Cited by 1,833Stress Responses and CortisolChild Abuse and TraumaHealth disparities and outcomes

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Allostasis and Allostatic Load Implications for Neuropsychopharmacology

McEwen, B·2000·Neuropsychopharmacology

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Abstract

The primary hormonal mediators of the stress response, glucocorticoids and catecholamines, have both protective and damaging effects on the body. In the short run, they are essential for adaptation, maintenance of homeostasis, and survival (allostasis). Yet, over longer time intervals, they exact a cost (allostatic load) that can accelerate disease processes. The concepts of allostasis and allostatic load center around the brain as interpreter and responder to environmental challenges and as a target of those challenges. In anxiety disorders, depressive illness, hostile and aggressive states, substance abuse, and post-traumatic stress disorder (PTSD), allostatic load takes the form of chemical imbalances as well as perturbations in the diurnal rhythm, and, in some cases, atrophy of brain structures. In addition, growing evidence indicates that depressive illness and hostility are both associated with cardiovascular disease (CVD) and other systemic disorders. A major risk factor for these conditions is early childhood experiences of abuse and neglect that increase allostatic load later in life and lead individuals into social isolation, hostility, depression, and conditions like extreme obesity and CVD. Animal models support the notion of lifelong influences of early experience on stress hormone reactivity. Whereas, depression and childhood abuse and neglect tend to be more prevalent in individuals at the lower end of the socioeconomic ladder, cardiovascular and other diseases follow a gradient across the full range of socioeconomic status (SES). An SES gradient is also evident for measures of allostatic load. Wide-ranging SES gradients have also been described for substance abuse and affective and anxiety disorders as a function of education. These aspects are discussed as important, emerging public health issues where the brain plays a key role.

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Authors: McEwen, B.
Affiliations: Rockefeller University (US)
Corresponding author: McEwen, B
Venue: Neuropsychopharmacology
Publisher: Springer Science and Business Media LLC
Published: 2000-02
Volume: 22
Issue: 2
Pages: 108-124
ISSN: 0893-133X (ISSN-L)
DOI: 10.1016/s0893-133x(99)00129-3
OpenAlex: W1978762354
Cited by: 1,833
References: 35
Citations by year: 2026: 68 · 2025: 94 · 2024: 98 · 2023: 127 · 2022: 98 · 2021: 92 · 2020: 82 · 2019: 71 · 2018: 74 · 2017: 100 · 2016: 109 · 2015: 85 · 2014: 69 · 2013: 87 · 2012: 74
FWCI: 2.59
Type: journal article
Language: en
Open access: closed
Locations: Neuropsychopharmacology (publishedVersion)
PubMed (publishedVersion)
Funders: John D. and Catherine T. MacArthur Foundation
University of California, San Francisco
National Institute of Mental Health (MH-41256)
Topics: Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
Social Sciences › Health › Health disparities and outcomes
Keywords: allostasis, allostatic load, stress response, glucocorticoids, catecholamines, anxiety disorders, depression, hostility, substance abuse, post-traumatic stress disorder, diurnal cycle, brain atrophy, cardiovascular disease, childhood abuse and neglect, socioeconomic status, social gradient
MeSH terms: Adaptation, Physiological, Mental Disorders, Homeostasis, Hormones, Humans, Stress, Physiological, Stress, Psychological

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Allostasis and Allostatic Load Implications for Neuropsychopharmacology

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