ALLOSTATIC LOAD IN ANXIETY AND TRAUMA AND STRESSOR-RELATED DISORDERS: A SYSTEMATIC REVIEW

Abstract

Background: The concept of allostatic load (AL) provides a theoretical framework for the role of stress in the development of psychiatric disorders and may have translational clinical implications. AL - the cumulative 'wear and tear' in response to repeated stressors - can be measured through a composite index of biomarkers, spanning a range of physiological systems. Anxiety disorders and trauma, and stressor-related disorders, are two interrelated Diagnostic and Statistical Manual of Mental Disorders Fifth Edition, Text Revision (DSM-5-TR) diagnostic categories that lend themselves intuitively to the AL framework. Objectives: To systematically review literature on the measurement of AL in adult individuals with anxiety and trauma and stressor-related disorders. Methods: A systematic review, pre-registered in PROSPERO and adherent to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, was performed through a search of EMBASE, PsycINFO, PubMed, Scopus, and Web of Science databases. Findings: Seven out of 1616 unique records identified by the search strategy met inclusion criteria after full text review. One of the studies pertained to measurement of AL in individuals with anxiety disorders. The remaining 6 studies examined AL in individuals with post-traumatic stress disorder. Synthesis of data was limited by the heterogeneity of methods and biomarkers used to calculate AL across studies. Conclusions: A limited number of studies has examined the AL concept as it relates to anxiety and trauma and stressor-related disorders. Further work in this area is required to determine the utility of measuring AL in clinical practice.