Allostatic load in women with and without PTSD symptoms.

Allostatic load (AL) is the term used to describe cumulative physiological wear and tear that results from repeated efforts to adapt to stressors over time. Operationalized as a composite index of biological risk factors (e.g., blood pressure, cholesterol, glycosylated hemoglobin, and cortisol, norepinephrine, and epinephrine), AL has been shown to increase with age, predict long-term morbidity and mortality among the elderly, and be associated with low parent education in a large adolescent sample. However, AL has not yet been studied in samples with putative "high stress" or posttraumatic stress disorder (PTSD). Accordingly, AL was measured in women with high acute and chronic stress: mothers of pediatric cancer survivors with and without PTSD and control mothers of healthy children. AL emerged in a "dose-dependent" ranking from high to low: cancer mothers meeting all criteria for PTSD, cancer mothers with no or low symptoms, and control mothers, respectively (p < .001). Effects were not altered by self-reported sleep quality or substance use (tobacco, caffeine, alcohol, or drugs) and remained significant when analyzing AL without cortisol or catecholamines. Results indicate elevated AL can be detected in relatively young women with high stress histories and particularly those with PTSD. Future prospective studies must evaluate whether this pattern represents an accelerated aging process and increased risk of disease.