A meta-analytic analysis of the acute effects of MDMA on empathy and emotion recognition in humans - PubMed (original) (raw)

Meta-Analysis

A meta-analytic analysis of the acute effects of MDMA on empathy and emotion recognition in humans

Leehe Peled-Avron et al. Sci Rep. 2025.

Abstract

3,4-methylenedioxymethamphetamine (MDMA) is an amphetamine derivative known as an "entactogen," influencing emotional and social processing. Phase III clinical trials of MDMA-assisted psychotherapy for post-traumatic stress disorder have reported promising results, and MDMA-assisted therapy is currently under regulatory review. However, the precise mechanisms underlying positive treatment outcomes remain largely unknown. This meta-analysis aims to systematically synthesize existing data on the effects of MDMA on empathy and emotion recognition. Specifically, we focus on two established tasks, the Multifaceted Empathy Test (MET) and the Facial Emotion Recognition Task (FERT), to comprehensively evaluate MDMA's role in social cognition. Separate meta-analyses for each emotion tested in the FERT will help discern potential variations in MDMA's impact on specific emotional responses. Following PRISMA guidelines, we conducted the meta-analysis. The MET assesses cognitive and emotional empathy, while the FERT measures accuracy in identifying basic emotional expressions. Separate meta-analyses were performed for each emotion tested in the FERT. MDMA administration enhances emotional empathy but diminishes recognition accuracy of negative facial expressions (sadness, fear, anger). No significant effects on cognitive empathy or recognition of happy expressions were found. Understanding these nuanced effects may inform the optimization of therapeutic applications and considerations for safety in clinical settings. Further studies are warranted to elucidate the underlying psychological and neural mechanisms, emphasizing the importance of continued investigation into the multifaceted influence of MDMA on social cognition.

Keywords: Emotion; Empathy; MDMA; Meta-analysis; Social cognition; Systematic review.

© 2025. The Author(s).

PubMed Disclaimer

Conflict of interest statement

Declarations. Competing interests: The author(s) declare no competing interests.

Figures

Fig. 1

Fig. 1

The search and selection procedure used to identify studies for inclusion in this meta-analysis.Template provided by PRISMA (

www.prisma-statement.org

). *Intervention studies include clinical populations which we did not examine here due to lack of data. We focused our meta-analysis on two specific tasks that received the highest number of studies. This decision was made after excluding cognitive tasks like memory or attention, as well as other social cognition tasks such as the ultimatum game, cyberball, and sexual behavior. This approach ensures a clear separation between non-social cognitive tasks and social cognition tasks that are outside the scope of our intended analysis.

Fig. 2

Fig. 2

Forest Plot illustrating the influence of MDMA intervention on cognitive empathy scores measured by the MET task.

Fig. 3

Fig. 3

Forest Plot illustrating the influence of MDMA intervention on explicit emotional empathy scores measured by the MET task.

Fig. 4

Fig. 4

Forest Plot illustrating the influence of MDMA intervention on implicit emotional empathy scores measured by the MET task.

Fig. 5

Fig. 5

Forest Plot illustrating the influence of MDMA intervention on facial emotion recognition of happiness scores measured by the FERT task.

Fig. 6

Fig. 6

Forest Plot illustrating the influence of MDMA intervention on facial emotion recognition of sadness scores measured by the FERT task.

Fig. 7

Fig. 7

Forest Plot illustrating the influence of MDMA intervention on facial emotion recognition of fear scores measured by the FERT task.

Fig. 8

Fig. 8

Forest Plot illustrating the influence of MDMA intervention on facial emotion recognition of anger scores measured by the FERT task.

References

    1. Colman, A. M. A Dictionary of Psychology. (Oxford quick reference, 2015).
    1. Mitchell, J. M. et al. MDMA-assisted therapy for severe PTSD: a randomized, double-blind, placebo-controlled phase 3 study. Focus21, 315–328 (2023). -DOI -PMC -PubMed
    1. Hysek, C. M. et al. MDMA enhances emotional empathy and prosocial behavior. Soc. Cognitive Affect. Neurosci.9, 1645–1652 (2014). -DOI -PMC -PubMed
    1. Baier, A. L., Kline, A. C. & Feeny, N. C. Therapeutic alliance as a mediator of change: a systematic review and evaluation of research. Clin. Psychol. Rev.82, 101921 (2020). -DOI -PubMed
    1. Schmid, Y. et al. Differential effects of MDMA and methylphenidate on social cognition. J. Psychopharmacol.28, 847–856 (2014). -DOI -PubMed

Publication types

MeSH terms

Substances

LinkOut - more resources