Biocultural Strategies for Measuring Psychosocial Stress Outcomes in Field-based Research

Biocultural frameworks to understand stress processes overlap greatly with biosocial ones (e.g., McDade and Harris 2018, Roberts and Rollins 2020); both are based in a recognition of human biology as dynamically connected to social contexts across the life span and that neither can be fully explained without some consideration of the other. Perhaps the clearest distinction of a biocultural approach is the emphasis on integrating the proximate (highly local) context into research design, and thus the primacy of both fieldwork and theories related to local cultural and biological variation. Almost all biocultural research is field based, anchored in the fundamental understanding that physiological expressions of stress are dynamic and based in proximate context. Physical bodies are situated in time, space, and patterns of practice in the “situated biologies” of real people in the real world (Niewöhner and Lock 2018). Biocultural studies of stress, however, now place greater emphasis on how data collection and interpretation happen, so typically integrate methods such as extended participant observation and interviewing, which elucidate more detailed salient dimensions of the social stress process (Dufour 2006). This work is situated in varied theories of culture as highly localized phenomena that can be both a source of psychosocial stress and a means to alleviate or buffer it. One example of a specific theory is cultural consonance; operationally, it evaluates metrically the extent to which an individual aligns with locally shared norms and practices (Dressler 2017, 2020). For example, Dressler and colleagues (2016) found that lower cultural consonance in social support in Brazil was associated with higher stress measures (based on blood C-reactive protein). Another example is social theories of gender as structural inequality. For example, Nepali women are primarily responsible for household water, so low water access elevates their stress as measured by blood pressure—but not that of their husbands (Brewis et al. 2019). Without such proximal theorization of within-cultural variation, it is difficult to interpret when and why individual measures of stress vary, such as between those in the same household.

Drawing on political–economic theory, biocultural assessments of stress also recognize that the stress experience is often situated within historically inequitable social structures (Leatherman and Goodman 2020). Factors like wealth, power, prestige, social connection, and historical trauma are all important mediators or moderators of the stress process (Link and Phelan 1995; McEwen 1998, 2012; Sapolsky 1998), including what people perceive as stressful (Dressler 1991; Singer et al. 2016). Again, recognition that these unequal structures matter then demands integration into fieldwork of theory and methods for characterizing relevant aspects of the political–economic context and the place of sampled individuals within it, so that measures of psychosocial stress can be interpreted correctly (e.g., Dressler 2005; Flinn and England 1997; Hicks and Leonard 2015). Piperata et al. (2016, 2020) use this approach to understand how long-standing land distribution and economic policies led to widespread food insecurity and, relatedly, psychosocial stress among women in León, Nicaragua. In this context, asking others for food was so stigmatized that when women drew on their social networks to cope with food insecurity, it promoted more (rather than less) psychosocial stress.

Applying anthropological theories of human genetic and developmental adaptation, biocultural assessments of psychosocial stress also recognize that meaningful interpretation of stress outcome biomarkers must consider possible underlying variation in relevant physiological processes (e.g., Martin 2019). Individuals vary in physiological stress responses with a host of individual factors like genetic predispositions, prior environmental exposures, gender, body size or composition, and sleep patterns, to name a few. Relatedly, life history theory suggests that the way bodies identify and respond to stress varies by life stage and may include trade-offs across organ systems and over time (e.g., skeletal growth versus immune function) (see Shattuck-Heidorn et al. 2017). Due to this fully expected variation, individuals may experience—and physically manifest—the same event or environmental condition very differently not just from person to person, but also across time and with changing personal circumstances.

Relatedly, in a biocultural framework, population-level variation in underlying stress physiology is always assumed, a point especially relevant when comparing stress outcome measures beyond a well-defined local context. Many, often irreversible, phenotypic traits in humans reflect highly localized interactions between genotypes and the environment through the process of developmental plasticity. One of the best examples is the extreme variation in the measurable ranges of ovarian hormones in women entering puberty in ecologies with differing energetic demands (Ellison 1996). Thus, comparing stress outcomes across groups requires explicit theories of exactly how and why stress markers might vary, a point carefully developed in the earliest biocultural studies using adaptability frameworks (e.g., Baker et al. 1986) and still adhered to today.

Finally, varied stress biomarkers capture outcomes of different and interacting phenomena at multiple scales. As Table 1 outlines, psychosocial stress responses manifest across multiple organ systems and over varying time scales, meaning biomarkers can potentially capture stress in many different dimensions. Identifying distinctions between the available options and examples of cutting-edge studies being done with each is the focus of the next section.