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Psychological and Physiological Trauma Research
Seize Your Journeys
_______________________ Traumatic stress is found in many competent, healthy, strong, good people. No one can completely protect themselves from traumatic experiences. Many people have long-lasting problems following exposure to trauma. Up to 8% of persons will have PTSD at some time in their lives. People who react to traumas are not going crazy. What is happening to them is part of a set of common symptoms and problems that are connected with being in a traumatic situation, and thus, is a normal reaction to abnormal events and experiences. Having symptoms after a traumatic event is NOT a sign of personal weakness. Given exposure to a trauma that is bad enough, probably all people would develop PTSD. By understanding trauma symptoms better, a person can become less fearful of them and better able to manage them. By recognizing the effects of trauma and knowing more about symptoms, a person will be better able to decide about getting treatment. _______________________
FUNCTIONAL NEUROANATOMY In order to best understand this atlas it is important to have a sense of the functional neuroanatomy of the brain. Over the next several pages there is a brief summary of the 5 major brain systems that relate to behavior, along with the general location seen on SPECT of these areas.
The Deep Limbic System
Functions
Problems
The Basal Ganglia System
Functions
Problems
The Prefrontal Cortex
Functions
Problems
The Cingulate Gyrus
Problems
The Temporal Lobes
Functions
Problems
Non-dominant Side (usually the right)
Secure Attachments as a Defense Against Trauma “All people mature and thrive in a social context that has profound effects on how they cope with life’s stresses. Particularly early in life, the social context plays a critical role in fuffering an individual against stressful situations, and in building the psychological and biological capacities to deal with further stresses. The primary function of parents can be thought of as helping children modulate their arousal by attuned and well-timed provision of playing, feeding, comforting, touching, looking, cleaning, and resting—in short, by teaching them skills that will gradually help them modulate their own arousal. Secure attachment bonds serve as primary defenses against trauma-induced psychopathology in both children and adults (Finkelhor & Browne, 1984). In children who have been exposed to severe stressors, the quality of the parental bond is probably the single most important determinant of long-term damage (McFarlane, 1988).” van der Kolk, Bessel, Alexander C. McFarlane, and Lars Weisaeth, eds. 1996. Traumatic stress: The effects of overwhelming experience on mind, body, and society. New York and London: Guilford Press. .p. 185 _______________________
Sleep Disorders
“The sleep disorders are organized into four major sections according to presumed etiology. Primary Sleep Disorders are those in which none of the etiologies listed below (i.e., another mental disorder, a general medical condition, or a substance) is responsible. Primary Sleep Disorders are presumed to arise from endogenous abnormalities in sleep-wake generating or timing mechanisms, often complicated by conditioning factors. Primary Sleep Disorders in turn are divided into Dyssomnias (characterized by abnormalities in the amount, quality, or timing of sleep) and Parasomnias (characterized by abnormal behavioral or physiological events occurring in association with sleep, specific sleep stages, or sleep-awake transitions). Sleep Disorder Related to Another Mental Disorder involves a prominent complaint of sleep disturbance that results from a diagnosable mental disorder (often a Mood Disorder or Anxiety Disorder) but that is sufficiently severe to warrant independent clinical attention. Presumably, the pathophysiological mechanisms responsible for the mental disorder also affect sleep-awake regulation. Sleep Disorder Due to a General Medical Condition involves a prominent complaint of sleep disturbance that results from the direct physiological effects of a general medical condition on the sleep-wake system. Substance-Induced Sleep Disorder involves prominent complaints of sleep disturbance that result from the concurrent use, or recent discontinuation of use, of a substance (including medications). That systematic assessment in individuals who present with prominent complaints of sleep disturbance includes an evaluation of the specific type of sleep complaint and a consideration of concurrent mental disorders, general medical conditions, and substance (including medication) use that may be responsible for the sleep disturbance. Five distinct sleep stages can be measured by polysomnography: rapid eye movement (REM) sleep and four stages of non-rapid eye movement (NREM) sleep (stages 1, 2, 3, and 4). Stage 1 NREM sleep is a transition from wakefulness to sleep and occupies about 5% of time spent asleep in healthy adults. Stage 2 NREM sleep, which is characterized by specific EEG waveforms (sleep spindles and K complexes), occupies about 50% of time spent asleep. Stages 3 and 4 NREM sleep (also known collectively as slow-wave sleep) are the deepest levels of sleep and occupy about 10%-20% of sleep time. REM sleep, during which the majority of typical storylike dreams occur, occupies about 20%-25% of total sleep. These sleep stages have a characteristic temporal organization across the night. NREM stages 3 and 4 tend to occur in the first one-third to one-half of the night and increase in duration in response to sleep deprivation. REM sleep occurs cyclically throughout the night, alternating with NREM sleep about every 80-100 minutes. REM sleep periods increase in duration toward the morning. Human sleep also varies characteristically across the life span. After relative stability with large amounts of slow-wave sleep in childhood and early adolescence, sleep continuity and depth deteriorate across the adult age range. This deterioration is reflected by increased wakefulness and stage 1 sleep and decreased stages 3 and 4 sleep. Because of this, age must be considered in the diagnosis of a Sleep Disorder in any individual. Polysomnography is the monitoring of multiple electrophysiological parameters during sleep and generally includes measurement of EEG activity, electroculographic activity, and electromyographic activity. Additional polysomnographic measures may include oral or nasal airflow, respiratory effort, chest and abdominal wall movement, oxyhemoglobin saturation, or exhaled carbon dioxide concentration; these measures are used to monitor respiration during sleep and to detect the presence and severity of sleep apnea. Measurement of peripheral electromyographic activity may be used to detect abnormal movements during sleep. Most polysomnographic studies are conducted during the person’s usual sleeping hours—that is, at night. However, daytime polysomnographic studies also are used to quantify daytime sleepiness. The most common daytime procedure is the Multiple Sleep Latency Test (MSLT), in which the individual is instructed to lie down in a dark room and not resist falling asleep; this protocol is repeated fives times during the day. Sleep latency (the amount of time required to fall asleep) is measured on each trial and is used as an index of physiological sleepiness. The converse of the MSLT is also used: In the Repeated Test of Sustained Wakefulness (RTSW), the individual is placed in a quiet, dimly lit room and instructed to remain awake; this protocol is repeated several times during the day. Again, sleep latency is measured, but is it used here as an index of the individual’s ability to maintain wakefulness. Standard terminology for polysomnographic measures is used throughout the test in this section. Sleep continuity refers to the overall balance of sleep and wakefulness during a night of sleep. “Better” sleep continuity indicates consolidated sleep and wakefulness; “worse” sleep continuity indicates disrupted sleep with more wakefulness. Specific sleep continuity measures include sleep latency—the amount of time required to fall asleep (expressed in minutes); intermittent wakefulness—the amount of awake time after initial sleep onset (expressed in minutes); and sleep efficiency—the ratio of actual time spent asleep to time spent in bed (expressed as a percentage, with higher numbers indicating better sleep continuity). Sleep architecture refers to the amount and distribution of specific sleep stages. Sleep architecture measures include absolute amount of REM sleep and each NREM sleep stage (in minutes), relative amount of REM seep and NREM sleep stages (expressed as a percentage of total sleep time), and latency between sleep onset and the first REM period (REM latency). The text for each of the Sleep Disorders contains a section describing its relationship to corresponding disorders in The International Classification of Sleep Disorders: (ICSD) diagnostic and Coding Manual, published in 1990 by the American Sleep Disorders Association. _________________
Substance Dependence “Features The essential feature of Substance Dependence is a cluster of cognitive, behavioral, and physiological symptoms indicating that the individual continues use of the substance despite significant substance-related problems. There is a pattern of repeated self-administration that can result in tolerance, withdrawal, and compulsive drug-taking behavior. A diagnosis of Substance Dependence can be applied to every class of substances except caffeine. The symptoms of Dependence are similar across the various categories of substances, but for certain classes some symptoms are less salient, and in a few instances not all symptoms apply (e.g., withdrawal symptoms are not specified for Hallucinogenic Dependence). Although not specifically listed as a criterion item, “craving” (a strong subjective drive to use the substance) is likely to be experienced by most (if not all) individuals with Substance Dependence. Dependence is defined as a cluster of three or more of the symptoms listed below occurring at any time in the same 12-month-period. Tolerance (Criterion 1) is the need for greatly increased amounts of the substance to achieve intoxication (or the desired effect) or a markedly diminished effect with continued use of the same amount of the substance. The degree to which tolerance develops varies greatly across substances. Furthermore, for a specific drug, varied degrees of tolerance may develop for its different central nervous system effects. For example, for opioids, tolerance to respiratory depression and tolerance to analgesia develop at different rates. Individuals with heavy use of opioids and stimulants can develop substantial (e.g., 10-f0ld) levels of tolerance, often to a dosage that would be lethal to a nonuser. Alcohol tolerance can also be pronounced, but is usually less extreme than for amphetamine. Many individuals who smoke cigarettes consume more than 20 cigarettes a day, an amount that would have produced symptoms of toxicity when they first started smoking. Individuals with heavy use of cannabis or phencyclidine (PCP) are generally not aware of having developed tolerance (although it has been demonstrated in animal studies and in some individuals). Tolerance may be difficult to determine by history alone when the substance used is illegal and perhaps mixed with various diluents or with other substances. In such situations, laboratory tests may be helpful (e.g., high blood levels of the substance coupled with little evidence of intoxication suggest that tolerance is likely). Tolerance must also be distinguished from individual variability in the initial sensitivity to the effects of particular substances. For example, some first-time drinkers show very little evidence of intoxication with three or four drink, whereas others of similar weight and drinking histories had slurred speech and incoordination. Withdrawal (Criterion 2a) is a maladaptive behavioral change, with physiological and cognitive concomitants, that occurs when blood or tissue concentrations of a substance decline in an individual who had maintained prolonged heavy use of the substance. After developing unpleasant withdrawal symptoms, the persons is likely to take the substance to relieve or to avoid those symptoms (Criterion 2b), typically using the substance throughout the day beginning soon after awakening. Withdrawal symptoms, which are generally the opposite of the acute effects of the substance, vary greatly across the calluses of substances, and separate criteria sets for Withdrawal are provided for most of the classes. Marked and generally easily measured physiological signs of withdrawal are common with alcohol, opioids, and sedatives, hypnotics, and anxiolytics. Withdrawal signs and symptoms are often present, but may be less apparent, with stimulants such as amphetamines and cocaine, as well as with nicotine and cannabis. No significant withdrawal is seen even after repeated use of hallucinogens. Withdrawal from phencyclidine and related substances has not yet been described in humans (although it has been demonstrated in animals). Neither tolerance nor withdrawal is necessary or sufficient for a diagnosis of Substance Dependence. However, for most classes of substances, a past history of tolerance or withdrawals is associated with a more severe clinical course (i.e., an earlier onset of Dependence, higher levels of substance intake, and a greater number of substance-related problems). Some individuals (e.g., those with Cannabis Dependence) show a pattern of compulsive use without obvious signs of tolerance or withdrawal. Conversely, some general medical and postsurgical patients without Opioid Dependence may develop a tolerance to prescribed opioids and experience withdrawal symptoms without showing any signs of compulsive use. The specifiers With Physiological Dependence and Without Physiological Dependence are provided to indicate the presence or absence of tolerance or withdrawal. The following items describe the pattern of compulsive substance use that is characteristic of Dependence. The individual may take the substance in larger amounts or over a longer period than was originally intended (e.g., continuing to drink until severely intoxicated despite having set a limit of only one drink) (Criterion 3). The individual may express a persistent desire to cut down or regulate substance use. Often, there have been many unsuccessful efforts to decrease or discontinue use (Criterion 4). The individual may spend a great deal of time obtaining the substance, using the substance, or recovering from its effects (Criterion 5). In some instances of Substance Dependence, virtually all of the person’s daily activities revolve around the substance. Important social, occupational, ore recreational activities may be given up or reduced because of substance use (Criterion 6). The individual may withdraw from family activities and hobbies in order to use the substance in private or to spend more time with substance-using friends. Despite recognizing the contributing role of the substance to a psychological or physical problem (e.g., sever depressive symptoms or damage to organ systems), the person continues to use the substance (Criterion 7). The key issue in evaluating this criterion is not eh existence of the problem, but rather the individual’s failure to abstain from using the substance despite having evidence of the difficulty it is causing.
Specifiers Tolerance and withdrawal may be associated with a higher risk for immediate general medical problems and a higher relapse rate. Specifiers are provided to note their presence or absence: With Physiological Dependence. This specifier should be used when Substance Dependence is accompanied by evidence of tolerance (Criterion 1) or withdrawal (Criterion 2). Without Physiological Dependence. This specifier should be used when there is no evidence of tolerance (Criterion 1) or withdrawal (Criterion 2). In these individuals, Substance Dependence is characterized by a pattern of compulsive use (at least three items from Criteria 3-7).”
Diagnostic and Statistical Manual of Mental Disorders. 2000. 4th ed. Washington, D.C.: American Psychiatric Association. P. 193-195.
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PTSD, DID, and EMDR Posttraumatic Stress Disorder "The essential feature of Posttraumatic Stress Disorder us the development of characteristic symptoms following exposure to an extreme traumatic stressor involving direct personal experience of an event that involves actual or threatened death or serious injury, or other threat to one's physical integrity; or witnessing an event that involves death, injury, or a threat to the physical integrity of another person; or learning about unexpected or violent death, serious harm, or threat of death or injury experienced by a family member or other close associate (Criteria A1). The person's response to the event must involve intense fear, helplessness, or horror (or in children, the response must involve disorganized or agitated behavior) (Criterion A2). The characteristic symptoms resulting from the exposure to the extreme trauma include persistent reexperiencing of the traumatic event (Criterion E), and the disturbance must cause clinically significant distress or impairment in social, occupational, or other important areas of functioning (Criterion F). Traumatic events that are experienced directly include, but are not limited to, military combat, violent personal assault (sexual assault, physical attack, robbery, mugging), being kidnapped, being taken hostage, terrorist attack, torture, incarceration as a prisoner of war or in a concentration camp, natural or manmade disasters, severe automobile accidents, or being diagnosed with a life-threatening illness. For children, sexually traumatic events may include developmentally inappropriate sexual experiences without threatened or actual violence or injury. Witnessed events include, but are not limited to, observing the serious injury or unnatural death of another person due to violent assault, accident, war, or disaster or unexpectedly witnessing a dead body or body parts. Events experienced by others that are learned about include, but are not limited to, violent personal assault, serious accident, or serious injury experienced y a family member or a close friend; learning about the sudden, unexpected death of a family member or a close friend; or learning that one's child has a life threatening disease. The disorder may be especially sever or long lasting when the stressor is of human design (e.g., torture, rape). the likelihood of developing this disorder may increase as the intensity of and physical proximity to the stressor increase. The traumatic event can be reexperienced in various ways. Commonly the person has recurrent and intrusive recollections of the event (Criterion B1) or recurrent distressing dreams during which the event can be replayed or otherwise represented (Criterion B2). In rare instances, the person experiences dissociative states that last from a few seconds to several hours, or even days, during which components of the event are relived and the person behaves as though experiencing the event at that moment (Criterion B3). These episodes, often referred to as "flashbacks," are typically brief but can be associated with prolonged distress and heightened arousal. Intense psychological distress (Criterion B4) or physiological reactivity (Criterion B5) often occurs when the person is exposed to triggering events that resemble or symbolize an aspect of the traumatic event (e.g., anniversaries of the traumatic event; cold, snowy weather or uniformed guards for survivors of death camps in cold climates; hot, humid weather for combat veterans of the South Pacific; entering any elevator for an woman who was reaped in an elevator). Stimuli associated with the trauma are persistently avoided. The person commonly makes deliberate efforts to avoid thoughts, feelings, or conversations about the traumatic event (Criterion C1) and to avoid activities, situations, or people who around recollections of it (Criterion C2). This avoidance of reminders may include amnesia for an important aspect of the traumatic event (Criterion C3). Diminished responsiveness to the external work, referred to as "psychic numbing" or "emotional anesthesia," usually begins soon after the traumatic event. The individual may complain of having markedly diminished interest or participation in previously enjoyed activities (Criterion C4), of feeling detached or estranged from other people (Criterion C5), or of having markedly reduced ability to feel emotions (especially those associated with intimacy, tenderness and sexuality) (Criterion C6). The individual may have a sense of a foreshortened future (e.g., not expecting to have a career, marriage, children, or a normal life span) (Criterion C7). The individual has persistent symptoms of anxiety or increased arousal that were not present before the trauma. these symptoms may include difficulty falling or staying asleep that may be to recurrent nightmares during which the traumatic event is relived (Criterion D1), hypervigilance (Criterion D4), and exaggerated startle response (Criterion D5). Some individuals report irritability or outburst of anger (Criterion D2) or difficulty concentrating or completing tasks (Criterion D3)."
Dissociative Identity Disorder (DID) "The essential feature of Dissociative identity Disorder is the presence of two or more distinct identities or personality states (Criterion A) that recurrently take control of behavior (Criterion B). There is an inability to recall important personal information, the extent of which is too great to be explained by ordinary forgetfulness (Criterion C). The disturbance is not due tot eh direct physiological effects of a substance or a general medical condition (Condition D.). In children, the symptoms cannot be attributed to imaginary playmates or other fantasy play. Dissociative Identity Disorder reflects a failure to integrate various aspects of identity, memory, and consciousness. Each personality state may be experienced as if it has a distinct personal history, self-image, and identity, including a separate name. Usually there is a primary identity that carries the individual's given name and is passive, dependent, guilty, and depressed. The alternate identities frequently have different names and characteristics that contrast with the primary identity (e.g., are hostile, controlling, and self-destructive). Particular identities may emerge in specific circumstances and may differ in reported age and gender, vocabulary, general knowledge, or predominant affect. Alternate identities are experienced as taking control in sequence, ore at the expense of the other, and may deny knowledge of one another, be critical of one another, or appear to be in open conflict. Occasionally, one or more powerful identities allocate time to the others. Aggressive or hostile identities may at times interrupt activities or place the others in uncomfortable situations. Individuals with this disorder experience frequent gaps in memory for personal history, both remote and recent. The amnesia is frequently asymmetrical. The more passive identities tend to have more constricted memories, whereas the more hostile, controlling, or "protector" identities have more complete memories. An identity that is not in control may nonetheless gain access to consciousness by producing auditory or visual hallucinations (e.g., a voice giving instructions). Evidence of amnesia may be uncovered by reports from others who have witnessed behavior that is disavowed by the individual or by the individual's own discoveries (e.g., finding items of clothing at home that the individual cannot remember having bought). There may be loss of memory not only for recurrent periods of time, but also an overall loss of biographical memory for some extended period of childhood, adolescence, or even adulthood. Transitions among identities are often triggered by psychosocial stress. The time required to switch from one identity to another is usually a matter of seconds, but, less frequently, may b gradual. Behavior that may be frequently associated with identity switches include rapid blinking, facial changes, changes in voice or demeanor, or disruption in the individual's train of thoughts. The number of identities reported ranges from 2 to more than 100. Half of reported cases include the individuals with 10 or fewer identities." Diagnostic and Statistical Manual of Mental Disorders. 2000. 4th ed. Washington, D.C.: American Psychiatric Association. EMDR Eye Movement Desensitization and Reprocessing "Eye Movement Desensitization and Reprocessing (EMDR)1 integrates elements of many effective psychotherapies in structured protocols that are designed to maximize treatment effects. These include psychodynamic, cognitive behavioral, interpersonal, experiential, and body-centered therapies2. EMDR is an information processing therapy and uses an eight phase approach. During EMDR1 the client attends to past and present experiences in brief sequential doses while simultaneously focusing on an external stimulus. Then the client is instructed to let new material become the focus of the next set of dual attention. This sequence of dual attention and personal association is repeated many times in the session. Eight Phases of Treatment The first phase is a history taking session during which the therapist assesses the client's readiness for EMDR and develops a treatment plan. Client and therapist identify possible targets for EMDR processing. These include recent distressing events, current situations that elicit emotional disturbance, related historical incidents, and the development of specific skills and behaviors that will be needed by the client in future situations. During the second phase of treatment, the therapist ensures that the client has adequate methods of handling emotional distress and good coping skills, and that the client is in a relatively stable state. If further stabilization is required, or if additional skills are needed, therapy focuses on providing these. The client is then able to use stress reducing techniques whenever necessary, during or between sessions. However, one goal is not to need these techniques once therapy is complete. In phase three through six, a target is identified and processed using EMDR procedures. These involve the client identifying the most vivid visual image related to the memory (if available), a negative belief about self, related emotions and body sensations. The client also identifies a preferred positive belief. The validity of the positive belief is rated, as is the intensity of the negative emotions. After this, the client is instructed to focus on the image, negative thought, and body sensations while simultaneously moving his/her eyes back and forth following the therapist's fingers as they move across his/her field of vision for 20-30 seconds or more, depending upon the need of the client. Athough eye movements are the most commonly used external stimulus, therapists often use auditory tones, tapping, or other types of tactile stimulation. The kind of dual attention and the length of each set is customized to the need of the client. The client is instructed to just notice whatever happens. After this, the clinician instructs the client to let his/her mind go blank and to notice whatever thought, feeling, image, memory, or sensation comes to mind. Depending upon the client's report the clinician will facilitate the next focus of attention. In most cases a client-directed association process is encouraged. This is repeated numerous times throughout the session. If the client becomes distressed or has difficulty with the process, the therapist follows established procedures to help the client resume processing. When the client reports no distress related to the targeted memory, the clinician asks him/her to think of the preferred positive belief that was identified at the beginning of the session, or a better one if it has emerged, and to focus on the incident, while simultaneously engaging in the eye movements. After several sets, clients generally report increased confidence in this positive belief. The therapist checks with the client regarding body sensations. If there are negative sensations, these are processed as above. If there are positive sensations, they are further enhanced. In phase seven, closure, the therapist asks the client to keep a journal during the week to document any related material that may arise and reminds the client of the self-calming activities that were mastered in phase two. The next session begins with phase eight, re-evaluation of the previous work, and of progress since the previous session. EMDR treatment ensures processing of all related historical events, current incidents that elicit distress, and future scenarios that will require different responses. The overall goal is produce the most comprehensive and profound treatment effects in the shortest period of time, while simultaneously maintaining a stable client within a balanced system. After EMDR processing, clients generally report that the emotional distress related to the memory has been eliminated, or greatly decreased, and that they have gained important cognitive insights. Importantly, these emotional and cognitive changes usually result in spontaneous behavioral and personal change, which are further enhanced with standard EMDR procedures." www.emdr.com __________________ Major Depressive Disorder “Diagnostic Features The essential feature of Major Depressive Disorder is a clinical course that is characterized by one or more Major Depressive Episodes without a history of Manic, Mixed, or Hypomanic Episodes (Criteria A and C). Episodes of Substance-Induced Mood Disorder (due to the direct physiological effects of a drug of abuse, a medication, or toxin exposure) or of Mood Disorder Due to a General Medical Condition do not count toward a diagnosis of Major Depressive Disorder. In addition, the episodes must not be better accounted for by Schizoaffective Disorder and are not superimposed on Schizophrenia, Schizophreniform Disorder, Delusional Disorder, or Psychotic Disorder Not Otherwise Specified (Criterion B). The fourth digit in the diagnostic code for Major Depressive Disorder indicates whether it is a Single Episode (used only for first episodes) or Recurrent. It is sometimes difficult to distinguish between a single episode with waxing and waning symptoms and two separate episodes. For purposes of this manual, an episode is considered to have ended when the full criteria for eh Major Depressive Episode have not been met for at least 2 consecutive months. During this 2-month period, there is either complete resolution of symptoms or the presence of depressive symptoms that no longer meet the full criteria for a Major Depressive Episode (In Partial Remission). The fifth digit in the diagnostic code for Major Depressive Disorder indicates the current state of the disturbance. If the criteria for a Major Depressive Disorder are met, the severity of the episode is notes as Mild, Moderate, Severe Without Psychotic Features, or Severe With Psychotic Features. If the criteria for a Major Depressive Episode are not currently met, the fifth digit is used to indicate whether the disorder is In Partial Remission or In Full Remission. If Manic, Mixed, or Hypomanic Episodes develop in the course of Major Depressive Disorder, the diagnosis is changed to a Bipolar Disorder. However, if manic or hypomanic symptoms occur as a direct effect of antidepressant treatment, use of other medications, substance use, or toxin exposure, the diagnosis of Major Depressive Disorder remains appropriate and an addition diagnosis of Substance-induced Mood Disorder, With Manic features (or With Mixed Features), should be noted. Similarly, if manic or hypomanic symptoms occur as a direct effect of a general medical condition, the diagnosis of Major Depressive Disorder remains appropriate and an additional diagnosis of Mood Disorder Due to a General Medical Condition, With Manic Features (or With Mixed Features), should be noted.” p. 369 “Course Major Depressive Disorder may begin at any age, with an average age at onset in the mid-20s. Epidemiological data suggest that the age at onset is decreasing for those born more recently. The course of Major Depressive Disorder, Recurrent, is variable. Some people have isolated episodes that are separated by many years without any depressive symptoms, whereas others have clusters of episodes, and still others have increasingly frequent episodes as they grow older. Some evidence suggests that the periods of remission generally last longer early in the course of the disorder. The number of prior episodes predicts the likelihood of developing a subsequent Major Depressive Episode. At least 60% of individuals with Major Depresssive Disorder, Single Episode, can be expected to have a second episode. Individuals who have had tow episodes have a 70% chance of having a third, and individuals who have had three episodes have a 90% chance of having a fourth. About 5%-10% of individuals with Major Depressive Disorder, single Episode, subsequently develop a Manic Episode (i.e., develop Bipolar I Disorder). Major Depressive Episodes may end completely (in about two-thirds of cases), or only partially or not at all (in about one-third of cases). For individuals who have only partial remission, there is a greater likelihood of developing additional episodes and of continuing the pattern of partial interepisode recovery. The longitudinal course specifiers With Full Interepisode Recovery and Without Full Interepisode Recovery may therefore have prognostic value. A number of individuals have pre-existing Dysthymic Disorder prior to the onset of Major Depressive Disorder, single Episode. Some evidence suggests that these individuals are more likely to have additional Major Depressive Episodes, have poorer interepisode recovery, and may require additional acute-phase treatment and a longer period of continuing treatment to attain and maintain a more thorough and longer-lasting euthymic state. Follow-up naturalistic studies suggested that 1 year after the diagnosis of a major Depressive Episode, 40% of individuals still have symptoms that are sufficiently severe to meet criteria for a full Major Depressive Episode, roughly 20% continue to have some symptoms that no longer meet full criteria for a Major Depressive Episode (i.e., major Depressive Disorder, In Partial Remission), and 40% have no Mood Disorder. The severity of the initial Major Depressive Episode appears to predict persistence. Chronic general medical conditions are also a risk factor for more persistent episodes. Episodes of Major Depressive Disorder often follow a severe psychosocial stressor, such as the death of a loved one or divorce. Studies suggest that psychosocial events 9stressors) may play a more significant role in the precipitation of the first or second episodes of Major Depressive Disorder and may play less of a role in the onset of subsequent episodes. Chronic general medical conditions and Substance Dependence (particularly Alcohol or Cocaine Dependence) may contribute to the onset or exacerbation of Major Depressive Disorder. It is difficult to predict whether the first episode of a Major Depressive Disorder in a young person will ultimately evolve into a Bipolar Disorder. Some data suggest that the acute onset of severe depression, especially with psychotic features and psychomotor retardation, in a young person without prepubertal psychopathology is more likely to predict a bipolar disorder. A family history of Bipolar Disorder may also be suggestive of subsequent development of Bipolar Disorder.” p. 372-373
Diagnostic and statistical manual of mental disorders. 2000. 4th ed. Washington, D.C.: American Psychiatric Association.
________________ Major Depressive Disorder “Diagnostic Features The essential feature of Major Depressive Disorder is a clinical course that is characterized by one or more Major Depressive Episodes without a history of Manic, Mixed, or Hypomanic Episodes (Criteria A and C). Episodes of Substance-Induced Mood Disorder (due to the direct physiological effects of a drug of abuse, a medication, or toxin exposure) or of Mood Disorder Due to a General Medical Condition do not count toward a diagnosis of Major Depressive Disorder. In addition, the episodes must not be better accounted for by Schizoaffective Disorder and are not superimposed on Schizophrenia, Schizophreniform Disorder, Delusional Disorder, or Psychotic Disorder Not Otherwise Specified (Criterion B). The fourth digit in the diagnostic code for Major Depressive Disorder indicates whether it is a Single Episode (used only for first episodes) or Recurrent. It is sometimes difficult to distinguish between a single episode with waxing and waning symptoms and two separate episodes. For purposes of this manual, an episode is considered to have ended when the full criteria for eh Major Depressive Episode have not been met for at least 2 consecutive months. During this 2-month period, there is either complete resolution of symptoms or the presence of depressive symptoms that no longer meet the full criteria for a Major Depressive Episode (In Partial Remission). The fifth digit in the diagnostic code for Major Depressive Disorder indicates the current state of the disturbance. If the criteria for a Major Depressive Disorder are met, the severity of the episode is notes as Mild, Moderate, Severe Without Psychotic Features, or Severe With Psychotic Features. If the criteria for a Major Depressive Episode are not currently met, the fifth digit is used to indicate whether the disorder is In Partial Remission or In Full Remission. If Manic, Mixed, or Hypomanic Episodes develop in the course of Major Depressive Disorder, the diagnosis is changed to a Bipolar Disorder. However, if manic or hypomanic symptoms occur as a direct effect of antidepressant treatment, use of other medications, substance use, or toxin exposure, the diagnosis of Major Depressive Disorder remains appropriate and an addition diagnosis of Substance-induced Mood Disorder, With Manic features (or With Mixed Features), should be noted. Similarly, if manic or hypomanic symptoms occur as a direct effect of a general medical condition, the diagnosis of Major Depressive Disorder remains appropriate and an additional diagnosis of Mood Disorder Due to a General Medical Condition, With Manic Features (or With Mixed Features), should be noted.” p. 369 “Course Major Depressive Disorder may begin at any age, with an average age at onset in the mid-20s. Epidemiological data suggest that the age at onset is decreasing for those born more recently. The course of Major Depressive Disorder, Recurrent, is variable. Some people have isolated episodes that are separated by many years without any depressive symptoms, whereas others have clusters of episodes, and still others have increasingly frequent episodes as they grow older. Some evidence suggests that the periods of remission generally last longer early in the course of the disorder. The number of prior episodes predicts the likelihood of developing a subsequent Major Depressive Episode. At least 60% of individuals with Major Depresssive Disorder, Single Episode, can be expected to have a second episode. Individuals who have had tow episodes have a 70% chance of having a third, and individuals who have had three episodes have a 90% chance of having a fourth. About 5%-10% of individuals with Major Depressive Disorder, single Episode, subsequently develop a Manic Episode (i.e., develop Bipolar I Disorder). Major Depressive Episodes may end completely (in about two-thirds of cases), or only partially or not at all (in about one-third of cases). For individuals who have only partial remission, there is a greater likelihood of developing additional episodes and of continuing the pattern of partial interepisode recovery. The longitudinal course specifiers With Full Interepisode Recovery and Without Full Interepisode Recovery may therefore have prognostic value. A number of individuals have pre-existing Dysthymic Disorder prior to the onset of Major Depressive Disorder, single Episode. Some evidence suggests that these individuals are more likely to have additional Major Depressive Episodes, have poorer interepisode recovery, and may require additional acute-phase treatment and a longer period of continuing treatment to attain and maintain a more thorough and longer-lasting euthymic state. Follow-up naturalistic studies suggested that 1 year after the diagnosis of a major Depressive Episode, 40% of individuals still have symptoms that are sufficiently severe to meet criteria for a full Major Depressive Episode, roughly 20% continue to have some symptoms that no longer meet full criteria for a Major Depressive Episode (i.e., major Depressive Disorder, In Partial Remission), and 40% have no Mood Disorder. The severity of the initial Major Depressive Episode appears to predict persistence. Chronic general medical conditions are also a risk factor for more persistent episodes. Episodes of Major Depressive Disorder often follow a severe psychosocial stressor, such as the death of a loved one or divorce. Studies suggest that psychosocial events 9stressors) may play a more significant role in the precipitation of the first or second episodes of Major Depressive Disorder and may play less of a role in the onset of subsequent episodes. Chronic general medical conditions and Substance Dependence (particularly Alcohol or Cocaine Dependence) may contribute to the onset or exacerbation of Major Depressive Disorder. It is difficult to predict whether the first episode of a Major Depressive Disorder in a young person will ultimately evolve into a Bipolar Disorder. Some data suggest that the acute onset of severe depression, especially with psychotic features and psychomotor retardation, in a young person without prepubertal psychopathology is more likely to predict a bipolar disorder. A family history of Bipolar Disorder may also be suggestive of subsequent development of Bipolar Disorder.” p. 372-373 Diagnostic and statistical manual of mental disorders. 2000. 4th ed. Washington, D.C.: American Psychiatric Association. ________________ DID-PTSD-EMDR Dissociative Identity Disorder (DID) "The essential feature of Dissociative identity Disorder is the presence of two or more distinct identities or personality states (Criterion A) that recurrently take control of behavior (Criterion B). There is an inability to recall important personal information, the extent of which is too great to be explained by ordinary forgetfulness (Criterion C). The disturbance is not due tot eh direct physiological effects of a substance or a general medical condition (Condition D.). In children, the symptoms cannot be attributed to imaginary playmates or other fantasy play. Dissociative Identity Disorder reflects a failure to integrate various aspects of identity, memory, and consciousness. Each personality state may be experienced as if it has a distinct personal history, self-image, and identity, including a separate name. Usually there is a primary identity that carries the individual's given name and is passive, dependent, guilty, and depressed. The alternate identities frequently have different names and characteristics that contrast with the primary identity (e.g., are hostile, controlling, and self-destructive). Particular identities may emerge in specific circumstances and may differ in reported age and gender, vocabulary, general knowledge, or predominant affect. Alternate identities are experienced as taking control in sequence, ore at the expense of the other, and may deny knowledge of one another, be critical of one another, or appear to be in open conflict. Occasionally, one or more powerful identities allocate time to the others. Aggressive or hostile identities may at times interrupt activities or place the others in uncomfortable situations. Individuals with this disorder experience frequent gaps in memory for personal history, both remote and recent. The amnesia is frequently asymmetrical. The more passive identities tend to have more constricted memories, whereas the more hostile, controlling, or "protector" identities have more complete memories. An identity that is not in control may nonetheless gain access to consciousness by producing auditory or visual hallucinations (e.g., a voice giving instructions). Evidence of amnesia may be uncovered by reports from others who have witnessed behavior that is disavowed by the individual or by the individual's own discoveries (e.g., finding items of clothing at home that the individual cannot remember having bought). There may be loss of memory not only for recurrent periods of time, but also an overall loss of biographical memory for some extended period of childhood, adolescence, or even adulthood. Transitions among identities are often triggered by psychosocial stress. The time required to switch from one identity to another is usually a matter of seconds, but, less frequently, may b gradual. Behavior that may be frequently associated with identity switches include rapid blinking, facial changes, changes in voice or demeanor, or disruption in the individual's train of thoughts. The number of identities reported ranges from 2 to more than 100. Half of reported cases include the individuals with 10 or fewer identities." Diagnostic and Statistical Manual of Mental Disorders. 2000. 4th ed. Washington, D.C.: American Psychiatric Association. PTSD, DID, and EMDR Posttraumatic Stress Disorder "The essential feature of Posttraumatic Stress Disorder us the development of characteristic symptoms following exposure to an extreme traumatic stressor involving direct personal experience of an event that involves actual or threatened death or serious injury, or other threat to one's physical integrity; or witnessing an event that involves death, injury, or a threat to the physical integrity of another person; or learning about unexpected or violent death, serious harm, or threat of death or injury experienced by a family member or other close associate (Criteria A1). The person's response to the event must involve intense fear, helplessness, or horror (or in children, the response must involve disorganized or agitated behavior) (Criterion A2). The characteristic symptoms resulting from the exposure to the extreme trauma include persistent reexperiencing of the traumatic event (Criterion E), and the disturbance must cause clinically significant distress or impairment in social, occupational, or other important areas of functioning (Criterion F). Traumatic events that are experienced directly include, but are not limited to, military combat, violent personal assault (sexual assault, physical attack, robbery, mugging), being kidnapped, being taken hostage, terrorist attack, torture, incarceration as a prisoner of war or in a concentration camp, natural or manmade disasters, severe automobile accidents, or being diagnosed with a life-threatening illness. For children, sexually traumatic events may include developmentally inappropriate sexual experiences without threatened or actual violence or injury. Witnessed events include, but are not limited to, observing the serious injury or unnatural death of another person due to violent assault, accident, war, or disaster or unexpectedly witnessing a dead body or body parts. Events experienced by others that are learned about include, but are not limited to, violent personal assault, serious accident, or serious injury experienced y a family member or a close friend; learning about the sudden, unexpected death of a family member or a close friend; or learning that one's child has a life threatening disease. The disorder may be especially sever or long lasting when the stressor is of human design (e.g., torture, rape). the likelihood of developing this disorder may increase as the intensity of and physical proximity to the stressor increase. The traumatic event can be reexperienced in various ways. Commonly the person has recurrent and intrusive recollections of the event (Criterion B1) or recurrent distressing dreams during which the event can be replayed or otherwise represented (Criterion B2). In rare instances, the person experiences dissociative states that last from a few seconds to several hours, or even days, during which components of the event are relived and the person behaves as though experiencing the event at that moment (Criterion B3). These episodes, often referred to as "flashbacks," are typically brief but can be associated with prolonged distress and heightened arousal. Intense psychological distress (Criterion B4) or physiological reactivity (Criterion B5) often occurs when the person is exposed to triggering events that resemble or symbolize an aspect of the traumatic event (e.g., anniversaries of the traumatic event; cold, snowy weather or uniformed guards for survivors of death camps in cold climates; hot, humid weather for combat veterans of the South Pacific; entering any elevator for an woman who was reaped in an elevator). Stimuli associated with the trauma are persistently avoided. The person commonly makes deliberate efforts to avoid thoughts, feelings, or conversations about the traumatic event (Criterion C1) and to avoid activities, situations, or people who around recollections of it (Criterion C2). This avoidance of reminders may include amnesia for an important aspect of the traumatic event (Criterion C3). Diminished responsiveness to the external work, referred to as "psychic numbing" or "emotional anesthesia," usually begins soon after the traumatic event. The individual may complain of having markedly diminished interest or participation in previously enjoyed activities (Criterion C4), of feeling detached or estranged from other people (Criterion C5), or of having markedly reduced ability to feel emotions (especially those associated with intimacy, tenderness and sexuality) (Criterion C6). The individual may have a sense of a foreshortened future (e.g., not expecting to have a career, marriage, children, or a normal life span) (Criterion C7). The individual has persistent symptoms of anxiety or increased arousal that were not present before the trauma. these symptoms may include difficulty falling or staying asleep that may be to recurrent nightmares during which the traumatic event is relived (Criterion D1), hypervigilance (Criterion D4), and exaggerated startle response (Criterion D5). Some individuals report irritability or outburst of anger (Criterion D2) or difficulty concentrating or completing tasks (Criterion D3)."
EMDR Eye Movement Desensitization and Reprocessing "Eye Movement Desensitization and Reprocessing (EMDR)1 integrates elements of many effective psychotherapies in structured protocols that are designed to maximize treatment effects. These include psychodynamic, cognitive behavioral, interpersonal, experiential, and body-centered therapies2. EMDR is an information processing therapy and uses an eight phase approach. During EMDR1 the client attends to past and present experiences in brief sequential doses while simultaneously focusing on an external stimulus. Then the client is instructed to let new material become the focus of the next set of dual attention. This sequence of dual attention and personal association is repeated many times in the session. Eight Phases of Treatment The first phase is a history taking session during which the therapist assesses the client's readiness for EMDR and develops a treatment plan. Client and therapist identify possible targets for EMDR processing. These include recent distressing events, current situations that elicit emotional disturbance, related historical incidents, and the development of specific skills and behaviors that will be needed by the client in future situations. During the second phase of treatment, the therapist ensures that the client has adequate methods of handling emotional distress and good coping skills, and that the client is in a relatively stable state. If further stabilization is required, or if additional skills are needed, therapy focuses on providing these. The client is then able to use stress reducing techniques whenever necessary, during or between sessions. However, one goal is not to need these techniques once therapy is complete. In phase three through six, a target is identified and processed using EMDR procedures. These involve the client identifying the most vivid visual image related to the memory (if available), a negative belief about self, related emotions and body sensations. The client also identifies a preferred positive belief. The validity of the positive belief is rated, as is the intensity of the negative emotions. After this, the client is instructed to focus on the image, negative thought, and body sensations while simultaneously moving his/her eyes back and forth following the therapist's fingers as they move across his/her field of vision for 20-30 seconds or more, depending upon the need of the client. Athough eye movements are the most commonly used external stimulus, therapists often use auditory tones, tapping, or other types of tactile stimulation. The kind of dual attention and the length of each set is customized to the need of the client. The client is instructed to just notice whatever happens. After this, the clinician instructs the client to let his/her mind go blank and to notice whatever thought, feeling, image, memory, or sensation comes to mind. Depending upon the client's report the clinician will facilitate the next focus of attention. In most cases a client-directed association process is encouraged. This is repeated numerous times throughout the session. If the client becomes distressed or has difficulty with the process, the therapist follows established procedures to help the client resume processing. When the client reports no distress related to the targeted memory, the clinician asks him/her to think of the preferred positive belief that was identified at the beginning of the session, or a better one if it has emerged, and to focus on the incident, while simultaneously engaging in the eye movements. After several sets, clients generally report increased confidence in this positive belief. The therapist checks with the client regarding body sensations. If there are negative sensations, these are processed as above. If there are positive sensations, they are further enhanced. In phase seven, closure, the therapist asks the client to keep a journal during the week to document any related material that may arise and reminds the client of the self-calming activities that were mastered in phase two. The next session begins with phase eight, re-evaluation of the previous work, and of progress since the previous session. EMDR treatment ensures processing of all related historical events, current incidents that elicit distress, and future scenarios that will require different responses. The overall goal is produce the most comprehensive and profound treatment effects in the shortest period of time, while simultaneously maintaining a stable client within a balanced system. After EMDR processing, clients generally report that the emotional distress related to the memory has been eliminated, or greatly decreased, and that they have gained important cognitive insights. Importantly, these emotional and cognitive changes usually result in spontaneous behavioral and personal change, which are further enhanced with standard EMDR procedures." www.emdr.com
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NeuroBiology of Trauma
Record: 1Title: Exploring emotion-regulation and autonomic physiology in metastatic breast cancer patients: Repression, suppression, and restraint of hostility. Author(s):
Giese-Davis, Janine, Department of
Psychiatry and Behavioral Sciences, Stanford University,
Stanford, CA, US,
jgiese@stanford.edu Address: Giese-Davis, Janine, Department of Psychiatry and Behavioral Sciences, Stanford University, 401 Quarry Road, Stanford, CA, US, 94305-5718, jgiese@stanford.edu Source: Personality and Individual Differences, Vol 44(1), Jan 2008. pp. 226-237. Publisher: Netherlands: Elsevier Science. ISSN: 0191-8869 (Print) Digital Object Identifier: 10.1016/j.paid.2007.08.002 Language: English Keywords: emotion regulation; autonomic physiology; metastatic breast cancer patients; repression; suppression; restraint of hostility Abstract: We examined relationships between three emotion-regulation constructs and autonomic physiology in metastatic breast cancer patients (N = 31). Autonomic measures are not often studied in breast cancer patients and may provide evidence of an increase in allostatic load. Patients included participated as part of a larger clinical trial of supportive-expressive group therapy. Systolic and diastolic blood pressure and heart rate were assessed at a semi-annual follow-up. We averaged three resting assessments and used measures of repression, suppression, restraint of hostility, and body mass index as predictors of autonomic response. We found that higher repression was significantly associated with higher diastolic blood pressure, while higher restraint of hostility was significantly associated with higher systolic blood pressure. A repressive emotion-regulation style may be a risk factor for higher sympathetic activation possibly increasing allostatic load, while restraint of hostility may be a protective factor for women with metastatic breast cancer. (PsycINFO Database Record (c) 2007 APA, all rights reserved)(from the journal abstract) Subjects: *Breast Neoplasms; *Emotional Regulation; *Physiology; Diastolic Pressure; Heart Rate; Hostility; Repression (Defense Mechanism); Suppression (Defense Mechanism); Systolic Pressure Classification: Cancer (3293) Population:
Human (10) Location: US Age Group: Adulthood (18 yrs & older) (300) Tests & Measures: Weinberger Adjustment Inventory WAI-short form Grant Information: This study was made possible by National Institute for Mental Health Grant MH47226 and MH47226-11 with additional funding from The National Cancer Institute, the John D. and Catherine T. MacArthur Foundation, California Breast Cancer Research Program Grants 1FB-0383 and 4bb-2901, and NIA/NCI Program Project AG18784 Conference: Annual Society for Behavioral Medicine Conference, Mar, 1999, San Diego, CA, US Conference Notes: Portions of this study were presented at the aforementioned conference. Methodology: Empirical Study; Quantitative Study Publication Type:
Journal, Peer Reviewed Journal; Electronic Document Type: Journal Article Release Date: 20071105 Accession Number: 2007-16420-021 Number of Citations in Source: 60 Persistent link to this record: http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2007-16420-021&site=ehost-live Cut and Paste: <A href="http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2007-16420-021&site=ehost-live">Exploring emotion-regulation and autonomic physiology in metastatic breast cancer patients: Repression, suppression, and restraint of hostility.</A> Database: PsycINFO Record: 2Title: Do chronic stressors lead to physiological disregulation? Testing the theory of allostatic load. Author(s):
Glei, Dana A., Department of Demography,
University of California, Berkeley, Berkeley, CA, US,
danaglei@sonic.net Address: Glei, Dana A., 5985 San Aleso Ct., Santa Rosa, CA, US, 95409-3912, danaglei@sonic.net Source: Psychosomatic Medicine, Vol 69(8), Oct 2007. pp. 769-776. Publisher: US: Lippincott Williams & Wilkins. ISSN:
0033-3174 (Print) Digital Object Identifier: 10.1097/PSY.0b013e318157cba6 Language: English Keywords: chronic stressors; physiological disregulation; theory of allostatic load; aging; Taiwan Abstract: Objectives: To explore three questions: 1) Do chronic stressors predict physiological dysregulation? 2) Is that relationship moderated by characteristics of the individual and his or her social environment? and 3) Do perceived levels of stress mediate the relationship between stressors and dysregulation? Methods: Data come from a nationally representative, longitudinal study of older Taiwanese (n = 916). Regression models are used to examine the relationship between the number of life challenges (i.e., stressors) during 1996 to 2000 and physiological dysregulation (in 2000) based on 16 biomarkers that reflect neuroendocrine function, immune system, cardiovascular function, and metabolic pathways. We include interaction terms to test whether psychosocial vulnerability moderates the impact of stressors. Additional models evaluate the mediating effects of perceived stress. Results: We find a positive association between the number of stressors and physiological dysregulation. The results indicate that this relationship is stronger for persons with greater psychosocial vulnerability, but even so, the magnitude of the effect remains modest. We find some evidence that the level of perceived stress mediates the relationship between chronic stressors and physiological dysregulation. Conclusions: Our results provide some support for the theory of allostatic load, although the relationship between life challenges and physiological dysregulation is weak. The evidence also supports the stress-buffering hypothesis: the combination of low social position, weak social networks, and poor coping ability is associated with greater physiological consequences of life challenges. (PsycINFO Database Record (c) 2007 APA, all rights reserved)(from the journal abstract) Subjects: *Aging; *Physiology; *Stress Classification: Physical & Somatoform & Psychogenic Disorders (3290) Population:
Human (10) Location: Taiwan Age Group: Adulthood (18 yrs & older) (300) Grant Information: This work has been supported by Grants R01AG16790 and R01AG16661 from the Demography and Epidemiology Unit of the Behavioral and Social Research Program of the National Institute of Aging, and by Grant 5P30HD32030 from the National Institute of Child Health and Human Development Methodology: Empirical Study; Quantitative Study Publication Type:
Journal, Peer Reviewed Journal; Print Document Type: Journal Article Release Date: 20071112 Accession Number: 2007-16770-010 Number of Citations in Source: 59 Persistent link to this record: http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2007-16770-010&site=ehost-live Cut and Paste: <A href="http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2007-16770-010&site=ehost-live">Do chronic stressors lead to physiological disregulation? Testing the theory of allostatic load.</A> Database: PsycINFO Record: 3Title: Job stress related to glyco-lipid allostatic load, adiponectin and visfatin. Author(s):
Li, Wei, Department of Occupational and
Environmental Health, Public Health School, Peking University
Health Science Centre, Bei Jing, China Address: Wang, Sheng, Department of Occupational and Environmental Health, Public Health School, Peking University Health Science Centre, Bei Jing, China, 100083, shengw@bjmu.edu.cn Source: Stress and Health: Journal of the International Society for the Investigation of Stress, Vol 23(4), Oct 2007. pp. 257-266. Publisher: US: John Wiley & Sons. Other Journal Title: Stress Medicine ISSN:
1532-3005 (Print) Digital Object Identifier: 10.1002/smi.1145 Language: English Keywords: job stress; glycolipids; allostatic load; adiponectin; visfatin; industrial employees; metabolism; lipoproteins; physiological correlates Abstract: Job stress has been associated with an increased risk for glyco-lipid metabolic dysfunction, which can lead to coronary artery disease, diabetes and other adverse health outcomes. We undertook a cross-sectional study to evaluate the relationship between job stress and glyco-lipid metabolic change in healthy industrial employees in China. Volunteers (n = 504) were investigated during the routine annual health examination period between June and August 2006. Job stress was assessed by the 22-item Job Content Questionnaire (JCQ), which included three dimensions: job control, job demand and social support. Glyco-lipid metabolic status was determined by the glyco-lipid allostatic load based on the allostasis paradigm and the concept of allostatic load. There were 11 parameters comprising the glyco-lipid allostatic load: body mass index (BMI); waist to hip ratio (WHR); high-density lipoprotein (HDL); low-density lipoprotein (LDL); total cholesterol (TC); triglyceride (TG); glycosylated haemoglobin (HbA-sub(1C)); homeostasis model assessment-insulin resistance (HOMA-IR); HOMA-β-cell function; plasma concentrations of adiponectin; and visfatin. Score points were given for values in the high-risk quartile (0-11). Multivariate analysis of variance (MANOVA) revealed that BMI, WHR, TG, adiponectin, visfatin and glyco-lipid allostatic load were significantly different between high and low job stress groups after being adjusted for demographic characteristics and health-related behaviour. Plasma adiponectin levels were negatively correlated with BMI, WHR, HbA-sub(1C), TG, IR and visfatin, and positively correlated with HDL. Plasma concentration of visfatin was positively correlated with BMI, WHR, TC and IR. Multiple stepwise linear regression analysis indicated that job control was significantly related to glyco-lipid allostatic load, plasma adiponectin concentration and plasma visfatin concentration after controlling for demographic characteristics and health-related behaviour. In conclusion, we found association between job stress, job control and the glyco-lipid metabolism summary score. Plasma adiponectin and visfatin concentrations related with job stress and job control. (PsycINFO Database Record (c) 2007 APA, all rights reserved)(from the journal abstract) Subjects: *Employee Attitudes; *Lipid Metabolism; *Lipoproteins; *Occupational Stress; *Physiological Correlates; Business and Industrial Personnel; Lipids; Psychoneuroendocrinology Classification:
Personnel Attitudes & Job Satisfaction
(3650) Population:
Human (10) Age Group: Adulthood (18 yrs & older) (300) Tests & Measures: Job Content Questionnaire Grant Information: This work was supported by Grant 2006050219 from the Lang Fang City Science Technology Foundation Methodology: Empirical Study; Quantitative Study Publication Type:
Journal, Peer Reviewed Journal; Print Document Type: Journal Article Release Date: 20071105 Accession Number: 2007-15518-007 Number of Citations in Source: 50 Persistent link to this record: http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2007-15518-007&site=ehost-live Cut and Paste: <A href="http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2007-15518-007&site=ehost-live">Job stress related to glyco-lipid allostatic load, adiponectin and visfatin.</A> Database: PsycINFO Record: 4Title: A life-span perspective on women's careers, health, and well-being. Author(s):
Johansson, Gunn, Stockholm University,
Stockholm, Sweden,
gj@psychology.su.se Address: Johansson, Gunn, gj@psychology.su.se Source: Social Science & Medicine, Vol 65(4), Aug 2007. pp. 685-697. Publisher: Netherlands: Elsevier Science. ISSN: 0277-9536 (Print) Digital Object Identifier: 10.1016/j.socscimed.2007.04.001 Language: English Keywords: life span perspective; women careers; health; well being; mid life; family involvement; life satisfaction Abstract: The purpose of this study was to investigate if and how health and well-being in mid-life are influenced by the ways in which individuals have combined educational, occupational, and family involvement throughout their adult lives. Life-career patterns (LC) and occupational career patterns (OC) were retrieved from a longitudinal cohort of Swedish women born in the 1950s. Retrospective occupational biographies retrieved at age 43 generated nine LC and 10 OC patterns which served as the basis for the present study. LC patterns combined timing, ordering, duration, and content of activities (e.g., education, work, and parenthood), while OC patterns considered occupational level and its stability over time. Data on life and job satisfaction, psychological well-being, work-family conflict, optimism, and mental distress were collected at age 49. For a sub-sample of the women who took part in a medical examination, seven biomarkers were combined into a measure of allostatic load (AL). The results showed that LC pattern-groups differed significantly but modestly in four aspects of health and well-being whereas OC pattern-groups displayed significant between-group differences in all outcome variables except life satisfaction. The results are interpreted in terms of a social-health gradient effect and a supportive societal context of the Swedish welfare state, which offered a considerable amount of free choice to the women in the cohort. (PsycINFO Database Record (c) 2007 APA, all rights reserved)(from the journal abstract) Subjects: *Job Satisfaction; *Life Satisfaction; *Occupations; *Well Being; Family Conflict; Health; Involvement; Life Span Classification: Social Processes & Social Issues (2900) Population:
Human (10) Location: Sweden Age Group:
Adolescence (13-17 yrs) (200) Tests & Measures:
Minnesota Questionnaire Grant Information: This research was supported by grants from the Swedish Council for Working Life and Social Research to Gunn Johansson. The data collections were supported financially by the Swedish National Board of Education, the Swedish Committee for the Planning and Coordination of Research, The Bank of Sweden Tercentenary Foundation, the Swedish Social Research Council, and The Örebro County Council Methodology: Empirical Study; Quantitative Study Publication Type:
Journal, Peer Reviewed Journal; Electronic Document Type: Journal Article Release Date: 20070924 Accession Number: 2007-11591-005 Number of Citations in Source: 62 Persistent link to this record: http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2007-11591-005&site=ehost-live Cut and Paste: <A href="http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2007-11591-005&site=ehost-live">A life-span perspective on women's careers, health, and well-being.</A> Database: PsycINFO Record: 5Title: The role of child adrenocortical functioning in pathways between interparental conflict and child maladjustment. Author(s):
Davies, Patrick T., Department of Clinical
and Social Sciences in Psychology, University of Rochester,
Rochester, NY, US,
davies@psych.rochester.edu Address: Davies, Patrick T., Department of Clinical and Social Sciences in Psychology, University of Rochester, Rochester, NY, US, 14627, davies@psych.rochester.edu Source: Developmental Psychology, Vol 43(4), Jul 2007. pp. 918-930. Publisher: US: American Psychological Association. ISSN:
0012-1649 (Print) Digital Object Identifier: 10.1037/0012-1649.43.4.918 Language: English Keywords: interparental conflict; family discord; cortisol; child coping; child maladjustment; externalizing symptoms; gender; race Abstract: This study examined the interplay between interparental conflict and child cortisol reactivity to interparental conflict in predicting child maladjustment in a sample of 178 families and their kindergarten children. Consistent with the allostatic load hypothesis (McEwen & Stellar, 1993), results indicated that interparental conflict was indirectly related to child maladjustment through its association with individual differences in child cortisol reactivity. Analyses indicated that the multimethod assessment of interparental conflict was associated with lower levels of child cortisol reactivity to a simulated phone conflict between parents. Diminished cortisol reactivity, in turn, predicted increases in parental reports of child externalizing symptoms over a 2-year period. Associations between interparental conflict, child cortisol reactivity, and child externalizing symptoms remained robust even after demographic factors and other family processes were taken into account. (PsycINFO Database Record (c) 2007 APA, all rights reserved)(from the journal abstract) Subjects: *Adjustment; *Childhood Development; *Hydrocortisone; *Marital Conflict; Emotional Adjustment; Externalization; Human Sex Differences; Racial and Ethnic Differences; Symptoms Classification: Psychosocial & Personality Development (2840) Population:
Human (10) Location: US Age Group:
Childhood (birth-12 yrs) (100) Tests & Measures:
Marital Daily Records Grant Information: This research was supported by National Institute of Mental Health Grant R01 MH57318 to Patrick T. Davies and E. Mark Cummings and Grant F32 MH66596 to Melissa L. Sturge-Apple Methodology: Empirical Study; Longitudinal Study; Quantitative Study Publication Type:
Journal, Peer Reviewed Journal; Electronic Document Type: Journal Article Release Date: 20070702 Correction Date: 20071210 Accession Number: 2007-09251-010 Number of Citations in Source: 81 Persistent link to this record: http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2007-09251-010&site=ehost-live Cut and Paste: <A href="http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2007-09251-010&site=ehost-live">The role of child adrenocortical functioning in pathways between interparental conflict and child maladjustment.</A> Database: PsycINFO Full Text Database: PsycARTICLES Record: 6Title: The associations between socioeconomic status, allostatic load and measures of health in older Taiwanese persons: Taiwan social environment and biomarkers of aging study. Author(s):
Hu, Peifeng, Multicampus Program in
Geriatric Medicine and Gerontology, UCLA School of Medicine, Los
Angeles, CA, US Source: Journal of Biosocial Science, Vol 39(4), Jul 2007. pp. 545-556. Publisher: US: Cambridge Univ Press. Other Journal Title: Eugenics Review ISSN:
0021-9320 (Print) Digital Object Identifier: 10.1017/S0021932006001556 Language: English Keywords: socioeconomic status; allostatic load; health; older Taiwanese persons; social environment; biomarkers; aging; physical activity Abstract: Data from a national representative sample of 1023 elderly and near-elderly Taiwanese were used to explore whether allostatic load is associated with health outcomes and mediates the association between socioeconomic status and health in a non-Western population. The information collected included: demographic characteristics; allostatic load scores; socioeconomic status, measured by education and income; health behaviours; health-related variables, including self-rated health, basic activities of daily living difficulties, instrumental activities of daily living difficulties, and physical activity difficulties. The adjusted prevalent odds ratios of higher allostatic load level were 1.25 (95% CI: 1.00, 1.56) for reporting one level worse in self-rated health and 1.43 (95% CI: 1.14, 1.82) for reporting one more physical activity difficulty. There were significant associations of lower education or less income with worse self-rated health and more difficulties with physical functioning. The associations between education, income and health status are not mediated by the conventional ten-point measure of allostatic load in older Taiwanese adults. (PsycINFO Database Record (c) 2007 APA, all rights reserved)(from the journal abstract) Subjects: *Aging; *Health; *Physical Activity; *Social Environments; *Socioeconomic Status; Activities of Daily Living; Daily Activities; Physique Classification: Gerontology (2860) Population:
Human (10) Location: Taiwan Age Group:
Adulthood (18 yrs & older) (300) Grant Information: This project was supported by funding from the National Institute on Aging (Grants AG16661, AG16790 and K23 AG021029), Pfizer/American Geriatrics Society Foundation for Health in Aging Junior Faculty Scholar Program for Research on Health Outcomes, the UCLA Claude Pepper Older American Independence Center (P06 AG10415-11), and the MacArthur Research Network on SES and Health through grants from the John D. and Catherine T. MacArthur Foundation Methodology: Empirical Study; Quantitative Study Publication Type:
Journal, Peer Reviewed Journal; Print Document Type: Journal Article Release Date: 20070924 Accession Number: 2007-10002-005 Number of Citations in Source: 28 Persistent link to this record: http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2007-10002-005&site=ehost-live Cut and Paste: <A href="http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2007-10002-005&site=ehost-live">The associations between socioeconomic status, allostatic load and measures of health in older Taiwanese persons: Taiwan social environment and biomarkers of aging study.</A> Database: PsycINFO Record: 7Title: Cardiovascular manifestations of posttraumatic stress disorder. Author(s):
Bedi, Updesh Singh, Department of Internal
Medicine, Rosalind Franklin University of Medicine &
Science/Chicago Medical School, Chicago, IL, US Address: Arora, Rohit, Rosalind Franklin University of Medicine & Science/Chicago Medical School, Chicago, IL, US, rohit.arora@va.gov Source: Journal of the National Medical Association, Vol 99(6), Jun 2007. pp. 642-649. Publisher: US: National Medical Assn. ISSN: 0027-9684 (Print) Language: English Keywords: cardiovascular manifestations; posttraumatic stress disorder; psychiatric symptoms; heart rate; blood pressure; tremor; physiological responses Abstract: Posttraumatic stress disorder (PTSD) involves the onset of psychiatric symptoms after exposure to a traumatic event. PTSD has an estimated lifetime prevalence of 7.8% among adult Americans, and about 15.2% of the men and 8.5% of the women who served in Vietnam suffered from posttraumatic stress disorder (PTSD) ≥15 years after their military service. Physiological responses (increase in heart rate, blood pressure, tremor and other symptoms of autonomic arousal) to reminders of the trauma are a part of the DSM-IV definition of PTSD. Multiple studies have shown that patients suffering from PTSD have increased resting heart rate, increased startle reaction, and increased heart rate and blood pressure as responses to traumatic slides, sounds and scripts. Some researchers have studied the sympathetic nervous system even further by looking at plasma norepinephrine and 24-hour urinary norepinephrine and found them to be elevated in veterans with PTSD as compared to those without PTSD. PTSD is associated with hyperfunctioning of the central noradrenergic system. Hyperactivity of the sympathoadrenal axis might contribute to cardiovascular disease through the effects of the catecholamines on the heart, the vasculature and platelet function. A psychobiological model based on allostatic load has also been proposed and states that chronic stressors over long durations of time lead to increased neuroendocrine responses, which have adverse effects on the body. PTSD has also been shown to be associated with an increased prevalence of substance abuse. With this review, we have discussed the effects of PTSD on the cardiovascular system. (PsycINFO Database Record (c) 2007 APA, all rights reserved)(from the journal abstract) Subjects: *Cardiovascular Disorders; *Cardiovascular Reactivity; *Posttraumatic Stress Disorder; Blood Pressure; Heart Rate; Psychiatric Symptoms; Tremor Classification: Neuroses & Anxiety Disorders (3215) Population:
Human (10) Location: US Age Group: Adulthood (18 yrs & older) (300) Methodology: Empirical Study; Quantitative Study Publication Type:
Journal, Peer Reviewed Journal; Print Document Type: Journal Article Release Date: 20071015 Accession Number: 2007-08886-002 Number of Citations in Source: 95 Persistent link to this record: http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2007-08886-002&site=ehost-live Cut and Paste: <A href="http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2007-08886-002&site=ehost-live">Cardiovascular manifestations of posttraumatic stress disorder.</A> Database: PsycINFO Record: 8Title: Repeated sleep restriction in rats leads to homeostatic and allostatic responses during recovery sleep. Author(s):
Kim, Youngsoo, Center for Sleep and
Circadian Biology, Department of Neurobiology and Physiology,
Northwestern University, Evanston, IL, US Address: Turek, Fred W., Center for Sleep and Circadian Biology, Department of Neurobiology and Physiology, Northwestern University, 2205 Tech Drive, Hogan 2-160, Evanston, IL, US, 60208, fturek@northwestern.edu Source: PNAS Proceedings of the National Academy of Sciences of the United States of America, Vol 104(25), Jun 2007. pp. 10697-10702. Publisher: US: National Academy of Sciences. ISSN: 0027-8424 (Print) Digital Object Identifier: 10.1073/pnas.0610351104 Language: English Keywords: sleep restriction; rats; homeostatic responses; allostatic responses; recovery sleep; brain function; peripheral physiology; sleep-wake system Abstract: Recent studies indicate that chronic sleep restriction can have negative consequences for brain function and peripheral physiology and can contribute to the allostatic load throughout the body. Interestingly, few studies have examined how the sleep-wake system itself responds to repeated sleep restriction. In this study, rats were subjected to a sleep-restriction protocol consisting of 20 h of sleep deprivation (SD) followed by a 4-h sleep opportunity each day for 5 consecutive days. In response to the first 20-h SD block on day 1, animals responded during the 4-h sleep opportunity with enhanced sleep intensity [i.e., nonrapid eye movement (NREM) delta power] and increased rapid eye movement sleep time compared with baseline. This sleep pattern is indicative of a homeostatic response to acute sleep loss. Remarkably, after the 20-h SD blocks on days 2-5, animals failed to exhibit a compensatory NREM delta power response during the 4-h sleep opportunities and failed to increase NREM and rapid eye movement sleep times, despite accumulating a sleep debt each consecutive day. After losing ≈35 h of sleep over 5 days of sleep restriction, animals regained virtually none of their lost sleep, even during a full 3-day recovery period. These data demonstrate that the compensatory/homeostatic sleep response to acute SD does not generalize to conditions of chronic partial sleep loss. We propose that the change in sleep-wake regulation in the context of repeated sleep restriction reflects an allostatic process, and that the allostatic load produced by SD has direct effects on the sleep-wake regulatory system. (PsycINFO Database Record (c) 2007 APA, all rights reserved)(from the journal abstract) Subjects: *Homeostasis; *Physiology; *Sleep; *Sleep Deprivation; *Sleep Wake Cycle; Brain; Rats Classification: Physiological Psychology & Neuroscience (2500) Population:
Animal (20) Grant Information: This research was supported by National Institutes of Health Grants P01AG11412 and R01HL075029 Methodology: Empirical Study; Quantitative Study Publication Type:
Journal, Peer Reviewed Journal; Electronic Document Type: Journal Article Release Date: 20070827 Accession Number: 2007-09507-009 Number of Citations in Source: 29 Persistent link to this record: http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2007-09507-009&site=ehost-live Cut and Paste: <A href="http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2007-09507-009&site=ehost-live">Repeated sleep restriction in rats leads to homeostatic and allostatic responses during recovery sleep.</A> Database: PsycINFO Record: 9Title: Allostatic load: Single parents, stress-related health issues, and social care. Author(s): Johner, Randy L., Faculty of Social Work, University of Regina, Regina, SK, Canada, Johner1r@uregina.ca Address: Johner, Randy L., Faculty of Social Work, University of Regina, 3737 Wascana Parkway, Regina, SK, Canada, S4S OA2, Johner1r@uregina.ca Source: Health & Social Work, Vol 32(2), May 2007. pp. 89-94. Publisher: US: NASW Press. ISSN: 0360-7283 (Print) Language: English Keywords: low income single parents; stress related health issues; social care; allostatic load Abstract: This article explores the possible relationships between allostatic load (AL) and stress-related health issues in the low-income single-parent population, using both a population health perspective (PHP) and a biological framework. A PHP identifies associations among such factors as gender, income, employment, and social support and their potential effect on health outcomes. A PHP also recognizes physiological and pathological manifestations of the body such as stress (mental or somatic) and individual biological parameters (for example, glucose levels) as health determinants. AL uses an aggregate score of individual biological parameters as a health measure that is exacerbated through repetitive movement of physiologic systems under stress. The social work profession should incorporate knowledge of both PHP and AL into its theory and practice domains for effective care of vulnerable populations such as single-parent families. (PsycINFO Database Record (c) 2007 APA, all rights reserved)(from the journal abstract) Subjects: *At Risk Populations; *Single Parents; *Social Casework; Health; Lower Income Level; Social Support Classification: Community & Social Services (3373) Population: Human (10) Publication Type:
Journal, Peer Reviewed Journal; Print Document Type: Journal Article Release Date: 20071015 Accession Number: 2007-08603-001 Number of Citations in Source: 40 Persistent link to this record: http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2007-08603-001&site=ehost-live Cut and Paste: <A href="http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2007-08603-001&site=ehost-live">Allostatic load: Single parents, stress-related health issues, and social care.</A> Database: PsycINFO Record: 10Title: Sleep and the affective response to stress and pain. Author(s):
Hamilton, Nancy A., Department of
Psychology, University of Kansas, Lawrence, KS, US,
nancyh@ku.edu Address: Hamilton, Nancy A., Department of Psychology, University of Kansas, 1415 Jayhawk Boulevard, Lawrence, US, 66045, nancyh@ku.edu Source: Health Psychology, Vol 26(3), May 2007. pp. 288-295. Publisher: US: American Psychological Association. Other Publishers: Mahwah, NJ, US: Lawrence Erlbaum Associates ISSN:
0278-6133 (Print) Digital Object Identifier: 10.1037/0278-6133.26.3.288 Language: English Keywords: fibromyalgia; rheumatoid arthritis; stress reactivity; pain; sleep duration; sleep quality Abstract: Objective: The current study examined sleep disturbance (i.e., sleep duration, sleep quality) as a correlate of stress reactivity and pain reactivity. Design and Outcome Measures: An ecological momentary assessment design was used to evaluate the psychosocial functioning of men and women with fibromyalgia or rheumatoid arthritis (N = 49). Participants recorded numeric ratings of pain, the occurrence of a stressful event, as well as positive and negative affect 7 times throughout the day for 2 consecutive days. In addition, participants reported on their sleep duration and sleep quality each morning. Results: Sleep disruption was not found to be an independent predictor of affect. However, sleep was found to buffer the relationship between stress and negative affect and the relationship between pain and both positive and negative affect. Conclusion: These results are consistent with a model in which good-quality sleep acts as a biobehavioral resource that minimizes allostatic load. (PsycINFO Database Record (c) 2007 APA, all rights reserved)(from the journal abstract) Subjects: *Fibromyalgia; *Pain; *Rheumatoid Arthritis; *Sleep; *Stress Reactions Classification: Health Psychology & Medicine (3360) Population:
Human (10) Age Group:
Adulthood (18 yrs & older) (300) Methodology: Empirical Study; Quantitative Study Publication Type:
Journal, Peer Reviewed Journal; Electronic Document Type: Journal Article Release Date: 20070514 Correction Date: 20071210 Accession Number: 2007-06671-006 Number of Citations in Source: 42 Persistent link to this record: http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2007-06671-006&site=ehost-live Cut and Paste: <A href="http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2007-06671-006&site=ehost-live">Sleep and the affective response to stress and pain.</A> Database: PsycINFO Full Text Database: PsycARTICLES Record: 11Title: Cumulative Risk, Maternal Responsiveness, and Allostatic Load Among Young Adolescents. Author(s):
Evans, Gary W., Department of Design &
Environmental Analysis, Cornell University, Ithaca, NY, US,
gwe1@cornell.edu Address: Evans, Gary W., Department of Design & Environmental Analysis, Cornell University, Ithaca, NY, US, 14853-4401, gwe1@cornell.edu Source: Developmental Psychology, Vol 43(2), Mar 2007. pp. 341-351. Publisher: US: American Psychological Association. ISSN:
0012-1649 (Print) Digital Object Identifier: 10.1037/0012-1649.43.2.341 Language: English Keywords: cumulative risk; stress; maternal responsiveness; allostatic load; adolescents Abstract: The purpose of this study was to examine the impact of cumulative risk exposure in concert with maternal responsiveness on physiological indicators of chronic stress in children and youth. Middle-school children exposed to greater accumulated psychosocial (e.g., family turmoil, poverty) and physical (e.g., crowding, substandard housing) risk factors manifested higher levels of allostatic load, a physiological marker of cumulative wear and tear on the body caused by the mobilization of multiple, physiological response systems. This effect was longitudinal, residualizing allostatic load 3-4 years earlier when the youth were in elementary school. This effect, however, occurred only among adolescents with mothers low in responsiveness. Cumulative risk was also associated with dynamic cardiovascular processes in response to an acute stressor (mental arithmetic). Higher risk was associated with muted reactivity and slower, less efficient recovery in blood pressure. These dynamic cardiovascular effects occurred irrespective of maternal responsiveness. (PsycINFO Database Record (c) 2007 APA, all rights reserved)(from the journal abstract) Subjects: *Chronic Stress; *Mother Child Relations; *Physiological Correlates; *Risk Factors; Family Classification: Psychosocial & Personality Development (2840) Population:
Human (10) Location: US Age Group: Adolescence (13-17 yrs) (200) Tests & Measures:
Life Events and Circumstances Checklist Grant Information: Partial support for this research came from the W. T. Grant Foundation and the John D. and Catherine T. MacArthur Foundation Research Network on Socioeconomic Status and Health Methodology: Empirical Study; Quantitative Study Publication Type:
Journal, Peer Reviewed Journal; Electronic Document Type: Journal Article Release Date: 20070312 Correction Date: 20071210 Accession Number: 2007-02739-006 Number of Citations in Source: 100 Persistent link to this record: http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2007-02739-006&site=ehost-live Cut and Paste: <A href="http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2007-02739-006&site=ehost-live">Cumulative Risk, Maternal Responsiveness, and Allostatic Load Among Young Adolescents.</A> Database: PsycINFO Full Text Database: PsycARTICLES Record: 12Title: How gene-stress-behavior interactions can promote adolescent alcohol use: The roles of predrinking allostatic load and childhood behavior disorders. Author(s):
Zimmermann, Ulrich S., Department of
Addictive Behavior and Addiction Medicine, Central Institute of
Mental Health, Mannheim, Germany,
ulrich.zimmermann@zi-mannheim.de Address: Zimmermann, Ulrich S., Department of Addictive Behavior and Addiction Medicine, J5, 68159, Mannheim, Germany, ulrich.zimmermann@zi-mannheim.de Source: Pharmacology, Biochemistry and Behavior, Vol 86(2), Feb 2007. Special issue: Adolescents, drug abuse and metal disorders. pp. 246-262. Publisher: Netherlands: Elsevier Science. ISSN: 0091-3057 (Print) Digital Object Identifier: 10.1016/j.pbb.2006.09.024 Language: English Keywords: gene-stress behavior; genetic factors; adolescent alcohol use; childhood behavior disorders; alcoholism; social environment Abstract: A variety of environmental and genetic factors modulating the risk for alcoholism have been described, which predominantly act by interacting with each other. For example, the family, peers and society determine the level of exposure to stress and alcohol, while genes modulate how sensitive an individual responds to both. The resulting behaviors feed back to the social environment, modulating and in the worst case increasing further stress exposure. We here review neurobiological evidence how such a process of mutual interaction can involve and affect drinking. In at-risk adolescents it may have been in force for many years before they have their first alcoholic drink, increasing their risk for addiction by generating allostatic load. As an example, psychiatric disorders involving attention deficit, hyperactivity, or disruptive behaviors first evolve during childhood and are influenced by all the above factors. They are also strongly associated with harmful adolescent drinking and later alcohol use disorders. One important implication of this concept is that issues such as family adversity, adolescent psychiatric disorders, or adolescent drinking might not only be associated with, but causally related to, the risk for later addiction. They are targets for preventive interventions, which should start as early as possible in subjects at-risk. (PsycINFO Database Record (c) 2007 APA, all rights reserved)(from the journal abstract) Subjects: *Adolescent Psychology; *Alcohol Abuse; *Genetics; *Risk Factors; Alcoholism; Behavior Disorders; Social Environments; Stress Classification: Substance Abuse & Addiction (3233) Population: Human (10) Age Group: Adolescence (13-17 yrs) (200) Methodology: Literature Review Publication Type:
Journal, Peer Reviewed Journal; Electronic Document Type: Journal Article Release Date: 20070514 Accession Number: 2007-03031-008 Number of Citations in Source: 210 Persistent link to this record: http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2007-03031-008&site=ehost-live Cut and Paste: <A href="http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2007-03031-008&site=ehost-live">How gene-stress-behavior interactions can promote adolescent alcohol use: The roles of predrinking allostatic load and childhood behavior disorders.</A> Database: PsycINFO Record: 13Title: Stress, poverty, frailty and mortality in older women. Author(s): Szanton, Sarah L., The Johns Hopkins U., US Source: Dissertation Abstracts International: Section B: The Sciences and Engineering, Vol 68(4-B), 2007. pp. 2258. Publisher: US: ProQuest Information & Learning. ISSN: 0419-4217 (Print) Order Number: AAI3262358 Language: English Keywords: stress; poverty; frailty; mortality rate; older women; risk factors Abstract: Background. Socioeconomic status health disparities exist even in the oldest age groups. These disparities are only partially explained by differential prevalence of disease risk factors. Objectives. This dissertation is the results of two related studies. The objectives of the first were to examine the extent to which perceived income inadequacy increased mortality risk in community dwelling older women, whether this risk was mediated by a cumulative index of biological dysregulation (allostatic load), and whether the relationship differed for African-American and Caucasian women. The objective of the second study was to investigate whether allostatic load was related to the frailty syndrome. Design and methods. The first study used Cox proportional hazards modeling to estimate the effect of perceived income inadequacy and biological dysregulation on five-year mortality rates. The second study used ordinal logistic regression to examine the relationships between allostatic load and frailty in the baseline examination of two complementary population-based cohort studies. Sample. Women's Health and Aging studies participants were drawn from a Medicare sampling frame of Eastern Baltimore City and county. This sample of 728 women had an age range of 70-79. Findings. Forty four percent of women were robust, 46% were pre-frail, and 10% were frail. Allostatic load ranged from 0-8. For each one unit increase in income inadequacy, participants were almost 70% more likely to die in 5 years independent of age, education, absolute income, and race. For each increase in allostatic load, participants were 14% more likely to die. The effects of inadequate income and allostatic load were independent. The association between income inadequacy and mortality was stronger for African-Americans than for Caucasians. Further, each unit increase in allostatic load score was associated with increasing levels of frailty controlling for race, age, education, smoking, and co-morbidities. Conclusions. Perception of adequacy of financial resources may be a better predictor of mortality than income, particularly for African-Americans. Future research could use income inadequacy as an additional measure of resources in older women. This dissertation also suggests that frailty is associated with allostatic load. (PsycINFO Database Record (c) 2007 APA, all rights reserved) Subjects: *Health Impairments; *Mortality Rate; *Poverty; *Risk Factors; *Stress Classification: Developmental Psychology (2800) Population:
Human (10) Location: US Age Group:
Adulthood (18 yrs & older) (300) Methodology: Empirical Study; Quantitative Study Publication Type:
Dissertation Abstract; Print Release Date: 20071126 Accession Number: 2007-99200-451 Persistent link to this record: http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2007-99200-451&site=ehost-live Cut and Paste: <A href="http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2007-99200-451&site=ehost-live">Stress, poverty, frailty and mortality in older women.</A> Database: PsycINFO Record: 14Title: Environmental stress, psychological stress and allostatic load. Author(s):
Clark, Michael S., School of Medicine,
Flinders University, Adelaide, SA, Australia,
michael.clark@rgh.sa.gov.au Address: Clark, Michael S., Rehabilitation and Ageing Studies Unit, Repatriation General Hospital, Daws Road, Daw Park, SA, Australia, 5041, michael.clark@rgh.sa.gov.au Source: Psychology, Health & Medicine, Vol 12(1), Jan 2007. pp. 18-30. Publisher: United Kingdom: Taylor & Francis. ISSN:
1354-8506 (Print) Digital Object Identifier: 10.1080/13548500500429338 Language: English Keywords: environmental stress; psychological stress; allostatic load; chronic caregiving stress; dementia caregiving Abstract: The mechanism by which chronic caregiving stress results in poor health is not well understood. The objective was to determine whether such a mechanism may be allostatic load, a novel concept specifying physiological systems that may suffer cumulative wear and tear following chronic stress, leading collectively to poor health. The study examines the association of allostatic load with environmental and psychological stress in the contexts of dementia caregiving and relinquishment of care, and is a 2-year longitudinal comparison of three groups: 80 new dementia spouse caregivers, 120 veteran caregivers, and 60 non-caregivers. Data comprised allostatic load markers and environmental and psychological stress measures. Cross-lagged analyses produced a statistically significant association between psychological stress and one allostatic load component (primary mediators). Psychological stress was a better predictor of primary mediators than environmental stress. Primary mediators rose with time for caregivers, but not for non-caregivers. A greater rise was evident for caregivers who had relinquished their role by the second year, although the level of psychological stress actually declined. Primary mediators are a key component of the relationship between allostatic load and prior stress. When allostatic load is treated as an outcome of stress, it is important to distinguish environmental and psychological stress. (PsycINFO Database Record (c) 2007 APA, all rights reserved)(from the journal abstract) Subjects: *Caregiver Burden; *Dementia; *Environmental Stress; *Psychological Stress; *Stress Reactions; Chronic Stress; Elder Care; Homeostasis; Physiological Stress Classification: Home Care & Hospice (3375) Population:
Human (10) Location: Australia Age Group:
Adulthood (18 yrs & older) (300) Tests & Measures: Geriatric Social Readjustment Rating Scale Grant Information: This study was conducted with the financial support of Project Grant No. 160042 from the National Health and Medical Research Council of Australia. We also acknowledge the support of the Ian Potter Foundation and the Flinders Medical Centre Foundation, who funded the assessment of relinquished caregivers Methodology: Empirical Study; Longitudinal Study; Quantitative Study Publication Type:
Journal, Peer Reviewed Journal; Electronic Document Type: Journal Article Release Date: 20061204 Accession Number: 2006-21381-003 Number of Citations in Source: 45 Persistent link to this record: http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2006-21381-003&site=ehost-live Cut and Paste: <A href="http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2006-21381-003&site=ehost-live">Environmental stress, psychological stress and allostatic load.</A> Database: PsycINFO Record: 15Title: Allostatic load: When protection gives way to damage. Author(s):
McEwen, Bruce, Harold and Margaret
Milliken Hatch Laboratory of Neuroendocrinology, Rockefeller
University, NY, US Source: The Praeger handbook on stress and coping (vol.1). Monat, Alan (Ed); Lazarus, Richard S. (Ed); Reevy, Gretchen (Ed); pp. 99-109. Westport, CT, US: Praeger Publishers/Greenwood Publishing Group, 2007. xxi, 279 pp. ISBN:
0-275-99198-9 (hardcover) Language: English Keywords: allostatic load; stress response systems; stress responses; chronic stress; stress related illness Abstract: (from the book) Material in this chapter is reprinted from The End of Stress as We Know It (2002). This chapter on allostatic load presents a relatively new topic in the stress field. The authors describe a variety of ways that our stress response system can malfunction and make us vulnerable to stress-related illness. Allostasis is a mechanism in the body that helps the organism to (1) remain stable even though physical events are changing and (2) maintain enough energy for necessary functioning. The stress response, if all goes well, functions in an allostatic fashion. Allostatic load is the damage that occurs to the body when the allostatic response causes a malfunction in body systems. McEwen and Lasley describe four allostatic load "scenarios." First, an individual may experience chronic, unrelenting stress that can lead to allostatic load. The second scenario describes circumstances where people are unable to adjust to stress that they should be able to adjust to, thus the person continues to produce the stress response when many or most people would not. Third, some individuals have stress systems that fail to shut off even after the stressor no longer exists. The fourth and final scenario involves a failure to produce a full stress response, even when one should. As McEwen and Lasley describe, this situation can be damaging also, as the stress system maintains a balance with other body systems. (PsycINFO Database Record (c) 2007 APA, all rights reserved) Subjects: *Adaptation; *Chronic Stress; *Homeostasis; *Stress; *Stress Reactions; Disorders; Physiological Correlates Classification: Psychological & Physical Disorders (3200) Population: Human (10) Intended Audience: Psychology: Professional & Research (PS) Publication Type: Book, Edited Book; Print Document Type: Chapter Book Type: Handbook/Manual Release Date: 20070702 Correction Date: 20070820 Accession Number: 2007-05755-005 Number of Citations in Source: 33 Persistent link to this record: http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2007-05755-005&site=ehost-live Cut and Paste: <A href="http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2007-05755-005&site=ehost-live">Allostatic load: When protection gives way to damage.</A> Database: PsycINFO Record: 16Title: Allostatic Load in women with and without PTSD Symptoms. Author(s):
Glover, Dorie A., Department of Psychiatry
and Biobehavioral Sciences, Division of Child and Adolescent
Psychiatry-Child Division, UCLA Neuropsychiatric Institute, Los
Angeles, CA, US, dglover@mednet.ucla.edu Address: Glover, Dorie A., UCLA Neuropsychiatric Institute, 760 Westwood Plaza, Room 68-237, Los Angeles, CA, US, 90024-1750, dglover@mednet.ucla.edu Source: Psychiatry: Interpersonal and Biological Processes, Vol 69(3), Fal 2006. pp. 191-203. Publisher: US: Guilford Publications. Other Journal Title: Psychiatry: Journal for the Study of Interpersonal Processes ISSN: 0033-2747 (Print) Digital Object Identifier: 10.1521/psyc.2006.69.3.191 Language: English Keywords: allostatic load; posttraumatic stress disorder; biological risk factors; cancer mothers; chronic stress; aging Abstract: Allostatic load (AL) is the term used to describe cumulative physiological wear and tear that results from repeated efforts to adapt to stressors over time. Operationalized as a composite index of biological risk factors (e.g., blood pressure, cholesterol, glycosylated hemoglobin, and cortisol, norepinephrine, and epinephrine), AL has been shown to increase with age, predict long-term morbidity and mortality among the elderly, and be associated with low parent education in a large adolescent sample. However, AL has not yet been studied in samples with putative "high stress" or posttraumatic stress disorder (PTSD). Accordingly, AL was measured in women with high acute and chronic stress: mothers of pediatric cancer survivors with and without PTSD and control mothers of healthy children. AL emerged in a "dose-dependent" ranking from high to low: cancer mothers meeting all criteria for PTSD, cancer mothers with no or low symptoms, and control mothers, respectively (p < .001). Effects were not altered by self-reported sleep quality or substance use (tobacco, caffeine, alcohol, or drugs) and remained significant when analyzing AL without cortisol or catecholamines. Results indicate elevated AL can be detected in relatively young women with high stress histories and particularly those with PTSD. Future prospective studies must evaluate whether this pattern represents an accelerated aging process and increased risk of disease. (PsycINFO Database Record (c) 2007 APA, all rights reserved)(from the journal abstract) Subjects: *Aging; *Chronic Stress; *Neoplasms; *Posttraumatic Stress Disorder; *Risk Factors; Biology; Mothers Classification: Cancer (3293) Population:
Human (10) Age Group:
Adulthood (18 yrs & older) (300) Tests & Measures:
Life Experience Survey Grant Information: This research was made possible by support to Dr. Glover from the National Institute of Mental Health (#1K01-MH01939-01A2), American Cancer Society (#PF-4480), Norman Cousins Program of Psychoneuroimmunology at UCLA (#34323), and General Clinical Research Center, UCLA School of Medicine (#5M01RR00865) Methodology: Empirical Study; Quantitative Study Publication Type:
Journal, Peer Reviewed Journal; Print Document Type: Journal Article Release Date: 20061120 Accession Number: 2006-20050-001 Number of Citations in Source: 55 Persistent link to this record: http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2006-20050-001&site=ehost-live Cut and Paste: <A href="http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2006-20050-001&site=ehost-live">Allostatic Load in women with and without PTSD Symptoms.</A> Database: PsycINFO Record: 17Title: Allostatic Load and Clinical Risk as Related to Sense of Coherence in Middle-Aged Women. Author(s):
Lindfors, Petra, Department of Psychology,
Stockholm University, Stockholm, Sweden, pls@psychology.su.se Address: Lindfors, Petra, Department of Psychology, Stockholm University, SE 106 91, Stockholm, Sweden, pls@psychology.su.se Source: Psychosomatic Medicine, Vol 68(5), Sep-Oct 2006. pp. 801-807. Publisher: US: Lippincott Williams & Wilkins. ISSN:
0033-3174 (Print) Digital Object Identifier: 10.1097/01.psy.0000232267.56605.22 Language: English Keywords: allostatic load; clinical risk; sense of coherence; middle aged women; physiologic dysregulation Abstract: Objective: To investigate how physiologic dysregulation, in terms of allostatic load and clinical risk, respectively, relates to sense of coherence (SOC) in women with no previously diagnosed pathology. Methods: At baseline, 200 43-year-old women took part in a standardized medical health examination and completed a 3-item measure of SOC, which they completed again 6 years later. According to data from the medical examination, two different measures of physiologic dysregulation were calculated: a) a measure of allostatic load based on empirically derived cut points and b) a measure of clinical risk based on clinically significant cut points. Results: In line with the initial hypotheses, allostatic load was found to predict future SOC, whereas clinical risk did not. In addition to baseline SOC and nicotine consumption, allostatic load was strongly associated with a weak SOC at the follow-up. Conclusions: The better predictive value of allostatic load to clinical risk indicates that focusing solely on clinical risk obscures patterns of physiologic dysregulation that influence future SOC. (PsycINFO Database Record (c) 2007 APA, all rights reserved)(from the journal abstract) Subjects: *At Risk Populations; *Health; *Physiology; *Risk Factors Classification: Psychological & Physical Disorders (3200) Population:
Human (10) Location: Sweden Age Group:
Adulthood (18 yrs & older) (300) Grant Information: This study was supported by grants to Prof. Ulf Lundberg from the Bank of Sweden Tercentenary Foundation and the Swedish Research Council and to Petra Lindfors from the Anna Ahlström and Ellen Terserus Foundation Methodology: Empirical Study; Quantitative Study Publication Type:
Journal, Peer Reviewed Journal; Print Document Type: Journal Article Release Date: 20061211 Accession Number: 2006-13324-023 Number of Citations in Source: 34 Persistent link to this record: http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2006-13324-023&site=ehost-live Cut and Paste: <A href="http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2006-13324-023&site=ehost-live">Allostatic Load and Clinical Risk as Related to Sense of Coherence in Middle-Aged Women.</A> Database: PsycINFO Record: 18Title: Self-rated recovery from work stress and allostatic load in women. Author(s):
von Thiele, Ulrica, Department of
Psychology, Center for Health Equity Studies, Stockholm
University, Stockholm, Sweden, uvt@psychology.su.se Address: von Thiele, Ulrica, Department of Psychology, Stockholm University, SE 106 91, Stockholm, Sweden, uvt@psychology.su.se Source: Journal of Psychosomatic Research, Vol 61(2), Aug 2006. pp. 237-242. Publisher: Netherlands: Elsevier Science. ISSN: 0022-3999 (Print) Digital Object Identifier: 10.1016/j.jpsychores.2006.01.015 Language: English Keywords: work stress; allostatic load; biologic dysregulation; biomarkers; women; public health care; recovery Abstract: Objective: The objective of this study was to investigate the relationships between self-rated recovery from work stress and biologic dysregulation in terms of allostatic load (AL) and individual biomarkers, respectively, in healthy women within the public health care sector. Methods: Two hundred forty-one women completed self-ratings of recovery and took part in a standardized medical examination, which provided individual biomarkers that were used to compute AL. Results: Cluster analysis of self-rated recovery resulted in three cluster profiles, including (1) recovered women (n=108), (2) nonrecovered women (n=51), and (3) fatigued women (n=82). Sequential logistic regression analysis showed that the fatigued profile had an increased risk for high AL. In contrast, there was no significant difference in individual biomarkers between recovery profiles. Conclusions: The findings establish an association between biologic processes and self-rated recovery from work stress, thus supporting the hypothesis that insufficient recovery may result in high AL. (PsycINFO Database Record (c) 2007 APA, all rights reserved)(from the journal abstract) Subjects: *Biological Markers; *Occupational Stress; *Recovery (Disorders); *Stress Reactions; *Work Load; Human Females; Public Health Services Classification: Personality Psychology (3100) Population:
Human (10) Location: Sweden Age Group: Adulthood (18 yrs & older) (300) Grant Information: This research was supported by grants to Ulf Lundberg from the Bank of Sweden Tercentenary Foundation, the Swedish Research Council, and the Swedish Council for Working Life and Social Research and to Petra Lindfors from the Anna Ahlström and Ellen Terserus Foundation Methodology: Empirical Study; Quantitative Study Publication Type:
Journal, Peer Reviewed Journal; Electronic Document Type: Journal Article Release Date: 20060821 Accession Number: 2006-10311-015 Number of Citations in Source: 26 Persistent link to this record: http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2006-10311-015&site=ehost-live Cut and Paste: <A href="http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2006-10311-015&site=ehost-live">Self-rated recovery from work stress and allostatic load in women.</A> Database: PsycINFO Record: 19Title: 'What's Missing from the Weathering Hypothesis?': Geronminus et al Respond. Author(s):
Geronimus, Arline T., Department of Health
Behavior and Health Education, University of Michigan, Ann
Arbor, MI, US, arline@umich.edu Address: Geronimus, Arline T., Department of Health Behavior and Health Education, University of Michigan School of Public Health, 1420 Washington Heights, Ann Arbor, MI, US, 48109-2029, arline@umich.edu Source: American Journal of Public Health, Vol 96(6), Jun 2006. pp. 955-956. Publisher: US: American Public Health Assn. ISSN:
0090-0036 (Print) Language: English Keywords: weathering; age patterns; allostatic load scores; Blacks; Whites; US; early health deterioration; biological indicators Abstract: Reply by the current authors to the comments made by Nigel Mark Thomas (see record 2006-07103-003) on the original article (see record 2006-05806-014). We see no paradox in the observation that Black women have longer life expectancies than White men, but that Black women experience weathering. Many factors affect life expectancy; weathering is only one. Additionally, morbidity processes influenced by weathering are not always life threatening, and those that are may be managed through secondary and tertiary prevention to avert mortality. The key question about weathering and life expectancy is the extent to which members of different populations experience healthy life expectancy. When we studied this question, we estimated that while Black women had longer life expectancies than their White male counterparts (60 additional years at age 16 compared with 58 additional years), Black women faced shorter active life expectancies than did White men (43 additional years compared with 48 additional years). (PsycINFO Database Record (c) 2007 APA, all rights reserved) Subjects: *Biological Markers; *Blacks; *Health Impairments; *Life Span; *Whites; Stress Classification: Personality Psychology (3100) Population: Human (10) Publication Type:
Journal, Peer Reviewed Journal; Electronic Document Type: Comment/Reply Release Date: 20061226 Accession Number: 2006-07103-004 Number of Citations in Source: 3 Persistent link to this record: http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2006-07103-004&site=ehost-live Cut and Paste: <A href="http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2006-07103-004&site=ehost-live">'What's Missing from the Weathering Hypothesis?': Geronminus et al Respond.</A> Database: PsycINFO Record: 20Title: What's Missing from the Weathering Hypothesis? Author(s): Thomas, Nigel Mark, nt170@columbia.edu Address: Thomas, Nigel Mark, 300 W 145th St, 2J, New York, NY, US, 10039, nt170@columbia.edu Source: American Journal of Public Health, Vol 96(6), Jun 2006. pp. 955. Publisher: US: American Public Health Assn. ISSN:
0090-0036 (Print) Language: English Keywords: weathering; age patterns; allostatic load scores; Blacks; Whites; US; early health deterioration; biological indicators Abstract: Comments on the article by A. T. Geronimus (see record 2006-05806-014). Geronimus and colleagues' finding is a curious one. The authors considered "whether US Blacks experience early health deterioration, as measured across biological indicators of repeated exposure and adaptation to stressors and found evidence of "weathering hypothesis" among Blacks. Blacks had higher cumulative risk measurements than did Whites. These racial differences were not explained by poverty. Poor Black women had the highest allostatic load scores, followed by Black women who were not poor. This finding suggests that within the racial and gender stratification of the United States, Black women are more likely than other groups to engage in "John Henryism"-persistent high-effort coping with the pernicious effects of discrimination. (PsycINFO Database Record (c) 2007 APA, all rights reserved) Subjects: *Biological Markers; *Blacks; *Health Impairments; *Life Span; *Whites; Stress Classification: Personality Psychology (3100) Population: Human (10) Publication Type:
Journal, Peer Reviewed Journal; Electronic Document Type: Comment/Reply Release Date: 20061226 Accession Number: 2006-07103-003 Number of Citations in Source: 6 Persistent link to this record: http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2006-07103-003&site=ehost-live Cut and Paste: <A href="http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2006-07103-003&site=ehost-live">What's Missing from the Weathering Hypothesis?</A> Database: PsycINFO Record: 21Title: 'Weathering' and Age Patterns of Allostatic Load Scores Among Blacks and Whites in the United States. Author(s):
Geronimus, Arline T., Department of Health
Behavior and Health Education, University of Michigan, Ann
Arbor, MI, US, arline@umich.edu Address: Geronimus, Arline T., Department of Health Behavior and Health Education, University of Michigan School of Public Health, 1420 Washington Heights, Ann Arbor, MI, US, 48109-2029, arline@umich.edu Source: American Journal of Public Health, Vol 96(5), May 2006. pp. 826-833. Publisher: US: American Public Health Assn. ISSN:
0090-0036 (Print) Digital Object Identifier: 10.2105/AJPH.2004.060749 Language: English Keywords: weathering; age patterns; allostatic load scores; Blacks; Whites; US; early health deterioration; biological indicators Abstract: Objectives: We considered whether US Blacks experience early health deterioration, as measured across biological indicators of repeated exposure and adaptation to stressors. Methods: Using National Health and Nutrition Examination Survey data, we examined allostatic load scores for adults aged 18-64 years. We estimated probability of a high score by age, race, gender, and poverty status and Blacks' odds of having a high score relative to Whites' odds. Results: Blacks had higher scores than did Whites and had a greater probability of a high score at all ages, particularly at 35-64 years. Racial differences were not explained by poverty. Poor and nonpoor Black women had the highest and second highest probability of high allostatic load scores, respectively, and the highest excess scores compared with their male or White counterparts. Conclusions: We found evidence that racial inequalities in health exist across a range of biological systems among adults and are not explained by racial differences in poverty. The weathering effects of living in a race-conscious society may be greatest among those Blacks most likely to engage in high-effort coping. (PsycINFO Database Record (c) 2007 APA, all rights reserved)(from the journal abstract) Subjects: *Biological Markers; *Blacks; *Health Impairments; *Life Span; *Whites; Stress Classification: Personality Psychology (3100) Population:
Human (10) Location: US Age Group:
Adulthood (18 yrs & older) (300) Grant Information: The authors are grateful for the financial support of the University of Michigan Population Studies Center, the National Institute of Child Health and Development (grant 5 T32 HD07339), and the National Institute of Aging (grant 5 T32 AG00221) Methodology: Empirical Study; Quantitative Study Publication Type:
Journal, Peer Reviewed Journal; Electronic Document Type: Journal Article Release Date: 20061113 Accession Number: 2006-05806-014 Number of Citations in Source: 47 Persistent link to this record: http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2006-05806-014&site=ehost-live Cut and Paste: <A href="http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2006-05806-014&site=ehost-live">'Weathering' and Age Patterns of Allostatic Load Scores Among Blacks and Whites in the United States.</A> Database: PsycINFO Record: 22Title: Exhaustion is associated with reduced habituation of free cortisol responses to repeated acute psychosocial stress. Author(s):
Kudielka, Brigitte M., Department of
Clinical and Theoretical Psychobiology, University of Trier,
Trier, Germany, kudielka@uni-trier.de Address: Kudielka, Brigitte M., Department of Clinical and Theoretical Psychobiology, University of Trier, Johanniterufer 15, D-54290, Trier, Germany, kudielka@uni-trier.de Source: Biological Psychology, Vol 72(2), May 2006. pp. 147-153. Publisher: Netherlands: Elsevier Science. ISSN: 0301-0511 (Print) Digital Object Identifier: 10.1016/j.biopsycho.2005.09.001 Language: English Keywords: cortisol responses; psychosocial stress; exhaustion; habituation Abstract: We investigated the association between exhaustion and the habituation of free cortisol responses to repeated stress exposure. The study comprised 25 healthy male subjects (38-59 years) who were confronted three times with the Trier Social Stress Test. Mean cortisol responses showed the well-known general habituation effect. A two-way interaction day by exhaustion (p<0.05) indicated that mean cortisol responses vary across stress sessions depending on the extent of exhaustion. Linear regression revealed a negative dose-response relationship between exhaustion and the degree of habituation (p<0.02). We identified 19 individuals showing a response habituation (negative slope) and 6 individuals showing a response sensitization over the three sessions (positive slope) with the latter reporting higher exhaustion scores. It might be hypothesized that impaired habituation to repeated exposure to the same stressor could reflect a state of increased vulnerability for allostatic load. Absence of normal habituation might be one potential mechanism how exhaustion relates to increased disease vulnerability. (PsycINFO Database Record (c) 2007 APA, all rights reserved)(from the journal abstract) Subjects: *Fatigue; *Habituation; *Hydrocortisone; *Psychological Stress Classification: Psychophysiology (2560) Population:
Human (10) Age Group:
Adulthood (18 yrs & older) (300) Tests & Measures:
Maastricht-Vital-Exhaustion-Questionnaire Grant Information: This work was supported by Grant 32-68277 from the Swiss National Science Foundation (SNF) and by the Federal Institute of Technology (ETH), Zurich, Switzerland. Since October 2004, BMK is supported by grants from the German Research Foundation (DFG grant KU1404/4-1) Methodology: Empirical Study; Quantitative Study Publication Type:
Journal, Peer Reviewed Journal; Electronic Document Type: Journal Article Release Date: 20060403 Accession Number: 2006-03664-004 Number of Citations in Source: 61 Persistent link to this record: http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2006-03664-004&site=ehost-live Cut and Paste: <A href="http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2006-03664-004&site=ehost-live">Exhaustion is associated with reduced habituation of free cortisol responses to repeated acute psychosocial stress.</A> Database: PsycINFO Record: 23Title: Reduction in Allostatic Load in Older Adults Is Associated With Lower All-Cause Mortality Risk: MacArthur Studies of Successful Aging. Author(s):
Karlamangla, Arun S., Division of
Geriatrics, Department of Medicine, David Geffen School of
Medicine at UCLA, Los Angeles, CA, US,
akarlamangla@mednet.ucla.edu Address: Karlamangla, Arun S., 10945 Le Conte Avenue #2339, Los Angeles, CA, US, 90095-1687, akarlamangla@mednet.ucla.edu Source: Psychosomatic Medicine, Vol 68(3), May-Jun 2006. pp. 500-507. Publisher: US: Lippincott Williams & Wilkins. ISSN:
0033-3174 (Print) Digital Object Identifier: 10.1097/01.psy.0000221270.93985.82 Language: English Keywords: allostatic load score; mortality risk; physiologic parameters; biological markers Abstract: Objectives: To study the association between change in allostatic load (a risk score constructed from multiple biological markers) over a 2.5-year period and mortality in the following 4.5 years in older adults. Methods: We measured 10 physiologic parameters at baseline (1988) in a cohort of 171 high-functioning, community-dwelling, 70- to 79-year-old adults. These measurements were repeated 2.5 years later, in 1991. Summary allostatic load scores for 1988 and 1991 were created as the weighted sum of the 10 biological markers and their second-order terms. Mortality status (alive or dead) for participants was determined 4.5 years later, in 1995. The association between change in allostatic load score (1988-1991) and subsequent mortality (1991-1995) was studied using logistic regression. Results: Compared with participants whose allostatic load score decreased between 1988 and 1991, individuals whose allostatic load score increased had higher risk of all-cause mortality between 1991 and 1995 (15% versus 5%, p = .047). Adjusted for age and baseline allostatic load, each unit increment in the allostatic load change score was associated with mortality odds ratio of 3.3 (95% confidence interval, 1.1-9.8). Conclusion: Our results suggest that even in older ages, change in risk scores can be followed to improve assessment of mortality risk. (PsycINFO Database Record (c) 2007 APA, all rights reserved)(from the journal abstract) Subjects: *Aging; *Biological Markers; *Mortality Rate; *Physiological Correlates; *Risk Factors; Death and Dying Classification: Physiological Processes (2540) Population:
Human (10) Location: US Age Group:
Adulthood (18 yrs & older) (300) Grant Information: Work on this article was supported by NIH/NIA Mentored Clinical Scientist Development Award 1K12AG01004, NIA grants AC-17056 and AG-17265, and by the MacArthur Research Network on Successful Aging and the MacArthur Research Network on SES and Health through grants from the John D. and Catherine T. MacArthur Foundation Methodology: Empirical Study; Longitudinal Study; Retrospective Study Publication Type:
Journal, Peer Reviewed Journal; Print Document Type: Journal Article Release Date: 20060612 Accession Number: 2006-07337-022 Number of Citations in Source: 43 Persistent link to this record: http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2006-07337-022&site=ehost-live Cut and Paste: <A href="http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2006-07337-022&site=ehost-live">Reduction in Allostatic Load in Older Adults Is Associated With Lower All-Cause Mortality Risk: MacArthur Studies of Successful Aging.</A> Database: PsycINFO Record: 24Title: Financial strain over the life course and health among older adults. Author(s):
Kahn, Joan R., University of Maryland,
College Park, MD, US, jkahn@socy.umd.edu Address: Kahn, Joan R., Department of Sociology, University of Maryland, College Park, MD, US, 20742, jkahn@socy.umd.edu Source: Journal of Health and Social Behavior, Vol 47(1), Mar 2006. pp. 17-31. Publisher: US: American Sociological Assn. Other Journal Title: Journal of Health & Human Behavior ISSN: 0022-1465 (Print) Language: English Keywords: financial strain; life course; health inequalities; older adults Abstract: This paper focuses on financial strain across the life course as a condition underlying health inequalities observed in later life. The analysis is based on data from 1,167 adults 65 years and older collected as part of the "Aging, Stress and Health Study." Relying on retrospective data about hardship experienced over the life course, we find that long-term financial hardship is reflected in a range of health outcomes at late life, even after controlling for the effects of current financial circumstances. Moreover, the sheer persistence of hardship matters more than its episodic occurrence or timing, so that the health effects of early hardship may be obviated if followed by no further hardship. This pattern of findings is consistent with the notion of allostatic load, the cumulative damage done to health and well-being under the burden of an unrelenting stressor in a critically important life domain. (PsycINFO Database Record (c) 2007 APA, all rights reserved)(from the journal abstract) Subjects: *Aging; *Financial Strain; *Health; *Life Span Classification: Gerontology (2860) Population:
Human (10) Location: US Age Group:
Adulthood (18 yrs & older) (300) Tests & Measures: Hopkins Symptom Checklist Grant Information: This work is supported by National Institute on Aging grant R01AG17461 (Leonard I. Pearlin P.I.) Conference: Annual meeting of the Gerontological Society of America, 2002, Boston, MA, US Conference Notes: Earlier versions of this paper were presented at the aforementioned conference and at the 2002 annual meeting of the Population Association of America, Minneapolis, MN. Methodology: Empirical Study; Longitudinal Study; Retrospective Study; Quantitative Study Publication Type:
Journal, Peer Reviewed Journal; Print Document Type: Journal Article Release Date: 20060410 Accession Number: 2006-03842-002 Number of Citations in Source: 41 Persistent link to this record: http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2006-03842-002&site=ehost-live Cut and Paste: <A href="http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2006-03842-002&site=ehost-live">Financial strain over the life course and health among older adults.</A> Database: PsycINFO Record: 25Title: Stress and Illness. Author(s): Carr, John E. Source: Behavior & medicine (4th ed.). Wedding, Danny (Ed); Stuber, Margaret L. (Ed); pp. 111-124. Ashland, OH, US: Hogrefe & Huber Publishers, 2006. xvi, 389 pp. ISBN:
0-88937-305-1 (paperback) Language: English Keywords: survival; adaptative response; challenge; threat; natural selection; homeostasis; fight or flight Abstract: (from the chapter) Illness, injury, and disease are byproducts of the individual's efforts to adapt to the challenge of survival (allostatic load), and are the result of interactions with the environment, and failures of the body's systems of maintenance and defense (e.g., cardiac arrest, renal failure). However, disease and illness also occur as the result of the body's "successful" adaptive response to challenge and threat. In other words, under certain conditions, the body's attempts to "cure" may be worse than the disease. Charles Darwin provided compelling evidence that individuals and species develop adaptive mechanisms and characteristics to facilitate survival. Natural selection over successive generations ensured that individual's with the capability to learn from experience would be more likely to survive and to genetically pass on that capability. Claude Bernard, a contemporary of Darwin, theorized that there was a system of adaptive responses that evolved in all species in order to maintain a constant internal state, the milieu interieur, despite changes in the external environment. This process by which adaptive efforts maintained temperature, electrolyte and fluid balance, blood pressure, waste removal, etc., was subsequently referred to as homeostasis by the physiologist, Walter Cannon. According to Cannon this system of adaptive responses, like the evolution of anatomical characteristics, evolved as a result of natural selection. While lower order organisms existed within their supportive and nurturing milieu, higher order organisms, in order to achieve independence from their environment, had to develop "life-support" systems that they could carry with them, i.e., circulatory, respiratory, digestive, and waste elimination systems. All of these systems had to be maintained in homeostatic balance and their responses to stress conditions coordinated. The organism's adaptive response to threat from the environment triggered a set of physiologic reactions, which Cannon labeled the "fight or flight" response, the goal of which was to mobilize the individual's resources in order to optimize ability to successfully meet any challenge to survival. (PsycINFO Database Record (c) 2007 APA, all rights reserved) Subjects: *Adaptive Behavior; *Homeostasis; *Natural Selection; *Stress; *Threat; Survivors Classification: Physiological Processes (2540) Population: Human (10) Intended Audience: Psychology: Professional & Research (PS) Publication Type: Book, Edited Book; Print Document Type: Chapter Book Type: Textbook/Study Guide Release Date: 20060918 Accession Number: 2006-06654-008 Persistent link to this record: http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2006-06654-008&site=ehost-live Cut and Paste: <A href="http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2006-06654-008&site=ehost-live">Stress and Illness.</A> Database: PsycINFO Record: 26Title: Beyond the stress concept: Allostatic load--a developmental biological and cognitive perspective. Author(s):
Lupien, Sonia J., McGill U, Montreal, PQ,
Canada Source: Developmental psychopathology, Vol 2: Developmental neuroscience (2nd ed.). Cicchetti, Dante (Ed); Cohen, Donald J. (Ed); pp. 578-628. Hoboken, NJ, US: John Wiley & Sons Inc, 2006. xvii, 876 pp. ISBN:
0-471-23737-X (hardcover) Language: English Keywords: allostatic load; biological development; cognitive development; allostasis; stress; pathophysiology; genetics; early experience Abstract: (from the chapter) The concepts of allostasis and allostatic load are inclusive of what we mean by stress, but they are much broader because they include aspects of lifestyle as well as genetic influences and developmental effects, including early life experiences and adversities. In this way, allostasis and allostatic load provide a general conceptual framework that allows us to evaluate the overall impact of the physical and social environment on individuals and groups of individuals. It should be emphasized that, although most of the work done so far has focused on the role of HPA activity and autonomic nervous system reactivity in these naturenurture interactions, the allostasis/allostatic load model can be generalized to other physiological systems that respond to environmental stimuli. In other words, allostasis and allostatic load attempt to embody a general biological principle: that the systems that help protect the body and promote adaptation in the short term can also participate in pathophysiological processes when they are overused or inefficiently managed. The most important feature of allostatic load is that it operates gradually over long periods of time in the life of an individual. In fact, as summarized in this chapter, influences of genetic factors and early experiences, when coupled with the subsequent life experiences of each individual, exert a lifelong effect on the physiology of an individual and alter the risk for developing a variety of pathophysiological conditions and diseases later in life as well as the rate of certain aspects of the aging process. More important, given that the primary stress mediators of allostatic load can access the brain, they can alter the way incoming information is processed, leading to important differences in the interpretation of events as being stressful (threatening) or nonstressful (nonthreatening). This multidisciplinary view of stress as a form of allostatic load should eventually allow us to identify very early in the life of an individual what are the potential risk factors for the negative effects of stress on physical and mental health. (PsycINFO Database Record (c) 2007 APA, all rights reserved) Subjects: *Early Experience; *Pathophysiology; *Psychogenesis; *Stress; *Stress Reactions; Biology; Cognitive Development; Genetics Classification: Psychological & Physical Disorders (3200) Population: Human (10) Intended Audience: Psychology: Professional & Research (PS) Publication Type: Book, Edited Book; Print Document Type: Chapter Book Type: Handbook/Manual Release Date: 20060424 Accession Number: 2006-03610-014 Number of Citations in Source: 448 Persistent link to this record: http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2006-03610-014&site=ehost-live Cut and Paste: <A href="http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2006-03610-014&site=ehost-live">Beyond the stress concept: Allostatic load--a developmental biological and cognitive perspective.</A> Database: PsycINFO Record: 27Title: Stress and cognitive performance in older adults. Author(s): Rosnick, Christopher B., U South Florida, US Source: Dissertation Abstracts International Section A: Humanities and Social Sciences, Vol 66(11-A), 2006. pp. 4137. Publisher: US: ProQuest Information & Learning. ISSN: 0419-4209 (Print) Order Number: AAI3197943 Language: English Keywords: cognitive performance; stress; older adults; life events Abstract: The current dissertation sought to examine stress in three different, but overlapping, ways. The first study examined how self-reported negative life events, in the aggregate and individually, are associated with cognitive performance. The results suggested that there was no significant relationship between the aggregate measures of self-reported negative life events and cognitive performance. On the other hand, several individual negative life events were associated with cognitive functioning. The findings support previous research indicating that using estimates of individual stressors rather than aggregate measures of stressors increases the predictive validity of stress measurement. The second study assessed the cross-sectional and longitudinal effects of bereavement on cognitive functioning. The cross-sectional results revealed that bereavement status alone was not associated with cognitive performance. On the other hand, there were several significant interactions between bereavement status and the background characteristics. The longitudinal results revealed that the bereaved individuals declined on the delayed naming recall task and there was a significant interaction between gender and bereavement on the delayed story recall task. Our results support the finding that bereavement is associated with poorer cognitive performance within certain subgroups (i.e., males and the young-old participants). The third and final study examined the effects of allostatic load (AL) on cognitive performance in bereaved and non-bereaved individuals over a twelve-month period post-bereavement. The cross-sectional findings suggested that the overall AL measure, the syndrome X (a collection of cardiovascular risk factors) and non-syndrome X measures (stress hormones), and the individual AL markers were associated with cognitive performance. Longitudinally, we were unable to find an association between the overall AL measure and cognitive performance. Taken together, the current findings suggest that there is an association between the multiple stress factors under investigation and cognitive performance. The cross-sectional results revealed that the individual negative life events (i.e., having less money to live on), bereavement, and the AL markers were associated with poorer cognitive performance. Furthermore, the results suggest that utilizing the individual life events and AL markers may be more informative when assessing cognitive functioning in the current samples compared to using the sum scores. (PsycINFO Database Record (c) 2007 APA, all rights reserved) Subjects: *Cognitive Ability; *Geriatrics; *Gerontology; *Life Experiences; *Stress Classification: Health & Mental Health Treatment & Prevention (3300) Population: Human (10) Age Group:
Adulthood (18 yrs & older) (300) Methodology: Empirical Study Publication Type:
Dissertation Abstract; Print Release Date: 20060807 Accession Number: 2006-99009-056 Persistent link to this record: http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2006-99009-056&site=ehost-live Cut and Paste: <A href="http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2006-99009-056&site=ehost-live">Stress and cognitive performance in older adults.</A> Database: PsycINFO Record: 28Title: Effects of stress in women with cancer. Author(s): Weissbecker, Inka, U Louisville, US Source: Dissertation Abstracts International: Section B: The Sciences and Engineering, Vol 67(3-B), 2006. pp. 1720. Publisher: US: ProQuest Information & Learning. ISSN: 0419-4217 (Print) Order Number: AAI3208801 Language: English Keywords: physiological stress; women; cancer; quality of life; life events; psychological distress Abstract: This dissertation theorized that stressful life events would result in more psychological distress, which could lead to dysregulation of physiological stress response systems and negatively impact functioning and quality of life in cancer patients. This utilized "Allostatic load," as a cumulative index of physiological stress. Patients diagnosed within the last five years with primary or recurrent endometrial (n=24) or ovarian (n=21) cancer who had completed treatment were eligible for the study. Data from both groups were pooled due to detecting no major differences on predictor and outcome variables and power limitations. Baseline questionnaires assessed demographics and psychological stress (stressful life events, perceived stress and psychological distress). The allostatic load index consisted of: serum cortisol, serum dehydroepiandrostorone sulfate (DHEA-S), urinary norepinephrine and epinephrine, blood plasma levels of total glycosylated hemoglobin, waist-hip ratio, serum high density lipoprotein and total cholesterol levels, as well as systolic and diastolic blood pressure. Diurnal salivary cortisol as another indicator of allostatic load was examined separately. Assessments of cancer outcomes (functional status and quality of life) were repeated at four-month follow-up. Exploratory secondary analyses examined effects of health behaviors and social support in the model, and explored individual effects of allostatic load variables. In all analyses, exploratory bivariate correlations were followed by hierarchical regressions controlling for relevant variables. Primary cross-sectional analyses revealed that traumatic life events predicted higher psychological distress levels. Furthermore, psychological stress measures predicted lower functioning and quality of life. In longitudinal analyses, depression and anxiety predicted lower quality of life at four-months follow-up. Contrary to expectation, cross-sectional analyses revealed no significant associations between psychological and physiological stress variables. Secondary analyses revealed that poor health behaviors were associated with more psychological stress, diurnal cortisol dysregulation, more abdominal fat and higher blood pressure. In turn, aversive social support was associated with more psychological stress and lower quality of life. This study highlights interconnections between life events, psychological stress, health behaviors and social support. Limitations of the study include the relatively low sample size and the pooling of date from two different cancer types. The measurement of allostatic load may benefit from further development in this population. (PsycINFO Database Record (c) 2007 APA, all rights reserved) Subjects: *Distress; *Human Females; *Neoplasms; *Physiological Stress; *Quality of Life; Experiences (Events) Classification:
Health & Mental Health Treatment &
Prevention (3300) Population:
Human (10) Methodology: Empirical Study; Followup Study; Quantitative Study Publication Type:
Dissertation Abstract; Print Release Date: 20061218 Accession Number: 2006-99018-180 Persistent link to this record: http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2006-99018-180&site=ehost-live Cut and Paste: <A href="http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2006-99018-180&site=ehost-live">Effects of stress in women with cancer.</A> Database: PsycINFO Record: 29Title: Allostasis and Allostatic Load Over the Life Course. Author(s):
Seeman, Teresa E., Department of Medicine,
University of California-Los Angeles School of Medicine, Los
Angeles, CA, US Source: Medical and psychiatric comorbidity over the course of life. Eaton, William W.; pp. 179-196. Washington, DC, US: American Psychiatric Publishing, Inc., 2006. xviii, 301 pp. ISBN:
1-58562-231-1 (hardcover) Language: English Keywords: allostasis; allostatic load; age differences; stressful life experiences; life course; brain-body processes Abstract: (from the chapter) In this chapter, we review the concepts of "allostasis" and "allostatic load" and examine evidence indicating that there is population variation in the accumulation of allostatic load related to differences in age and exposure to stressful life experiences. The concept of allostasis (i.e., stability through change) refers to the idea that parameters of most physiological regulatory systems change to accommodate environmental demands. In contrast to homeostasis, which refers to negative feedback systems in the body that serve to maintain a given physiological parameter at a certain setpoint or within a narrow range, allostasis refers to processes of one or more physiological systems that vary more broadly to adapt to internal or external challenges such as infection, fleeing a predator, or an argument with one's spouse. The complex brain-body processes of allostasis manifested across the body's multiple regulatory systems allow for a fine-tuning of physiological resources, including tuning as a function of anticipation and experience, to meet the demands of life's events. Although allostatic processes are critical for adaptive functioning, chronic or repeated activation of physiological systems in response to life's challenges are hypothesized to exact a toll on such systems. This hypothesis is reflected in the concept of allostatic load. Allostatic load refers to the idea that biological regulatory systems may begin to exhibit cumulative patterns of dysregulation (i.e., "wear and tear") over time as a consequence of ongoing efforts to adapt to life demands. (PsycINFO Database Record (c) 2007 APA, all rights reserved) Subjects: *Age Differences; *Life Experiences; *Life Span; *Physiological Correlates; *Stress Classification: Psychological & Physical Disorders (3200) Population: Human (10) Intended Audience: Psychology: Professional & Research (PS) Publication Type: Book, Edited Book; Print Document Type: Chapter Release Date: 20060605 Accession Number: 2005-13362-009 Number of Citations in Source: 16 Persistent link to this record: http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2005-13362-009&site=ehost-live Cut and Paste: <A href="http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2005-13362-009&site=ehost-live">Allostasis and Allostatic Load Over the Life Course.</A> Database: PsycINFO Record: 30Title: Allostatic Load in Women With and Without PTSD Symptoms. Series Title: Annals of the New York Academy of Sciences Author(s): Glover, Dorie A., Division of Child and Adolescent Psychiatry, Psychiatry, and Biobehavioral Sciences, UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA, US, dglover@mednet.ucla.edu Address: Glover, Dorie A., UCLA Semel Institute, 760 Westwood Plaza, Room 68-237, Los Angeles, CA, US, 90024, dglover@mednet.ucla.edu Source: Psychobiology of posttraumatic stress disorders: A decade of progress (Vol. 1071). Yehuda, Rachel (Ed); pp. 442-447. Malden, MA, US: Blackwell Publishing, 2006. xxiii, 547 pp. ISBN:
1-57331-619-9 (hardcover) Language: English Keywords: posttraumatic stress disorder symptoms; allostatic load; risk factors; physiological correlates; mothers of pediatric cancer survivors Abstract: (from the chapter) Allostatic load (AL) is the cumulative physiological "cost" of prolonged stress. An AL composite measure successfully predicts morbidity and mortality among the elderly but has not been reported in "high stress" samples with postraumatic stress disorder (PTSD). Accordingly, AL was measured in mothers (ages 29-55) of pediatric cancer survivors and control mothers of healthy children. A significant "dose-response" pattern (high to low AL) emerged: cancer mothers meeting all PTSD criteria, cancer mothers with no/low symptoms, and controls, respectively. Results indicate elevated AL can be detected in relatively young women with high stress histories, and particularly those with PTSD. (PsycINFO Database Record (c) 2007 APA, all rights reserved) Subjects: *Mothers; *Physiological Correlates; *Posttraumatic Stress Disorder; *Risk Factors; *Stress Reactions; Neoplasms; Psychiatric Symptoms; Survivors Classification: Neuroses & Anxiety Disorders (3215) Population:
Human (10) Age Group:
Adulthood (18 yrs & older) (300) Tests & Measures: Posttraumatic Stress Diagnostic Scale Intended Audience: Psychology: Professional & Research (PS) Grant Information: The National Institute of Mental Health provided support to the New York Academy of Sciences and Mount Sinai School of Medicine for both the conference "Psychobiology of Posttraumatic Stress Disorder: A Decade of Progress" and this volume, a product of that conference Conference: The Psychobiology of Post-Traumatic Stress Disorder, Sep, 2005, Mount Sinai School of Medicine, New York, NY, US Methodology: Empirical Study; Quantitative Study Publication Type: Book, Edited Book; Print Document Type: Chapter Release Date: 20060925 Accession Number: 2006-10981-039 Number of Citations in Source: 14 Persistent link to this record: http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2006-10981-039&site=ehost-live Cut and Paste: <A href="http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2006-10981-039&site=ehost-live">Allostatic Load in Women With and Without PTSD Symptoms.</A> Database: PsycINFO Record: 31Title: Protective environments and health status: Cross-talk between human and animal studies. Author(s):
Singer, Burton, Office of Population
Research, Princeton University, Princeton, NJ, US,
singer@princeton.edu Address: Singer, Burton, Office of Population Research, Princeton University, Princeton, NJ, US, 08544, singer@princeton.edu Source: Neurobiology of Aging, Vol 26(Suppl1), Dec 2005. Special issue: Aging, Diabetes, Obesity, Mood and Cognition. pp. S113-S118. Publisher: Netherlands: Elsevier Science. ISSN: 0197-4580 (Print) Digital Object Identifier: 10.1016/j.neurobiolaging.2005.08.020 Language: English Keywords: social environments; health status; aging; depression; hippocampus; amygdala; oxytocin Abstract: Although aging populations tend to have increased prevalence of a diversity of diseases and disabilities, there are substantial numbers of people who, nevertheless, maintain good health into old age. Human studies frequently demonstrate associations between environmental factors, particularly supportive social environments, and positive states of health. Identifying the pathways from protective social environments to reduced disease risk necessitates the use of animal models as a basis of explanation and a source of suggestions for further human research. We present two examples of this kind of cross-talk: (i) the possibility that the success of well-being therapy following pharmacological treatment for depression as a means of preventing recurrent depressive episodes is based on the stimulation of enrichment of dendritic networks in the hippocampus and spine retraction in the basolateral amygdala; (ii) the possibility that the release of intracerebral oxytocin is a mediating factor between persistently supportive social environments and reduced disease in later life, as exemplified by low levels of allostatic load. (PsycINFO Database Record (c) 2007 APA, all rights reserved)(from the journal abstract) Subjects: *Aging; *Health; *Social Environments; Amygdala; Hippocampus; Major Depression; Oxytocin Classification: Gerontology (2860) Population:
Human (10) Grant Information: This research was supported by the National Institute on Aging (PO1-AG 020166 {BS & CDR}, P30 - AG 017265 (TS)) and the Robert Wood Johnson Health & Society Scholars Program at University of Wisconsin, Madison (EF) Publication Type:
Journal, Peer Reviewed Journal; Print Document Type: Journal Article Release Date: 20060313 Accession Number: 2005-16648-024 Number of Citations in Source: 37 Persistent link to this record: http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2005-16648-024&site=ehost-live Cut and Paste: <A href="http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2005-16648-024&site=ehost-live">Protective environments and health status: Cross-talk between human and animal studies.</A> Database: PsycINFO Record: 32Title: Defining stress as a prelude to mapping its neurocircuitry: No help from allostasis. Author(s): Day, Trevor A., School of Biomedical Sciences, University of Newcastle, Newcastle, NSW, Australia, trevor.day@newcastle.edu.au Address: Day, Trevor A., School of Biomedical Sciences, University of Newcastle, Newcastle, NSW, Australia, 2308, trevor.day@newcastle.edu.au Source: Progress in Neuro-Psychopharmacology & Biological Psychiatry, Vol 29(8), Dec 2005. pp. 1195-1200. Publisher: Netherlands: Elsevier Science. Other Journal Title: Progress in Neuro-Psychopharmacology ISSN: 0278-5846 (Print) Digital Object Identifier: 10.1016/j.pnpbp.2005.08.005 Language: English Keywords: stress; neurocircuitry mapping; allostasis; brain; homeostasis Abstract: The way in which researchers conceptualise and thus define stress shapes the way in which they approach the task of mapping the brain's stress control pathways. Unfortunately, much of the research currently being done on stress neurocircuitry is occurring within a poorly developed conceptual framework, a framework that limits the depth of the questions that our studies ask, and even our ability to fully appreciate and make use of the data that they yield. Consequently, any attempt to improve our conceptual framework merits close attention. In that regard it is notable that in recent years it has been argued that the concept of homeostasis should be supplemented by the concepts of allostasis (literally 'stability through change') and allostatic load (in effect, the cost of allostasis). One of the purported benefits of this change has been that it will clarify the concept of stress. A close review of the arguments leads us to conclude that the introduction of the concept of allostasis has largely occurred as a result of misunderstandings and misapprehensions concerning the concept of homeostasis. In terms of understanding how the organism operates, it is not clear that the concepts of 'allostasis' or 'allostatic load' offer us anything that was not already apparent, or at least readily derivable, from an accurate reading of the original concept of homeostasis. Not surprisingly then, these more recently proposed concepts also offer little help in clarifying our understanding of stress. Indeed, rather than clarifying the concept of stress, the primary effort appears to be directed at subsuming the concept of stress within the concept of allostasis, which has the inadvertent effect of collapsing the study of homeostatic responses and stress responses together. This seems to be out of step with the fact that there is now considerable evidence that the brain does indeed possess certain pathways that merit the title of 'stress neurocircuitry'. The attempt to subsume the concept of stress within the concept of allostasis is also counter-productive in that it distracts stress researchers from the important task of developing conceptual frameworks that allow us to tackle fundamental issues such as how the organism differentiates stressful from non-stressful challenges. (PsycINFO Database Record (c) 2007 APA, all rights reserved)(from the journal abstract) Subjects: *Brain; *Homeostasis; *Nervous System; *Stress; *Stress Reactions Classification: Psychophysiology (2560) Population: Human (10) Methodology: Literature Review Publication Type:
Journal, Peer Reviewed Journal; Print Document Type: Journal Article Release Date: 20060109 Accession Number: 2005-15910-002 Number of Citations in Source: 24 Persistent link to this record: http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2005-15910-002&site=ehost-live Cut and Paste: <A href="http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2005-15910-002&site=ehost-live">Defining stress as a prelude to mapping its neurocircuitry: No help from allostasis.</A> Database: PsycINFO Record: 33Title: Das stresskonzept von allostase und allostatic load: Einordnung psychoneuroimmunologischer forschungsbefunde an beispielen zur autoimmunität und onkologie. Translated Title: The Concept of Allostasis and Allostatic Load: Psychoneuroimmunological Findings. Author(s):
SchuIz, Karl-Heinz, Institut und
Poliklinik für Medizinische Psychologie, Zentrum für
Psychosoziale Medizin, Germany, khschulz@uke.uni-hamburg.de Address: SchuIz, Karl-Heinz, Universitatsklinikum Eppendorf, Transplantationszentrum und Institut fur Medizinische Psychologie, Martinistrasse 52, Gebaude S 35, 20246, Hamburg, Germany, khschulz@uke.uni-hamburg.de Source: Psychotherapie Psychosomatik Medizinische Psychologie, Vol 55(11), Nov 2005. pp. 452-461. Publisher: Germany: Georg Thieme Verlag KG. ISSN: 0937-2032 (Print) Digital Object Identifier: 10.1055/s-2005-866939 Language: German Keywords: allostatis; allostatic load concept; stress; stress response systems; dysregulation; multiple sclerosis; breast cancer; psychoneuroimmunology; homeostasis Abstract: Classical theories have conceptualized stress as a reaction to threat to the homeostasis within the organism requiring an adaptive response. However, postulating mechanisms that could link such responses to long-term detrimental health outcomes remains difficult. The allostatic load concept enables us to think about how mediators can be protective in the short run but may have damaging effects when overused and/or not shut off. It further facilitates the formulation of cause-effects cascades to explain the link of dysregulations in stress mediators such as glucocorticoids and catecholamines and increased susceptibility for certain diseases. In the first section, we briefly summarize the theoretical background. We then employ the concept to integrate findings from basic and clinical research on dysregulations of the stress response systems in multiple sclerosis and breast cancer. Based on this model, it seems likely that such dysregulations are implicated in progression and possibly pathogenesis of these diseases. When using allostatic load as a heuristic model, one needs to consider that stress mediators and outcomes are interconnected in a non-linear network. (PsycINFO Database Record (c) 2007 APA, all rights reserved)(from the journal abstract) Subjects: *Breast Neoplasms; *Multiple Sclerosis; *Psychoneuroimmunology; *Stress Reactions; *Susceptibility (Disorders); Homeostasis; Models Classification: Physical & Somatoform & Psychogenic Disorders (3290) Population: Human (10) Publication Type:
Journal, Peer Reviewed Journal; Print Document Type: Journal Article Release Date: 20060213 Accession Number: 2005-15411-001 Number of Citations in Source: 85 Persistent link to this record: http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2005-15411-001&site=ehost-live Cut and Paste: <A href="http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2005-15411-001&site=ehost-live">Das stresskonzept von allostase und allostatic load: Einordnung psychoneuroimmunologischer forschungsbefunde an beispielen zur autoimmunität und onkologie.</A> Database: PsycINFO Record: 34Title: Exposure to violence and cardiovascular and neuroendocrine measures in adolescents. Author(s):
Murali, Rama, University of British
Columbia, Vancouver, BC, Canada Address: Chen, Edith, Department of Psychology, University of British Columbia, 2136 West Mall, Vancouver, BC, Canada, V6T 1Z4, echen@psych.ubc.ca Source: Annals of Behavioral Medicine, Vol 30(2), Oct 2005. pp. 155-163. Publisher: US: Lawrence Erlbaum. Other Journal Title: Behavioral Medicine Update ISSN:
0883-6612 (Print) Digital Object Identifier: 10.1207/s15324796abm3002_8 Language: English Keywords: violence exposure; cardiovascular measures; neuroendocrine measures; blood pressure; heart rate; heart rate variability; cortisol levels Abstract: Background: Exposure to violence has clear, detrimental psychological consequences, but the physiological effects are less well understood. Purpose: This study examined the influence of exposure to violence on biological basal and reactivity measures in adolescents. Methods: There were 115 high school student participants. Systolic and diastolic blood pressure (SBP, DBP), heart rate (HR), HR variability (HRV), and cortisol levels were recorded during baseline and a laboratory stressor. The Exposure to Violence interview was administered and assessed two dimensions: total observed violence and total personally experienced violence. These were then divided into component parts: lifetime frequency, proximity, and severity. Results: Greater total experienced violence was associated with increased basal SBP (r = .19, p < .05) and decreased acute stress reactivity in terms of SBP (β = -.13, p = .05), HR (β = -.21, p = .00), and HRV (β = .13, p = .05). Lifetime frequency of experienced violence was associated with higher basal DBP (r = .33, p < .05), HR (r = .33, p < .05), and cortisol (r = .53, p < .00), and decreased SBP (β = -.27, p < .05) and DBP (β = -.31, p < .05) reactivity. Exposure to violence is associated with increased biological basal levels in adolescents, supporting allostatic-load research and decreased cardiovascular reactivity, supporting the inoculation effect. Conclusions: The findings illustrate that being a victim of violence has more pervasive biological consequences than witnessing violence and that the accumulation of stressful experiences has the greatest effect on biological markers. (PsycINFO Database Record (c) 2007 APA, all rights reserved)(from the journal abstract) Subjects: *Adolescent Development; *Cardiovascular Reactivity; *Neuroendocrinology; *Violence; Blood Pressure; Heart Rate; Hydrocortisone Classification: Developmental Psychology (2800) Population:
Human (10) Location: US Age Group:
Adolescence (13-17 yrs) (200) Tests & Measures: Exposure to Violence scale Methodology: Empirical Study; Quantitative Study Publication Type:
Journal, Peer Reviewed Journal; Print Document Type: Journal Article Release Date: 20060117 Accession Number: 2005-13013-008 Number of Citations in Source: 44 Persistent link to this record: http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2005-13013-008&site=ehost-live Cut and Paste: <A href="http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2005-13013-008&site=ehost-live">Exposure to violence and cardiovascular and neuroendocrine measures in adolescents.</A> Database: PsycINFO Record: 35Title: Allostatic Load and Health Disparities: A Theoretical Orientation. Author(s):
Carlson, E. D., University of Texas, M.D.
Anderson Cancer Center, Department of Epidemiology, Houston, TX,
US Address: Carlson, E. D., University of Texas, M.D. Anderson Cancer Center, Department of Epidemiology, 1515 Holcombe Blvd., Unit 189, Houston, TX, US, 77090 Source: Research in Nursing & Health, Vol 28(4), Aug 2005. pp. 306-315. Publisher: US: John Wiley & Sons. ISSN:
0160-6891 (Print) Digital Object Identifier: 10.1002/nur.20084 Language: English Keywords: allostatic load; health disparities; physiological theories; allotasis explanations; mediation processes Abstract: Eliminating racial and ethnic health disparities requires restructuring the biomedical models that have focused on the individual as the level of analysis and emphasized the parts rather than the whole. A recently developed understanding of human physiology and adaptive regulation, constructs of allostasis and allostatic load, provides a theoretical orientation that needs to be explored. Thus, the purpose of this article is to present an orientation of allostasis and allostatic load as a theoretical framework for exploring health disparities. This article will (a) present a general background on the evolution of relevant physiologic theories, (b) offer the general theoretical definitions and explanations of allostasis, allostatic load, and mediation processes, (c) examine empirical evidence for the constructs, and (d) discuss the implications of this orientation for health disparities research. (PsycINFO Database Record (c) 2007 APA, all rights reserved)(from the journal abstract) Subjects: *Health; *Health Impairments; *Mediation; *Physiology; *Theoretical Orientation Classification: Health & Mental Health Treatment & Prevention (3300) Population: Human (10) Location: US Age Group:
Adulthood (18 yrs & older) (300) Methodology: Empirical Study; Longitudinal Study; Qualitative Study Publication Type:
Journal, Peer Reviewed Journal; Print Document Type: Journal Article Release Date: 20051017 Accession Number: 2005-09401-004 Number of Citations in Source: 56 Persistent link to this record: http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2005-09401-004&site=ehost-live Cut and Paste: <A href="http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2005-09401-004&site=ehost-live">Allostatic Load and Health Disparities: A Theoretical Orientation.</A> Database: PsycINFO Record: 36Title: The Clinical Domains of Psychosomatic Medicine. Author(s):
Fava, Giovanni A., Department of
Psychology, University of Bologna, Bologna, Italy,
giovanniandrea.fava@unibo.it Address: Fava, Giovanni A., Department of Psychology, University of Bologna, Viale Berti Pichat 5, 40127, Bologna, Italy, giovanniandrea.fava@unibo.it Source: Journal of Clinical Psychiatry, Vol 66(7), Jul 2005. pp. 849-858. Publisher: US: Physicians Postgraduate Press. ISSN: 0160-6689 (Print) Language: English Keywords: psychosomatic medicine; somatic symptoms; psychological distress Abstract: Background: The psychosomatic evidence that has consolidated over the past decades provides the ideal background for dealing with the new needs that emerge in current medical practice. Method: A review of the psychosomatic literature, using both MEDLINE and manual searches, was performed. Search terms were psychosomatic, psychosomatic medicine, mind-body medicine, and biopsychosocial. Medical journals and books in English were also searched manually. Articles, with particular reference to review articles, which were judged to be relevant to clinical practice, were selected. Results: The following aspects were found of particular clinical interest: assessment of psychosocial factors affecting individual vulnerability (life events, chronic stress and allostatic load, well-being, and health attitudes), evaluation of psychosocial correlates of medical disease (psychiatric disturbances, psychological symptoms, illness behavior, and quality of life), application of psychological therapies to medical disease (lifestyle modification, treatment of psychiatric comorbidity, and abnormal illness behavior). Conclusion: A psychosomatic approach may be crucial in managing patients with unexplained somatic symptoms and in identifying psychological distress that cannot be diagnosed by psychiatric categories. Furthermore, it may contribute to recovery and rehabilitation by specific interventions. (PsycINFO Database Record (c) 2007 APA, all rights reserved)(from the journal abstract) Subjects: *Psychosomatic Medicine; Stress Classification: Health Psychology & Medicine (3360) Population: Human (10) Methodology: Literature Review Publication Type:
Journal, Peer Reviewed Journal; Print Document Type: Journal Article Release Date: 20050822 Accession Number: 2005-08480-007 Number of Citations in Source: 150 Persistent link to this record: http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2005-08480-007&site=ehost-live Cut and Paste: <A href="http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2005-08480-007&site=ehost-live">The Clinical Domains of Psychosomatic Medicine.</A> Database: PsycINFO Record: 37Title: Depressive Symptoms Predict Norepinephrine Response to a Psychological Stressor Task in Alzheimer's Caregivers. Author(s):
Mausbach, Brent T., Department of
Psychiatry, University of California, San Diego, CA, US,
bmausbach@ucsd.edu Address: Mausbach, Brent T., Department of Psychiatry, University of California, San Diego, 0680, 9500 Gilman Drive, La Jolla, CA, US, 92093-0680, bmausbach@ucsd.edu Source: Psychosomatic Medicine, Vol 67(4), Jul-Aug 2005. pp. 638-642. Publisher: US: Lippincott Williams & Wilkins. ISSN:
0033-3174 (Print) Digital Object Identifier: 10.1097/01.psy.0000173312.90148.97 Language: English Keywords: depressive symptoms; Norepinephrine; psychological stressors; Alzheimers caregivers Abstract: Objective: Increased depressive symptoms have been associated with increased basal plasma norepinephrine (NE), and may be associated with exaggerated NE response to stress. This exaggerated response may play a role in health consequences associated with caring for a loved-one with Alzheimer's disease. The current study examined the relations between the level of depressive symptoms in spousal caregivers and the physiological response to a psychological stress task. Methods: Fifty-five spousal caregivers (mean age 73 ± 8 years) completed the depression subscale of the Brief Symptom Inventory (BSI). Plasma NE levels were assessed before and immediately after a speech stressor conducted at the caregiver's home. Hierarchical linear regression was used to determine whether caregiver depressive symptoms significantly improved prediction of change in NE levels beyond other factors theoretically and empirically related to NE. Results: Level of depressive symptoms significantly predicted post-stressor change in NE levels (p < .01), even when controlling for age, caregiver distress, presence of caregiver hypertension, and care recipient level of cognitive function. Higher levels of depressive symptoms were associated with a greater plasma NE response to the psychological stress task. Conclusions: Depressive symptoms may act to exaggerate NE response to the stress of caregiving, potentially leading to an allostatic load that might predispose caregivers to negative health consequences, including cardiovascular morbidity. (PsycINFO Database Record (c) 2007 APA, all rights reserved)(from the journal abstract) Subjects: *Alzheimers Disease; *Major Depression; *Norepinephrine; *Psychiatric Symptoms; *Psychological Stress; Caregivers Classification: Affective Disorders (3211) Population:
Human (10) Location: US Age Group: Adulthood (18 yrs & older) (300) Tests & Measures:
Neuropsychiatric Inventory-Caregiver
Distress Scale [Appended] Methodology: Quantitative Study Publication Type:
Journal, Peer Reviewed Journal; Print Document Type: Journal Article Release Date: 20050822 Accession Number: 2005-08293-020 Number of Citations in Source: 42 Persistent link to this record: http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2005-08293-020&site=ehost-live Cut and Paste: <A href="http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2005-08293-020&site=ehost-live">Depressive Symptoms Predict Norepinephrine Response to a Psychological Stressor Task in Alzheimer's Caregivers.</A> Database: PsycINFO Record: 38Title: An Immune Risk Phenotype, Cognitive Impairment, and Survival in Very Late Life: Impact of Allostatic Load in Swedish Octogenarian and Nonagenarian Humans. Author(s):
Wikby, Anders, Department of Natural
Science and Biomedicine, School of Health Sciences, Jönköping
University, Sweden Address: Johansson, Boo, Department of Psychology, Goteborg University, Box 500, 405 30, Goteborg, Sweden, boo.johansson@psy.gu.se Source: Journals of Gerontology: Series A: Biological Sciences and Medical Sciences, Vol 60A(5), May 2005. pp. 556-565. Publisher: US: Gerontological Society of America. Other Journal Title:
Journal of Gerontology ISSN: 1079-5006 (Print) Language: English Keywords: cognitive impairment; immune risk phenotype; immune system measurements; late life survival; allostatic load; octogenarian humans; nonagenarian humans Abstract: In the previous OCTO longitudinal study, we identified an immune risk phenotype (IRP) of high CDS and low CD4 numbers and poor proliferative response. We also demonstrated that cognitive impairment constitutes a major predictor of nonsurvival. In the present NONA longitudinal study, we simultaneously examine in a model of allostatic load IRP and compromised cognition in 4-year survival in a population-based sample (n = 138, 86-94 years). Immune system measurements consisted of determinations of T-cell subsets, plasma interleukin 6 and cytomegalovirus and Epstein-Barr virus serology. Interleukin 2 responsiveness to concanavalin A, using data from the previous OCTO (octogenarians) immune study, hereafter OCTO immune, was also examined. Cognitive status was rated using a battery of neuropsychological tests. Logistic regression indicated that the IRP and cognitive impairment together predicted 58% of observed deaths. IRP was associated with late differentiated CD8-super(+)CD28-super(-)CD27-super(-) cells (p < .001), decreased interleukin 2 responsiveness (p < .05) and persistent viral infection (p < .01). Cognitive impairment was associated with increased plasma interleukin 6 (p < .001). IRP individuals with cognitive impairment were all deceased at the follow-up, indicating an allostatic overload. (PsycINFO Database Record (c) 2007 APA, all rights reserved)(from the journal abstract) Subjects: *Cognitive Impairment; *Geriatric Patients; *Immunology; *Phenotypes; *Risk Factors Classification: Neurological Disorders & Brain Damage (3297) Population:
Human (10) Location: Sweden Age Group:
Adulthood (18 yrs & older) (300) Tests & Measures:
Memory-in-Reality (MIR) test Methodology: Empirical Study; Longitudinal Study; Quantitative Study Publication Type:
Journal, Peer Reviewed Journal; Print Document Type: Journal Article Release Date: 20051024 Accession Number: 2005-06752-001 Number of Citations in Source: 56 Persistent link to this record: http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2005-06752-001&site=ehost-live Cut and Paste: <A href="http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2005-06752-001&site=ehost-live">An Immune Risk Phenotype, Cognitive Impairment, and Survival in Very Late Life: Impact of Allostatic Load in Swedish Octogenarian and Nonagenarian Humans.</A> Database: PsycINFO Record: 39Title: The Darwinian concept of stress: Benefits of allostasis and costs of allostatic load and the trade-offs in health and disease. Author(s):
Korte, S. Mechiel, Animal Sciences Group,
Wageningen University and Research Centre, Lelystad,
Netherlands, mechiel.korte@wur.nl Address: Korte, S. Mechiel, Animal Sciences Group, Wageningen University and Research Centre, Box 65, Edelhertweg 15, 8200 AB, Lelystad, Netherlands, mechiel.korte@wur.nl Source: Neuroscience & Biobehavioral Reviews, Vol 29(1), Feb 2005. Special issue: Individual differences in behavior and physiology: causes and consequences. pp. 3-38. Publisher: Netherlands: Elsevier Science. ISSN: 0149-7634 (Print) Digital Object Identifier: 10.1016/j.neubiorev.2004.08.009 Language: English Keywords: Darwinianism; stress; allostasis; health; disease; depression; evolutionary strategy; vulnerability; cardiac rhythm; aggression; personality traits Abstract: Why do we get the stress-related diseases we do? Why do some people have flare ups of autoimmune disease, whereas others suffer from melancholic depression during a stressful period in their life? In the present review possible explanations will be given by using different levels of analysis. First, we explain in evolutionary terms why different organisms adopt different behavioral strategies to cope with stress. It has become clear that natural selection maintains a balance of different traits preserving genes for high aggression (Hawks) and low aggression (Doves) within a population. The existence of these personality types (Hawks-Doves) is widespread in the animal kingdom, not only between males and females but also within the same gender across species. Second, proximate (causal) explanations are given for the different stress responses and how they work. Hawks and Doves differ in underlying physiology and these differences are associated with their respective behavioral strategies; for example, bold Hawks preferentially adopt the fight-flight response when establishing a new territory or defending an existing territory, while cautious Doves show the freeze-hide response to adapt to threats in their environment. Thus, adaptive processes that actively maintain stability through change (allostasis) depend on the personality type and the associated stress responses. Third, we describe how the expression of the various stress responses can result in specific benefits to the organism. Fourth, we discuss how the benefits of allostasis and the costs of adaptation (allostatic load) lead to different trade-offs in health and disease, thereby reinforcing a Darwinian concept of stress. Collectively, this provides some explanation of why individuals may differ in their vulnerability to different stress-related diseases and how this relates to the range of personality types, especially aggressive Hawks and nonaggressive Doves in a population. A conceptual framework is presented showing that Hawks, due to inefficient management of mediators of allostasis, are more likely to be violent, to develop impulse control disorders, hypertension, cardiac arrhythmias, sudden death, atypical depression, chronic fatigue states and inflammation. In contrast, Doves, due to the greater release of mediators of allostasis (surplus), are more susceptible to anxiety disorders, metabolic syndromes, melancholic depression, psychotic states and infection. (PsycINFO Database Record (c) 2007 APA, all rights reserved)(from the journal abstract) Subjects: *Darwinism; *Health; *Heart Rate; *Personality Traits; *Stress Reactions; Aggressiveness; Evolutionary Psychology; Inflammation; Major Depression; Susceptibility (Disorders) Classification: Physiological Processes (2540) Population: Animal (20) Methodology:
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