Fig. 2.

Hypothetical ATP Model of CNS allostatic triage based on EMAL. Each colored box represents a different category or “bucket” of energy use in the CNS. Increased task-dependent neural activation (red box) is required for cognitive activities that produce the behaviors necessary to respond to stressors, and in the context of increased energy demand (i.e., stress) and insufficient energy production, can necessitate allostatic triage from other networks within that category, or when extreme, from other categories (other colored boxes). Moving from left to right on the figure, the level of bioenergetic demand on the CNS increases, starting with mild stress (− or healthy allostasis) to moderate to intense stress (+, ++ or allostatic load), and extreme stress and energetic demand (+++, ++++ or allostatic overload). The red shaded area indicates which categories are being triaged to support additional resource allocation to task-dependent activation based on the level of demand. Affect, which is derived from the internal model of the predicted bioenergetic state of the organism, is represented by the three different shades of blue dashed lines. We propose that affect determines the setpoint (i.e., the level of energetic demand) at which allostatic triage begins to occur (i.e., affect-driven prioritization) Negative affect, representing the prediction that energy efficiency is low or uncertain (bottom darkest blue dashed line), causes triage at lower levels of stress. Positive affect represents the prediction that energy is abundant and results in reduced triage as stress increases (top lightest blue dashed line). Importantly, allostatic triage need not first triage energy from neuroplasticity followed by maintenance and repair, and so on, in that order. Rather, energetic resources are likely triaged from multiple buckets simultaneously, a limitation of presenting this figure in two dimensions. ATP Model: Allostatic Triage Model of Psychopathology; CNS: Central Nervous System; EMAL: Energetic Model of Allostatic Load. Figure created on Biorender.com.