Psychological Trauma: Theory, Research, Practice, and Policy, Vol 18(3), Mar 2026, 473-484; doi:10.1037/tra0001958
Objective: Leading cognitive behavioral theories propose trauma can inform psychotic symptom content directly through posttraumatic intrusions and thematically through trauma-related beliefs. A small number of studies have utilized varied methodologies to assess these content relationships. To inform future research, this conceptual review sought to analyze theoretical and methodological issues in literature examining the relationship between trauma, posttraumatic sequelae, and the content of psychotic symptoms. Method: Searches of three databases led to identification of nine empirical articles. The methodologies for identifying content relationships and the frequencies of identified relationships were reviewed for each. An assessment of quality was completed with the Joanna Briggs Institute checklist for analytical cross-sectional studies. Results: In the reviewed studies, 12%–33% of participants experienced psychotic symptoms with content directly related to trauma. Confidence in this frequency was limited due to different definitions across studies of what a direct content relationship was. In the reviewed studies, 36%–67% of participants experienced psychotic symptoms with content thematically related to trauma. Examinations of thematic relationships were also impacted by methodological challenges: in particular, the likelihood that any psychotic symptom with negative valence could be identified as thematically related and difficulty designing studies that test the null hypothesis. Conclusion: Meaningful relationships between trauma and psychotic symptom content can be identified. However, there is a need for novel methodologies including qualitative research designs and greater rigor when examining content relationships. Further, additional posttraumatic sequelae such as hyperarousal and dissociation may impact the content of psychotic symptoms and should be a focus of future investigation. (PsycInfo Database Record (c) 2026 APA, all rights reserved)