Evidence Report: Risk of Adverse Cognitive or Behavioral Conditions and Psychiatric Disorders Human Research Program Behavioral Health and Performance Approved for Public Release: National Aeronautics and Space Administration Lyndon B. Johnson Space Center Houston, Texas 1 CURRENT CONTRIBUTING AUTHORS: Kelley J. Slack, Ph.D. Wyle/LZ Technology Thomas J. Williams, Ph.D. Wyle Jason S. Schneiderman, Ph.D. Wyle Alexandra M. Whitmire, Ph.D. Wyle James J. Picano, Ph.D. Wyle 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 ..........................................................................................17 c. Behavioral and psychiatric emergencies ................................................................ 21 d. Mood and mood disorders ...................................................................................... 24 e. Neurasthenia ........................................................................................................... 28 f. Psychosomatic reactions ......................................................................................... 29 g. Salutogenesis .......................................................................................................... 30 h. Cognitive Functioning ............................................................................................ 31 i. Post-expedition cognitive and behavioral health .................................................... 34 3. Predictors and contributing factors ............................................................................. 35 a. Personality .............................................................................................................. 35 b. Resiliency and hardiness ........................................................................................ 37 c. Emotional Reactions ............................................................................................... 39 d. Sleep and the Circadian Rhythm ............................................................................ 40 e. Habitability and environmental design ................................................................... 41 f. Job design—Autonomy and meaningful work ....................................................... 42 g. Monotony and boredom ......................................................................................... 44 h. Daily hassles and major life events ........................................................................ 44 i. Cultural factors ....................................................................................................... 45 j. Ground support / Mission support .......................................................................... 45 k. Family and Social Support ..................................................................................... 46 l. World Events .......................................................................................................... 47 4. Prevention and monitoring countermeasures ............................................................. 47 a. Selection ................................................................................................................. 48 b. Pre-flight ................................................................................................................. 49 3 c. In flight ................................................................................................................... 53 d. Post-flight ............................................................................................................... 58 5. Monitoring and treatment countermeasures ............................................................... 58 a. Pre-flight ................................................................................................................. 58 b. In flight ................................................................................................................... 58 c. Post-flight ............................................................................................................... 60 6. Evolution of countermeasures .......................................................................................... 61 B. Ground-based Evidence ................................................................................................. 61 1. Sources of evidence .................................................................................................... 61 2. Occurrences of behavioral signs and symptoms ......................................................... 62 a. Behavioral and psychiatric emergencies ................................................................ 62 b. Mood and mood disorders ...................................................................................... 63 c. Winter-over syndrome ............................................................................................ 65 d. Salutogenesis .......................................................................................................... 66 e. Cognitive functioning ............................................................................................. 66 f. Analog Mission Duration of 2 or More Years ....................................................... 67 g. Post-expedition cognitive and behavioral health .................................................... 68 2. Predictors and contributing factors to behavioral health ............................................ 68 a. Personality .............................................................................................................. 68 b. Personality as a predictor of adjustment ................................................................. 69 c. Monotony, boredom, and meaningful work ........................................................... 69 3. Prevention and treatment countermeasures` ............................................................... 70 a. Selection ................................................................................................................. 70 b. Prevention ............................................................................................................... 70 c. Treatment ................................................................................................................ 74 C. Summary ........................................................................................................................ 76 V. COMPUTER-BASED MODELING AND SIMULATION ................................................ 77 VI. RISK IN CONTEXT OF EXPLORATION MISSION OPERATIONAL SCENARIOS.....71 A. Constraints for exploration missions .............................................................................. 78 B. Additional stressors for exploration missions ................................................................ 78 C. Likelihood of a behavioral emergency or psychiatric condition .................................... 79 VII. GAPS .....................................................................................................................................75 VIII. CONCLUSIONS ...................................................................................................................76 IX. REFERENCES ......................................................................................................................78 4 X. TEAM ..................................................................................................................................102 A. Current Contributing Authors ...................................................................................... 119 B. Previous Contributing Authors ..................................................................................... 119 C. Acknowledgements ...................................................................................................... 119 XI. LIST OF ACRONYMS .......................................................................................................105 5 I. PRD RISK TITLE: RISK OF ADVERSE COGNITIVE OR BEHAVIORAL CONDITIONS AND PSYCHIATRIC DISORDERS A. Risk statement Taken verbatim from the Human Research Program Roadmap, the risk statement for Adverse Cognitive or Behavioral Conditions and Psychiatric Disorders (“Risk”, 2015) states: Given the