Positive Psychotic Symptoms

The Presence of Odd Feelings or Behaviors

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Psychotic symptoms can be divided into two groups: positive psychotic symptoms and negative psychotic symptoms.

Characterized by the presence of odd or unusual feelings, thoughts or behaviors, positive psychotic symptoms may include:

  • Auditory hallucinations such as hearing voices that other people cannot hear
  • Visual hallucinations, or seeing things that are not really there
  • Tactile hallucinations, or feeling things that are not really there
  • Gustatory hallucinations, or smelling things that are not really there
  • Delusions, or strongly held beliefs or ideas that are odd and unlikely to be true
  • Disorganized thought and speech such as making up words or speaking incoherently
  • Disorganized behavior such as sudden agitation, odd behavior, or staying in unusual poses for long periods of time

Positive symptoms are often associated with the diagnosis of schizophrenia; however, they can also be seen in posttraumatic stress disorder (PTSD) as well.

Negative psychotic symptoms are those characterized by absence or loss of experience. The best way to think of negative psychotic symptoms is as follows:

  • Affective flattening (diminished emotional expression)
  • Alogia (decrease in speaking)
  • Avolition (lack of motivation, leading to poor follow through on tasks and apathy)
  • Asociality (avoidance of social interaction with others)
  • Anhedonia (inability to experience pleasure)

Psychotic Symptoms and PTSD

Researchers at the University of Manitoba, Columbia University and the University of Regina examined the data on 5,877 people from across the United States to determine the rates with which people with posttraumatic stress disorder (PTSD) experience different psychotic symptoms.

They found that, among people with PTSD, the experience of positive psychotic symptoms was most common.

Approximately 52% of people who reported having PTSD at some point in their lifetime also reported experiencing a positive psychotic symptom.

The most common positive symptoms were:

  • Believing that other people were spying on or following them (27.5%)
  • Seeing something that others could not see (19.8%)
  • Having unusual feelings inside or outside of their bodies, such as feeling as though they were being touched when no one was really there (16.8%)
  • Believing that they could hear what someone else was thinking (12.4%)
  • Being bothered by strange smells that no one else could smell (10.3%)
  • Believing that their behaviors and thoughts were being controlled by some power or force (10%)

The researchers also found evidence that the more PTSD symptoms a person was experiencing, the greater the likelihood that they would also experience positive psychotic symptoms.

To take their study a step further, the researchers also looked at what traumatic events were most commonly related to the experience of psychotic symptoms. They found the following to be most strongly connected:

  • Being involved in a fire, flood, or natural disaster
  • Seeing someone get seriously injured or killed
  • Experiencing tremendous shock as a result of a traumatic event that happened to a close relative, friend, or significant other

A Word From Verywell

Positive symptoms can cause severe disruptions in daily functioning, however, with an appropriate diagnosis, treatment, and support, you or someone you love can discover ways to cope effectively.

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  • American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders, 4th ed. Washington, DC: Author.

By Matthew Tull, PhD
Matthew Tull, PhD is a professor of psychology at the University of Toledo, specializing in post-traumatic stress disorder.