Research on mind-body interactions and health.

The NIH, through the participating institutes, centers, and offices noted below, invites applications in support of research on mind-body interactions and health. "Mind-body interactions and health" refers to the relationships among cognitions, emotions, personality, social relationships, and health. A central goal of this program isto encourage interdisciplinary collaboration and innovation toward understanding the processes underlying mind-body interactions and health as well as toward the application of such basic knowledge into interventions and clinical practice in the promotion of health mad the prevention or treatment of disease and disabilities.

Mind-body research is viewed as one component of health and behavior research. The Public Health Service has documented that many of the leading causes of morbidity and mortality in the United States are attributable to social, behavioral, and lifestyle factors (such as tobacco use, lack of exercise, poor diet, drug and alcohol abuse). Numerous studies have also documented that psychological stress is linkedto a variety of health outcomes, and researchers and public health officials are becoming increasingly interested in understanding the nature of this relationship. Research has shown, for example, that psychological stress can contribute to increased heart disease and decreased immune system functioning. Other research has demonstrated that cognitions (attitudes, beliefs values), social support, prayer, and meditation can reduce psychological stress and contribute to positive health outcomes.

Consequently, over the past decade the NIH has increased efforts to encourage and support research on health and behavior. In 1999, using funds especially appropriated by Congress to the Office of Behavioral and Social Sciences Research (OBSSR), the NIH issued a request for applications (RFA) for Centers for Mind-Body Interactions and Health (OD-99-005) and subsequently awarded five P50 center grants. On 9 January 2003, the NIH issued two related RFAs tided Mind-Body Interactions and Health: Research Infrastructure Program (OB-03-004) and Mind-Body Interactions and Health: Exploratory/Developmental Research Program (OB43-005). The NIH also commissioned a series of reports from the National Research Council and the Institute of Medicine, which include calls for expansion of interdisciplinary health research on mind-body topics.

Three areas of research are emphasized in this RFA. In addition, special importance is given to mind-body research in diverse racial/ethnic and socioeconomic status populations (e.g., cultural beliefs regarding health, perceived racism and health, distrust of health care systems and health care utilization, perceived disability, health). The formation of interdisciplinary teams to perform the research of this initiative is viewed as essential.

The first area of emphasis is the effect of cognitions or personality (e.g., beliefs, attitudes, values, modes of thinking) and of emotions on physical health. Included is research on social, psychological, behavioral, affective, and biological factors mediating these effects. What are the physiological, behavioral, and social pathways by which beliefs, attitudes, and values or particular stress-management interventions affect health? How do emotions, personality, and cognitions interact to affect health?

The second area of emphasis is determinants or antecedents of health-related cognitions (beliefs, attitudes, values, modes of thinking, decision-making styles). That is, given that some beliefs and attitudes have been shown to affect health, how are these beliefs, attitudes, and values developed, maintained, or changed? Specifically, this RFA will support research that addresses issues such as: What contributes to individual differences in the beliefs, attitudes, and values that affect health and biological processes? How are health-related beliefs, attitudes, and values formed, maintained, and changed? How do social class, family, culture, disability, age, gender, or ethnicity influence health-related beliefs, attitudes, values, or cognitive styles?

The third area of emphasis is how stress influences physical health, including 1) basic research investigating how affect, attitudes, beliefs, and values influence perceived stress, individual differences in the biology of stress, and interactions between stress and behavioral risk factors for disease; 2) behavioral, affective, and biological mediators of the relationship between stress and health or disease; 3) the evaluation of mind-body interventions (e.g., relaxation-based, cognitive therapy, support group) for physical illness and/or biological functioning; and 4) the translation of successful interventions into programs deliverable in clinical settings. These interventions may be examined alone or in conjunction with other stress management techniques.

Issues such as the following would be appropriate here: Through which psychological or physiological pathways do stress management approaches affect health? What are the effective components in successful stress-management practices? Does the combination of various stress management techniques improve outcome? Are particular stress-management interventions more effective for certain individuals, populations, or health outcomes? Can successful stress-management practices be effectively implemented in natural settings? What are the possible economic implications of utilizing stress management interventions? What are the factors that leadto individual differences in how stress is experienced and managed as well as in the health consequences of stress?

Examples of topics of interest specific to the institutes and centers that have joined with the OBSSR in supporting this initiative are:

NIEHS. The NIEHS is particularly interested in stimulating interdisciplinary research that seeks to prevent and reduce morbidity and mortality of environmentally induced diseases. In order to better understand the linkage between exposures to environmental agents and human disease, consideration should he given to behaviors that place individuals at risk of these exposures. The NIEHS is interested in better understanding beliefs, knowledge, and attitudes associated with these exposures, which will help elucidate the sources of body burden and allow scientists to design appropriate and effective strategies to reduce or eliminate exposure from one's environment. With regards to housing and the built environment, where there are multiple environmental stressors (social, chemical, physical, biological), the NIEHS is interested in exploring how these stressors impact health. Of particular interest are new programs that seek to understand how health promotion activities (such as healthier nutritional choices, physical activity) and behavioral change to reduce exposures can mitigate some of the untoward health outcomes in these environments. In general the NIEHS is interested in exploring further the impact of social and economic factors on the health of the community and the individual, especially issues related to minority and immigrant communities, who generally work in high-injury and high-stress jobs and live in substandard housing and environments. It is also important to the NIEHS that these projects are able to communicate and disseminate their findings to have public health and policy impacts.