Fig. 2.

Simple graphical representation of inclusion of pre-existing influencing factors in calculations of both psychosocial allostatic load (PsyAL) and physiological AL (PsyAL) and some of their associated health outcomes. Arrows also indicate likely interactions whereby PsyAL may produce or exacerbate physiological as well as psychological disorders and vice versa as well as interactions between the disorders (e.g., impacts of chronic anxiety on cardiovascular diseases). Calculating both PsyAL and PhyAL for the same individuals in long-term cohort studies would allow consideration and assessment of such interactions over the life course and multiple traumatic events. (*Includes but not limited to anxiety, depression, PTSS, eating disorders, substance abuse, interpersonal conflict, difficulty concentrating, malaise, mood issues. ⁺ Includes but not limited to cardiovascular disease, respiratory and digestive complaints, headaches, and others).