## Summary: The Challenging Experience Questionnaire (CEQ) assesses adverse reactions during hallucinogenic experiences, particularly with psilocybin mushrooms. The assessment identifies seven factors of challenging experiences: grief, fear, death, insanity, isolation, physical distress, and paranoia. It is used to evaluate the difficulty, meaning, spiritual significance, and the impact on an individual's well-being. The CEQ aids in understanding the predictors and outcomes of difficult psychedelic experiences and has applications in research and therapy.
## Instructions: Clinicians administering the Challenging Experience Questionnaire (CEQ) should follow these steps: - Confirm that the individual has had a psilocybin mushroom experience. - Ensure the individual is in a stable mental state and has had time to reflect on their experience. - Instruct the individual to recall the intensity of sensations and emotional states during the experience. You can say the following: “Looking back on the entirety of your session, please rate the degree to which at any time during that session you experienced the following phenomena. Answer each question according to your feelings, thoughts, and experiences at the time of the session.” - Use the quantified data to provide context in both clinical and research settings. Adherence to these guidelines will ensure effective and accurate use of the CEQ.
## Scoring Methodology: The Challenging Experience Questionnaire (CEQ) involves the following scoring procedures: - Utilize the established seven-factor model that includes grief, fear, death, insanity, isolation, physical distress, and paranoia. Grief: 2, 6, 9, 11, 23, 25 Fear: 4, 7, 14, 21, 26 Physical Distress: 3, 5, 15, 17, 18 Insanity: 8, 13, 19 Isolation: 1, 10, 24 Death: 16, 20 Paranoia: 12, 22 - Score responses based on these factors to gauge the overall challenge, meaning, and the resulting impact on well-being. - The validated factor structure is consistent and unaffected by gender or past mental health history. These scores provide a quantifiable measure of challenging psychedelic experiences.
## Authors and Citations: - Authors: Frederick S. Barrett, Matthew P. Bradstreet, Jeannie-Marie S. Leoutsakos, Matthew W. Johnson, Roland R. Griffiths - Affiliation: Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine - Citation: Barrett FS, Bradstreet MP, Leoutsakos JM, Johnson MW, Griffiths RR. The Challenging Experience Questionnaire: Characterization of challenging experiences with psilocybin mushrooms. J Psychopharmacol. 2016; 30(12): 1279-1285. DOI: 10.1177/0269881116678781. The aforementioned details are imperative for referencing the CEQ in academic contexts.
Item # | Subscale | Item description | None / Not at all | So slight cannot decide | Slight | Moderate | Strong | Extreme (more than ever before in my life) |
1 | Is | Isolation and loneliness | 0 | 1 | 2 | 3 | 4 | 5 |
2 | S | Sadness | 0 | 1 | 2 | 3 | 4 | 5 |
3 | PD | Feeling my heart beating | 0 | 1 | 2 | 3 | 4 | 5 |
4 | F | I had the feeling something horrible would happen | 0 | 1 | 2 | 3 | 4 | 5 |
5 | PD | Feeling my body shake/tremble | 0 | 1 | 2 | 3 | 4 | 5 |
6 | S | Feelings of grief | 0 | 1 | 2 | 3 | 4 | 5 |
7 | F | Experience of fear | 0 | 1 | 2 | 3 | 4 | 5 |
8 | In | Fear that I might lose my mind or go insane | 0 | 1 | 2 | 3 | 4 | 5 |
9 | S | I felt like crying | 0 | 1 | 2 | 3 | 4 | 5 |
10 | Is | Feeling of isolation from people and things | 0 | 1 | 2 | 3 | 4 | 5 |
11 | S | Feelings of despair | 0 | 1 | 2 | 3 | 4 | 5 |
12 | P | I had the feeling that people were plotting against me | 0 | 1 | 2 | 3 | 4 | 5 |
13 | In | I was afraid that the state I was in would last forever | 0 | 1 | 2 | 3 | 4 | 5 |
14 | F | Anxiousness | 0 | 1 | 2 | 3 | 4 | 5 |
15 | PD | I felt shaky inside | 0 | 1 | 2 | 3 | 4 | 5 |
16 | D | I had the profound experience of my own death | 0 | 1 | 2 | 3 | 4 | 5 |
17 | PD | I felt my heart beating irregularly or skipping beats | 0 | 1 | 2 | 3 | 4 | 5 |
18 | PD | Pressure or weight in my chest or abdomen | 0 | 1 | 2 | 3 | 4 | 5 |
19 | In | I experienced a decreased sense of sanity | 0 | 1 | 2 | 3 | 4 | 5 |
20 | D | I felt as if I was dead or dying | 0 | 1 | 2 | 3 | 4 | 5 |
21 | F | Panic | 0 | 1 | 2 | 3 | 4 | 5 |
22 | P | Experience of antagonism toward people around me | 0 | 1 | 2 | 3 | 4 | 5 |
23 | S | Despair | 0 | 1 | 2 | 3 | 4 | 5 |
24 | Is | I felt isolated from everything and everyone | 0 | 1 | 2 | 3 | 4 | 5 |
25 | S | Emotional and/or physical suffering | 0 | 1 | 2 | 3 | 4 | 5 |
26 | F | I felt frightened | 0 | 1 | 2 | 3 | 4 | 5 |