Relationships between trauma and psychosis: A review and integration

Objectives. This paper examines the research and theoretical literature on potential links between trauma and psychosis. Methods. Three main alternatives are considered; can psychosis cause PTSD, can trauma cause psychosis and could psychosis and PTSD both be part of a spectrum of responses to a traumatic event? The more influential studies considered are critically evaluated and methodological considerations specific to research regarding trauma and psychosis are also examined. Results. Evidence is found in support of each of these relationships, and an integrative approach to conceptualizing the relationships is suggested. Conclusions. Recent conceptualizations of PTSD and psychosis are used to inform the consideration of these different pathways, and the implications for theories of psychosis and trauma and the clinical implications for services for psychotic patients are discussed.