**3. Earthquake and schizotypical personality**

In Schizotypical personality disorder, people exhibit odd behavior, respond inappropriately to social cues and hold peculiar beliefs. Schizotypical personality disorder occurs in 3% of the general population and occurs slightly more commonly in males than females. People with classic schizotypical personalities are apt to be loners. They feel extremely anxious in social situations, but they're likely to blame their social failings on others. They view themselves as alien or outcast, and this isolation causes pain as they avoid relationships and the outside world. People with schizotypical personalities may ramble oddly and endlessly during a conversation. They may dress in peculiar ways and have very strange ways of viewing the world around them. Often they believe in unusual ideas, such as the powers of Extra Sensory Perception (ESP) or a sixth sense. At times, they believe they can magically influence people's thoughts, actions and emotions. In adolescence, signs of a schizotypical personality may begin as an increased interest in solitary activities or a high level of social anxiety. The child may be an underperformer in school or appear socially out-of-step with peers, and as a result often becomes the subject of bullying or teasing. Schizotypical personality disorder typically begins in early adulthood and is likely to endure, though symptoms may improve with age.

Experiencing trauma is a factor that appears to increase the risk of schizotypical personality disorder. In a sample of 75 women recruited from the community, researchers measured trauma/maltreatment history and symptoms of schizotypical personality disorder, using both questionnaire and interview measures [Howard Berenbaum, et al. 2003]. As hypothesized, individuals with histories of trauma/maltreatment had elevated levels of schizotypical symptoms. Among types of trauma, maltreatment was especially strongly associated with schizotypical symptoms. Although posttraumatic stress disorder symptom severity, depression, dissociation, and difficulty identifying one's emotions were all associated with schizotypical symptoms, they could not account completely for the association between trauma/maltreatment and schizotypical symptoms.

Previous research has demonstrated that prenatal exposure to maternal stress is a possible risk factor for development of schizophrenia-spectrum diagnoses among adult offspring; however, research examining the effects of prenatal stress exposure on sub-threshold psychotic symptoms is lacking. Similarly, there is a paucity of research investigating

Earthquake and Mental Health 217

20 points), the more possibility of schizotypical personality was. Differences of means were evaluated with t-test in the two groups. Six hundred and three in exposure group and 598 in control group completed the SPQ-B evaluation, and effective data were obtained and all were included in the analysis. Total score and score of Cognitive-Perceptual factor of SPQ-B score in fetus of sixth month of gestation in the exposure group were (9.1± 4.6) and (13.4± 2.1) points, respectively, which were markedly higher than those in the control group [(7.6±3.6),(2.7±1.6) points, t=2.04,2.00, P<0.05].There was no significant difference between the Interpersonal Deficits factor and Disorganization facto r(P>0.05).②Comparison of total score and factor scores of SPQ-B in fetus of sixth month (different weeks) of gestation in the two groups: At week 23 the total score of SPQ-B in the exposure group was remarkably higher than that in the control group (t=2.1, P<0.05).Score of Cognitive-Perceptual factor was higher than that in the control group, but there was no significant difference (P>0.05). Score of Disorganization factor was distinctly higher than that in the control group (t=2.3, P<0.05). There was no significant difference of SPQ-B score at weeks 21, 22 and 24 in the two groups (P>0.10). The fetus exposed to the earthquake in their sixth month of gestation may be has high risk for adult

Trauma has been shown to significantly compromise cognitive development. [Levine, 2007; Perry & Szalavitz, 2006] Cognitive deficits such as poor problem solving, (unable to think things out or make sense of what is happening), low self-esteem (how one thinks of oneself – victim-thinking) and hopelessness (loss of future orientation) have all been clearly linked to traumatic events including earthquake, influenza, and so on [Stein & Kendell, 2004; William Steele, 2007]. There is evidence in two independent studies that the trauma and second-trimester influenza, is associated with deficits in cognitive ability as measured by infant habituation to visual stimuli [Wang Xueyi, et al. 2001; Watson JB, 1999; Van OS, 1998]. In both of these studies, the infants whose mothers suffered an influenza infection during their second trimester of fetal development exhibited impaired habituation to visual stimuli. The test of infant habituation of attention is excellent predictor of later intellectual development school readiness and intelligence quotients. Based on the above two studies, we hypothesized that the trauma is related to cognitive impairment. Our purpose of this investigation was to examine the long-term effects of the severe earthquake (7.8 Richter Scale) that struck Tangshan, China in July 1976 on the offspring of women who were pregnant at the time of the earthquake. The extremely severe stress of the earthquake may have resulted in a physiological response in the pregnant women of Tangshan, which adversely affected their fetuses. To determine if exposure to the earthquake as a fetus results in a negative outcome we administered a test of cognitive functioning to test the following hypotheses: 1). The stress of a severe earthquake during gestation will disrupt neural development producing deficits in cognitive functioning. Thus, the exposed group should have poorer cognitive functioning as compared to the control group. 2) Exposure to a severe stressor during a critical period of fetal brain development (the second trimester of gestation) may result in more pronounced cognitive deficits as compared to those exposed during the first or third trimesters. The exposed group consists of 606 high school seniors who were fetuses at the time of the earthquake. The birth dates of the subjects were used to

Schizotypal personality characteristics. [Wang Xueyi, et al.2007]

**4. Earthquake and cognitive function disorders** 

prenatal stress exposure in relation to anxiety and depression among adult offspring, and how anxiety and depression may contribute to schizophrenia-spectrum symptom outcome among prenatally exposed offspring. The present study examined a large dataset to investigate whether 18-year-old, male and female, Chinese, high school seniors exposed to the 1976 Tangshan earthquake during one of nine months of gestation demonstrated higher levels of schizophrenia-spectrum, anxiety, and depression symptoms than unexposed control participants. This study further examined the relationship between schizophreniaspectrum, anxiety, and depression symptoms, and investigated the effects of prenatal stress exposure on schizophrenia-spectrum symptoms after controlling for anxiety and depression. Results indicated that prenatal exposure to the Tangshan earthquake did not have an overall effect on schizophrenia-spectrum, anxiety, or depression symptoms [Wang Xueyi, et al.2011; Armstrong, Nikki Panasci, 2009]. However, exposed female participants demonstrated higher negative schizotype scores (SPQ Interpersonal scale) than unexposed females, even when anxiety and depression were controlled statistically [Wang Xueyi, et al.2007]. When anxiety and depression were included in analyses, exposed females also demonstrated higher disorganized schizotype scores (SPQ Disorganized scale) [Wang Xueyi, et al.2007; Armstrong, Nikki Panasci, 2009]. Additionally, females exposed to the earthquake during gestational months one and five produced higher depressions scores than unexposed females of the same gestational months. Finally, anxiety and depression significantly correlated with schizophrenia-spectrum scores; however, their relationships with negative and positive schizophrenia-spectrum symptom scores were relatively similar. An interesting finding in this study was that control group participants demonstrated higher levels of psychopathology symptoms on some measures. A possible explanation for such findings is that although control participants were not exposed to the earthquake, their mothers (who did experience the earthquake a year prior to pregnancy) may have experienced chronic stress that possibly resulted in more disruption to their offspring's stress response system, and ultimately to increased symptoms of psychopathology in their offspring. Future research examining the effects of prenatal exposure to acute vs. chronic stress on schizophrenia-spectrum symptom outcome is suggested.

Our research named "Adult schizotypical personality characteristics of a fetus exposed to Tangshan earthquake in its sixth month of gestation", aimed to evaluate the fetus exposed to earthquake in their sixth month of gestation with or without high risk for adult schizotypical personality characteristics.The subjects were drawn from the fourteen high schools in the Tangshan area. All 12th grade students who were 18 years were invited to participate in the research project. Discarding any data from subjects whose mothers resided outside the Tangshan area during the 1976 earthquake, 604 subjects who were born from July 28th, 1976 to April 28th, 1977 were selected as the exposure group. The control group consisted of 601 subjects who were born one year after the exposure group from July 28th, 1977 to April 28th, 1978. The recruitment and testing of exposure group took place in December of 1995 and for the control group in December of 1996.This ensured that exposure group and control group were the same age at the time of the assessment. Fully informed consent was obtained in all subjects. Raine's Schizotypical Personality Questionnaire (SPQ-B) was used as a measure of schizotypice personality. The SPQ-B of 22 True-False items made up a total score together with three sub-factors: Cognitive-Perceptual factor, Interpersonal Deficits factor and Disorganization factor. The more mean scores on SPQ-B (0-

prenatal stress exposure in relation to anxiety and depression among adult offspring, and how anxiety and depression may contribute to schizophrenia-spectrum symptom outcome among prenatally exposed offspring. The present study examined a large dataset to investigate whether 18-year-old, male and female, Chinese, high school seniors exposed to the 1976 Tangshan earthquake during one of nine months of gestation demonstrated higher levels of schizophrenia-spectrum, anxiety, and depression symptoms than unexposed control participants. This study further examined the relationship between schizophreniaspectrum, anxiety, and depression symptoms, and investigated the effects of prenatal stress exposure on schizophrenia-spectrum symptoms after controlling for anxiety and depression. Results indicated that prenatal exposure to the Tangshan earthquake did not have an overall effect on schizophrenia-spectrum, anxiety, or depression symptoms [Wang Xueyi, et al.2011; Armstrong, Nikki Panasci, 2009]. However, exposed female participants demonstrated higher negative schizotype scores (SPQ Interpersonal scale) than unexposed females, even when anxiety and depression were controlled statistically [Wang Xueyi, et al.2007]. When anxiety and depression were included in analyses, exposed females also demonstrated higher disorganized schizotype scores (SPQ Disorganized scale) [Wang Xueyi, et al.2007; Armstrong, Nikki Panasci, 2009]. Additionally, females exposed to the earthquake during gestational months one and five produced higher depressions scores than unexposed females of the same gestational months. Finally, anxiety and depression significantly correlated with schizophrenia-spectrum scores; however, their relationships with negative and positive schizophrenia-spectrum symptom scores were relatively similar. An interesting finding in this study was that control group participants demonstrated higher levels of psychopathology symptoms on some measures. A possible explanation for such findings is that although control participants were not exposed to the earthquake, their mothers (who did experience the earthquake a year prior to pregnancy) may have experienced chronic stress that possibly resulted in more disruption to their offspring's stress response system, and ultimately to increased symptoms of psychopathology in their offspring. Future research examining the effects of prenatal exposure to acute vs. chronic

stress on schizophrenia-spectrum symptom outcome is suggested.

Our research named "Adult schizotypical personality characteristics of a fetus exposed to Tangshan earthquake in its sixth month of gestation", aimed to evaluate the fetus exposed to earthquake in their sixth month of gestation with or without high risk for adult schizotypical personality characteristics.The subjects were drawn from the fourteen high schools in the Tangshan area. All 12th grade students who were 18 years were invited to participate in the research project. Discarding any data from subjects whose mothers resided outside the Tangshan area during the 1976 earthquake, 604 subjects who were born from July 28th, 1976 to April 28th, 1977 were selected as the exposure group. The control group consisted of 601 subjects who were born one year after the exposure group from July 28th, 1977 to April 28th, 1978. The recruitment and testing of exposure group took place in December of 1995 and for the control group in December of 1996.This ensured that exposure group and control group were the same age at the time of the assessment. Fully informed consent was obtained in all subjects. Raine's Schizotypical Personality Questionnaire (SPQ-B) was used as a measure of schizotypice personality. The SPQ-B of 22 True-False items made up a total score together with three sub-factors: Cognitive-Perceptual factor, Interpersonal Deficits factor and Disorganization factor. The more mean scores on SPQ-B (020 points), the more possibility of schizotypical personality was. Differences of means were evaluated with t-test in the two groups. Six hundred and three in exposure group and 598 in control group completed the SPQ-B evaluation, and effective data were obtained and all were included in the analysis. Total score and score of Cognitive-Perceptual factor of SPQ-B score in fetus of sixth month of gestation in the exposure group were (9.1± 4.6) and (13.4± 2.1) points, respectively, which were markedly higher than those in the control group [(7.6±3.6),(2.7±1.6) points, t=2.04,2.00, P<0.05].There was no significant difference between the Interpersonal Deficits factor and Disorganization facto r(P>0.05).②Comparison of total score and factor scores of SPQ-B in fetus of sixth month (different weeks) of gestation in the two groups: At week 23 the total score of SPQ-B in the exposure group was remarkably higher than that in the control group (t=2.1, P<0.05).Score of Cognitive-Perceptual factor was higher than that in the control group, but there was no significant difference (P>0.05). Score of Disorganization factor was distinctly higher than that in the control group (t=2.3, P<0.05). There was no significant difference of SPQ-B score at weeks 21, 22 and 24 in the two groups (P>0.10). The fetus exposed to the earthquake in their sixth month of gestation may be has high risk for adult Schizotypal personality characteristics. [Wang Xueyi, et al.2007]
