{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T00:50:22Z","timestamp":1790297422973,"version":"4.1.0"},"reference-count":81,"publisher":"Public Library of Science (PLoS)","issue":"1","license":[{"start":{"date-parts":[[2024,1,10]],"date-time":"2024-01-10T00:00:00Z","timestamp":1704844800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/"}],"funder":[{"name":"Multidisciplinary Association for Psychedlic Studies","award":["MAPP1"],"award-info":[{"award-number":["MAPP1"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Introduction<\/jats:title>\n<jats:p>There is a resurgence of interest in the therapeutic potential of psychedelic substances such as 3,4-methylenedioxymethamphetamine (MDMA). Primary findings from our randomized, double-blind, placebo-controlled, multi-site Phase 3 clinical trial of participants with severe PTSD (NCT03537014) showed that MDMA-assisted therapy induced significant attenuation in the Clinician-Administered PTSD Scale for DSM-5 compared to Therapy with placebo. Deficits in emotional coping skills and altered self-capacities constitute major obstacles to successful completion of available treatments. The current analysis evaluated the differential effects of MDMA-assisted therapy and Therapy with placebo on 3 transdiagnostic outcome measures and explored the contribution of changes in self-experience to improvement in PTSD scores.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>Participants were randomized to receive manualized therapy with either MDMA or placebo during 3 experimental sessions in combination with 3 preparation and 9 integration therapy visits. Symptoms were measured at baseline and 2 months after the last experimental session using the 20-item Toronto Alexithymia Scale (TAS-20), the 26-item Self Compassion Scale (SCS), and the 63-item Inventory of Altered Self-Capacities (IASC).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>90 participants were randomized and dosed (MDMA-assisted therapy, n = 46; Therapy with placebo, n = 44); 84.4% (76\/90) had histories of developmental trauma, and 87.8% (79\/90) had suffered multiple traumas. MDMA-assisted therapy facilitated statistically significant greater improvement on the TAS-20, the SCS, and most IASC factors of interpersonal conflicts; idealization disillusionment; abandonment concerns; identity impairment; self-awareness; susceptibility to influence; affect dysregulation; affect instability; affect skill deficit; tension reduction activities; the only exception was identity diffusion.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Compared with Therapy with placebo, MDMA-assisted therapy had significant positive effects on transdiagnostic mental processes of self-experience which are often associated with poor treatment outcome. This provides a possible window into understanding the psychological capacities facilitated by psychedelic agents that may result in significant improvements in PTSD symptomatology.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0295926","type":"journal-article","created":{"date-parts":[[2024,1,10]],"date-time":"2024-01-10T18:22:33Z","timestamp":1704910953000},"page":"e0295926","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":38,"title":["Effects of MDMA-assisted therapy for PTSD on self-experience"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5383-957X","authenticated-orcid":true,"given":"Bessel A.","family":"van der Kolk","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7039-6061","authenticated-orcid":true,"given":"Julie 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Jerome","year":"2020","journal-title":"Psychopharmacology"},{"issue":"6","key":"pone.0295926.ref004","doi-asserted-by":"crossref","first-page":"1025","DOI":"10.1038\/s41591-021-01336-3","article-title":"MDMA-assisted therapy for severe PTSD: a randomized, double-blind, placebo-controlled phase 3 study","volume":"27","author":"JM Mitchell","year":"2021","journal-title":"Nat Med"},{"issue":"7","key":"pone.0295926.ref005","doi-asserted-by":"crossref","first-page":"656","DOI":"10.1001\/jama.2019.20825","article-title":"First-line Psychotherapies for Military-Related PTSD.","volume":"323","author":"MM Steenkamp","year":"2020","journal-title":"JAMA"},{"issue":"2","key":"pone.0295926.ref006","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1176\/appi.ajp.162.2.214","article-title":"A multidimensional meta-analysis of psychotherapy for PTSD","volume":"162","author":"R Bradley","year":"2005","journal-title":"The American journal of psychiatry"},{"issue":"11","key":"pone.0295926.ref007","doi-asserted-by":"crossref","first-page":"894","DOI":"10.1176\/appi.ajp.2019.19080895","article-title":"Targeting PTSD.","volume":"176","author":"WM McDonald","year":"2019","journal-title":"The American journal of psychiatry"},{"key":"pone.0295926.ref008","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1016\/j.jpsychires.2014.12.011","article-title":"PTSD, emotion dysregulation, and dissociative symptoms in a highly traumatized sample","volume":"61","author":"A Powers","year":"2015","journal-title":"J Psychiatr Res"},{"issue":"1","key":"pone.0295926.ref009","doi-asserted-by":"crossref","first-page":"e2136921","DOI":"10.1001\/jamanetworkopen.2021.36921","article-title":"Comparison of Prolonged Exposure vs Cognitive Processing Therapy for Treatment of Posttraumatic Stress Disorder Among US Veterans: A Randomized Clinical Trial","volume":"5","author":"PP Schnurr","year":"2022","journal-title":"JAMA Netw 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psychological consequences.","volume":"9","author":"AC McFarlane","year":"2010","journal-title":"World Psychiatry."},{"issue":"13","key":"pone.0295926.ref013","doi-asserted-by":"crossref","first-page":"2260","DOI":"10.1017\/S0033291717000708","article-title":"Posttraumatic stress disorder in the World Mental Health Surveys.","volume":"47","author":"KC Koenen","year":"2017","journal-title":"Psychological medicine."},{"issue":"5","key":"pone.0295926.ref014","doi-asserted-by":"crossref","first-page":"494","DOI":"10.1080\/10926771.2014.904467","article-title":"Cognitive behavioral therapy for PTSD: The role of complex PTSD on treatment outcome","volume":"23","author":"M. Lonergan","year":"2014","journal-title":"Journal of Aggression, Maltreatment & Trauma."},{"issue":"6","key":"pone.0295926.ref015","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1097\/NMD.0b013e31803044e2","article-title":"Self-awareness, affect regulation, and relatedness: differential sequels of childhood versus adult victimization experiences","volume":"195","author":"J Briere","year":"2007","journal-title":"The Journal of nervous and mental disease"},{"key":"pone.0295926.ref016","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1186\/1471-244X-13-3","article-title":"Developmental trauma disorder: pros and cons of including formal criteria in the psychiatric diagnostic systems.","volume":"13","author":"M Schmid","year":"2013","journal-title":"BMC Psychiatry."},{"issue":"1","key":"pone.0295926.ref017","doi-asserted-by":"crossref","first-page":"1929028","DOI":"10.1080\/20008198.2021.1929028","article-title":"Psychiatric comorbidity of developmental trauma disorder and posttraumatic Stress disorder: findings from the DTD field trial replication (DTDFT-R).","volume":"12","author":"JD Ford","year":"2021","journal-title":"European journal of psychotraumatology"},{"issue":"5","key":"pone.0295926.ref018","doi-asserted-by":"crossref","first-page":"631","DOI":"10.1002\/jts.22320","article-title":"When nowhere is safe: Interpersonal trauma and attachment adversity as antecedents of posttraumatic stress disorder and developmental trauma disorder","volume":"31","author":"J Spinazzola","year":"2018","journal-title":"Journal of traumatic stress"},{"issue":"2","key":"pone.0295926.ref019","doi-asserted-by":"crossref","first-page":"686","DOI":"10.1016\/j.neuropharm.2011.02.008","article-title":"Executive function and PTSD: disengaging from trauma","volume":"62","author":"RL Aupperle","year":"2012","journal-title":"Neuropharmacology"},{"issue":"4","key":"pone.0295926.ref020","doi-asserted-by":"crossref","first-page":"430","DOI":"10.1037\/a0021576","article-title":"Links between specific posttrauma appraisals and three forms of trauma-related distress.","volume":"3","author":"AP DePrince","year":"2011","journal-title":"Psychological Trauma: Theory, Research, Practice, and Policy."},{"issue":"12","key":"pone.0295926.ref021","doi-asserted-by":"crossref","first-page":"1050","DOI":"10.1016\/j.brat.2009.08.001","article-title":"Attentional biases in PTSD: More evidence for interference.","volume":"47","author":"SL Pineles","year":"2009","journal-title":"Behav Res Ther"},{"key":"pone.0295926.ref022","doi-asserted-by":"crossref","first-page":"109940","DOI":"10.1016\/j.jpsychores.2020.109940","article-title":"Twenty-five years with the 20-item Toronto Alexithymia Scale.","volume":"131","author":"RM Bagby","year":"2020","journal-title":"J Psychosom Res"},{"issue":"2","key":"pone.0295926.ref023","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1002\/jts.20320","article-title":"Meta-analysis of alexithymia in posttraumatic stress disorder","volume":"21","author":"PA Frewen","year":"2008","journal-title":"Journal of traumatic stress"},{"issue":"1","key":"pone.0295926.ref024","first-page":"439","article-title":"A meta-analytic study examining the relationship between alexithymia and dissociation in psychiatric and nonclinical populations.","volume":"23","author":"SM Reyno","year":"2020","journal-title":"Res Psychother."},{"key":"pone.0295926.ref025","doi-asserted-by":"crossref","first-page":"466","DOI":"10.1007\/s10608-012-9515-y","article-title":"Emotion regulation deficits as mediators between trauma exposure and borderline symptoms.","volume":"37","author":"RM Gaher","year":"2013","journal-title":"Cognitive therapy and research."},{"issue":"8","key":"pone.0295926.ref026","doi-asserted-by":"crossref","first-page":"978","DOI":"10.1016\/j.paid.2013.08.001","article-title":"Decoupling between physiological, self-reported, and expressed emotional responses in alexithymia.","volume":"55","author":"JM Eastabrook","year":"2013","journal-title":"Personality and Individual Differences"},{"issue":"6","key":"pone.0295926.ref027","doi-asserted-by":"crossref","first-page":"545","DOI":"10.1016\/j.cpr.2012.06.003","article-title":"Exploring compassion: a meta-analysis of the association between self-compassion and psychopathology.","volume":"32","author":"A MacBeth","year":"2012","journal-title":"Clin Psychol Rev"},{"issue":"7","key":"pone.0295926.ref028","doi-asserted-by":"crossref","first-page":"1180","DOI":"10.1016\/j.chiabu.2014.04.005","article-title":"The mediating role of self-compassion in the relationship between victimization and psychological maladjustment in a sample of adolescents.","volume":"38","author":"R Jativa","year":"2014","journal-title":"Child Abuse Negl"},{"issue":"4","key":"pone.0295926.ref029","doi-asserted-by":"crossref","first-page":"645","DOI":"10.1007\/s10802-014-9937-y","article-title":"Self-compassion in recovery following potentially traumatic stress: longitudinal study of at-risk youth.","volume":"43","author":"M Zeller","year":"2015","journal-title":"J Abnorm Child Psychol"},{"issue":"11","key":"pone.0295926.ref030","doi-asserted-by":"crossref","first-page":"754","DOI":"10.1097\/01.nmd.0000144694.30121.89","article-title":"The role of experiential avoidance in posttraumatic stress symptoms and symptoms of depression, anxiety, and somatization","volume":"192","author":"MT Tull","year":"2004","journal-title":"The Journal of nervous and mental disease"},{"key":"pone.0295926.ref031","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.pbb.2013.11.030","article-title":"MDMA decreases the effects of simulated social rejection","volume":"117","author":"CG Frye","year":"2014","journal-title":"Pharmacology, biochemistry, and behavior"},{"issue":"5","key":"pone.0295926.ref032","first-page":"e15070","article-title":"The Efficacy of MDMA (3,4-Methylenedioxymethamphetamine) for Post-traumatic Stress Disorder in Humans: A Systematic Review and Meta-Analysis.","volume":"13","author":"S Tedesco","year":"2021","journal-title":"Cureus"},{"key":"pone.0295926.ref033","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1016\/j.brat.2014.05.006","article-title":"Self-compassion as an emotion regulation strategy in major depressive disorder.","volume":"58","author":"A Diedrich","year":"2014","journal-title":"Behav Res Ther."},{"key":"pone.0295926.ref034","doi-asserted-by":"crossref","first-page":"103965","DOI":"10.1016\/j.brat.2021.103965","article-title":"The effects of inducing self-compassion on affective and physiological recovery from a psychosocial stressor in depression.","volume":"146","author":"A Tracy","year":"2021","journal-title":"Behav Res Ther"},{"issue":"2","key":"pone.0295926.ref035","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1007\/s00213-012-2645-9","article-title":"MDMA enhances \"mind reading\" of positive emotions and impairs \"mind reading\" of negative emotions.","volume":"222","author":"CM Hysek","year":"2012","journal-title":"Psychopharmacology"},{"issue":"3","key":"pone.0295926.ref036","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1037\/pas0000486","article-title":"The Clinician-Administered PTSD Scale for DSM\u20135 (CAPS-5): Development and initial psychometric evaluation in military veterans.","volume":"30","author":"FW Weathers","year":"2018","journal-title":"Psychological assessment"},{"issue":"4","key":"pone.0295926.ref037","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1016\/S0749-3797(98)00017-8","article-title":"Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The Adverse Childhood Experiences (ACE) Study","volume":"14","author":"VJ Felitti","year":"1998","journal-title":"Am J Prev Med"},{"key":"pone.0295926.ref038","first-page":"82","volume-title":"Manual for the beck depression inventory-II.","author":"AT Beck","year":"1996"},{"issue":"7","key":"pone.0295926.ref039","doi-asserted-by":"crossref","first-page":"1035","DOI":"10.1176\/ajp.2007.164.7.1035","article-title":"Columbia Classification Algorithm of Suicide Assessment (C-CASA): classification of suicidal events in the FDA\u2019s pediatric suicidal risk analysis of antidepressants.","volume":"164","author":"K Posner","year":"2007","journal-title":"The American journal of psychiatry"},{"issue":"9","key":"pone.0295926.ref040","doi-asserted-by":"crossref","first-page":"1485","DOI":"10.1002\/jclp.22634","article-title":"A systematic review of randomized trials of mind-body interventions for PTSD","volume":"74","author":"BL Niles","year":"2018","journal-title":"Journal of clinical psychology"},{"issue":"12","key":"pone.0295926.ref041","doi-asserted-by":"crossref","first-page":"e0166752","DOI":"10.1371\/journal.pone.0166752","article-title":"A Randomized Controlled Study of Neurofeedback for Chronic PTSD.","volume":"11","author":"BA van der Kolk","year":"2016","journal-title":"PLoS One."},{"issue":"3","key":"pone.0295926.ref042","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1177\/1073191102009003002","article-title":"The Inventory of Altered Self-Capacities (IASC): a standardized measure of identity, affect regulation, and relationship disturbance.","volume":"9","author":"J Briere","year":"2002","journal-title":"Assessment"},{"issue":"8","key":"pone.0295926.ref043","doi-asserted-by":"crossref","first-page":"1806","DOI":"10.1177\/10731911211033894","article-title":"The Structure of the Toronto Alexithymia Scale (TAS-20): A Meta-Analytic Confirmatory Factor Analysis.","volume":"29","author":"U Schroeders","year":"2022","journal-title":"Assessment"},{"issue":"1","key":"pone.0295926.ref044","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1007\/s12671-015-0479-3","article-title":"The self-compassion scale is a valid and theoretically coherent measure of self-compassion.","volume":"7","author":"KD Neff","year":"2016","journal-title":"Mindfulness"},{"key":"pone.0295926.ref045","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1146\/annurev-psych-032420-031047","article-title":"Self-Compassion: Theory, Method, Research, and Intervention.","volume":"74","author":"KD Neff","year":"2023","journal-title":"Annu Rev Psychol"},{"issue":"2","key":"pone.0295926.ref046","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1111\/eth.12713","article-title":"Generalized estimating equations: A pragmatic and flexible approach to the marginal GLM modelling of correlated data in the behavioural sciences.","volume":"124","author":"S Pek\u00e1r","year":"2018","journal-title":"Ethology."},{"issue":"1","key":"pone.0295926.ref047","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1016\/0022-3999(94)90006-X","article-title":"The Twenty-item Toronto Alexithymia Scale\u2014II. Convergent, discriminant, and concurrent validity.","volume":"38","author":"RM Bagby","year":"1994","journal-title":"J Psychosom Res."},{"key":"pone.0295926.ref048","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1080\/15298860309027","article-title":"The Development and validation of a scale to measure self-compassion","volume":"2","author":"K. Neff","year":"2003","journal-title":"Self and Identity"},{"issue":"2","key":"pone.0295926.ref049","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1007\/s00213-017-4701-y","article-title":"Psychedelics and connectedness","volume":"235","author":"RL Carhart-Harris","year":"2018","journal-title":"Psychopharmacology"},{"issue":"1","key":"pone.0295926.ref050","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1037\/0021-843X.109.1.69","article-title":"Predicting PTSD symptoms in victims of violent crime: the role of shame, anger, and childhood abuse.","volume":"109","author":"B Andrews","year":"2000","journal-title":"J Abnorm Psychol"},{"issue":"4","key":"pone.0295926.ref051","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1017\/S1461145713001405","article-title":"The effect of acutely administered MDMA on subjective and BOLD-fMRI responses to favourite and worst autobiographical memories.","volume":"17","author":"RL Carhart-Harris","year":"2014","journal-title":"Int J Neuropsychopharmacol"},{"issue":"12","key":"pone.0295926.ref052","doi-asserted-by":"crossref","first-page":"1134","DOI":"10.1016\/j.biopsych.2010.08.003","article-title":"Is ecstasy an \"empathogen\"? Effects of +\/-3,4-methylenedioxymethamphetamine on prosocial feelings and identification of emotional states in others.","volume":"68","author":"G Bedi","year":"2010","journal-title":"Biological psychiatry"},{"issue":"11","key":"pone.0295926.ref053","doi-asserted-by":"crossref","first-page":"1645","DOI":"10.1093\/scan\/nst161","article-title":"MDMA enhances emotional empathy and prosocial behavior","volume":"9","author":"CM Hysek","year":"2014","journal-title":"Social cognitive and affective neuroscience"},{"issue":"10","key":"pone.0295926.ref054","first-page":"CD012371","article-title":"Psychological therapies for children and adolescents exposed to trauma.","volume":"10","author":"D Gillies","year":"2016","journal-title":"Cochrane Database Syst Rev."},{"key":"pone.0295926.ref055","doi-asserted-by":"crossref","first-page":"105215","DOI":"10.1016\/j.chiabu.2021.105215","article-title":"Child maltreatment and the development of psychopathology: The role of developmental timing and chronicity","volume":"120","author":"J Russotti","year":"2021","journal-title":"Child Abuse Negl"},{"key":"pone.0295926.ref056","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1016\/j.brat.2015.09.002","article-title":"Prediction of treatment discontinuation and recovery from Borderline Personality Disorder: Results from an RCT comparing Schema Therapy and Transference Focused Psychotherapy.","volume":"74","author":"A Arntz","year":"2015","journal-title":"Behav Res Ther."},{"key":"pone.0295926.ref057","doi-asserted-by":"crossref","first-page":"382","DOI":"10.3389\/fpsyt.2018.00382","article-title":"A Systematic Review of Cognitive Predictors of Treatment Outcome in Major Depression.","volume":"9","author":"SJ Groves","year":"2018","journal-title":"Front Psychiatry."},{"key":"pone.0295926.ref058","first-page":"1","article-title":"Emotion response disconcordance among trauma-exposed adults: the impact of alexithymia.","author":"A Putica","year":"2022","journal-title":"Psychological medicine"},{"issue":"3","key":"pone.0295926.ref059","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1037\/a0027314","article-title":"The role of early emotional neglect in alexithymia.","volume":"5","author":"S Aust","year":"2013","journal-title":"Psychological trauma: theory, research, practice, and policy."},{"key":"pone.0295926.ref060","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1016\/j.psychres.2017.12.026","article-title":"Childhood maltreatment is associated with attachment insecurities, dissociation and alexithymia in bipolar disorder.","volume":"260","author":"MC Kefeli","year":"2018","journal-title":"Psychiatry research."},{"key":"pone.0295926.ref061","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1111\/j.1749-6632.1997.tb48276.x","article-title":"Psychobiological effects of sexual abuse. A longitudinal study","volume":"821","author":"FW Putnam","year":"1997","journal-title":"Annals of the New York Academy of Sciences"},{"issue":"6","key":"pone.0295926.ref062","doi-asserted-by":"crossref","first-page":"462","DOI":"10.1016\/j.whi.2020.07.004","article-title":"Emotion Dysregulation Predicts Dropout from Prolonged Exposure Treatment among Women Veterans with Military Sexual Trauma-Related Posttraumatic Stress Disorder.","volume":"30","author":"AK Gilmore","year":"2020","journal-title":"Womens Health Issues."},{"key":"pone.0295926.ref063","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1016\/j.jad.2020.02.028","article-title":"The role of emotion dysregulation in negative affect reactivity to a trauma cue: Differential associations through elicited posttraumatic stress disorder symptoms","volume":"267","author":"AM Raudales","year":"2020","journal-title":"Journal of affective disorders"},{"issue":"1","key":"pone.0295926.ref064","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1037\/0022-006X.66.1.185","article-title":"Influence of emotional engagement and habituation on exposure therapy for PTSD","volume":"66","author":"LH Jaycox","year":"1998","journal-title":"Journal of consulting and clinical psychology"},{"issue":"12","key":"pone.0295926.ref065","doi-asserted-by":"crossref","first-page":"927","DOI":"10.1002\/da.22449","article-title":"Taking the Pulse of Prolonged Exposure Therapy: Physiological Reactivity to Trauma Imagery as an Objective Measure of Treatment Response.","volume":"32","author":"BC Wangelin","year":"2015","journal-title":"Depress Anxiety."},{"issue":"9","key":"pone.0295926.ref066","doi-asserted-by":"crossref","first-page":"1251","DOI":"10.1016\/j.brat.2005.10.001","article-title":"Effects of suppression and acceptance on emotional responses of individuals with anxiety and mood disorders.","volume":"44","author":"L Campbell-Sills","year":"2006","journal-title":"Behav Res Ther"},{"issue":"2","key":"pone.0295926.ref067","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1016\/j.janxdis.2013.01.003","article-title":"Emotion regulation difficulties as a prospective predictor of posttraumatic stress symptoms following a mass shooting","volume":"27","author":"JR Bardeen","year":"2013","journal-title":"Journal of anxiety disorders"},{"issue":"4","key":"pone.0295926.ref068","doi-asserted-by":"crossref","first-page":"587","DOI":"10.1016\/j.beth.2010.04.004","article-title":"Emotion regulation difficulties in trauma survivors: the role of trauma type and PTSD symptom severity.","volume":"41","author":"T Ehring","year":"2010","journal-title":"Behav Ther"},{"key":"pone.0295926.ref069","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1016\/j.pnpbp.2017.11.005","article-title":"Neural indices of emotional reactivity and regulation predict course of PTSD symptoms in combat-exposed veterans","volume":"82","author":"JM Fitzgerald","year":"2018","journal-title":"Prog Neuropsychopharmacol Biol Psychiatry"},{"issue":"4","key":"pone.0295926.ref070","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1080\/10615806.2019.1618842","article-title":"Emotion dysregulation and posttraumatic stress disorder: a test of the incremental role of difficulties regulating positive emotions.","volume":"32","author":"NH Weiss","year":"2019","journal-title":"Anxiety Stress Coping"},{"key":"pone.0295926.ref071","doi-asserted-by":"crossref","first-page":"102367","DOI":"10.1016\/j.janxdis.2021.102367","article-title":"Transdiagnostic emotion regulation processes explain how emotion-related factors affect co-occurring PTSD and MDD in relation to trauma","volume":"78","author":"LM Post","year":"2021","journal-title":"Journal of anxiety disorders"},{"issue":"1","key":"pone.0295926.ref072","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1016\/j.jbtep.2012.07.007","article-title":"Trauma-related reactivity and regulation of emotion: associations with posttraumatic stress symptoms.","volume":"44","author":"CL Badour","year":"2013","journal-title":"J Behav Ther Exp Psychiatry"},{"issue":"1","key":"pone.0295926.ref073","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1037\/0021-843X.109.1.45","article-title":"Posttraumatic stress disorder following political imprisonment: the role of mental defeat, alienation, and perceived permanent change.","volume":"109","author":"A Ehlers","year":"2000","journal-title":"J Abnorm Psychol"},{"key":"pone.0295926.ref074","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.brat.2016.04.003","article-title":"Self-compassion enhances the efficacy of explicit cognitive reappraisal as an emotion regulation strategy in individuals with major depressive disorder.","volume":"82","author":"A Diedrich","year":"2016","journal-title":"Behav Res Ther"},{"issue":"2","key":"pone.0295926.ref075","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1002\/jts.21995","article-title":"Self-Compassion as a prospective predictor of PTSD symptom severity among trauma-exposed U.S. Iraq and Afghanistan war veterans","volume":"28","author":"R Hiraoka","year":"2015","journal-title":"Journal of traumatic stress"},{"issue":"2","key":"pone.0295926.ref076","doi-asserted-by":"crossref","first-page":"430","DOI":"10.1016\/j.beth.2018.08.003","article-title":"An Internet-Based Compassion-Focused Intervention for Increased Self-Criticism: A Randomized Controlled Trial.","volume":"50","author":"T Krieger","year":"2019","journal-title":"Behav Ther."},{"issue":"1","key":"pone.0295926.ref077","doi-asserted-by":"crossref","first-page":"20442","DOI":"10.1038\/s41598-020-75706-1","article-title":"MDMA-assisted psychotherapy for treatment of anxiety and other psychological distress related to life-threatening illnesses: a randomized pilot study.","volume":"10","author":"PE Wolfson","year":"2020","journal-title":"Sci Rep."},{"key":"pone.0295926.ref078","first-page":"appiajp20221043","article-title":"Must Psilocybin Always \"Assist Psychotherapy\"?","author":"GM Goodwin","year":"2023","journal-title":"The American journal of psychiatry"},{"issue":"2","key":"pone.0295926.ref079","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1002\/cpt.565","article-title":"Potential Psychiatric Uses for MDMA","volume":"101","author":"BB Yazar-Klosinski","year":"2017","journal-title":"Clin Pharmacol Ther"},{"issue":"1","key":"pone.0295926.ref080","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1017\/S0033291710000401","article-title":"Race\/ethnic differences in exposure to traumatic events, development of post-traumatic stress disorder, and treatment-seeking for post-traumatic stress disorder in the United States.","volume":"41","author":"AL Roberts","year":"2011","journal-title":"Psychological medicine."},{"issue":"8","key":"pone.0295926.ref081","doi-asserted-by":"crossref","first-page":"974","DOI":"10.1177\/02698811221104052","article-title":"MDMA-assisted therapy for posttraumatic stress disorder: A pooled analysis of ethnoracial differences in efficacy and safety from two Phase 2 open-label lead-in trials and a Phase 3 randomized, blinded placebo-controlled trial","volume":"36","author":"TH Ching","year":"2022","journal-title":"Journal of psychopharmacology (Oxford, England)."}],"container-title":["PLOS 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