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Allostatic Load and Clinical Risk as Related to Sense of Coherence in Middle-Aged Women

From the Department of Psychology, Stockholm University and Centre for Health Equity Studies, Stockholm University/Karolinska Institutet, Stockholm, Sweden (P.L., U.L.); Centre for Health Equity Studies, Stockholm University/Karolinska Institutet, Stockholm, Sweden (O.L.).

Address correspondence and reprint requests to Petra Lindfors, PhD, Department of Psychology, Stockholm University and Centre for Health Equity Studies, Stockholm University/Karolinska Institutet, SE 106 91 Stockholm, Sweden. E-mail: pls{at}psychology.su.se.

Objective: To investigate how physiologic dysregulation, in terms of allostatic load and clinical risk, respectively, relates to sense of coherence (SOC) in women with no previously diagnosed pathology.

Methods: At baseline, 200 43-year-old women took part in a standardized medical health examination and completed a 3-item measure of SOC, which they completed again 6 years later. According to data from the medical examination, two different measures of physiologic dysregulation were calculated: a) a measure of allostatic load based on empirically derived cut points and b) a measure of clinical risk based on clinically significant cut points.

Results: In line with the initial hypotheses, allostatic load was found to predict future SOC, whereas clinical risk did not. In addition to baseline SOC and nicotine consumption, allostatic load was strongly associated with a weak SOC at the follow-up.

Conclusions: The better predictive value of allostatic load to clinical risk indicates that focusing solely on clinical risk obscures patterns of physiologic dysregulation that influence future SOC.

Key Words: allostatic load • clinical risk • medical examination • salutogenesis • sense of coherence • women

Abbreviations: ANOVA = analysis of variance; Hb_A1c = glycosylated hemoglobin; HDL = high-density lipoproteins; PEF = peak expiratory flow; SOC = sense of coherence; TC = total cholesterol; WHR = waist/hip ratio.

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