Life Changes in Patients After Out-of-Hospital Cardiac Arrest

Near-death experiences after cardiac arrest: a scoping review

BACKGROUND

This scoping review aimed to characterise near-death experiences in the setting of cardiac arrest, a phenomenon that is poorly understood and may have clinical consequences.

METHOD

PubMed/MEDLINE was searched to 23 July 2023 for prospective studies describing near-death experiences in cardiac arrest. PRISMA-ScR guidelines were adhered to. Qualitative and quantitative data were synthesised. Meta-analysis was precluded due to data heterogeneity.

RESULTS

60 records were identified, of which 11 studies involving interviews were included from various countries. Sample size ranged from 28-344, and proportion of female patients (when reported) was 0-50%, with mean age (when reported) ranging 54-64 years. Comorbidities and reasons for cardiac arrest were heterogeneously reported. Incidence of near-death experiences in the included studies varied from 6.3% to 39.3%; with variation between in-hospital (6.3-39.3%) versus out-of-hospital (18.9-21.2%) cardiac arrest. Individual variables regarding patient characteristics demonstrated statistically significant association with propensity for near-death experiences. Reported content of near-death experiences tended to reflect the language of the questionnaires used, rather than the true language used by individual study participants. Three studies conducted follow-up, and all suggested a positive life attitude change, however one found significantly higher 30-day all-cause mortality in patients with near-death experiences versus those without, in non-controlled analysis.

CONCLUSIONS

From prospective studies that have investigated the phenomenon, near-death experiences may occur in as frequent as over one-third of patients with cardiac arrest. Lasting effects may follow these events, however these could also be confounded by clinical characteristics.

Ayahuasca-induced personal death experiences: prevalence, characteristics, and impact on attitudes toward death, life, and the environment

Introduction

Despite an emerging understanding regarding the pivotal mechanistic role of subjective experiences that unfold during acute psychedelic states, very little has been done in the direction of better characterizing such experiences and determining their long-term impact. The present paper utilizes two cross-sectional studies for spotlighting - for the first time in the literature - the characteristics and outcomes of self-reported past experiences related to one's subjective sense of death during ayahuasca ceremonies, termed here Ayahuasca-induced Personal Death (APD) experiences.

Methods

Study 1 (n = 54) reports the prevalence, demographics, intensity, and impact of APDs on attitudes toward death, explores whether APDs are related with psychopathology, and reveals their impact on environmental concerns. Study 2 is a larger study (n = 306) aiming at generalizing the basic study 1 results regarding APD experience, and in addition, examining whether APDs is associated with self-reported coping strategies and values in life.

Results

Our results indicate that APDs occur to more than half of those participating in ayahuasca ceremonies, typically manifest as strong and transformative experiences, and are associated with an increased sense of transcending death (study 1), as well as the certainty in the continuation of consciousness after death (study 2). No associations were found between having undergone APD experiences and participants' demographics, personality type, and psychopathology. However, APDs were associated with increased self-reported environmental concern (study 1). These experiences also impact life in profound ways. APDs were found to be associated with increases in one's self-reported ability to cope with distress-causing life problems and the sense of fulfillment in life (study 2).

Discussion

The study's findings highlight the prevalence, safety and potency of death experiences that occur during ayahuasca ceremonies, marking them as possible mechanisms for psychedelics' long-term salutatory effects in non-clinical populations. Thus, the present results join other efforts of tracking and characterizing the profound subjective experiences that occur during acute psychedelic states.

Verified account of near-death experience in a physician who survived cardiac arrest

Research exploring the nature of near-death experiences (NDEs) is extensive. There are a variety of hypothesized mechanisms proposed to explain the origin of the experiences, including hallucinations due to physiological changes in a dying brain. However, there is growing evidence that these theories cannot explain a number of the characteristics of NDEs. In this article we present a detailed and extensively verified case study of a physician, Bettina Peyton, who experienced an NDE during the birth of her third child when she was 32 years old. The data provide additional evidence that supports the hypotheses 1) that during NDEs individuals have sensory perceptual experiences that are not possible according to the materialist framework in which consciousness is solely produced by the activity of neurons in the brain, and 2) that NDEs lead to a fundamental change in their understanding of the nature of consciousness, and in the place of the sacred in their lives.

Virtual mortality and near-death experience after a prolonged exposure in a shared virtual reality may lead to positive life-attitude changes

Mortality is an obvious if uncomfortable part of the human condition, yet it is impossible to study its impact on anyone who experiences it. Reports of phenomena associated with death such as out-of-the-body (OBE) and near death experiences (NDE) can only be studied post-hoc, since it is impossible to design a scientific study where an experimental group experiences death (and returns) and a control group does not. Yet NDEs seem to have a profound influence on the subsequent lives of people and are therefore worthy of study. Terror Management Theory, which argues that death anxiety contributes to in-group solidarity and hostility to out-groups, relies on studies that manipulate opinions and cannot be based on experiential evidence. Here we introduce a potential methodology that uses immersive virtual reality (VR) for the study of mortality and NDEs. Participants are embodied in alternate bodies in a beautiful island along with two companions. They explore the island and carry out tasks together. The mechanism of embodiment produces strong illusions of ownership over their life-sized virtual bodies. Over time each participant witnesses the death of the two companions and then her own death-which includes the reported features of an NDE (OBE, life review, the tunnel leading to white light) followed by a period of observation of the continuing activities in the virtual world on an external screen. Fifteen female participants experienced 6 sessions in the island, each starting as a child and gradually maturing, and eventually ageing and dying. Sixteen control subjects formed a waiting group. We introduce this as a methodology for the study of these issues, and present promising results, suggesting that those who experienced the island report life attitude changes, becoming more concerned with others and more interested in global rather than material issues compared to the control group. The results are based on a small sample size, and should be considered as indicative of the possibilities of this new methodology as a way forward for future studies in this field.

Burn Survivors' Near-Death Experiences: A Qualitative Examination

Persons who come close to death but survive catastrophic accidents sometimes report very vivid experiences during times when their survival was in doubt, when they were believed to be dead, and during resuscitation efforts. This qualitative study builds upon existing research on near-death experiences (NDEs) by focusing on the oral accounts from a sample of individuals with large and life-threatening burns. The NDE accounts were obtained from burn survivors attending the Phoenix Society's World Burn Congress and are similar to reports by notable researchers ( Greyson, 2003 ; Moody, 1975 ; Ring, 1980 ) while reflecting the uniqueness of the individual survivor's experiences. Six major themes are reported. Counselors and health professionals need to be aware of and educated about NDEs as these experiences can have profound effects upon the individual. Patients who have had NDEs may need to discuss them but fear professionals will reject their stories as being crazy.

Near-death experiences, posttraumatic growth, and life satisfaction among burn survivors

Survivors of large burns may face positive and negative psychological after-effects from close-to-death injuries. This study is the first to examine their near-death experiences (NDEs) and posttraumatic growth (PTG) and life satisfaction afterwards. With an available sample of 92 burn survivors, half met the criteria for an NDE using an objective scale. Those who indicated religion was a source of strength and comfort had high scores on life satisfaction, PTG, and the NDE Scale. Individuals with larger burns reported greater PTG than those with smaller total body surface area burned (TBSA). There were no significant differences on life satisfaction, PTG, or NDEs when examined by gender or years since the burn injury. Elements of the NDE most frequently reported were: An altered sense of time, a sense of being out of the physical body, a feeling of peace, vivid sensations, and sense of being in an "other worldly" environment. Social workers and other health providers need to be comfortable helping burn survivors discuss any NDEs and process these through survivors' spirituality and religious belief systems as they recover.

A Virtual Out-of-Body Experience Reduces Fear of Death

Immersive virtual reality can be used to visually substitute a person’s real body by a life-sized virtual body (VB) that is seen from first person perspective. Using real-time motion capture the VB can be programmed to move synchronously with the real body (visuomotor synchrony), and also virtual objects seen to strike the VB can be felt through corresponding vibrotactile stimulation on the actual body (visuotactile synchrony). This setup typically gives rise to a strong perceptual illusion of ownership over the VB. When the viewpoint is lifted up and out of the VB so that it is seen below this may result in an out-of-body experience (OBE). In a two-factor between-groups experiment with 16 female participants per group we tested how fear of death might be influenced by two different methods for producing an OBE. In an initial embodiment phase where both groups experienced the same multisensory stimuli there was a strong feeling of body ownership. Then the viewpoint was lifted up and behind the VB. In the experimental group once the viewpoint was out of the VB there was no further connection with it (no visuomotor or visuotactile synchrony). In a control condition, although the viewpoint was in the identical place as in the experimental group, visuomotor and visuotactile synchrony continued. While both groups reported high scores on a question about their OBE illusion, the experimental group had a greater feeling of disownership towards the VB below compared to the control group, in line with previous findings. Fear of death in the experimental group was found to be lower than in the control group. This is in line with previous reports that naturally occurring OBEs are often associated with enhanced belief in life after death.

Specific and Individuated Death Reflection Fosters Identity Integration

Identity integration is the process wherein a person assimilates multiple or conflicting identities (e.g., beliefs, values, needs) into a coherent, unified self-concept. Three experiments examined whether contemplating mortality in a specific and individuated manner (i.e., via the death reflection manipulation) facilitated outcomes indicative of identity integration. Participants in the death reflection condition (vs. control conditions) considered positive and negative life experiences as equally important in shaping their current identity (Experiment 1), regarded self-serving values and other-serving values as equally important life principles (Experiment 2), and were equally motivated to pursue growth-oriented and security-oriented needs (Experiment 3). Death reflection motivates individuals to integrate conflicting aspects of their identity into a coherent self-concept. Given that identity integration is associated with higher well-being, the findings have implications for understanding the psychological benefits of existential contemplation.

Impact of a near-death experience and religious conversion on the mental health of a criminal: case report and literature review

OBJECTIVE

Near-death experiences have been defined as profound psychological events that may occur to a person while close to death or in a situation of extreme physical or emotional distress. These experiences seem to have an important effect on the patients' mental health and may occur in several situations despite their cultural and religious beliefs.

CASE DESCRIPTION

The present case report describes the positive impact of a near-death experience (Greyson scale > 7) followed by religious conversion on the mental health of a former prisoner.

COMMENTS

Investigation of the role of near-death experiences by the scientific community could shed light on the coping mechanisms and moral/ethical transformations that take place in these individuals.