The allostatic load model expands the stress-disease literature by proposing a temporal cascade of multi-systemic physiological dysregulations that contribute to disease trajectories. By incorporating an allostatic load index representing neuroendocrine, immune, metabolic, and cardiovascular system functioning, numerous studies have demonstrated greater prediction of morbidity and mortality over and beyond traditional detection methods employed in biomedical practice. This article reviews theoretical and empirical work using the allostatic load model vis-à-vis the effects of chronic stress on physical and mental health. Specific risk and protective factors associated with increased allostatic load are elucidated and policies for promoting successful aging are proposed.
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"symptoms, cognitive decline, physical/mobility limitations, and neurological atrophy   ) that parallel associations found in sleep medicine. While it has been hypothesized that sleep deprivation causes AL , sleep has received limited attention in the AL literature. "
"A negative spiral seems to be created wherein amygdala hyperactivity leads to increased metabolic dysfunction, which in turn instigates dysfunction of emotion regulation circuitry and increased sensitivity to threatening cues, further increasing the risk of metabolic consequences (McIntyre et al., 2007). The trajectory of depressive disease starts early and continues unless addressed by effective and targeted interventions (McEwen, 2003; Juster et al., 2010; Dannlowski et al., 2012). We therefore suggest that the first priority in treating pediatric depression should be to normalize amygdala and limbic hyperactivity and ACC dysfunction by specially designed practice as outlined in the later sections of this article. "
[Show abstract][Hide abstract]ABSTRACT: Major depressive disorder (MDD) is one of the current leading causes of disability worldwide. Adolescence is a vulnerable period for the onset of depression, with MDD affecting 8–20% of all youth. Traditional treatment methods have not been sufficiently effective to slow the increasing prevalence of adolescent depression. We therefore propose a new model for the treatment of adolescent depression – Training for Awareness, Resilience, and Action (TARA) – that is based on current understanding of developmental and depression neurobiology. The TARA model is aligned with the Research Domain Criteria (RDoC) of the National Institute of Mental Health. In this article, we first address the relevance of RDoC to adolescent depression. Second, we identify the major RDoC domains of function involved in adolescent depression and organize them in a way that gives priority to domains thought to be driving the psychopathology. Third, we select therapeutic training strategies for TARA based on current scientific evidence of efficacy for the prioritized domains of function in a manner that maximizes time, resources, and feasibility. The TARA model takes into consideration the developmental limitation in top-down cognitive control in adolescence and promotes bottom-up strategies such as vagal afference to decrease limbic hyperactivation and its secondary effects. The program has been informed by mindfulness-based therapy and yoga, as well as modern psychotherapeutic techniques.The treatment program is semi-manualized, progressive, and applied in a module-based approach designed for a group setting that is to be conducted one session per week for 12 weeks. We hope that this work may form the basis for a novel and more effective treatment strategy for adolescent depression, as well as broaden the discussion on how to address this challenge.
Full-text · Article · Aug 2014 · Frontiers in Human Neuroscience
"The proposed conceptual model comes with several potential implications. First, biomarkers have been proposed to assess differences in allostatic load between populations of adults (Juster et al. 2010, 2011). while not specific for CvS, these tests could assess the validity of the proposed framework that CvS is characterized by allostatic load, as measured by altered circadian patterns and stress-induced changes in autonomic, neuroendocrine, and even metabolic and immune factors. "
[Show abstract][Hide abstract]ABSTRACT: Cyclic vomiting syndrome (CVS) is an idiopathic illness characterized by stereotypic and sudden-onset episodes of intense retching and repetitive vomiting that are often accompanied by severe abdominal pain. Many associated factors that predict CVS attacks, such as prolonged periods of fasting, sleep deprivation, physical and emotional stress, or acute anxiety, implicate sympathetic nervous system activation as a mechanism that may contribute to CVS pathogenesis. Furthermore, adult patients with CVS tend to have a history of early adverse life events, mood disorders, chronic stress, and drug abuse-all associations that may potentiate sympathetic neural activity. In this review, we set forth a conceptual model in which CVS is viewed as a brain disorder involving maladaptive plasticity within central neural circuits important for allostatic regulation of the sympathetic nervous system. This model not only can account for the varied clinical observations that are linked with CVS, but also has implications for potential therapeutic interventions. Thus, it is likely that cognitive behavioral therapy, stress management ("mind-body") interventions, regular exercise, improved sleep, and avoidance of cannabis and opiate use could have positive influences on the clinical course for patients with CVS.
Full-text · Article · Apr 2014 · Experimental Brain Research