Evidence Report: Risk of Adverse Cognitive or Behavioral Conditions and Psychiatric Disorders Human Research Program Behavioral Health and Performance Approved for Public Release: April 11, 2016 National Aeronautics and Space Administration Lyndon B. Johnson Space Center Houston, Texas 1 CURRENT CONTRIBUTING AUTHORS: Kelley J. Slack, Ph.D. Wyle Science Technology & Engineering Thomas J. Williams, Ph.D. Wyle Science Technology & Engineering Jason S. Schneiderman, Ph.D. Wyle Science Technology & Engineering Alexandra M. Whitmire, Ph.D. Wyle Science Technology & Engineering James J. Picano, Ph.D. Universities Space Research Association PREVIOUS CONTRIBUTING AUTHORS: Lauren B. Leveton, Ph.D. NASA Johnson Space Center Lacey L. Schmidt, Ph.D. Minerva Work Solutions Camille Shea, Ph.D. Houston Police Department 2 TABLE OF CONTENTS I. PRD RISK TITLE: RISK OF ADVERSE COGNITIVE OR BEHAVIORAL CONDITIONS AND PSYCHIATRIC DISORDERS ............................................................................................. 6 II. EXECUTIVE SUMMARY .................................................................................................... 9 III. INTRODUCTION ................................................................................................................ 11 IV. EVIDENCE ........................................................................................................................... 14 A. Space Flight Evidence .................................................................................................... 17 1. Sources of evidence .................................................................................................... 17 2. Occurrences of behavioral signs and symptoms ......................................................... 18 a. Occurrences of behavioral signs and symptoms in general .................................... 18 b. Psychosocial adaptation ..........................................................................................19 c. Behavioral and psychiatric emergencies ................................................................ 22 d. Mood and mood disorders ...................................................................................... 25 e. Neurasthenia ........................................................................................................... 29 f. Psychosomatic reactions ......................................................................................... 30 g. Salutogenesis .......................................................................................................... 31 h. Cognitive Functioning ............................................................................................ 32 i. Post-expedition cognitive and behavioral health .................................................... 35 3. Predictors and contributing factors ............................................................................. 35 a. Personality .............................................................................................................. 36 b. Resiliency and hardiness ........................................................................................ 38 c. Emotional Reactions ............................................................................................... 40 d. Sleep and the Circadian Rhythm ............................................................................ 40 e. Habitability and environmental design ................................................................... 42 f. Job design—Autonomy and meaningful work ....................................................... 43 g. Monotony and boredom ......................................................................................... 44 h. Daily hassles and major life events ........................................................................ 45 i. Cultural factors ....................................................................................................... 46 j. Ground support / Mission support .......................................................................... 46 k. Family and Social Support ..................................................................................... 47 l. World Events .......................................................................................................... 48 4. Prevention and monitoring countermeasures ............................................................. 48 a. Selection ................................................................................................................. 49 b. Pre-flight ................................................................................................................. 50 3 c. In flight ................................................................................................................... 54 d. Post-flight ............................................................................................................... 58 5. Monitoring and treatment countermeasures ............................................................... 59 a. Pre-flight ................................................................................................................. 59 b. In flight ................................................................................................................... 59 c. Post-flight ............................................................................................................... 61 6. Evolution of countermeasures .......................................................................................... 61 B. Ground-based Evidence ................................................................................................. 62 1. Sources of evidence .................................................................................................... 62 2. Occurrences of behavioral signs and symptoms ......................................................... 63 a. Behavioral and psychiatric emergencies ................................................................ 63 b. Mood and mood disorders ...................................................................................... 64 c. Winter-over syndrome ............................................................................................ 66 d. Salutogenesis .......................................................................................................... 66 e. Cognitive functioning ............................................................................................. 67 f. Analog Mission Duration of 2 or More Years ....................................................... 68 g. Post-expedition cognitive and behavioral health .................................................... 68 2. Predictors and contributing factors to behavioral health ............................................ 69 a. Personality .............................................................................................................. 69 b. Personality as a predictor of adjustment ................................................................. 70 c. Monotony, boredom, and meaningful work ........................................................... 70 3. Prevention and treatment countermeasures` ............................................................... 70 a. Selection ................................................................................................................. 70 b. Prevention ............................................................................................................... 71 c. Treatment ................................................................................................................ 75 C. Summary ........................................................................................................................ 76 V. COMPUTER-BASED MODELING AND SIMULATION ................................................ 78 VI. RISK IN CONTEXT OF EXPLORATION MISSION OPERATIONAL SCENARIOS.....79 A. Constraints for exploration missions .............................................................................. 79 B. Additional stressors for exploration missions ................................................................ 79 C. Likelihood of a behavioral emergency or psychiatric condition .................................... 80 VII. GAPS .....................................................................................................................................83 VIII. CONCLUSIONS ...................................................................................................................84 IX. REFERENCES ......................................................................................................................86 4 X. TEAM ..................................................................................................................................120 A. Current Contributing Authors ...................................................................................... 120 B. Previous Contributing Authors ..................................................................................... 120 C. Acknowledgements ...................................................................................................... 120 XI. LIST OF ACRONYMS .......................................................................................................122 5 I. PRD RISK TITLE: RISK OF ADVERSE COGNITIVE OR BEHAVIORAL CONDITIONS AND PSYCHIATRIC DISORDERS A. Risk statement Taken verbatim