Research on the relationship between trauma and psychosis continues to grow. However, a clear understanding of processes involved from trauma-related stress to vulnerability for psychosis has yet to emerge. Processes associated with post-traumatic responses have been suggested to be involved in psychosis-related experiences, such as dissociation and avoidance. There is increasing evidence that depicts an association between dissociation and psychosis-related phenomena, and avoidance has been found to relate to voice-related distress and to forms of dissociation. This review aimed to critically evaluate literature that depicts the roles of both dissociation and avoidance in the context of psychosis and to present a metasummary of the emerging themes across studies.

Ten quantitative papers and three qualitative papers met the eligibility criteria, which collectively comprised of outcome evaluation data and interview-based research. Sandelowski & Barroso’s (2006) metasummary approach was taken to synthesise the findings.

Six themes were found (presented in descending order of the number of papers contributing to each theme): dissociation and avoidance linking trauma and psychosis; working with dissociation and avoidance in psychosis; associations between dissociation and avoidance with psychosis; conceptualising dissociation and avoidance; using measures of dissociation; and the relationship between dissociation and avoidance in psychosis. Results suggested dissociation and avoidance could be grouped as emotion regulation strategies in the context of psychosis, and demonstrated ways in which these processes may distinctly occur.

Combined investigation of both dissociation and avoidance as processes within psychosis requires further investigation considering the limited empirical research available. Implications for practice and further research are outlined.