Turn on, Tune in, and Drop out: Predictors of Attrition in a Prospective Observational Cohort Study on Psychedelic Use

Abstract

Background The resurgence of research and public interest in the positive psychological effects of psychedelics, together with advancements in digital data collection techniques, have brought forth a new type of research design, which involves prospectively gathering large-scale naturalistic data from psychedelic users; that is, before and after the use of a psychedelic compound. A methodological limitation of such studies is their high attrition rate, particularly owing to participants who stop responding after initial study enrollment. Importantly, study dropout can introduce systematic biases that may affect the interpretability of results. Objective Based on a previously collected sample (baseline n=654), here we investigated potential determinants of study attrition in web-based prospective studies on psychedelic use. Methods Logistic regression models were used to examine demographic, psychological trait and state, and psychedelic-specific predictors of dropout. Predictors were assessed 1 week before, 1 day after, and 2 weeks after psychedelic use, with attrition being defined as noncompletion of the key endpoint 4 weeks post experience. Results Predictors of attrition were found among demographic variables including age (β=0.024; P=.007) and educational levels, as well as personality traits, specifically conscientiousness (β=–0.079; P=.02) and extraversion (β=0.082; P=.01). Contrary to prior hypotheses, neither baseline attitudes toward psychedelics nor the intensity of acute challenging experiences were predictive of dropout. Conclusions The baseline predictors of attrition identified here are consistent with those reported in longitudinal studies in other scientific disciplines, suggesting their transdisciplinary relevance. Moreover, the lack of an association between attrition and psychedelic advocacy or negative drug experiences in our sample contextualizes concerns about problematic biases in these and related data.

Decreases in State and Trait Anxiety Post-psilocybin: A Naturalistic, Observational Study Among Retreat Attendees

“…The concern of such dropouts is that they could create problematic biases in the data, with for example only those individuals experiencing benefits from the experience being motivated to continue responding to the questions. A recent study investigating potential determinants of study attrition in web-based prospective studies on psychedelic use identified that baseline predictors of attrition (i.e., age, educational levels, and personality traits) were consistent with those reported in longitudinal studies in other scientific disciplines, suggesting their transdisciplinary relevance (80). Moreover, they did not find an association between attrition and psychedelic advocacy or negative drug experiences, advocating against the concerns about problematic biases in these and related data.…”

“…Finally, we ran an exploratory analysis (independent sample t -tests and chi-square tests) with a twofold purpose: (1) to examine if there are differences between psilocybin-naïve and experienced participants on the anxiety measures (both state and trait anxiety); (2) to assess attrition factors for variables that have previously found to be significant in similar studies [i.e., demographic variables and personality traits; ( 80 )], as well as study-specific factors of interest [i.e., baseline anxiety levels (state and trait) and acute drug effects (EDI scores)].…”

Validation of the Psychological Insight Scale: A new scale to assess psychological insight following a psychedelic experience

“…Greater efforts should be made in future studies to both minimise attrition rates and assess what factors are contributing to them, as done here (Hübner et al, 2021). Fortunately, initial explorations of potential attrition bias in the present datasets have generally been reassuring.…”

Sustained, Multifaceted Improvements in Mental Well-Being Following Psychedelic Experiences in a Prospective Opportunity Sample

“…This question is important, not least because of considerations of efficiency in the design of future studies, where, for example, the number of questionnaires could be reduced to just a few, sensitive but sufficiently orthogonal and therefore complementary ones. This issue is particularly relevant in prospective web-based surveys where high attrition rates due to participant burden are a common problem (84,106).…”