Sticks, Stones, and Words: Correlates of
Violence and Survival
Dr. Inga Schalinski
inga.schalinski@uni-konstanz.de
Introduction
-
First Study
-
Second Study
-
Third Study
-
Conclusion
What%we%have%learned%from%the%Adverse%Childhood%
Experiences%(ACE)%Study%is%that...%
%
Childhood%AdversiAes%
Childhood%AdversiAes%
%
Early%Death%
are%related%to%
are%related%to%mental%
%overweight,%
illness.%
Disease,%Disability%
%
diabetes...%
and%Social%Problems%
%
AdopAon%of%HealthErisk%
%
Behaviors%
%
%
Social,%EmoAonal,%and%CogniAve%Impairment%
%
%
Neurodevelopmental%and%Biological%AdaptaAon%
%
%%
Adverse%Childhood%Experiences%
Anda,&Feli+&&&van&der&Kolk:&see&for&more&details&h8p://acestudy.org&
Introduction
-
First Study
-
Second Study
-
Third Study
Impact%of%Childhood%AdversiAes%
%
Early.Death.
Disease,.Disability.
and.Social.Problems.
Adop4on.of.Health=risk.
Behaviors.
Social,.Emo4onal,.and.Cogni4ve.Impairment.
Neurodevelopmental.and.Biological.Adapta4on.
Adverse.Childhood.Experiences.
-
Conclusion
Introduction
-
First Study
-
Second Study
-
Third Study
-
Conclusion
Research%QuesAons%
First%Study:%Do&childhood&adversiAes&affect&the&CorAsol&stress&
response&(in&paAents&with&trauma&spectrum&disorders)?&
&
Second%Study:%Do&type&and&Aming&of&childhood&adversiAes&
ma8er&for&symptoms&of&dissociaAon&(in&paAents&with&psychoAc&
spectrum&disorders)?&
&
Third%Study:%The&third&study&sought&to&clarify&the&impact&of&
childhood&adversiAes&on&illness&severity,&outcome&measures&in&
paAents&with&psychoAc&spectrum&disorders.&
&
Introduction
-
First Study
-
Second Study
-
Third Study
-
First Study:
The%corAsol%paradox%of%traumaErelated%disorders
Schalinski, Elbert & Kirschbaum
Conclusion
Introduction
-
First Study
-
Second Study
-
Third Study
-
Conclusion
Background:%The&HPA&axis&
&
O&
&
&
&
Hypothalamus&
CRH&
+&
&
&
&
&
O&
Pituitary&Gland&
ACTH&
+&
Adrenal&Gland&
+&
CorAsol&
Introduction
-
First Study
-
Second Study
-
Third Study
-
Conclusion
Background:%
Individuals&who&present&with&a&trauma&spectrum&disorder&
frequently&have&an&altered&regulaAon&of&the&hypothalamicO
pituitaryOadrenal&(HPA)&axis&(see&for&a&metaOanalysis&and&reviews:&
Meewisse&et&al.,&2008;&Miller,&Chen,&&&Zhou,&2007;&Shea&et&al.,&
2005).&&
&
But&there&are&inconsistencies&about&the&direcAon&
(downregulaAon&vs.&hyperacAvity&of&the&HPA&axis).&
&
in&shortOterm&measure&of&CorAsol&(Saliva:&Shea&et&al.,&2005)&
in&longOterm&measure&of&CorAsol&(Hair:&Steudte&et&al.,&2011;&2013)&
&
Both&early&life&stress&as&well&as&the&number&of&lifeAme&traumaAc&
&
experiences&seem&to&be&powerful&modulators&of&individual&HPA&
&
axis&acAvity.&&
Introduction
-
First Study
-
Second Study
-
Third Study
-
Conclusion
ParAcipants:%
%
N&=&43&female&survivors&of&organised&violence&with&Pos8raumaAc&
Stress&Disorder&(PTSD)&and&different&levels&of&Childhood&
AdversiAes&
&
The&following&traumaAc&event&types&were&reported&most&
frequently:&Physical&assault&with&life&threat&(72%),&assault&with&a&
weapon&(62%)&and&sexual&assault&(58%).&&
&&
&
&
&
&
&
&
Introduction
-
First Study
-
Second Study
-
Third Study
-
Conclusion
Method:%„Phasic%CorAsol%Response“%
Schematic Description of the Structured Interview and Physiological Assessment
1.  Sociodemographic Data
SD = 0:32 min
&
&
&
2. Assessment of Traumatic Experiences
and Childhood Adversities
SD = 0:49 min
SD = 0:49 min
3. Symptom
Assessment
SD = 0:56 min
SD = 0:49 min
Introduction
-
First Study
-
Second Study
Method:%„LongEterm%Levels%of%CorAsol“%
&
&
&
-
Third Study
-
Conclusion
-
First Study
Results%%
-
Third Study
-
No Childhood Sexual Abuse
Childhood Sexual Abuse
*
*
Heart Rate Change (in bpm)
-6
-4
-2
0
2
4
6
Heart Rate Change
No Childhood Sexual Abuse
Childhood Sexual Abuse
*
*
-8
Change in Salivary Cortisol in nmol/l
-4
-2
0
2
4
6
&
&
Second Study
Change in Salivary Cortisol
-50
0
50
100
150
Time in Minutes in Relation to Trauma Assessment
-50
0
50
100
150
Time in Minutes in Relation to Trauma Assessment
Change in Systolic Blood Pressure
Change in Diastolic Blood Pressure
Change in Systolic Pressure (in mm Hg)
-5
0
5
10
&
-
No Childhood Sexual Abuse
Childhood Sexual Abuse
-50
0
50
100
150
Time in Minutes in Relation to Trauma Assessment
Change in Diastolic Pressure (in mm Hg)
-6
-4
-2
0
2
4
6
8
Introduction
No Childhood Sexual Abuse
Childhood Sexual Abuse
-50
0
50
100
150
Time in Minutes in Relation to Trauma Assessment
Conclusion
Introduction
-
First Study
-
Second Study
-
Third Study
-
Conclusion
Results%
Patient
Control
2
0
0
2
Median Quotient
4
6
8
Patient
Control
0
10
20
30
40
Severity of Childhood Adversities
0
10
20
30
40
Severity of Childhood Adversities
Median Quotient
4
6
8
10
Segment 2
Patient
Control
0
2
Patient
Control
2
Median Quotient
4
6
8
10
Segment 1
0
&
&
Segment 2
10
10
Segment 1
Median Quotient
4
6
8
&
0
5
10
15
Number of Different Traumatic Event Types
Segment&1&(3&cm)&
0
5
10
15
Number of Different Traumatic Event Types
Segment&2&(3&cm)&
Introduction
-
First Study
-
Second Study
-
Third Study
-
Conclusion
Results%
Patient
Control
2
0
0
2
Median Quotient
4
6
8
Patient
Control
0
10
20
30
40
Severity of Childhood Adversities
0
10
20
30
40
Severity of Childhood Adversities
Median Quotient
4
6
8
10
Segment 2
Patient
Control
0
2
Patient
Control
2
Median Quotient
4
6
8
10
Segment 1
0
&
&
Segment 2
10
10
Segment 1
Median Quotient
4
6
8
&
0
5
10
15
Number of Different Traumatic Event Types
Segment&1&(3&cm)&
0
5
10
15
Number of Different Traumatic Event Types
Segment&2&(3&cm)&
Third Study
-
&
&
6
Heart Rate Change
*
*
*
-8
*
No Childhood Sexual Abuse
Childhood Sexual Abuse
Heart Rate Change (in bpm)
-6
-4
-2
0
2
4
Change in Salivary Cortisol in nmol/l
-4
-2
0
2
4
6
Change in Salivary Cortisol
No Childhood Sexual Abuse
Childhood Sexual Abuse
Change in Diastolic Blood Pressure
No Childhood Sexual Abuse
Childhood Sexual Abuse
-50
0
50
100
150
Time in Minutes in Relation to Trauma Assessment
Change in Diastolic Pressure (in mm Hg)
-6
-4
-2
0
2
4
6
8
-50
0
50
100
150
Time in Minutes in Relation to Trauma Assessment
Change in Systolic Blood Pressure
Change in Systolic Pressure (in mm Hg)
-5
0
5
10
-50
0
50
100
150
Time in Minutes in Relation to Trauma Assessment
No Childhood Sexual Abuse
Childhood Sexual Abuse
-50
0
50
100
150
Time in Minutes in Relation to Trauma Assessment
Segment 2
10
10
Segment 1
Patient
Control
0
2
Median Quotient
4
6
8
Patient
Control
Median Quotient
4
6
8
0
10
20
30
40
Severity of Childhood Adversities
0
10
20
30
40
Severity of Childhood Adversities
Segment 2
Patient
Control
2
Median Quotient
4
6
8
10
Segment 1
Patient
Control
0
Conclusion%
•  ShortOterm:&DisAnct&reacAvity&pa8ern&for&the&
group&with&childhood&sexual&abuse&vs.&without&
childhood&sexual&abuse&
•  LongOterm:&PosiAve&relaAonship&between&
childhood&adversiAes&as&well&as&traumaAc&stress&
load&and&hair&corAsol&
•  Both&childhood&adversiAes&as&well&as&traumaAc&
stress&contribute&to&increased&levels&of&hair&
corAsol&
•  ShortOterm&and&longOterm&corAsol&responses&are&
capable&to&show&both,&down&regulaAon&in&shortO
term&levels&(saliva&corAsol),&but&increase&in&longO
term&(hair&corAsol).&&
•  Early&exposure&to&adversiAes&may&results&in&a&
biological&disAnct&phenotype&
Conclusion
2
-
0
Second Study
10
-
Median Quotient
4
6
8
First Study
2
-
0
Introduction
0
5
10
15
Number of Different Traumatic Event Types
0
5
10
15
Number of Different Traumatic Event Types
Early.Death.
Disease,.Disability.
and.Social.Problems.
Adop4on.of.Health=risk.
Behaviors.
Social,.Emo4onal,.and.Cogni4ve.Impairment.
Neurodevelopmental.and.Biological.Adapta4on.
Adverse.Childhood.Experiences.
Introduction
-
First Study
-
Second Study
-
Third Study
-
Conclusion
Second Study:
Type and Timing of Childhood
Maltreatment and Severity of Shutdown
Dissociation in Patients with
Schizophrenia Spectrum Disorder
Schalinski & Teicher, 2014
Introduction
-
First Study
-
Second Study
-
Third Study
-
Conclusion
Background:%
&
DissociaAon,&parAcularly&the&shu+ng&down&of&sensory,&motor&and&
speech&systems,&has&been&proposed&to&emerge&in&suscepAble&
individuals&as&a&defensive&response&to&traumaAc&stress&(Schauer&&&
Elbert,&2010).&
&
Compelling&evidence&shows&that&the&exposure&to&adverse&
experiences&in&childhood,&leads&to&an&increase&of&dissociaAve&
symptoms&in&adults&with&schizophrenia&(e.g.,&Goff&et&al.,&1991)&
&
&
A&history&of&adverse&childhood&experiences&is&common&in&paAents&
with&severe&psychopathology,&especially&paAents&diagnosed&with&
&
psychoAc&disorders&(Holowka,&King,&Saheb,&Pukall&&&Brunet,&2003;&
&
Sar&et&al.,&2009;&Schäfer&et&al.,&2006).&&
&
Introduction
-
First Study
-
Second Study
-
Third Study
-
Conclusion
The%defense%Cascade%Model%
Shutdown Dissociation
Scale- Interview
Item: Have you felt like you
couldn’t hear for a while,
as if you were deaf? When
people were talking to you,
did they sound far away?
Response:
(0) not at all
(1)  once a month/or less
(2)  several times a month
(3)  several times a week
Schalinski,&Schauer&&&Elbert,&2014;&Schauer&&&Elbert,&2010&
Introduction
-
First Study
-
Second Study
-
Third Study
-
Research%QuesAons:%
&
Does&the&type&of&Childhood&Adversity&ma8er&for&Shutdown&
DissociaAon?&
&
Does&the&Aming&ma8er&for&Shutdown&DissociaAon?&
&
&
&
&
&
Conclusion
Introduction
-
First Study
-
Second Study
-
Third Study
-
Conclusion
Method:
ParAcipants:&N&=&75&paAents&with&psychoAc&
spectrum&disorder&
&
Instruments:&
MACE&(=&Maltreatment&and&Abuse&Chronology&of&
Exposure)O&Scale&(Isele&et&al.,&2014;&Teicher&&&
Parigger,&2011)&
ShutdownEDissociaAon%Scale%(Schalinski,&Schauer,&
&&Elbert,&submi8ed)&
Introduction
-
First Study
-
Second Study
-
Third Study
-
Conclusion
Results%„Type%of%Adversity“%
Importance (± 95% CI)
&
Sensitivity by Type of Maltreatment − shutdown_sum (cforest )
3
&
&
2
1
0
Emotional Non−Verbal
Neglect
Emotional
Abuse
Parental
Verbal
Abuse
Peer
Emotional
Abuse
Peer
Physical
Physical
Physical Maltreatment Neglect
Abuse
Types of Maltreatment
Sexual
Abuse
Witnessing Witnessing
Interparental Sibling
Abuse
Abuse
Introduction
-
First Study
-
Second Study
-
Third Study
-
Conclusion
Results%„Timing“%
&
Sensitive Period Analysis − shutdown_sum (cforest )
Importance (± 95% CI)
3
●
2
&
&
●
1
●
●
●
●
●
1
2
●
●
●
●
0
3
4
5
6
●
●
●
●
●
16
17
●
7
8
9
10
11
12
Recalled Ages of Exposure (years)
Explains&31%&of&the&variaAon&of&Shutdown&DissociaAon&
13
14
15
●
18
Introduction
-
First Study
-
Second Study
-
Third Study
-
Conclusion
Conclusion%
&
%
%
%
%
%
Importance (± 95% CI)
●
2
●
1
●
●
●
●
1
2
●
●
4
5
●
●
●
0
3
6
●
●
●
●
●
16
17
●
7
8
9
10
11
12
13
14
15
●
18
Recalled Ages of Exposure (years)
Sensitivity by Type of Maltreatment − shutdown_sum (cforest )
Importance (± 95% CI)
We&found&differenAal&Aming&effects&across&the&
childhood&with&peak&vulnerability&occurring&at&13O14&
years&of&age.&&
&
The&impact&of&specific&types&of&childhood&adversiAes&
on&severity&of&shutdown&dissociaAon:&&
EmoAonal&neglect&>&exposure&to&peer&emoAonal&
abuse&>parental&nonOverbal&emoAonal&abuse&>&
parental&verbal&abuse&
Sensitive Period Analysis − shutdown_sum (cforest )
3
3
2
1
0
Emotional Non−Verbal
Neglect
Emotional
Abuse
Parental
Verbal
Abuse
Peer
Emotional
Abuse
Peer
Physical
Physical
Physical Maltreatment Neglect
Abuse
Types of Maltreatment
Sexual
Abuse
Witnessing Witnessing
Interparental Sibling
Abuse
Abuse
Introduction
-
First Study
-
Second Study
-
Third Study
-
Conclusion
Third Study:
Impact of Childhood Adversities on the
Short-term Course of Illness in Psychotic
Spectrum Disorders
Schalinski, Fischer & Rockstroh
Introduction
-
First Study
-
Second Study
-
Third Study
-
Conclusion
Background%
•  AccumulaAng&evidence&shows&that&childhood&adversiAes&
modify&the&course&of&mental&disorders.&&It&is&sAll&unclear,&how&
early&life&stress&affect&the&course&in&psychoAc&paAents.&&
•  Understanding&factors&that&influence&the&shortOterm&outcome&
(in&inpaAent&se+ngs)&are&important&to&unmask&prognosAc&
factors,&and&improve&therapeuAc&strategies.&&
•  By&straAfying&two&groups&of&paAents&with&low&versus&high&
childhood&adversiAes,&we&compared&indicators&of&illness&
severity&(number&of&current&comorbid&psychiatric&diagnoses),&
shortOterm&symptom&course&across&a&4&months&period&of&
observaAon.&
&
Introduction
-
First Study
-
Second Study
-
Third Study
-
Conclusion
Method%
ParAcipants&&
N&=&62&inpaAents&with&a&diagnosis&of&psychoAc&disorder&
Instruments&
Using&the%MACE%Maltreatment&and&Abuse&Chronology&of&Exposure&
(MACE)&Scale&A&comprehensive&profile&of&types&of&childhood&
adversiAes&should&improve&understanding&of&the&pathways&and&
consequences&(Isele&et&al.,&2014)"
PosiAve%and%NegaAve%Syndrome%Scale%(PANSS;&Kay,&Fiszbein,&&&Opler,&
1987)&
&Using&stringent&criteria&proposed&by&Andreasen&and&colleagues&
(2005),&symptomaAc&remission&was&defined&with&a&maintaining&
period&of&3&months.&
%
% At&
3&Months&
Admission&
1&Month&
1&Month&
3&Months&
FollowOup&
Introduction
Results%
%
&
-
First Study
-
Second Study
-
Third Study
-
Conclusion
72%&report&at&least&one&type&
of&childhood&adversity&
&
and&
&
around&half&(53%)&of&the&
sample&fulfilled&the&
maltreatment&and&abuse&
criteria&of&two&or&more&
different&types&
Schalinski,&Fischer&&&Rockstroh,&2014&
Introduction
-
First Study
-
Results%
%
Second Study
-
Third Study
-
Conclusion
Severity%of%Illness%
Low%Childhood% High%
AdversiAes%
Childhood%
(n%=%29)%%
AdversiAes%%
(n%=%33)%%
StaAsAcs%for%
Group%
Difference%%
Number&of&Individuals&with&Axis&I&
ComorbidiAes&&
1&(3%)&
16&(49%)&
χ²(1,62)&=&15.73&
p&<&.001&&
Number&of&Individuals&with&Abuse& 1&(3%)&
or&AddicAon&Diagnosis&(ICDO10:&
F10O&F19)&&
12&(36%&)&
χ²(1,62)&=&10.09&
p&=&.002&&
&
Schalinski,&Fischer&&&Rockstroh,&2014&
Introduction
-
First Study
-
Second Study
-
Third Study
-
Conclusion
Results%
%
&
Remission%Rate:%
26%&for&the&group&
with&high&Childhood&
AdversiAes&vs.&
39%&for&the&group&
with&low&Childhood&
AdverisAes&
Schalinski,&Fischer&&&Rockstroh,&2014&
60
70
-
Overall Composite Score
50
Second Study
Social Cognition
Reasoning and Problem Solving
Visual Learning
Verbal Learning
40
-
Working Memory
30
First Study
Attention Vigilance
Speed of Processing
20
&
10
Results%
%
-
0
Introduction
Third Study
Conclusion
MCCB Cognitive Domain
Nuechterlein&et&al.,&2008;&Schalinski,&Carolus&&&Rockstroh,&2014&
Introduction
-
First Study
-
Second Study
-
Conclusion
100
40
60
80
First Admission
Repeated Episode
0
20
60
40
20
&
Social Cognition (T Score)
100
First Admission
Repeated Episode
80
Third Study
Social&CogniAon&
0
Working Memory (T Score)
Results%
%
Working&Memory&
-
0
10
20
30
40
50
MACE Sumscore
60
70
0
10
20
30
40
50
60
70
MACE Sumscore
Schalinski,&Carolus&&&Rockstroh,&2014&
-
100
20
40
60
80
First Admission
Repeated Episode
0
Working Memory (T Score)
Conclusion%of%the%Third%Study%
%
•  Early&life&stress&was&associated&with&clinical&
complexity&(higher&rates&of&comorbidity)&
•  PosiAve&and&global&symptoms&were&higher&at&4&
months&followOup&in&the&group&with&high&compared&
to&the&group&with&low&exposure&of&childhood&
adversiAes&…&and&predicted&an&unfavorable&
symptomaAc&course.&
•  Childhood&adversiAes&were&related&to&poorer&
performance&in&working&memory&and&social&
cogniAon.&
%
Conclusion
0
10
100
Third Study
First Admission
Repeated Episode
80
-
60
Second Study
40
-
20
First Study
Social Cognition (T Score)
-
0
Introduction
20
30
40
50
MACE Sumscore
60
70
0
10
20
30
40
50
60
70
MACE Sumscore
Schalinski,&Carolus,&&&Rockstroh&in&prep;&Schalinski,&Fischer&&&Rockstroh,&2014&
Introduction
-
First Study
-
Second Study
-
Third Study
-
Conclusion
General%Conclusion&
Childhood&AdversiAes&are&related&to...&
•  disAnct&stress&response&(downregulaAon&in&shortOterm,&but&
increased&levels&of&CorAsol&in&longOterm)&
•  type&and&Aming&of&adversiAes&ma8ers&for&symptoms&of&
dissociaAon&&
•  poorer&symptomaAc&outcome&
•  poorer&cogniAve&performance&(working&memory&&&social&
cogniAon)&
&
&
Early.Death.
Disease,.Disability.
and.Social.Problems.
Adop4on.of.Health=risk.
Behaviors.
Social,.Emo4onal,.and.Cogni4ve.Impairment.
Neurodevelopmental.and.Biological.Adapta4on.
Adverse.Childhood.Experiences.
Introduction
-
First Study
-
Second Study
-
Third Study
-
Conclusion
General%Conclusion&
•  Childhood&adversiAes&in&mental&illness&may&consAtute&a&
subtype&within&various&diagnoses&(see&review&Teicher&&&
Samson,&2013)&
•  The&Aming&and&type&of&early&life&stress&may&contribute&as&well&
for&the&striking&variaAon&of&behavioral,&emoAonal&and&
cogniAve&psychopathology.&
•  ...&hurqul&words&will&injure&my&soul&
&
Early.Death.
&
Disease,.Disability.
and.Social.Problems.
Adop4on.of.Health=risk.
Behaviors.
Social,.Emo4onal,.and.Cogni4ve.Impairment.
Neurodevelopmental.and.Biological.Adapta4on.
Adverse.Childhood.Experiences.
Introduction
-
First Study
-
Second Study
-
Third Study
%
%Thanks%y‘all%
&
&
-
Conclusion
DANKE
Alexandra Geist
Allen Versuchsteilnehmern
Almut Carolus
Amelie Lehrmann
Brigitte Rockstroh
Christiane Wolf
Deutsche Forschungsgesellschaft
Dorothea Isele
Europäischer Flüchtlingsfond
Franziska Steinmaier
Heike Riedke
Ken Varner
Kompetenzzentrum Traumatologie
Maggie Schauer
Michael Odenwald
Petia Popova
Sarah Dölker
Team der Station 33
Team der Station 34
Thomas Elbert
Universität Konstanz
vivo victims‘s voice
Yolanda Fischer
&
References
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&
&
&
&
&
%
the&Maltreatment&and&Abuse&Chronology&of&Exposure&&
MACE%Scale&
Teicher%&%Parigger,%2011
SomeAmes%parents,%stepparents%or%other%adults%living%in%the%house%do%hurZul%things.%
If%this%happened%during%your%childhood%(first%18%years%of%your%life)%please%provide%your%
best%esAmate%of%your%age%at%the%Ame(s)%of%occurrence.&
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Parental&Verbal&Abuse&
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Teicher%&%Parigger,%2011
SomeAmes%parents,%stepparents%or%other%adults%living%in%the%house%do%hurZul%things.%
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Nonverbal&EmoAonal&Abuse&
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SomeAmes%parents,%stepparents%or%other%adults%living%in%the%house%do%hurZul%things.%
If%this%happened%during%your%childhood%(first%18%years%of%your%life)%please%provide%your%
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EmoAonal&Neglect&
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Please%indicate%if%the%following%statements%were%true%about%you%and%your%family%during%
your%childhood,%and%your%age%at%the%Ame(s)%you%felt%this%to%be%true.%%
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If%this%happened%during%your%childhood%(first%18%years%of%your%life)%please%provide%your%
best%esAmates%of%your%age%at%the%Ame(s)%of%occurrence.%%
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X
Witnessing&Violence&to&Siblings&
Teicher%&%Parigger,%2011
SomeAmes%children%your%own%age%or%older%do%hurZul%things%like%bully%or%harass%you.%
If%this%happened%during%your%childhood%(first%18%years%of%your%life)%please%provide%your%
best%esAmates%of%your%age%at%the%Ame(s)%of%occurrence.%%
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X
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SomeAmes%children%your%own%age%or%older%do%hurZul%things%like%bully%or%harass%you.%
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best%esAmates%of%your%age%at%the%Ame(s)%of%occurrence.%%
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X
X
X
X
X X
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X
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SomeAmes%intense%arguments%or%physical%fights%occur%between%parents,%stepparents%or%
other%adults%(boyfriends,%girlfriends,%grandparents)%living%in%the%household.%
If%this%happened%during%your%childhood%(first%18%years%of%your%life)%please%provide%your%
best%esAmates%of%your%age%at%the%Ame(s)%of%occurrence.%%
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X
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Witnessing&Interparental&Violence&
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SomeAmes%adults%or%older%individuals%NOT%living%in%the%house%do%hurZul%things%to%you.%
If%this%happened%during%your%childhood%(first%18%years%of%your%life)%please%provide%your%
best%esAmates%of%your%age%at%the%Ame(s)%of%occurrence.%
Please%check%all%ages%that%apply.%
X
Sexual&Abuse&
Timing&in&RelaAon&to&PosiAve&and&NegaAve&Symptoms&in&Schizophrenia&
1.&What&happens&in&the&brain&and&the&body&
during&the&traumaAc&event?&
Freeze:&
interrupAon&of&the&ongoing&perceptual&and&
behavioral&processes;&&turning&all&perceptual&
channels&to&the&threatening&sAmulus;&while&
the&body&prepares&for&acAve&defense&
responses&
FAST&but&less&acurate&
&
08/26/2013&
&
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1.&What&happens&in&the&brain&and&the&body&
during&the&traumaAc&event?&
Flight/&Fight&
SympatheAc&arousal&(heart&beat&
acceleraAon,&skin&conductance),&release&of&
adrenal&hormones&
&
&
51&
1.&What&happens&in&the&brain&and&the&body&
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perceived,&if&there&is&a&chance&to&escape,&
vicAm&may&escape&
&
&
52&
1.&What&happens&in&the&brain&and&the&body&
during&the&traumaAc&event?&
Flag/&Faint&
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drop&in&heart&rate,&blood&pressure,&
shuAng&down&the&perceptual&processing,&
dizziness,&analgesia;&emoAonal&numbness&
&
53&
1.&What&happens&in&the&brain&and&the&body&during&the&
traumaAc&event?
&
direct&physical&contact&with&the&
perpetrator&
presence&of&body&fluids&(e.g.,&blood,&
sperm)&
depending&on&the&vicAms&own&power&
for&defense&(e.g.,&children&are&more&
likely&to&show&a&“shutdown”&
response&
contact&with&sharp&objects&(e.g.,&
teeth,&knife)&
&
54&
First Study
-
Second Study
-
Conclusion
100
80
60
60
0
20
40
&
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40
100
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80
Third Study
Social&CogniAon&
0
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Results%
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-
20
-
Social Cognition (T Score)
Introduction
0
10
20
30
40
50
MACE Sumscore
60
70
0
10
20
30
40
50
60
70
MACE Sumscore
Schalinski,&Carolus&&&Rockstroh,&2014&
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Schalinski,&Carolus&&&Rockstroh,&2014&