Allostasis and Allostatic Load: A Neurobiological Assessment of Psychopathology

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One of the most important current issues in the study of psychopathology and work/life balance issues is the role that stress plays as both a causal factor and an outcome of mental illness; specifically, the types of assessments used to quantify,
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  Running Head: ALLOSTATIC LOAD 1 Allostasis and Allostatic Load: A Neurobiological Assessment of Psychopathology Myrna D. Washington University of the Rockies  ALLOSTATIC LOAD   2 Abstract One of the most important current issues in the study of psychopathology and work/life balance issues is the role that stress plays as both a causal factor and an outcome of mental illness; specifically, the types of assessments used to quantify, understand, and predict the resulting  behaviors. In this paper, we take a look at the emerging neurobiologically-based concept of „allostatic load‟ as a superior means of measuring stress and its potential physiological and  behavioral effects, as presented in Bruce S. McEwen‟s (2000) article, “Allostasis and Allostatic Load: Implications for Neuropsychopharmacology.” McEwen‟s (2000) article provides a comprehensive model for examining the contradicting effects of allostasis and its opposite, allostatic load. In addition, we examine the diagnostic information provided by the measurement of allostatic load, the affects to the employee, organization and work performance; and suggested intervention strategies for implementing the measurement of allostatic load in organizational assessments. By studying allostatic load, which includes “stress” as well as perturbations of diurnal rhythm of stress mediators, and the influences of various aspects of lifestyle such as diet and exercises, psychiatrists will be forced to consider pathways of cause and effect on specific systems, in which neuroendocrine factors play a major role (McEwen, 2000). Moreover, according to McEwen (2000), focusing on allostatic load will require an appreciation of the multiple interactions between organ systems; one that will force a new integration of knowledge from different fields of science, medicine, and biology.  ALLOSTATIC LOAD   3 Allostasis and Allostatic Load: A Neurobiological Assessment of Psychopathology Martin is a successful forty-something executive who travels abroad for a large, international clothing manufacturer. He has a wife, three children, a beautiful home, and three new cars. When he is at home, he works long hours and weekends, often missing the most important personal and social events in his and his family‟s lives. When he is abroad, he misses everything and works even longer hours. He has convinced himself that he is working to provide the „good life‟ for his family and takes refuge in the „promise‟ th at he will discontinue this hectic work  pace as soon as he makes “enough” money . His wife is lonely, depressed, and is threatening divorce and his children feel neglected and act out their frustrations; no one is happy. When Martin complains to his employer about his deteriorating home life, being tired all the time, having problems with concentration, and his unexplained aches and pains, his complaints go unheeded. After all, his intimacy concerns are not consistent with the objectives and policies of the organization and are, in fact, seen as a distraction to Martin‟s productivity, which, as his boss phrased it, i s only “as good as the current month‟s achievements.” Understandably, Martin begins to experience hostilities and resentments that cause him to feel overworked and underappreciated. As he represses his feelings, he accurately describes his  position as being „caught between a rock and a hard place‟; the „rock‟  being his personal life and the „hard place , ‟ his work.  It is no small wonder that Martin is hypertensive, anxious, depressed, aggressive, and frequently drowns his sorrows in increasing amounts of alcohol. While his immediate supervisors hardly notice changes in his behaviors, his co-workers and subordinates describe him as quick-to-anger, hostile , brooding, and “not at all the way he used to be.” Martin is a powder-keg with a short fuse. Can he or his organization assess and defuse his volatile concoction of feelings before it is too late?  ALLOSTATIC LOAD   4 In today‟s competitive, fast-paced, round-the-clock, global economy, an executive or manager like Martin (one who is struggling desperately to balance his/her personal and  professional lives) spends as much as one-quarter of his/her total life and one half of his/her waking life in his/her work environment. This means that a busy executive spends as much time at work as he/she does at home and, as a consequence, his/her personalities and problems influence both life structures in a bidirectional, interdependent interaction that has the capacity to influence the tone of his work environment in positive and negative directions (Thomas and Hersen, 2004). Most likely, mental health issues will be the most prominent problems Martin (and any manager like him) will experience; and, when these issues occur, they will influence his/her attitudes, efficiency, and ability to get along with others (Thomas and Hersen, 2004). For this reason, it is important that organizations are able to identify and assess their employe es‟ stress levels and the psychological dis-eases, dis-tresses, and dis-orders they potentiate …  before they become „powder kegs with short fuses‟ and the least upset ignites them. One of the most important and current issues in the study of psychopathology and work/life balance issues is the role that stress plays as both a causal factor and an outcome of mental illness; specifically, the types of assessments used to quantify, understand, and predict the resulting behaviors. Traditionally, the most common-used techniques to identify  psychopathology include structured clinical interviews (e.g., the SCID-I, the Structured Clinical Interview for the DSM-IV), symptom scales (e.g., personality inventories such as the Minnesota Multiphasic Personality Inventory [MMPI-2] and the California Psychology Inventory [CPT]),  projective tests (e.g., the Rorschach Inkblot Test), and functional assessments (e.g., the Global Assessment of Functioning Scale [GAF], the Colorado Client Assessment Record [CCAR], and the Behavior and Symptom Identification Scale [BASIS-32]) (Thomas and Hersen, 2004). These  ALLOSTATIC LOAD   5 assessments are based in one or more alternative perspectives (e.g., neurobiological, sociobiological, psychodynamic, behavioristic, cognitive, interpersonal systems, humanistic, and/or anthropological) for understanding the etiology and pathology of mental disorders (Thomas and Hersen, 2004). This paper looks at the emerging neurobiologically-based concept of „ allostatic load ‟  as a superior means of measuring stress and its potential physiological and behavioral effects, as  presented in B ruce S. McEwen‟s (2000) article, “Allostasis and Allostatic Load: Implications for  Neuropsychopharmacology .” McEwen‟s (2000) article provides a comprehensive model for examining the contradicting effects of allostasis and its opposite, allostatic load. In addition, this  paper examines the diagnostic information provided by the measurement of allostatic load, the affects to the employee, organization and work performance; and the suggested intervention strategies for implementing the measurement of allostatic load in organizational assessments. From the neurobiological perspective, psychopathology is largely the result of a neurochemical pathology, in which each and every thought, impulse, affect, perception, and motivation is isomorphic and with a commensurate pattern of brain activity (Thomas and Hersen, 2004). From this perspective, mental disease and disorders are the result of the brain‟s inability to adapt, react, and learn from experiences and resolve challenges. According to Thomas and Hersen (2004), these mental disorders consist of maladaptive cognitions, feelings, and behaviors resulting from dysregulations along neurochemical pathways within the central (and peripheral nervous systems (pp. 9-10). In addition, gene expression and the lasting effect of a traumatic, abusive, or otherwise harmful psychological experience is also reducible to a neurophysiological  pathology (Thomas and Hersen, 2004). Although traditional psychiatry has distanced itself from this view in the past, it is now beginning to shift back toward neurbiology to enhance its
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