Shaffer · Annual review of clinical psychology 2022 · narrative review · n=?

Allostasis, Action, and Affect in Depression: Insights from the Theory of Constructed Emotion.

Cited 91 times in the scientific literature.

Level 5 - mechanism / opinion, no new human data

Narrative review presenting theoretical framework and mechanism-based reasoning without primary data or systematic synthesis

PubMed 35534123 · doi:10.1146/annurev-clinpsy-081219-115627 · record verified 2026-08-26

What was done

This is a narrative review presenting a theoretical framework based on the theory of constructed emotion and systems neuroscience. The authors propose that allostatic dysregulation—failure of the brain to predictively regulate metabolic needs—serves as a trans-disorder vulnerability, and synthesize literature connecting major depressive disorder (MDD) symptoms (e.g., fatigue, distress, context insensitivity, reward insensitivity, motor retardation) to energy regulation deficits.

What was found

The abstract reports no numerical findings, sample sizes, or quantitative effect estimates. It outlines a conceptual model reframing MDD etiology from heightened emotional reactivity and reduced cognitive control to systemic problems in energy regulation.

Why it matters

It offers a predictive processing and metabolic framework linking physical and mental illness, generating testable mechanistic hypotheses for MDD development, prevention, and treatment.

Limits

As a narrative review and theoretical proposal, it provides no original empirical data, quantitative meta-analysis, or systematic review methodology. Hypothesized pathways linking allostasis to specific depressive symptoms require empirical validation.

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