Reactive and Dissociative Psychosis Re-visited: Trauma, Identity, and the Phenomenology of Collapse
Mykhaylo Pustovoyt, Ivan Romash, Yuliia Medynska, Roman Kechur, Oxana Shevchuk, Iryna Romash, Vasyl Neyko, Volodymyr Paliichuk, Liubov Lutska, Olexander Myronenko, Berger Hartmut
Mental Health: Global Challenges Journal September 10, 2026 DOI: 10.56508/mhgcj.v9i1.368 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Theoretical or philosophical paper Peer reviewed |
|---|---|
| Topics | Philosophy of mind |
| Key points | Argues that existing classification systems inadequately differentiate dissociative, reactive, and psychotic disorders, and proposes a novel hypothetical diagnostic construct, "schizo-dissociative reactive disorder," defined by the intersection of dissociative fragmentation, trauma-related reactive mechanisms, and psychotic disorganization, with phenomenologically oriented criteria intended to improve diagnostic clarity. |
Abstract
To read the full-text Open Access article and download the PDFs, please visit our Issue portal at Paradigm (Walter de Gruyter): https://reference-global.com/article/10.56508/mhgcj.v9i1.368
Introduction: Diagnostic differentiation between dissociative, reactive, and psychotic disorders remains conceptually and clinically challenging due to overlapping phenomenology and insufficiently specified psychopathological criteria. Existing classification systems often fail to adequately capture the dynamic and phenomenological complexity of trauma.
Purpose: This article identifies key diagnostic gaps in the field of dissociative and reactive disorders and proposes a refined conceptual framework for their differentiation, including a novel diagnostic construct. Methodology: A conceptual and clinical-theoretical analysis was conducted based on accumulated clinical experience and integration of relevant psychopathological and phenomenological perspectives. Particular attention was given to the analysis of symptom structure, developmental dynamics, and differential diagnostic boundaries.
Results: The analysis highlights persistent limitations in the current differentiation of dissociative and reactive conditions, particularly regarding their overlap with psychotic disorganization processes. In response, a novel hypothetical diagnostic category - schizo-dissociative reactive disorder - is proposed. This construct is defined as a clinical entity emerging at the intersection of dissociative fragmentation, trauma-related reactive mechanisms, and psychotic disorganization. Phenomenologically oriented diagnostic criteria are outlined to improve the identification of core features, including identity fragmentation, affective-cognitive disintegration, and dynamic trauma-related symptom modulation.
Conclusion: The proposed model emphasizes the need for a trauma-informed, phenomenologically grounded, and dimensionally oriented approach to diagnostic classification. Introducing the concept of schizo-dissociative reactive disorder may contribute to improved diagnostic clarity and more precise clinical stratification of complex trauma-related psychopathology.