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Institute of Medicine (2000) Bridging Disciplines in the Brain, Behavioral, and Clinical Sciences. Committee on Building Bridges in the Brain, Behavioral, and Clinical Sciences. Terry C. Pellmar and Leon Eisenberg, eds. Division of Neuroscience and Behavioral Health. Washington, D.C.: National Academy Press. Available at:
http://www.nap.edu/openbook.php?isbn=0309070783
Institute of Medicine (2001) Health and Behavior: The Interplay of Biological, Behavioral and Societal Influences. Committee on Health and Behavior, Research, Practice, and Policy. Board on Neuroscience and Behavioral Health. Washington, D.C.: National Academy Press. Available at:
http://www.nap.edu/openbook.php?isbn=0309070309
Institute of Medicine (2006) Genes, Behavior and the Social Environment: Moving Beyond the Nature/Nurture Debate. Committee on Assessing Interaction, Among Social, Behavioral and Genetic Factors in Health. Lyla M. Hernandez and Dan G. Blazer, eds. Board on Health Sciences Policy. Washington, D.C.: National Academies Press. Available at:
http://books.nap.edu/catalog.php?record_id=11693
National Research Council (2001) New Horizons in Health: An Integrative Approach. Committee on Future Directions for Behavioral and Social Sciences Research at the National Institutes of Health. Burton H. Singer and Carol D. Ryff, eds. Board on Behavioral, Cognitive, and Sensory Sciences. Commission on Behavioral and Social Sciences and Education. Washington, D.C.: National Academy Press. Available at:
http://www.nap.edu/openbook.php?isbn=0309072964
National Research Council and Institute of Medicine (2000) From Neurons to Neighborhoods: The Science of Early Childhood Development. Committee on Integrating the Science of Early Childhood Development. Jack P. Shonkoff and Deborah A. Phillips, eds. Board on Children, Youth and Families, Commission on Behavioral and Social Sciences and Education. Washington, D.C.: National Academy Press. Available at:
http://books.nap.edu/catalog.php?record_id=9824
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OBSSR (2007) The Contributions of Behavioral and Social Sciences Research to Improving the Health of the Nation: A Prospectus for the Future. Available at:
http://obssr.od.nih.gov/NR/rdonlyres/D14DE54C-F3A9-4A53-8DCE-
A5FA9685B12D/0/OBSSRStrategicProspectus7_3DRAFT.pdf
NIH (2004) Report of the Working Group of the NIH Advisory Committee to the Director on Research Opportunities in the Basic Behavioral and Social Sciences. Available at:
http://obssr.od.nih.gov/Documents/BSSRCC/Meetings/Minutes/
Minutes_2005/Basic%20Beh%20Report_complete.pdf
Specific bBSSR priority areas and opportunities
identified in the NIH (2004) Report of the Working Group of the NIH Advisory Committee to the Director on Research Opportunities in the Basic Behavioral and Social Sciences.:
Macro-Social Behavior
Social integration and social capital
- Changes in technology and mobility can undermine neighborhood social networks which, in turn, affect individual capacity for resilience, effectiveness, and connectedness, with implications for health behaviors and health outcomes, all of which need investigation.
- High levels of immigration have recently altered U.S. race and ethnic relations, changing health outcomes at the level of individual lives, communities, and the Nation. Understanding these dynamics will protect the health of all Americans, old and new, as well as visitors.
Work-related stresses
- More demanding jobs and new economic forms challenge the idea of a fixed workplace and its relation to the community, which then impacts work-related stresses, family cohesion, and health; these changes need further study.
- As women have entered the labor force in advanced industrial societies, conflict between work and family has increased, with effects on social stress, human functioning, and health, in ways not fully known.
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Social and Interpersonal Behavior
Stigma and discrimination
- Prejudice and discrimination create stressors for both perceiver and target; for example, both hate crimes and everyday ethnic incivility pose physical and mental risks via direct stress for targets, indirect stress for other members of target groups, and stress for perpetrators. We need to understand the social processes and biological mechanisms involved.
- Stigmatization and consequent avoidance of and exclusion from optimal healthcare delivery leads to disparities in health care, perhaps accounting for some health disparities across racial and ethnic groups. This situation needs further study.
Well-being
- Well-being depends on motives beyond self-interest, including secure belonging, socially shared understanding, efficacy, self-affirmation, and trust. Studying these motivations can promote healthy behavior, which accounts for enormous differences in individual health outcomes.
- Self-regulation of emotion, cognition, and behavior depends on a range of genetic, developmental, personality, and social factors, with clear implications for a variety of health behaviors. What factors affect self-regulation? Under what conditions is it impeded or facilitated?
- Social phenomena affect health and functioning via physiological pathways that might include stress and recovery processes, immune function, endocrine function, and inflammation. We are just beginning to understand the processes involved.
- Interpersonal processes, memory and executive functions, and emotion systems overlap and combine, suggesting that interdisciplinary teams can address the complex stimuli, complex decisions, and complex environments typical of health behavior.
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Perception, Learning, Emotion, and Cognition
Exercise and cognition
- Regular moderate exercise improves cognition and prevents onset of Type 2 diabetes, which is a risk factor for dementia. The behavioral and biological mechanisms need to be investigated.
- People’s representations and regulation of habits such as exercise routines and driving may help explain who, when, and how such routines are adopted and endure.
Fear, anxiety and vigilance
- Amygdala, hippocampus, and prefrontal cortex operate in long-lasting learning and extinction, with neuronal mechanisms potentially being uncovered at the molecular and cellular levels.
- Broad mechanisms of arousal, vigilance, and readiness for action follow from basic neural studies of fear, with implications for behavior in emergencies (e.g., accidents and heart attacks) and in expected but aversive events (e.g., unpleasant medical procedures).
Emotion, health, and disease
- The role of stress and emotion in a host of disease states and in the progression of disease-related processes such as immunity and healing has been established.
- Problems with the regulation of specific emotions have been linked to specific disease processes, such as the role that anger and hostility play in coronary artery disease and hypertension.
- More precise and differentiated measures of emotional functioning have provided more accurate measures of emotional dysfunction in a range of psychiatric diseases (e.g., schizophrenia, autism) and neurological diseases (e.g., Alzheimer’s disease, frontotemporal lobar degeneration) that may provide early warning signs, identify important subtypes, and help monitor improvement with treatment.
Memory and the life course
- Short assessment techniques allow physicians to screen for dementia during medical visits. Development of reliable, predictive, easy-to-administer measurement is vital.
- Older people better remember positive information than negative, pointing to ways to improve the effectiveness of public health messages and holding implications for the assessment and treatment of trauma.
- Studies combining molecular and cellular techniques with behavioral assessment in animal models are uncovering fundamental mechanisms for memory as well as for disruption of memory in mild cognitive impairment and dementia; these findings are complemented by non-invasive imaging to assess brain regions involved in memory and to follow degenerative processes in the living human brain.
Perception and behavior
- Better understanding is needed of the representation of the sensory world in the brain and how that representation leads to behavior.
- Behavioral studies of perception help develop visual and motor prostheses, improve instrumentation for both normal and impaired individuals, and create training for people losing perceptual capabilities (e.g., age-related macular degeneration) Basic research on perception lays the groundwork.
- Research on spatial orientation leads to innovations that help people of varying abilities and disabilities navigate space. Novel technologies such as virtual environments promise new insights.
- It is profoundly important to understand how the brain acquires and retains information. Recent developments in theory and measurement provide opportunities for advances in understanding neural plasticity and regeneration.
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Early Development
Infant temperament
- Observation and neuro-imaging of young children delineate early individual differences in sensory and emotional processing, with influences over-time on development, socialization, and mental and physical health. These differentials need to be explored.
- In studies of primate foraging, maternal anxiety and care influence offspring emotionality, with long-term changes in brain regions such as hippocampus. Studies of the relationship between early parenting and brain development hold promise for better understanding of the impact of the social environment on brain development.
Intergenerational transmission of behavior
- Behavioral transmission to offspring mediates transgenerational effects on emotionality, which include methylation of DNA, indicating long-term effects on gene expression. We have much to learn about these processes.
- Cycles of child abuse (abusees becoming the abusers) decreases in individuals possessing alleles of the monoamine oxidase A gene. Why is this the case?
Infant pattern recognition
- Infants rely heavily on detecting correlations between events ( pattern detection) to process information, acquire language, and guide behavior. Children at genetic risk for autism and learning disorders apparently fail to understand the salience of such correlations and are unable to attach meaning to patterns. Research on normal perception will be instrumental in early detection and possibly interventions in these serious mental disorders.
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Gene-Environment Interactions
Biology of resilience
- Genetics and neurobiology of resilience can show vulnerabilities associated with certain genetic traits, early life experiences, and later health habits such as exercise thus, it is important to understand the links among them.
Precursors of obesity
- Brain activation patterns to food presentation differ in lean individuals versus obese and recovered obese individuals, which strongly suggest genetic and early life programming during a window of development.
Biosocial stress markers
- Vulnerability to depression after a major stressful life event increased in subjects having the short form of the serotonin transporter gene. More understanding is needed to aid diagnosis of vulnerabilities and the mechanism of depression.
- Chronic stress remodels the brain: it increases amygdala neuron branching, suppresses neurogenesis and branching of dendrites in the hippocampus, and suppresses branching of dendrites in the prefrontal cortex. Results from rodent models resemble structural changes in the human brain in depressive illness. To understand the effects of stress on long-term cognitive and affective reactions, we need to understand the neurological effects.
Technology, Measurement and Methodology
- Development of technology and methods for collecting biophysical data (biomarkers) in the population setting vastly expands the possibility of deciphering multi-level pathways linking biology, behavior, environment and society.
- While recent advances in knowledge about the genome have spurred interest in gene environment interactions, progress will be made only with further investment in research to develop measures to better characterize the relevant social and physical environments.
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Cutting Across More Than Two Levels
Some of the most pressing questions about health and illness now facing us involve processes at the level of the population or social group, the individual, organ systems, and the cell. Major advances in understanding these questions will require the skills and collaboration of scientists across a range of disciplines. This will require the integrated training of scientists in biological, behavioral and social sciences. Below we discuss several examples of these overarching challenges and the opportunities for addressing them.
Health disparities continue to be a priority for the NIH. The focus has expanded to include racial/ethnic, socioeconomic and rural/urban disparities in health outcomes. Epidemiological, sociological and demographic studies have revealed linear gradients of morbidity and mortality across socioeconomic status (SES), as reflected in educational attainment or income, which cannot be explained by such factors as smoking or access to health care. The linearity means that these health disparities reach the middle of the SES range, and are not confined to those people with the lowest SES. Moreover, evidence shows that regions of the United States and other nations that show greater gradients of income distribution also show greater effects on such endpoints as mental health and mortality. Racial and ethnic differences also impact health. Clearly, the processes that produce health disparities involve stratification in societies, differential treatment of individuals and social groups, day-to-day interactions among individuals, and affective and physiological responses. New biological and behavioral assessment tools are now available to examine how these gradients “get under the skin” and affect measures of health and quality of life across the life course.
Obesity, diabetes and mood and affective disorders are a growing concern at the NIH. These disorders show disparities across SES and reflect the multiple social, behavioral and biological influences across the lifecourse that must be better understood in order to develop effective treatments. In terms of behavioral treatments, one example is regular, moderate exercise, which has been shown to reduce the incidence of Type II diabetes and to improve executive function and attention, and to have antidepressant effects along with promoting neurogenesis and enhancing neurotrophin levels in the brain. In addition to the physical activity per se, the exercise intervention is also likely to promote social integration and to have other psychological benefits to the participants.
Events early in life play an important role in predisposition to disorders such as obesity, diabetes and mood and affective disorders, but the relevant mechanisms are not well understood and need intensive inter-disciplinary investigation. Furthermore, data show that early life interventions both in the home and in "head start"- type programs can help to improve both parenting skills as well as the socialization of the children and their readiness to learn. These types of interventions deserve much more emphasis and intensive study, along with implementation of programs such as the "Experience Corps" in Baltimore which brings older adults into schools to assist in the classrooms and school programs. In addition to improving behavior and learning among the children, these programs also benefit the health of the older adult teacher-assistants in similar ways to the benefits of regular exercise. They also improve mood by providing a purpose for living. The social, behavioral and biological aspects of these programs need to be better understood and require collaboration among biological, behavioral and social scientists.
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