October 26, 2016

Questionnaires

The selection of Questionnaires for the ASDB

An intensive analysis on scientific literature about altered states of consciousness was conducted. We identified multiple questionnaires that have been used in research. Different questionnaires measure different aspects of  altered states experiences. We selected those questionnaires that allow comparisons between altered states induced by different methods.

Background information

Over the last decades, it has been the gold standard to assess altered states experiences by self-report questionnaires and structured interviews. Multiple psychometric tools were applied to assess experimentally induced ASCs and related naturally occurring phenomena. In this context, a questionnaire has to be intended as a research instrument composed of a series of written questions designed to gather information from respondents to categorize different behaviors, traits, or conditions. Despite some limitations congenital in the nature of such instruments, the choice of investigating aspects of consciousness by means of these tools relies on the fact that by asking the same questions to a target population it allows meaningful quantification of the collected answers. Specifically, the obtained results can be easily used to analyze and compare the views of the respondents and to draw more general interpretations.


Procedure to identify Questionnaires for the ASDB:

  • A systematic literature research was performed into psychometric tools which assess the subjective experience during ASCs. Based on overviews by Passie (2007), Yeginer (2000), and MacKillop & de Wit (2013) an extensive list was compiled.
  • To identify relevant questionnaires, first the conceptual framework was evaluated to (i) cover a broad spectrum of phenomena and to (ii) aim at comparing different induction methods.
  • Trait questionnaires were excluded as not being relevant for the database.
  • For the resulting N=9 questionnaires and corresponding versions all items (N>2000) were collected and available reliability and validity measures were assessed.
  • Finally, the prevalence in the literature was evaluated by MEDLINE queries to yield unbiased suggestions for application in future research.

Information to interpret the reported questionaire data

The following information on the questionnaires should help to interprete the data presented in the ASDB

ARCI

The original form of the Addiction Research Center Inventory has been developed in the attempt to measure a broad range of physical, emotive, cognitive, and subjective effects of different drugs, and subjective experiences related to personality and psychiatric disorders. Its long version consisting of a total of 550 items has been frequently used only in respect to some relevant scales specific for the purpose of the study. Through its availability in different languages the ARCI became a common instrument to measure drug effects mainly in clinical settings but also in experimental research. The current version of the questionnaire, including 49 items clustered into five group variability scales, has become the most established short form.

Amphetamine scale: Items included in this scale describe general effects normally induced by stimulants such as amphetamine  (e.g. I feel more excited than dreamy; I feel very patient.; I feel like avoiding people although I usually do not feel this way.; It seems harder than usual to move around.)
Benzedrine scale: Items clustered in this scale depict effects induced by benzedrine (e.g. My memory seems sharper to me than usual.; Answering these questions was very easy today.; I feel as if I could write for hours.)
LSD scale: Items belonging to this scale characterize the typical effects induced by administration of psychedelic drugs (e.g. Some parts of my body are tingling.; I have a weird feeling.; I feel anxious and upset.)
Morphine-Benzedrine scale: Items clustered in this scale report effects induced by opiate drugs such as morphine (e.g. I feel in complete harmony with the world and those about me; I feel so good that I know other people can tell it; I would be happy all the time if I felt as I do now.)
Pentobarbital-Chlorpromazine-Alcohol (PCAG)PCAG scale: Items grouped in this dimension describe typical effect such as sleepiness and movement impairments induced by barbiturate and antipsychotic drugs as well as by alcohol  (e.g. My speech is slurred.; It seems harder than usual to move around.; I am full of energy.)

APZ(3D)

The Abnormal Mental States Questionnaire relies on assumptions and evidences that ASC share a common core, and therefore it aims to map the characteristics of such experiences invariant across conditions. This first form of the questionnaire includes a total of 72 items derived from self-reports and subsequently clustered in three common dimensions:

Oceanic Boundlesness (OBN): Items clustered in the OBN dimension measure the positive symptoms of dissolution of boundaries between self and surroundings. In general, they describe common states that can be compared to a mystical experience.(e.g. I had the feeling everything around me was somehow unreal; The boundary between myself and my surroundings seemed to blur; I felt totally free and released from all responsibilities.) GERMAN: Ozeanische Selbstentgrenzung (OSE).
Dread of Ego Dissolution (DED): Items clustered in the DED dimension measure the negative symptoms of dissolution of boundaries between self and surroundings. The common state depicted by this list of items can be interpreted as an experience of depersonalization.(e.g. I had difficulty in distinguishing important from unimportant things; My thinking was constantly being interrupted by insignificant thoughts; My own feelings seemed strange to me, as though they did not belong to me.) Alternative naming: Anxious Ego Dissolution (AED), GERMAN: Angstvolle Ichauflösung (AIA)
Visual restructuralization (VRS): Items clustered in the VRS dimension measure both changes in perception as well as in imagination (e.g. I saw lights or flashes of light in total darkness or with closed eyes; I saw scenes rolling by like in a film in total darkness or with my eyes closed; Objects around me engaged me emotionally much more than usual.) GERMAN: Visionäre Umstrukturierung (VUS)

5D-ASC(3D-OAV+2D)

This refined version of the questionnaire consists of a total of 94 items to which two additional empirically derived scales were added (AUA and VIR):

Oceanic Boundlesness (OBN): Items (e.g. I had the feeling everything around me was somehow unreal; The boundary between myself and my surroundings seemed to blur; I felt totally free and released from all responsibilities. ) clustered in the OBN dimension measure the positive symptoms of dissolution of boundaries between self and surroundings. In general, they describe common states that can be compared to a mystical experience. GERMAN: Ozeanische Selbstentgrenzung (OSE).
Dread of Ego Dissolution (DED): Items (e.g. I had difficulty in distinguishing important from unimportant things; My thinking was constantly being interrupted by insignificant thoughts; My own feelings seemed strange to me, as though they did not belong to me. ) clustered in the DED dimension measure the negative symptoms of dissolution of boundaries between self and surroundings. The common state depicted by this list of items can be interpreted as an experience of depersonalization. Alternative naming: Anxious Ego Dissolution (AED), GERMAN: Angstvolle Ichauflösung (AIA)
Visual restructuralization (VRS): Items (e.g. I saw lights or flashes of light in total darkness or with closed eyes; I saw scenes rolling by like in a film in total darkness or with my eyes closed; Objects around me engaged me emotionally much more than usual.) clustered in the VRS dimension measure both changes in perception as well as in imagination. GERMAN: Visionäre Umstrukturierung (VUS)
Auditory Alterations (AUA): Items (e.g. A voice commented on everything I thought although no one was there; I heard complete sentences without knowing where they came from; I heard music without knowing where it came from) clustered in the AUA dimension measure specific changes in auditory perception, as for example hallucinations. GERMAN: Auditive Veränderung (AVE)
Vigilance Reduction (VIR): Items (e.g. My thoughts and actions were slowed down; I felt sleepy; I felt drunk.) clustered in the VIR dimension measure drowsiness or clouding of consciousness. GERMAN: Vigilanz Reduktion (VR)

5D-ASC (11D + 2D)

This is the same questionnaire as the 5D-ASC(3D-OAV+2D), however, it is analyzed in a different way. That is, items are combined to ‘more basic’ dimensions of consciousness:
Spiritual Experience: Items clustered in this scale describes typical traits of spiritual experiences, such as a new deep understanding regarding truth or other religious expression. (e.g. My experience had religious aspects to it; I felt connected to a higher power; My experience had religious aspects.)
Impaired Control and Cognition: Items belonging to this scale characterise important defect in cognitive abilities as well as in self-control. (e.g. I had the feeling that I no longer had my own will.; I had difficulties in distinguishing important from unimportant.; I felt incapable of making even the smallest decision.)
Blissful state: Items grouped in this dimension depict experiences of spiritual joy such as being in a state of ecstasy. (e.g. I experienced boundless pleasure.; I experienced profound inner peace.; I experienced an all-embracing love.)
Elementary Imagery: This dimension groupes items describing experiences of creating mental images of things or events. (e.g. I saw brightness or flashes of light with closed eyes or in complete darkness; I saw colors with closed eyes or in complete darkness; I saw regular patterns with closed eyes or in complete darkness.)
Experience of unity: This dimension includes items depicting the state of being united and forming a complete whole, both internally with the self, and externally with the surrounding. (e.g. Everything seemed to unify into a oneness.; I felt one with my surroundings.; Conflicts and contradictions seemed to dissolve.)
Audio-Visual Synaesthesia: Items included in this dimension describe the experience of perceiving a sound stimulus as a visual experience and vice versa. (e.g. The colors of things seemed to be altered by sounds or noises.; Sounds seemed to influence what I saw.; The colors of things seemed to be changed by sounds and noises.)
Disembodiment: Items grouped in this dimension describe the experience of feeling divest from the own body, losing its contact. (e.g. I had the feeling of being outside of my body.; I felt as though I were floating.; It seemed to me as though I did not have a body anymore.)
Changed Meaning of Percepts: This dimension groups items depicting alteration and changes in the ordinary perceptive abilities. (e.g. Everyday things gained a special meaning.; Things around me had a new strange meaning for me.; Objects around me engaged me emotionally much more than usual.)
Anxiety: This dimension includes items describing anxious states such as distress and restlessness of the mind. (e.g. I felt threatened.; I experienced my surroundings as strange and weird.; I was afraid without being able to say exactly why.)
Complex Imagery: This dimension groupes items describing experiences of creating complex mental images of things or events (e.g. I could see pictures from my past or fantasy extremely clearly.; My imagination was extremely vivid.; I saw scenes rolling by in total darkness or with my eyes closed.)
Insightfulness: Items grouped in this dimension characterize the experience of having a deeper intuition and understanding of facts and situations. (e.g. I felt very profound.; I gained clarity into connections that puzzled me before.; I had very original thoughts.)

HRS

Originally developed to quantify acute effects of synthetic dimethyltryptamine (DMT), the Hallucinogen Rating Scale has become a frequently used instrument in the assessment of hallucinogen induced ASCs. Characteristic effects of hallucinogenic substances are covered by a collection of 100 items conceptually distinct in six distinct dimensions:
Somaesthesia: It includes items depicting interoceptive, visceral, and cutaneous/tactile effects In general, it describes the faculty of being sensitive to stimuli originated inside the body (e.g. Urge to urinate; Urge to move bowels; Sexual feelings )
Affect: It includes items describing emotional as well as affective responses (e.g. Feel like laughing; Feel presence of numinous force, higher power, God; Awe, amazement ).
Perception: It includes items describing changes in the process of perceiving. Specifically, they describe alterations in the ordinary visual, auditory, gustatory, and olfactory experiences (e.g. Change in visual distinctness of objects in room; Visual synesthesia (“seeing” sound or other non-visual perception); Kaleidoscopic nature of images/visions/hallucinations ) .
Cognition: It includes items describing alterations in thought processes or content (e.g. Sense of chaos; Memories of childhood; Change in rate of thinking) .
Volition: it includes items describing changes in the interactive capacity such as the faculty of making deliberate choices or decisions. Specifically, alterations in the ability to willfully interact can be addressed to themselves, the environment, or certain aspects of the experience (e.g. Able to focus attention; Able to remind yourself of being in a research room, being administered a drug, the temporary nature of the experience; Able to follow the sequence of effects).
Intensity: It includes items describing the overall strength and the course of the experience (e.g. Waxing and waning of the experience; Intensity; High).

PCI

The Phenomenology of Consciousness Inventory (PCI) proves to be a theoretically as well as empirically well-founded psychometric tool for the assessment of general characteristics of consciousness and specific features of altered states. Originating from three previous versions (the Phenomenology of Consciousness Questionnaire, the (Abbreviated) Dimensions of Consciousness Questionnaire, and the Pre-PCI ) the present version of the PCI is available in two different versions. Form1 and Form2 contain the same number of items, which are, however, arranged in a different order. The items of the PCI are presented as two opposing statements located on the two poles of a 7-point Likert scale. The statements address 12 major dimensions, five being further subdivided into more specific sub-dimensions:

Altered state of awareness: Items belonging to this dimension generally describe variation in the ordinary wakefulness state and its related ability of being aware of external circumstances. (e.g. My state of consciousness was not any different or unusual from what it ordinarily is; My state of awareness was very different from what I usually experience; My state of awareness was not unusual or different from what it ordinarily is. )
Altered experience: Items clustered in this dimension generally describes alterations in the process of undergoing of things. Specifically, its sub-dimension relates to variation in the ability of experiencing the own body, the sense of time, the intuition about external circumstances and their related meanings.
Altered body image (e.g. My body ended at the boundary between my skin and the world; My bodily feelings seemed to expand into the world around me; I continually maintained a very strong sense of separation between myself and the environment. )
Altered time sense (e.g. My perception of the flow of time changed drastically; Time seemed to greatly speed up or slow down; I felt no sense of timelessness)
Altered perception (e.g. My perception of the world changed drastically; The world around me became extremely different in color or form; I noticed no changes in the size, shape, or perspective of the objects in the world around me)
Altered meaning (e.g. I had an experience which I would label as very religious, spiritual, or transcendental; I had an experience of awe and reverence; I experienced no profound insights besides my usual cognitive understanding of things.)
Volitional control: Items belonging to this dimensions characterize impairments in the faculty of choosing and making deliberate decisions. (e.g. The thoughts and images I had were under my control; I had complete control over what I was paying attention to; I relinquished control and became receptive and passive to what I was experiencing)
Self-awareness: Items belonging to this dimension generally describe variation in the ordinary ability of being aware of internal states and in the introspective processes. (e.g. I was not aware of being aware of myself at all; I had no self-awareness; I was continually conscious and well aware of myself)
Rationality: This dimension includes items depict variations and changes in the possession of reason and its related functions, such as thinking. (e.g. My thinking was clear and understandable; Conceptually, my thinking was clear and distinct; My thought processes were non rational and very hard to comprehend)
Internal dialogue: Items clustered in this dimension characterize the experience of processing information and other mental activity through inner conversations with the self. (e.g. I was silently talking to myself a great deal; I did not engage in any silent talking to myself)
Positive affect: This dimension includes items describing general positive states, in terms of feelings and emotions. Specifically, its sub-dimensions characterize experiences of joy, sexual excitement and love.
Joy (e.g. I felt ecstatic and joyful; I experienced no feelings of ecstasy or extreme happiness beyond my usual feelings)
Sexual excitement (e.g. I became aware of very intense sexual feelings; I was not aware of any sexual feelings)
Love (e.g. I experienced no feelings of love; I felt intense feelings of loving-kindness)
Negative affect: This dimension includes items describing general negative states, in terms of feelings and emotions. Specifically, its sub-dimensions characterize experiences of anger, sadness and fear.
Anger (e.g. I felt no emotions of rage whatsoever; I felt very angry and upset.)
Sadness (e.g. I felt very, very sad; I felt no feelings of unhappiness or dejection.)
Fear (e.g. I felt very frightened; I felt no feelings of being scared or afraid.)
Imagery: This dimension groupes items describing experiences of creating more or less complex mental images of things or events. Specifically, its sub-dimensions relate to the amount and vividness, in terms of quality and quantity, of such experiences.
Amount (e.g. I experienced a great deal of visual imagery; I experienced no or very few images)
Vividness (e.g. My visual imagery was so vivid and three dimensional, it seemed real; My imagery was very vague)
Attention: This dimension includes items characterizing changes and variation in the ability of being attentive and focused towards external events. Its sub-dimensions specify the direction and the intensity of such alterations.
Direction: (e.g. My attention was completely directed toward my own internal subjective experience; My attention was totally directed toward the environment around me; My attention was completely inner-directed.)
Absorption: (e.g. I was forever distracted and unable to concentrate on anything; I was not distracted, but was able to be completely absorbed in what I was experiencing)
Memory: Items clustered in this dimension depict impairment or changes in the ability of recollecting episodes and more in general in the ability of remembering past experiences. (e.g. I cannot remember what I experienced; I can recall nothing that happened to me; My memory of the events I experienced is extremely clear and vivid)
Arousal: Items belonging to this dimensions specify the ability of feeling organs stimulated to a point of perception (e.g. The muscles of my body felt very tense and tight; I felt no feelings of tension or tightness at all)


References

For a comprehensive overview, including all references to the original publications, please see: Empirische Untersuchung veränderter Bewusstseinszustände