Publications

Center-Related Publications

Friedman, M.J., & McEwen, B.S. (2004). Posttraumatic stress disorder, allostatic load, and medical illness. In P.P. Schnurr & B.L. Green (Eds.). Trauma and health: physical health consequences of exposure to extreme stress. Washington , DC : American Psychological Association (pp. 157-188).

In this chapter we present a psychobiological conceptual framework that accounts for the mounting evidence that PTSD is a risk factor for medical illness. First we describe the human response to stress to provide the context for the ensuing discussion. Then we summarize the extensive literature on the relationship of chronic stress syndrome to medical illness. Next we review the biological alterations associated with chronic PTSD and how these PTSD-related psychobiological abnormalities might increase the risk for medical illness among affected individuals. Then we introduce the allostatic load model and demonstrate how this theoretical approach enables us to understand the etiological significance of such abnormalities. Finally, we discuss how the allostatic load model helps us conceptualize resilience, prevention, and treatment.