thought to result from cognitive dissonance as an effort to reconcile our choices and values. In the present preregistered study, we asked when this phenomenon develops. We reasoned that cognitive dissonance may emerge around 2 years of age in connection with the development of children's self-concept. We presented N=200 children aged 16 to 36 months with a blind choice between two toys, and then tested whether their choice had induced a preference for the chosen, and a devaluation of the discarded, toy.Indeed, children's choice-induced preferences substantially increased with age. 26-to 36-months-old children preferred a neutral over the previously blindly discarded toy, but the previously chosen over the neutral toy, in line with cognitive dissonance predictions. Younger infants showed evidence against such blind choice-induced preferences, indicating its emergence around 2 years of age. Contrary to our hypotheses, the emergence of blind choice-induced preferences was not related to measures of selfconcept development in the second year of life. Our results suggest that cognitive dissonance develops around 2 years. We speculate about cognitive mechanisms that underlie this development, including later-developing aspects of the self-concept and increasingly abstract representational abilities.
When infants start mastering their first language, they may start to notice when words are used incorrectly. Around 14-months of age, infants detect incorrect labeling when they are presented with an object which is labeled while still visible. However, things that are referred to are often out of sight when we communicate about them. The present study examined infants’ detection of semantic mismatch when the object was occluded at the time of labeling. Specifically, we investigated whether mislabeling that referred to an occluded object could elicit a semantic mismatch. We showed 14-month-old Danish-speaking infants events where an onscreen agent showed an object and then hid it in a box. This was followed by another agent’s hand pointing at the box, and a concurrent auditory category label played, which either matched or did not match the hidden object. Our results indicate that there is an effect of semantic mismatch with a larger negativity in incongruent trials. Thus, infants detected a mismatch, as indicated by a larger n400, when occluded objects were mislabeled. This finding suggests that infants can sustain an object representation in memory and compare it to a semantic representation of an auditory category label.
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