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Why sense of safety? A strengths-based approach to the whole
Published in Johanna Lynch, A Whole Person Approach to Wellbeing, 2020
Modern-day stress research, as per Selye’s original observations, describes stress as a ‘non-specific response’ to alarm (Van Praag, de Kloet, and van Os 2004, 12) that only occurs if the perceived stressor is more than the individual can adapt to (Van Praag, de Kloet, and van Os 2004, 13). Selye coined the term ‘stress’ to name the impact on the organism of what he termed a ‘stressor’, which can be conceptualised as threats to sense of safety. He crossed disciplinary boundaries to suggest a unifying concept – called the General Adaptation Syndrome – that named the loss of capacity of all organisms to adapt to stressors as ‘diseases of adaptation’ (Selye 1950, 1956). This concept is a foundation for recent research into allostatic load, multimorbidity and chronic disease (Tomasdottir et al. 2015, England-Mason et al. 2018, Delpierre et al. 2016, McEwen 2000, Lupien et al. 2009).
Neurophysiological Perspectives
Published in Marlysa Sullivan, Laurie C. Hyland Robertson, Understanding Yoga Therapy, 2020
Marlysa Sullivan, Laurie C. Hyland Robertson
Allostatic load indicates this “cumulative cost to the body of allostasis.”5 This term helps to describe the damage to the body that results from the wear and tear of prolonged exposure to allostatic states, which can predispose us to injury or disease. Chronic hypertension or elevation of inflammatory cytokines, for example, contributes to the development of pathological conditions including atherosclerotic plaques, neuronal remodeling or loss, chronic pain, impaired immunity, obesity, and bone demineralization.6 It is important to understand that the nuances of stress include a continuum from healthy adaptation in response to changing stimuli to unhealthy overload that damages systems. Allostasis and allostatic load help to explain how protective and healthy mediators of stress can have unhealthy consequences.
Discrimination and health
Published in Bernadette N. Kumar, Esperanza Diaz, Migrant Health, 2019
Although most stressful experiences do not increase vulnerability to illness, certain kinds of stressors – those that are uncontrollable and unpredictable – are particularly harmful to health, and these characteristics are common to discrimination experiences. Various models conceptualize discrimination as a social stressor that sets into motion a process of physiological responses (e.g. elevated blood pressure, heart rate, cortisol secretions), and these heightened physiological responses can have downstream effects on health over time (13). Routine discrimination can become a chronic stressor that may erode an individual's protective resources and increase vulnerability to physical illness (14). As with other forms of cumulative stress, perceived discrimination may lead to chronic over- or underactivity of allostatic systems impacting allostatic load and other pathophysiological processes (15). Allostatic load (Chapter 2) is the sum of ‘the wear and tear on the body’ accumulating over time with exposure to chronic or repetitive stress. In addition, negative affective/cognitive and other pathopsychological processes alone or in combination with restricted access to social resources such as employment, housing, and education, and/or increased exposure to risk factors (such as unnecessary contact with the criminal justice system) can create and perpetuate ill health.
Socioeconomic status and fertility treatment outcomes in high-income countries: a review of the current literature
Published in Human Fertility, 2023
Rachel Imrie, Srirupa Ghosh, Nitish Narvekar, Kugajeevan Vigneswaran, Yanzhong Wang, Mike Savvas
There are many theories as to how differences in socioeconomic status have an impact on an individual (the ‘biology of social adversity’) and their response to disease and medical treatments (Boyce et al., 2012). The term ‘allostatic load’ refers to the cumulative wear and tear throughout life on the body after exposure to chronic and recurrent stress (McEwen & Stellar, 1993). Exposure to psychological chronic stressors, especially in early childhood, can cause epigenetic changes (Lam et al., 2012) that impact lifelong biological responses. Short-term protection from acute stressors provided by hormones such as adrenal steroids and glucocorticoids can, in the long-term, negatively impact health. These factors combined are thought to account for socially mediated discrepancies in behaviour, immune responses (Slopen et al., 2015), inflammatory cascades and cardiovascular and metabolic health (McCrory et al., 2015). In particular, it is thought that environmental factors can influence the epigenome of spermatozoa which may be a factor in any socioeconomic differences in fertility treatment outcomes (Donkin & Barrès, 2018). It is currently not known whether any difference in outcomes between SES groups is because of gamete quality and the subsequent embryos that are created through ART, or the physiological environment to which they are transferred (e.g. pelvic infections are higher in lower SES groups (Leichliter et al., 2013) which may influence implantation).
Current understanding of the etiology of cyclic vomiting syndrome and therapeutic strategies in its management
Published in Expert Review of Clinical Pharmacology, 2022
Rosita Frazier, Thangam Venkatesan
Allostasis is defined as the process by which the host maintains homeostasis through adaptive changes to meet perceived and anticipated demands [39]. Autonomic dysfunction as well as alterations in neuroendocrine mechanisms such as the endocannabinoid signaling system (ECSS), the Hypothalamic–pituitary–adrenal (HPA) axis, and altered neurocircuitry in CVS suggests that these patients may not be able to respond to increased allostatic load resulting in symptoms of CVS [40]. Allostatic load can be measured by various biomarkers that include measures of cardiovascular activities such as systolic and diastolic blood pressure and heart rate, serum lipid levels, and measurement of neuroendocrine markers such as cortisol and epinephrine levels [41]. Levinthal et al. have postulated that aberrant CNS response to allostatic load may lead to CVS episodes such as migraine and epilepsy. Additionally, associated psychiatric comorbidity in CVS can also contribute to attenuated stress responsivity in CVS [42]. Assessment of allostatic load in CVS and the presence of early adverse life experiences that can contribute to altered neuronal plasticity might offer insight into the underlying mechanisms that contribute to symptoms in CVS [43]. Strategies to improve stress responsivity and enhance resilience might be yet another strategy to improve symptoms in CVS.
Personalized community-based prehabilitation for a high-risk surgical patient opting for pylorus-preserving pancreaticoduodenectomy: a case report
Published in Physiotherapy Theory and Practice, 2021
Christel A. van Beijsterveld, Bart C. Bongers, Marcel den Dulk, Cornelis H. Dejong, Nico L. van Meeteren
The HOAC II and the recently revised WHO framework of the ICF were used to structure and organize the patient history and clinical status, as well as to develop hypotheses prior to the preoperative examination and development of the plan of care (Figure 2). The aim of the preoperative medical and functional examination 29 days after the diagnostic tests (Figure 1) was to identify whether the patient was able to cope with the mental and physical stress of the pathology, hospitalization, and surgical stress response. The physiological response to stress can be described with the concepts of allostasis and allostatic load (McEwen and Wingfield, 2010). Allostasis is the process in which physiological systems adapt to excessive stressors to remain homeostasis. The cumulative effect of an allostatic state is an allostatic load (McEwen and Wingfield, 2010). If additional load of unpredictable events (e.g. pathology, hospitalization, and surgery) is superimposed on the already existing allostatic load (e.g. comorbidities), and the patient is not able to cope with this increased load, it may lead to allostatic overload, resulting in adverse health outcomes such as complications and a decline in physical functioning (McEwen and Wingfield, 2010).