The bidirectional relationship of PTSD and psychosis: Conceptualization of prevention of comorbidity and intervention for bidirectionality.

Abstract

Objective: The research on posttraumatic stress disorder and psychosis has now shown that these experiences can be bidirectional and actually potentiate each other. This scientific knowledge provides the field invaluable insight about points of prevention for either condition so that the risk for onset of the other mental health challenge does not occur, as well as diverse information for when the experiences are fully comorbid. In this article, a conceptual model is provided outlining practical conceptual and clinical applications.

Method: By using an innovative conceptual model, this article provides more insight about understanding and using the literature we know to inform prevention of co-occurrence and a diverse approach when both disorders are present in comorbidity, actually potentiating each other, and how to then address the situation holistically, rather than in silos.

Results: Using the innovative conceptual model, this article is able to help systems and providers move toward more effective treatment of the bidirectionality of posttraumatic stress disorder and psychosis holistically and equally rather than treating either of the conditions solely, in silos, or treating one condition over the other, as this is a risk that is reductionistic and negates the true capabilities of our clinical interventions. Practical clinical applications are provided as part of this conceptual piece.

Conclusion: This conceptual model is innovative as common practice in many settings is to still prioritize one diagnosis, and this failure in treatment falls short of adequately targeting every element that makes up the complexity of experience for individuals who experience comorbid posttraumatic stress disorder and psychosis. (PsycInfo Database Record (c) 2026 APA, all rights reserved).