Dr Alameda will provide an overview of the evidence on the biological mechanisms linking childhood trauma and psychosis. He will present the results of a new systematic review examining this question and offer insights based on this and his own previous work. He will summarise how genetic load, measured in the form of polygenic risk scores, can influence sensitivity to trauma in relation to psychosis risk and clinical presentation. He will also discuss how epigenetic changes may mediate the association between childhood trauma and psychosis and provide insights the role of oxidative stress and dopaminergic dysregulation as key promising pathways linking trauma and psychosis. Dr Alameda will then discuss how this may affect dopaminergic dysregulation as the "final common pathway" and the implications for future drug discovery.
Professor Emmanuelle Peters will then present the important outcomes from the Study of Trauma and Recovery (STAR) RCT. People with psychosis have high rates of trauma, with a post-traumatic stress disorder (PTSD) prevalence rate of approximately 15%, which exacerbates psychotic symptoms such as delusions and hallucinations, and gets in the way of living life. STAR is a multisite randomised controlled trial of the clinical and cost-effectiveness of trauma focused cognitive behaviour therapy for psychosis in reducing post-traumatic stress symptoms in people with co-morbid post-traumatic stress disorder and psychosis, compared to treatment as usual
Finally, Professor James MacCabe will discuss the practical difficulties in conducting randomised controlled trials in people living with Treatment Resistant Schizophrenia, and what this means for the applicable evidence. He will share some potential solutions to this challenge, such as using legal representatives in the consenting process, as well as highlight the potential and pitfalls of the emerging field of target trial emulations using electronic health records.
Learning objectives
In this webinar you will:
• gain knowledge on the biological mechanisms linking childhood trauma with psychosis
• hear about the (as yet unpublished) results of the STAR trial of trauma focused CBT for psychosis
• gain greater overall understanding of the relationship between psychosis and trauma and past and future options to help people who have experienced both
• understand the challenges in recruiting people with treatment resistant schizophrenia and what this means for the evidence available to guide our decision making.
Speakers
Chair: Professor Fiona Gaughran, South London and Maudsley NHS Foundation Trust, London
Co-Chair: Professor Helene Verdoux, University of Bordeaux, France
Dr Luis Alameda, South London and Maudsley NHS Foundation Trust, London
Professor Emmanuelle Peters, South London and Maudsley NHS Foundation Trust, London
Professor James MacCabe, South London and Maudsley NHS Foundation Trust and the Institute of Psychiatry, London
Funding
RCPsych International Congress is financially supported by the purchase of exhibition stand packages. A full list of confirmed exhibitors can be found here: Exhibiting Organisations at International Congress 2026
Availability
This webinar is part of the Congress webinar 2026 package. If you attended all four days of Congress, you will have access to these as part of your Congress package. Otherwise the Congress webinar 2026 package can be purchased below.
