Witham, Layla; (2025) MDMA and Psychosocial Change in Autistic Adults: Implications for Mental Health. Doctoral thesis (D.Clin.Psy), UCL (University College London).

Text Thesis MDMA Autism.pdf - Accepted Version Access restricted to UCL open access staff until 1 July 2026. Download (2MB)

Abstract

This thesis explores the potential of MDMA to support psychological and social wellbeing in autistic adults, a population that frequently experiences significant mental health challenges and for whom current therapeutic options can be limited or poorly tailored. This volume is comprised of three parts: a conceptual introduction, an empirical study, and a critical appraisal. The conceptual introduction outlines theoretical and empirical foundations for investigating MDMA-assisted therapy in autism. It introduces models of autism and associated mental health challenges, followed by an overview of MDMA’s pharmacology, therapeutic use, and risks. Five psychosocial processes are identified as potentially relevant mechanisms of change: social connectedness, camouflaging, self-compassion, compassion for others, and psychological insight. The introduction highlights the need for further research on how MDMA may influence these areas in autistic populations. The empirical study surveyed 178 autistic adults about a memorable MDMA experience. Perceived psychological and social changes and current mental health were assessed. Participants reported perceived increases in social connectedness, self-compassion, othercompassion, and psychological insight, and a reduction in camouflaging. Greater perceived increases in self-compassion predicted better current mental health, while increases in camouflaging and other-compassion were linked to worse outcomes. The critical appraisal reflects on the research process, including the researcher’s positionality, ethical and methodological challenges, and conceptual tensions in interpreting perceived change. Together, the thesis provides a theoretically informed and empirically grounded contribution to the emerging field of MDMA-assisted therapy in autism, demonstrating its potential while underscoring the need for further rigorous, autism-informed research.

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