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We review ethnographic methods that allow researchers to assess distress in a culturally sensitive manner. We begin with an overview of standardized biomedical and psychological approaches to assessing distress cross-culturally. We then focus on literature describing the development of reliable and valid culturally sensitive assessment tools that can serve as complements or alternatives to biomedical categories and diagnostic frameworks. The methods we describe are useful in identifying forms of suffering—expressed in culturally salient idioms of distress—that might be misidentified by biomedical classifications. We highlight the utility of a cognitive anthropological theoretical approach for developing measures that attend to local cultural categories of knowledge and experience. Attending to cultural insider perspectives is necessary because expressions of distress, thresholds of tolerance for distress, expectations about stress inherent in life, conceptions of the good life, symptom expression, and modes of help-seeking vary across cultures.

The goal of assessing psychosocial stress as a process and outcome in naturalistic (i.e., field) settings is applicable across the social, biological, and health sciences. Meaningful measurement of biology-in-context is, however, far from simple or straightforward. In this brief methods review, we introduce theoretical framings, methodological conventions, and ethical concerns around field-collection of markers of psychosocial stress that have emerged from 50 years of research at the intersection of anthropology and human biology. Highlighting measures of psychosocial stress outcomes most often used in biocultural studies, we identify the circumstances under which varied measures are most appropriately applied and provide examples of the types of cutting-edge research questions these measures can address. We explain that field-based psychosocial stress measures embedded in different body systems are neither equivalent nor interchangeable, but this recognition strengthens the study of stress as always simultaneously cultural and biological, situated in local ecologies, social–political structures, and time.