Psychosis in the Context of Travel, Substance Use, and Media Exposure: A Stress-Diathesis Perspective.

Brief psychotic disorder is a transient psychotic condition often precipitated by acute stress in vulnerable individuals. We describe the case of a 40-year-old woman with no prior history of psychosis who developed persecutory delusions during international travel. Her symptoms emerged in the context of multiple vulnerability factors, including heavy alcohol use, prior cocaine exposure, traumatic brain injury, and acute physiologic stress. During this period, repeated exposure to media coverage of violent crime appeared to reinforce perceived threat and escalate paranoia. Neuroimaging revealed structural abnormalities involving frontal and temporal regions, raising concern for an underlying vulnerability to psychosis. This case illustrates the stress-diathesis model of psychosis and highlights media-driven stress as a potentially underrecognized precipitating factor in susceptible individuals.