Greyson NDE Scale & the Future of Recalled Experience of Death Research

I will be going over the Grace Near Death Experience Scale. This scale was published in 1983 and this was during a time where the near death experience was not something that was very commonly looked into and the definition or definitions had just come about. So this was definitely something that not a lot of people were researching at the time. And so I will be providing you with an overview of this scale and I'll review questions that make up the the scale as a whole and describe limitations and discuss future directions. Raymond Moody was one of the first people to look into the near death experience literature and he did kind of expand on this in his book Life After Life. And in that book he specifically defined this experience as a clinical situation that would normally have led to the death of an individual without medical intervention. And he expands on this by saying it's a pattern experience people have after dying or almost dying. No two near death experiences are exactly the same but there are striking commonalities. And as I mentioned before there's other definitions out there and there's many more than this but this one really stood out to us because it mentions the current medical understanding. So it says transcendental experiences precipitated by the confrontation with death and which do not seem to be accounted for by our current medical understanding of the dying process. And this was a definition that was during a time where there was no understanding of death and coming back to life for that matter. So Grayson did pull from other literature that existed at the time and I believe you mentioned Noyce. And so there are other physicians and psychologists psychiatrists that have looked into this experience further. Savum classed three near death experience types. So the out of body, the transcendental, and a component involving both. And then Noyce did class the response of life-threatening danger and this may have involved the near-death experience. And then Ring what actually created a measure, a measuring tool for the near-death experience. But this was not valid it was based off of what little literature and knowledge was out there. So Grayson did look into his index as well The creation of this was began by the compilation of 80 near-death experience themes features from very little limited knowledge of what a near-death experience was and what literature existed. He included only 40 of these. They were most commonly mentioned in the literature that existed at the time and he excluded seven of these that showed ambiguity and redundancy. This left him with 33 items and he did a standard three category weighted response scale and the scale represented a 0, 1, or 2 for not present, mildly ambiguously present, or definitively present. Subjects who had claimed to have the near-death experience encounter were selected from 100, or sorry let me rephrase that, the 33 item questionnaire was administered to 100 subjects who came from the International Association of Near-Death Studies. 67 of these subjects responded. They described 74 near-death experience in total among all of them and these were each considered a separate case in the analysis portion of this. The mean age and time of the completion of the questionnaire was about 50 years of age. The mean age and time of the near-death experience though was 32 years so there was an elapsed time of about 18 years and 31 were male and 43 were female and the distribution of these medical conditions leading to these near-death experience events really was very broad. Either complications of surgery or childbirth, exasperation of ongoing illness or complications of pregnancy, unanticipated accidents, sudden natural events, sudden loss of consciousness, of unidentified etiology, and suicide attempts and all of these are out of the 67 total respondents who reported. So frequency counts were made of the responses to the 33 questionnaire item. Correlation coefficients were computed to test the association between the questionnaire item and the remaining 32 questionnaire items as a whole. So based off of this, the questionnaire items of the correlation coefficient had to have at least an r value of 0.35 and they were grouped into clinically meaningful clusters which I'll expand on later and these clusters were tested for further association and the final near-death experience was constructed based on the summation of these clusters. So here you see the preliminary questionnaire. All the near-death experience features came from what literature was out there as I mentioned before and automatically he excluded these from the final questionnaire due to the r value being less than 0.35 and then we would like to just point out some of these questions or features I should say and how ambiguous they are and how well how broad they really are. They could really mean anything to whoever had experienced a near-death experience. So if you want to go ahead. So the problem is you can see how people might say you know I could go from Manhattan which is so busy and crazy you give me a week on a mountaintop and I will come back and tell you my god I had a really unearthly experience it was just different and someone else who takes drugs might say the same thing and so you can see why the problem is if these terms are not very precise it's very easy for it to be misused and misclassified I would like to do a poll among a hundred people and have them define what an unearthly being is. So I don't I mean I realized the intent wasn't there at the time this was the best they could do there was very little available to them you know perhaps people started saying using these terms but I think we're trying to understand the actual descriptions and these terms are problematic or or number 13 you know did you experience strange bodily sensations yeah when I had an allergy reaction I had a very strange bodily sensation when I had my you know hay fever burst yeah I did you know what I mean it's not very clear agree with those terms I think they're not necessarily as accurate as they should be I don't even know what that means and part of it we were talking about earlier is that people who try to do this end up translating these descriptions into old-fashioned terms terms that other have used you know which I don't think are appropriate or accurate as we go forward so I just asked Annalise to highlight some of these to show you and then when the same scale is used on someone who takes a drug you can clearly see why it's possible to to score as if you've had a near-death experience even though you didn't have a near-death experience at all so that's part of the challenge yes oh and then also a life review and then here you are like one of the most fundamental things that people talk about is this very powerful life review which just gets a bare mention among all the other sort of stuff you know and again recognizing now we've had millions of people who survive we have a lot more data and we recognize how powerful that is so part of our challenge which is completely outside my realm of expertise is how do we make the appropriate scale to go forward that reflects the true experience that people are describing that will be sensitive and specific enough to what we're trying to test and detect we will we will present that for you actually it's an entire slides the frequency she's going to present so we'll do that so this is just an overview of what i um just explained um so ad compiled near-death experience themes 40 that were most commonly mentioned um he went on to exclude an additional seven questions resulting in the 33 item questionnaire this was administered to the 100 subjects frequency counts were made and then you have the final questionnaire which he went on to validate and test for reliability but first as i mentioned before he took these 16 questions and he did group them into psychologically meaningful components and he chose to do this because he wanted to look at the components in themselves and the questions and the the range that these participants may experience these near-death experiences based off of maybe their what what had them what caused them to have that near-death experience in the first place and it was actually later removed due to lack of meaningful associations between these components so if you look at a scale now you're not going to see these components um listing out the 16 questions and again if i can just highlight one of my favorites like you know this like a paranormal like what does it even mean i mean to me that's again these are victorian terms almost that we shouldn't be using anymore like every experience is normal i don't just because you can't explain it like it just means you have to figure a way to so um you know um but the point is everyone's been using this single bruce thankfully created the scale that everyone's been using but i do think it's time for us to revise this and the mean score of this final near-death experience scale was 15 with a standard deviation of 7.84 this ranged from 2 to 31 and a true near-death experience had to have a score of 7 or greater which um as dr parnia may mention later on that that can exclude a lot of people because if you look at the way this well we'll get into that but if you look at the way the scale is really um is developed it's based off of scoring of zero one or two so you'd have to have more than four near-death experiences in order to be considered um you know yeah in other words if you think about it like any single feature will only get you a maximum score of two so if somebody says i had an out-of-body experience and i reviewed my life deeply meaningful and i saw a being of love they would only score a six because you can only get two for each of those features but then somebody goes on top of a mountain who says oh this was unearthly i felt at peace and i was really pumped you know etc will score an eight so that person who never was even near death didn't really have a near-death experience will be categorized as a near-death experience the person who truly had near-death experience will be missed because they didn't you have to have at least four features four strong features if they're not even strong then you have to have more to get it so that's one of the challenges as you as you can see so he did go on to validate the study um associations were made between the near-death experience the preliminary um scale the subject's age elapsed time since the near-death experience and no difference was found among any of these associations he did tests for reliability internal consistency and by administering this finalized near-death experience scale to 50 of the first subjects who completed the preliminary scale so 50 out of the 67 these are the four components and we'll begin with the questionnaire um so the questionnaire can uh is broken up into the 16 questions the four components and um as you can see these questions are um very broad um and could really mean something different to everyone um did time seem to speed up were your thoughts speeded up did scenes from your past come back to you did you suddenly seem to understand everything and the uh scoring of these are um different in themselves as well uh everything seems to be happening all at once time seemed to go faster than usual so um this could mean different things to people as well so let's look at this like for example look at the life review look at what it gets the scenes from your past come back to you past flash my past flash before me out like that is such a with all respect this service as you'll see from what farah's going to describe what people really say and unfortunately you look at the media they say oh yeah when you die your passion flashes by you it's so much more meaningful than that what people really describe so you can sort of see some of the challenges that we've had which is again why i'm grateful that you are here because i'm hoping you're going to fix this all for us and also number four you can only ever know what you understand to the extent that you know so asking someone did you understand everything relative to what they think they know i'm sure nobody understands everything you see so it's again these questions are misleading um did you have a feeling of peace or pleasantness did you have a feeling of joy did you feel a sense of harmony did you and just to say that you can see just those three things you can have those five six and seven under any almost any circumstance in your life you know you're happy about something so you can see how easy it is to incorrectly score for a near-death experience you just need one more feature and then that's it well it's made to be a continuous scale and it's not continuing right obviously two and one are often just different categories can i can i interrupt with a real quick comment that's about this yes please um so when i was i was looking at this handbook of near-death experiences just yesterday was kind of going through a lot of this stuff and in the chapter that talked about pleasurable near-death experiences there were some studies that have been done that record that gave all these different features and things and they said that only like some small percentage of the people had actually been near death like 10 or 15 percent or something so it was really confusing as to what was going on it sounded like people had a variety of mystical experiences and things but that the fact that they were even making it into a database or a study that was about near-death experiences i was really confused like well what are these what are some of these things about then so it makes me think maybe some of what you were saying was happening sam where people were above that seven cut off with a very different type of experience but then they did get bumped into they looked like they were people who had ndes in these studies even though they hadn't even been near death so it does become very confusing that's exactly right and the other problem is so one of the challenges that this scale has nothing to do whether you are actually close to death or not by definition you have to be that's that and then as you said yeah a lot of things are getting bumped into and unfortunately in the past and i i was one of them i have stood up and said oh you can have a near-death experience when you're not near death that was when i just started out i didn't understand that's not true in other words yes you can have a religious profound experience under many circumstances but clearly that you know to to be close to death what we're talking about has to be prominently there and that's misleading what people say the paranormal uh where your sense is more vivid than usual did you seem to be aware of things going on elsewhere as if by esp did scenes from the future come to you and did you feel separated from your physical body and then lastly transcendental um did you seem to enter some other unearthly world did you seem to encounter a mystical being or presence did you see deceased spirits or religious figures and did you come to a border since we're doing a dual act i'm doing commentary i'm the commentator yeah so you see the problem here right i mean what is an unearthly world could someone define that for me and if you can't define it how can you ask somebody else to ask it and then you see people have started to infuse religious terms like i would always i'm not even a spirit right it's just halloween's coming up my daughter's getting dressed up you know like these are terms that you should well you see what people say is they're describing themselves like the person says i saw myself it was me and you know people have started to do this and then if you remember them just go back one slide and look at what the so-called out-of-body experience where my colleagues come back to me and they're freaked out where the patients come back and describe 30 minutes of events that are going on when their heart isn't beating is relegated to this did you feel separated i really left my body i lost awareness about it it's not even weighted properly in terms of the real things that people are saying so i hope you can see some of the challenges and how easy it is to score above the seven well this is really bothering me i mean there's a lot of double-barreled questions right so you're asking with two things in one question and it's really bothering me that two is not really the more intense version of one they just decided to ask like solve two different questions and call them one bigger than the other but i think what i do want to say in defense because i have to say first of all bruce grayson is the person who's done the most work in this area and he started this in 1983 where people have just started describing it even in the late 90s when i started doing this like you would literally be shocked for bringing this up and you want to study and i can imagine i was telling these guys the challenges that would have been faced to try to do this but thankfully because we had it at but clearly and he acknowledges now as a professor who's only recently retired but still working very hard and he'll be joining us but we all recognize the limitations that were there in the early 90s so there definitely are some potential limitations to the scale near-death experience scale scoring can be ambiguous for some of the 16 questions a respondent can endorse two answers so corresponding with a score of one or two and with this for example a barrier i was not permitted to cross or i was sent back to life involuntarily or a conscious decision to return to life they would that would result in them getting the higher of those two scores if they couldn't really decide between a one or a two and in reality these two are completely different and should not be scaled recall bias as well time of near-death experience and the time of completing the near-death experience questionnaire we had some people or some people recalled that they were not aware if they had a near-death experience and since the time of the questionnaire was you know 18 years in the future people said i'm not clear it could have been mixed with my dreams so and that's the point i'm going to come to before taro's book i want to elaborate on the challenges i'm looking for his experiences but just hold on to that point um the near-death experience has no definitive definition um could which could really result in misuse of the scale um when subjects who are using the scale don't understand the actual near-death experience um using a near-death experience cut off of seven will exclude many people as we mentioned before and um the final 16 features are ambiguous consequently the scale is misused for other experiences for example failing unearthly and these could all be interpreted differently based on the person so future directions and points of discussion um is a near-death experience defined by the proximity to death um what are the conditions of a close brush of death and should physiological measures of a person be considered when defining a near-death experience and how do we make the scale specific for a near-death experience while excluding other experiences and is unconsciousness necessary for a near-death experience