A careful understanding of epigenetic mechanisms allows sociologists to include a new biological perspective into research designs – when it is incorporated carefully and not used casually or blindly as a deus ex machina explanatory device that is.
Epigenetics provides us with one of several “mechanisms by which social influences become embodied” (Kuzawa and Sweet 2008: 2). A promising place for sociologists to enter into this research or use it fruitfully is to examine how social environments and inequalities become embodied as epigenetic imprints, altering gene expression and consequently affecting a wide array of health outcomes. Additionally, while mapping the epigenome, epigeneticists are exploring differences in the plasticity of particular alleles at various points in the lifecourse. Could the inclusion of epigenetic biomarkers in sociological work allow for the separation of early life events from cumulative ones?
These mechanistic stories are bound to be messy, but such feedback loops and the enmeshment of social and biological processes are inescapable. With the knowledge and technology available today, we are far beyond oversimplified nature versus nurture debates. Many biologists who do epigenetic work realize that in order to get a complete, complex mapping of these mechanisms, the social needs to be included. These biologists view sociological and cultural variables as more of a signal rather than just contextual noise. Sociologists should not only collaborate with such researchers, but also help shape what these projects look like.
Further, sociologists should be aware of developing epigenetic discourse and how it is being received in the media. Over the past year or so, non-scientific magazines from Time to Newsweek have picked up on epigenetic findings, publishing articles for the general public on the topic. However, not all of this reporting clearly emphasizes epigenetics’ softening of geneticization’s hard line determinism. Further, some of it mistakenly over-emphasizes our agency in the changing of our own and our future generations’ genetic code. Sociologists should be aware of such reporting, lest it follow the route of the powerful, persuasive, and pervasive hold the narrative of geneticization has in everyday, non-scientific talk (Chaufan 2007) – especially since general understandings of genetic findings often easily allow genetics to take the stage as a deus ex machina of causal efficacy despite findings that clearly prove otherwise.
What is Epigenetics?
Controlling Your Genes
DNA: How You Can Control Your Genes, Destiny
Ghost in Our Genes
The recent uptick in genetic testing for a range of illnesses has prompted great debate in the medical community about how reliable and useful the testing is, as well as discussion among social scientists about the social and ethical consequences of the testing. One line of inquiry that has been around a bit longer is about biological thinking, specifically as it is related to stigma and inequality. In particular, there is a fascinating and timely discussion of the geneticization of mental illness by Jo Phelan (2005) that, even before the emergence of the current debate about technology, delved into the promise and perils of genetic thinking – though not specifically about genetic testing. For instance, Phelan addresses issues of stigma and labeling associated with seeing mental illness as a genetic problem. Phelan finds that stigma is, at the same time, both enhanced and alleviated by geneticization. In other words, if an illness is genetic, it removes the feelings of responsibility from the sufferer and makes it more difficult for others to blame him or her for said illness. The illness and the person who embodies said condition, then, are not seen as one and the same. However, the same genetic thinking opens the door to a range of new judgments that can be detrimental both in terms of self-concept and the way in which others make assumptions about those who experience, in this case, mental illness. There has been some, but not much work, overall, in the social sciences, about the social problems associated with genetic testing (for a lovely summary, see the article linked below). In the last few weeks, genetic testing has been thrust into the forefront once again after fervent debate that ended with Eric Holder, US Attorney General ruling that genes cannot be patented – thus, genes are in the public domain – even though companies like “Myriad,” a testing company, already possess the patent to two human genes (and it is unclear what will happen to these patents).
Drawing on the existent literature on genetic testing, Richard Tutton (whose recent article in Sociology Compass is linked below) reviews the literature on genetic testing and calls for sociologists to pay more attention to these issues. Though Tutton does not address issues of inequality directly, the recent debate on access to genetic testing led me to wonder, for instance, who can afford the testing? Who will it be offered to? Will insurance cover it? How might this testing “blame” ethnic/racial groups for illness? In reference to the Phelan article mentioned above, would knowing one is predestined to developed depression, for instance, change the way we see someone struggling with that condition? And on and on and on. Tutton does survey the literature on the use of genetic testing and forensics and there is clearly an open door to an over-reliance on an imperfect technology when someone’s freedom or life hangs in the balance. One of the great fears about genetic testing is that it will become a central determining factor in whether we see people as “criminal” or not — a frightening idea.
The New York Times Sunday Magazine featured an article (a preview of a book) by Ethan Watters about the globalization of American concepts of mental illness (linked below). In short, along with our flavored lattes, burgers and GAP jeans, American concepts of illness are spreading across the globe. I would argue they have spread and are relatively well-integrated into the majority of societies’ understandings of a wide range of symptoms. There are very few places untouched by American conceptualizations of mental disorders, particularly those of the American Psychiatric Association. Relatively ignored in this shortened version of Watters’s argument are the contributions of Sociologists of mental health in describing the construction of illness and how illness conceptualizations/categories spread and affect both individuals diagnosed with the myriad psychiatric conditions now considered biological disorders by American Psychiatry as well as cultures and societies more generally once these concepts become commonly accepted.
For decades, sociologists of mental health have focused on the the ways in which certain symptoms come to be classified as disorders and how psychiatry has become the discipline considered to be the legitimate conceptualizers of these conditions. Allan Horwitz, for example, has been particularly influential in this debate (see the article below). Medications for treating these illnesses are also centrally implicated in these illness definitions. Further, as mentioned in the Times article, though not attributed to sociological research, sociologists have also noted the complex question of whether American criteria for psychiatric illness are being used to diagnose illness across the globe where it had been previously been ignored or whether these criteria are in fact creating illness where it did not exist before by providing cultures previously unexposed to knowledge of, for instance, depression symptomatology. In other words, are we exposing illness where it had been previously been ignored or are we creating illness by imposing our illness categories on societies where the same symptoms we see in the US were not around until our categories hit the scene?
By Dena T. Smith
In the last several decades, the field of medicine has become increasingly dominated by biological thinking. Psychiatry, a sub-field aimed at treating mental illness is largely focused on the genetic causes of a wide range of conditions. This perspective stands in opposition to the notion that environmental factors cause symptoms – that changes in biology and/or neurochemistry are dictated by certain situations and conditions to which an organism is exposed. Depression is one illness category under scrutiny as of late. The majority of psychiatric studies on depression claim a genetic responsibility for this condition. Some even conclude that there is a single serotonin gene responsible for this disease, making it seem as though the gene-environment puzzle has been solved; differences in one gene or several explain why people respond differently even to the same conditions.
There has been fervent disagreement from mental health researchers outside psychiatry, but, in the last few months there has been opposition to the one-gene argument from within the psychiatric world. A review in the June 17th edition of JAMA attempts to replicate the 2003, ‘single-gene’ findings of Caspi et al and show that the relationship between genes and environment is far more complicated and muddled than one serotonin gene causing an illness. In fact, these researchers found more evidence that stressful life events would predict depressive episodes than would a particular gene. While this is a complicated debate and there is certainly no clear answer, discussions such as this highlight the importance of the work of sociologists of mental health. Epidemiological studies show, time and again, that factors such as poverty, gender, ethnicity, and culture more broadly affect one’s likelihood to become depressed – or to experience a range of what psychiatry views as pathological, neuro-biologically driven conditions.