This study describes differences in symptoms in young people with psychosis, with and without a history of trauma. The files of 118 mental health inpatients, aged 8 to 18 years, all reporting hallucinations and/or delusions, were reviewed for a history of trauma. Symptoms reported by inpatients with and without a history of trauma were compared. Variables found to be significantly associated with trauma in the univariate analysis were entered into a logistic regression analysis. Variables were entered if they met a significance of p < .05 or an adjusted odds ratio of < 2. Young people with a history of trauma reported a highly significant increase in disturbed behavior, particularly those with a history of sexual assault. This study illustrates the importance of obtaining an adequate assessment of children and adolescents with psychotic symptoms to ensure they receive the most effective treatment.