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Exploring Group Differences in Attenuated Symptoms and Functioning Between Clinical High-Risk Individuals With and
Danielle Pham1, Leda Kennedy2, Jean Addington3
1Department of Public Health, UCSD, San Diego, California, USA.
Early Intervention in Psychiatry
|June 24, 2026
Summary
Posttraumatic stress disorder (PTSD) in youth at clinical high risk for psychosis is linked to worse symptoms but not a higher risk of conversion to psychosis. Early identification and treatment of PTSD are crucial for improving outcomes in these individuals.
Area of Science:
- Psychiatry and Mental Health
- Neuroscience
- Developmental Psychology
Background:
- Posttraumatic stress disorder (PTSD) frequently co-occurs with psychotic disorders.
- The impact of comorbid PTSD on youth at clinical high risk (CHR) for psychosis remains understudied.
Purpose of the Study:
- To compare symptom severity, psychosis conversion risk, and functioning in CHR youth with and without PTSD.
- To elucidate the relationship between PTSD and psychosis development in a vulnerable youth population.
Main Methods:
- A longitudinal study of 693 individuals meeting CHR criteria from the North American Prodrome Longitudinal Study 3 (NAPLS-3).
- Comparison of demographic, symptom, and functional variables between CHR individuals with and without PTSD.
- Cox proportional hazards models were used to assess the association between PTSD and time to psychosis conversion.
Main Results:
- Individuals with PTSD (N=54) exhibited more severe positive, negative, and general symptoms compared to those without PTSD (N=639).
- Specific symptom differences included grandiose symptoms, emotional blunting, sleep disturbances, dysphoric mood, and impaired stress tolerance.
- PTSD diagnosis was not significantly associated with an increased risk of psychosis conversion.
Conclusions:
- PTSD diagnosis in CHR youth is associated with greater symptom severity but does not predict conversion to psychosis.
- Recognizing and treating comorbid PTSD in CHR populations is vital for symptom reduction and improved patient outcomes.
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