Researchers develop new method to assess stress vulnerability

An impressive body of knowledge has linked stress to illness vulnerability. Yet stress is inextricably linked to everyday life. So when does it hurt?

Allostatic load reflects the cumulative effects of stressful experiences in daily life. When the cost of chronic exposure to fluctuating or heightened neural or neuroendocrine responses exceeds the coping resources of an individual, allostatic overload ensues. In this paper, clinimetric criteria for the determination of allostatic overload are suggested. They are based on: (a) the presence of a stressor exceeding individual coping skills, and (b) clinical manifestations of distress.

A group of researchers of the University of Bologna headed by Prof. Giovanni Fava has developed a new method for assessing it that is described in the current issue of Psychotherapy and Psychosomatics.

The concept of allostasis emphasizes that healthy functioning requires continual adjustments to the internal physiological milieu. Allostatic load reflects the cumulative effects of stressful experiences in daily life. When the cost of chronic exposure to fluctuating or heightened neural or neuroendocrine responses exceeds the coping resources of an individual, allostatic overload ensues. So far these issues have been addressed only on pathophysiological terms that do not find application in clinical settings. However, several features that have been described in psychosomatic research may allow the assessment of allostatic load on clinical grounds. Clinimetric criteria for the determination of allostatic overload are suggested. They are based on: (a) the presence of a stressor exceeding individual coping skills, and (b) clinical manifestations of distress. They may provide specification to the fourth axis of DSM, may supplement the Diagnostic Criteria for Psychosomatic Research, and may help discriminate neuroendocrine patterns with important clinical and research implications. A state of allostatic overload is frequently associated with alterations in biological markers and calls for a close medical evaluation of the patient's condition. The ultimate goal is to be able to prevent or decrease the negative impact of excessive stress on health.