Allostatic Load in Children and Adolescents: A Systematic Review

Marcella Lucente · Jenny Guidi

60 citations0/0 files storedPsychotherapy and Psychosomatics

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Child Abuse and Trauma Stress Responses and Cortisol Health disparities and outcomes

Abstract

INTRODUCTION: The concept of allostatic load encompasses the cumulative effects of both ordinary daily life events as well as major challenges, and also includes related health-damaging behavior. Allostatic overload ensues when environmental challenges exceed the individual's ability to cope. Identification of allostatic load is carried out through the use of biomarkers and clinimetric criteria. Studies are increasingly reported on allostatic load in younger populations, yet a systematic review is missing. OBJECTIVE: The aim of the present systematic review was to summarize the current knowledge on allostatic load/overload among children and adolescents. METHODS: PubMed, PsycINFO, Web of Science, and the Cochrane Library were searched from inception to April 2023. A manual search of the literature was also performed. We considered only studies in which allostatic load or overload were adequately described and assessed in either clinical or non-clinical populations younger than 18 years. RESULTS: A total of 38 original investigations were included in this systematic review. Studies reported an association between allostatic load and sociodemographic characteristics (e.g., poverty, ethnicity, perceived discrimination, adverse childhood experiences) and environmental factors, as well as consequences of allostatic load on both physical and mental health among children and adolescents. CONCLUSIONS: The findings indicate that greater allostatic load is associated with poorer health outcomes in both clinical and non-clinical pediatric populations, with possible enduring effects. The results support the clinical utility of the transdiagnostic identification of allostatic load and overload in children and adolescents across a variety of settings, with a number of potential clinical implications.

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2021The PRISMA 2020 statement: an updated guideline for reporting systematic reviews 2011Adverse childhood experiences, allostasis, allostatic load, and age-related disease 2001Allostatic load as a marker of cumulative biological risk: MacArthur studies of successful aging 1997Price of Adaptation—Allostatic Load and Its Health Consequences 2000Dispositional emotionality and regulation: Their role in predicting quality of social functioning.2009Childhood poverty, chronic stress, and adult working memory 2003A multimethodological analysis of cumulative risk and allostatic load among rural children.2017Social Structure, Adversity, Toxic Stress, and Intergenerational Poverty: An Early Childhood Model

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