Environmental stress, psychological stress and allostatic load

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.

Conflict, health care and professional perseverance: A qualitative study in the West Bank

“…Results suggest that consequences to health care due to political conflict are evident in both emergency as well as primary care. Reports by doctors in this study linking the chronic stress of political conflict to diseases like diabetes and heart problems are in line with the increasing amount of knowledge about the effect of chronic stress on health (Clark et al 2007;McEwen 2000). Results also demonstrate the considerable consequences for health care workers in terms of stress.…”

Short-term changes in sleep, mastery & stress: Impacts on depression and health in dementia caregivers

“…Evidence that stress increases over time for caregivers was found by Clark, Bond and Hecker. 38 In a longitudinal study of new caregivers (M 5.4, SD 3 months of caregiving), veteran caregivers (M 39.7, SD 17.9), and noncaregivers, veteran caregivers reported significantly more perceived stress than did new caregivers. Perceived stress was a predictor of allostatic load (the cumulative toll of the body's attempt to achieve stability through change or allostasis), 39 which increased for both caregiving groups over the study year.…”

Do Chronic Stressors Lead to Physiological Dysregulation? Testing the Theory of Allostatic Load

“…Few studies have demonstrated an association between stressful life events and a measure of multisystem physiological dysregulation (15)(16)(17)(18)(19). Rather, most have focused on individual biological measures believed to be part of the stress response.…”