Paying Attention to Context

At the time of his retirement, a favorite professor from my past advised that I “always pay attention to context.”  His advice stuck with me over time and has proven to be sage given the growing body of research suggesting the important role that context plays in human health and happiness.  Context appears to influence both psychology and biology and the order of how and the degrees to which these influences are combined appears to be somewhat fluid. While research in this area is largely correlational, en masse it does point to the need for a greater emphasis on the role a context may be playing in the experiences and life outcomes of individuals and societies, and may raise the question of whether more concrete supports might serve as better and perhaps necessary and more cost-effective options for facilitating individual or societal life improvements.  While these more concrete supports may largely fall in the realm of public policy and how a society treats its marginalized or disenfranchised groups, this does not discount the fact that much can be done with individuals to alter contextual influences just by paying greater attention to them; paying attention highlights cognitive and behavioral choices.  

     

As recent examples of this line of research, there were three studies published in the recent edition of the journal Health Psychology (Volume 31, #4) that highlighted the role that childhood life context and related stressors play in the elevation of a stress related biological marker (C-reactive protein, or CRP) in adulthood, and the role that positive perceptions and non-work social ties play in a healthier lifestyle and lowered risk for disease.  Elevated CRP has been identified as a marker for elevated inflammation and increased risk for disease in adults. 

In the first article, Hagger-Johnson, Mottus, Craig and Starr ( http://psycnet.apa.org/index.cfm?fa=buy.optionToBuy&id=2012-02775-001 ) modeled a life course pathway from childhood intelligence and parental social class that proved to serve  as a potential platform for unhealthy behaviors, low quality of life, high body-mass index and increased risk for cardiovascular disease as measured by CRP.  In the second, Appleton, Buka, McCormick, et al. ( http://www.ncbi.nlm.nih.gov/pubmed/22329424 ) found that childhood emotional problems on their own do not necessarily contribute to elevated CRP or the increased risk of disease in adulthood.  Increased risk for elevated stress (CRP) and adulthood disease was however found with children with emotional problems who were also exposed to the stress related to low socioeconomic status.  Both articles appear to point to the question of cost-to-society and the cost effective benefit of strategies targeted at altering the socioeconomic conditions that today appear to be growing the population of those in poverty in the USA.        

In a third study Ferris, Kline and Bourdage ( http://psycnet.apa.org/index.cfm?fa=buy.optionToBuy&id=2012-00038-001 ) considered the more immediate contextual components of work (positive perceptions of job characteristics) and non-work social ties.  These predicted biopsychosocial health and a healthier lifestyle which predicted lower risk for cardiovascular disease.  This would suggest that we do have some control, to a point; is there a socioeconomic cut off where the choice or control is largely lost?     

Outside of the public policy arena (the realm of making things better for most) it would seem that Acceptance and Commitment ( http://contextualpsychology.org/act/ ), Cognitive (identifying more helpful ways of thinking about circumstances), and Behavioral (functional analysis and change of behavioral antecedents and rewards) (http://www.rebt.org/ ) therapies do present as options for reframing or even changing the context even where minimal resources are in play.  Sometimes however, it would seem that the larger context will have to change before that growing population below the socioeconomic cut are able to muster the resources, self efficacy and hope necessary for any therapy to work.