NOTE: End date changed to 9/30/2021 per NSSC information (Ed., 4/22/2020)

NOTE: End date changed to 3/31/2020 per NSSC information (Ed., 1/29/2020)

NOTE: End date changed to 12/31/2019 per NSSC information (Ed., 7/17/19)

NOTE: End date changed to 5/31/2019 per NSSC information (Ed., 2/12/19)

NOTE: End date changed to 1/31/2019 per NSSC information (Ed., 12/28/18)

NOTE: End date changed to 11/12/2018 per NSSC information (Ed., 12/13/17)

NOTE: Element change to Human Factors & Behavioral Performance; previously Behavioral Health & Performance (Ed., 1/17/17)

Unfortunately however, these collective data ultimately serve to raise more questions than answers. Differences in collection methods, types of symptoms/reactions assessed, psychological constructs examined, and timing and duration of measurements limit conclusions that can be drawn from this research. As a result, understanding of the discrete symptoms and conditions most likely to occur during space flight and thus, ability to quantify the magnitude, probability, or consequences of such risk remains inadequate. The current project proposes to address these notable gaps in knowledge via three specific Aims. First, we will conduct extensive scientific literature reviews and interviews with subject matter experts in order to synthesize existing knowledge of the psychological and behavioral symptoms experienced in space and other extreme environments (Aim 1). Our review will directly inform the development of a comprehensive checklist of symptoms to be monitored among 6 separate cohorts (i.e., 2 Antarctic and 4 Human Exploration Research Analog (HERA) cohorts)) as part of a longitudinal investigation (Aim 2). Symptoms will be examined based on their point/period prevalence, severity, and duration. The checklist will also be administered (repeatedly) in conjunction with a physical symptoms checklist in order to examine concurrent and sequential overlap between psychological and physical health symptoms as means of clarifying potential etiologies. Finally, our study will extend previous research by exploring relationships among psychological health, sleep loss/dysregulation, biomarkers of stress, and performance-based outcomes (Aim 3). A comprehensive battery of cognitive and performance measures (including a perception-action coupling task) will be administered repeatedly as part of our longitudinal study. These outcomes will inform a final list of psychological/ behavioral symptoms to be examined during an extended International Space Station (ISS) mission.

This project specifically addresses several knowledge gaps related to Risks of Adverse Behavioral Conditions and Psychiatric Disorders [Ed. note: August 2021--Gaps have changed since this grant was awarded in FY2015; see Human Research Roadmap https://humanresearchroadmap.nasa.gov/ ] including: Gap 1 (Need to identify and quantify the key threats to and promoters of mission relevant behavioral health and performance during exploration class missions) and Gap 3 (Need to identify and validate measures to monitor behavioral health and performance and determine acceptable thresholds for these measures during exploration missions). Our primary goal is to identify the psychological and behavioral health symptoms with the greatest likelihood of occurrence during extended human space flight/habitation to space and to estimate associated levels of threat imposed to mission-based performance. As a final deliverable, a checklist of symptoms will be developed for implementation during an ISS mission (>6 months) in order to determine its feasibility, reliability, and facilitation of evidence-based decision making with regard to crew health, safety, and mission success.

As a first step, we will conduct extensive scientific literature reviews and interviews with subject matter experts in order to synthesize existing knowledge of the psychological and behavioral symptoms experienced in space and other extreme environments (Aim 1). Our review will directly inform the development of a comprehensive checklist of symptoms to be monitored in two longitudinal studies including one HERA campaign and cohorts at the McMurdo and South Pole Antarctic stations (Aim 2). The checklist will also be administered (repeatedly) in conjunction with a list of physical complaints in order to examine concurrent and sequential overlap between psychological and physical health symptoms. Finally, our study will extend previous research by exploring relationships among psychological health, sleep dysregulation, biomarkers of stress, and performance-based cognitive outcomes (Aim 3). A comprehensive battery of cognitive and performance measures will be administered in conjunction with our other measures as part of our longitudinal study. Outcomes will inform a final mental health checklist for use during long duration space flight. As a supplemental Aim, we will examine the reliability of our mental health checklist in two Antarctic cohorts at the Palmer station.

Prevalence and severity of physical symptoms increased significantly from baseline to the end of study in the full Antarctic sample but there were no significant differences in physical symptoms between the two stations. Changes in biomarkers of stress (cortisol, DHEA, or the cortisol:DHEA ratios) were not observed from baseline to the end of the mission. However, cortisol and cortisol:DHEA ratios were significantly higher among McMurdo compared to South Pole participants. Cognitive performance was also examined monthly using the Psychomotor Vigilance Test (PVT), the Spaceflight Cognitive Assessment Tool for Windows (WinSCAT), and the Perception-Action Coupling Task (PACT). Performance on the WinSCAT improved during early mission months and was sustained through the end of the study. PACT performance decreased across mission, but no changes were observed in PVT scores.

Several study participants underwent emergency evacuation from the McMurdo station during the study. We examined monthly reports, biomarkers, and cognitive performance among 4 evacuees compared to the remaining McMurdo sample (n = 84) to identify potential indicators of distress prior to evacuation. Emergency evacuation occurred for medical reasons (n = 2) or for psychiatric reasons (n = 2). Elevated MHCL anxious apprehension scores were most common among all evacuees. Elevated physical symptoms were also apparent in one psychiatric and one medical evacuee in the months prior to evacuation. We did not find any biomarker of stress or objective sleep regularity to differ among evacuees compared to the full sample.

At the Palmer station, the MHCL measure was administered to 26 participants during two winter-over seasons. MHCL data were collected for 4 consecutive months. The Palmer station is similar to the McMurdo station in climate and its coastal location, but similar to the South Pole in terms of size/number of residents. Similar to Antarctic participants at the McMurdo and South Pole stations, positive adaptation scores declined across mission whereas changes in poor self-regulation were more modest. The greatest increases in anxious apprehension scores were observed in later mission months.

Collective findings indicate the MHCL is a reliable and useful measure for assessing psychological risk in ICE settings. Each of the MHCL scales contributes unique information in this regard, particularly when combined with assessment of physical complaints.

NOTE: End date changed to 9/30/2021 per NSSC information (Ed., 4/22/2020)

NOTE: End date changed to 3/31/2020 per NSSC information (Ed., 1/29/2020)

NOTE: End date changed to 12/31/2019 per NSSC information (Ed., 7/17/19)

NOTE: End date changed to 5/31/2019 per NSSC information (Ed., 2/12/19)

NOTE: End date changed to 1/31/2019 per NSSC information (Ed., 12/28/18)

NOTE: End date changed to 11/12/2018 per NSSC information (Ed., 12/13/17)

NOTE: Element change to Human Factors & Behavioral Performance; previously Behavioral Health & Performance (Ed., 1/17/17)

Unfortunately however, these collective data ultimately serve to raise more questions than answers. Differences in collection methods, types of symptoms/reactions assessed, psychological constructs examined, and timing and duration of measurements limit conclusions that can be drawn from this research. As a result, understanding of the discrete symptoms and conditions most likely to occur during space flight and thus, ability to quantify the magnitude, probability, or consequences of such risk remains inadequate. The current project proposes to address these notable gaps in knowledge via three specific Aims. First, we will conduct extensive scientific literature reviews and interviews with subject matter experts in order to synthesize existing knowledge of the psychological and behavioral symptoms experienced in space and other extreme environments (Aim 1). Our review will directly inform the development of a comprehensive checklist of symptoms to be monitored among 6 separate cohorts (i.e., 2 Antarctic and 4 Human Exploration Research Analog (HERA) cohorts)) as part of a longitudinal investigation (Aim 2). Symptoms will be examined based on their point/period prevalence, severity, and duration. The checklist will also be administered (repeatedly) in conjunction with a physical symptoms checklist in order to examine concurrent and sequential overlap between psychological and physical health symptoms as means of clarifying potential etiologies. Finally, our study will extend previous research by exploring relationships among psychological health, sleep loss/dysregulation, biomarkers of stress, and performance-based outcomes (Aim 3). A comprehensive battery of cognitive and performance measures (including a perception-action coupling task) will be administered repeatedly as part of our longitudinal study. These outcomes will inform a final list of psychological/ behavioral symptoms to be examined during an extended International Space Station (ISS) mission.

This project specifically addresses several knowledge gaps related to Risks of Adverse Behavioral Conditions and Psychiatric Disorders [Ed. note: August 2021--Gaps have changed since this grant was awarded in FY2015; see Human Research Roadmap https://humanresearchroadmap.nasa.gov/ ] including: Gap 1 (Need to identify and quantify the key threats to and promoters of mission relevant behavioral health and performance during exploration class missions) and Gap 3 (Need to identify and validate measures to monitor behavioral health and performance and determine acceptable thresholds for these measures during exploration missions). Our primary goal is to identify the psychological and behavioral health symptoms with the greatest likelihood of occurrence during extended human space flight/habitation to space and to estimate associated levels of threat imposed to mission-based performance. As a final deliverable, a checklist of symptoms will be developed for implementation during an ISS mission (>6 months) in order to determine its feasibility, reliability, and facilitation of evidence-based decision making with regard to crew health, safety, and mission success.

As a first step, we will conduct extensive scientific literature reviews and interviews with subject matter experts in order to synthesize existing knowledge of the psychological and behavioral symptoms experienced in space and other extreme environments (Aim 1). Our review will directly inform the development of a comprehensive checklist of symptoms to be monitored among 8 separate cohorts (i.e., 4 Antarctic and 4 HERA cohorts) as part of a longitudinal investigation (Aim 2). Symptoms will be examined based on their point/period prevalence, severity, and duration. The checklist will also be administered (repeatedly) in conjunction with the Space Medicine Exploration Medical Condition List (SMEMCL) in order to examine concurrent and sequential overlap between psychological and physical health symptoms as means of clarifying potential etiologies. Finally, our study will extend previous research by exploring relationships among psychological health, sleep loss/dysregulation, biomarkers of stress, and performance-based outcomes (Aim 3). A comprehensive battery of cognitive and performance measures (including a perception-action coupling task) will be administered repeatedly as part of our longitudinal study. These outcomes will inform a final list of psychological/ behavioral symptoms to be examined during an extended ISS mission.

We also examined changes in the severity of physical symptoms across mission, finding significant increases from baseline to the end of study at both stations. Elevation in physical symptoms during mission also predicted end of study poor self-regulation and anxious apprehension. Monthly levels of cortisol and cortisol:DHEA ratios were higher in McMurdo compared to South Pole participants indicating greater experiences of stress at the coastal station. Again, the larger McMurdo population likely influences levels of psychosocial stress; laboratory-based studies incorporating social stress paradigms have routinely been shown to evoke a cortisol response. In conjunction with higher MHCL anxious apprehension scores, findings are suggestive of higher levels of arousal/activation at McMurdo.

Assessment of within-mission use of regulatory strategies indicated that savoring, reappraisal, and self-focused rumination were more often used in response to positive emotions than dampening and suppression. This pattern of responding is generally considered adaptive, as the former strategies are associated with effectively increasing and maintaining positive affect. Decreased use of suppression over time was also associated with greater end of study positive adaptation scores, aligning with community-based findings showing that, in addition to being cognitively taxing, suppression results in worsened emotional outcomes. Interestingly, savoring was significantly reduced late in the mission and at the end of the study, when positive adaptation scores were lowest.

We also examined whether several trait-based constructs assessed at baseline predicted MHCL scores at the end of the study. Controlling for baseline positive adaptation scores, higher baseline Difficulties with Emotion Regulation Scale (DERS) scores predicted less positive adaptation at the end of the study.

Overall, our findings add to a limited body of literature regarding mental health changes in the Antarctic. In all subjects, positive adaptation scores progressively decreased across the study, suggestive of increasing feelings of detachment and/or indifference over time. Conversely, poor self-regulation scores increased across the study and were predicted by co-occurring increases in the severity of physical symptoms. One particularly novel aspect of our study was the assessment of within-mission use of strategies for regulating positive emotion. These data suggest that greater expression of positive emotions and savoring positive experiences may provide a buffer against typical decreases in positive adaptation that occur over long periods in ICE environments. Interventions and/or countermeasures directed at sustaining and enhancing positive emotions across extended missions may therefore be useful tool for reducing psychological risk.

NOTE: End date changed to 3/31/2020 per NSSC information (Ed., 1/29/2020)

NOTE: End date changed to 12/31/2019 per NSSC information (Ed., 7/17/19)

NOTE: End date changed to 5/31/2019 per NSSC information (Ed., 2/12/19)

NOTE: End date changed to 1/31/2019 per NSSC information (Ed., 12/28/18)

NOTE: End date changed to 11/12/2018 per NSSC information (Ed., 12/13/17)

NOTE: Element change to Human Factors & Behavioral Performance; previously Behavioral Health & Performance (Ed., 1/17/17)

Unfortunately however, these collective data ultimately serve to raise more questions than answers. Differences in collection methods, types of symptoms/reactions assessed, psychological constructs examined, and timing and duration of measurements limit conclusions that can be drawn from this research. As a result, understanding of the discrete symptoms and conditions most likely to occur during space flight and thus, ability to quantify the magnitude, probability, or consequences of such risk remains inadequate. The current project proposes to address these notable gaps in knowledge via three specific Aims. First, we will conduct extensive scientific literature reviews and interviews with subject matter experts in order to synthesize existing knowledge of the psychological and behavioral symptoms experienced in space and other extreme environments (Aim 1). Our review will directly inform the development of a comprehensive checklist of symptoms to be monitored among 6 separate cohorts (i.e., 2 Antarctic and 4 Human Exploration Research Analog (HERA) cohorts) as part of a longitudinal investigation (Aim 2). Symptoms will be examined based on their point/period prevalence, severity, and duration. The checklist will also be administered (repeatedly) in conjunction with a physical symptoms checklist in order to examine concurrent and sequential overlap between psychological and physical health symptoms as means of clarifying potential etiologies. Finally, our study will extend previous research by exploring relationships among psychological health, sleep loss/dysregulation, biomarkers of stress, and performance-based outcomes (Aim 3). A comprehensive battery of cognitive and performance measures (including a perception-action coupling task) will be administered repeatedly as part of our longitudinal study. These outcomes will inform a final list of psychological/ behavioral symptoms to be examined during an extended International Space Station (ISS) mission.

This project specifically addresses several knowledge gaps related to Risks of Adverse Behavioral Conditions and Psychiatric Disorders including: Gap 1 (Need to identify and quantify the key threats to and promoters of mission relevant behavioral health and performance during exploration class missions) and Gap 3 (Need to identify and validate measures to monitor behavioral health and performance and determine acceptable thresholds for these measures during exploration missions). Our primary goal is to identify the psychological and behavioral health symptoms with the greatest likelihood of occurrence during extended human space flight/habitation to space and to estimate associated levels of threat imposed to mission-based performance. As a final deliverable, a checklist of symptoms will be developed for implementation during an ISS mission (>6 months) in order to determine its feasibility, reliability, and facilitation of evidence-based decision making with regard to crew health, safety, and mission success.

As a first step, we will conduct extensive scientific literature reviews and interviews with subject matter experts in order to synthesize existing knowledge of the psychological and behavioral symptoms experienced in space and other extreme environments (Aim 1). Our review will directly inform the development of a comprehensive checklist of symptoms to be monitored among 8 separate cohorts (i.e., 4 Antarctic and 4 HERA cohorts) as part of a longitudinal investigation (Aim 2). Symptoms will be examined based on their point/period prevalence, severity, and duration. The checklist will also be administered (repeatedly) in conjunction with the Space Medicine Exploration Medical Condition List (SMEMCL) in order to examine concurrent and sequential overlap between psychological and physical health symptoms as means of clarifying potential etiologies. Finally, our study will extend previous research by exploring relationships among psychological health, sleep loss/dysregulation, biomarkers of stress, and performance-based outcomes (Aim 3). A comprehensive battery of cognitive and performance measures (including a perception-action coupling task) will be administered repeatedly as part of our longitudinal study. These outcomes will inform a final list of psychological/ behavioral symptoms to be examined during an extended ISS mission.

NOTE: End date changed to 5/31/2019 per NSSC information (Ed., 2/12/19)

NOTE: End date changed to 1/31/2019 per NSSC information (Ed., 12/28/18)

NOTE: End date changed to 11/12/2018 per NSSC information (Ed., 12/13/17)

NOTE: Element change to Human Factors & Behavioral Performance; previously Behavioral Health & Performance (Ed., 1/17/17)

Unfortunately however, these collective data ultimately serve to raise more questions than answers. Differences in collection methods, types of symptoms/reactions assessed, psychological constructs examined, and timing and duration of measurements limit conclusions that can be drawn from this research. As a result, understanding of the discrete symptoms and conditions most likely to occur during space flight and thus, ability to quantify the magnitude, probability, or consequences of such risk remains inadequate. The current project proposes to address these notable gaps in knowledge via three specific Aims. First, we will conduct extensive scientific literature reviews and interviews with subject matter experts in order to synthesize existing knowledge of the psychological and behavioral symptoms experienced in space and other extreme environments (Aim 1). Our review will directly inform the development of a comprehensive checklist of symptoms to be monitored among 6 separate cohorts (i.e., 2 Antarctic and 4 Human Exploration Research Analog (HERA) cohorts) as part of a longitudinal investigation (Aim 2). Symptoms will be examined based on their point/period prevalence, severity, and duration. The checklist will also be administered (repeatedly) in conjunction with a physical symptoms checklist in order to examine concurrent and sequential overlap between psychological and physical health symptoms as means of clarifying potential etiologies. Finally, our study will extend previous research by exploring relationships among psychological health, sleep loss/dysregulation, biomarkers of stress, and performance-based outcomes (Aim 3). A comprehensive battery of cognitive and performance measures (including a perception-action coupling task) will be administered repeatedly as part of our longitudinal study. These outcomes will inform a final list of psychological/ behavioral symptoms to be examined during an extended International Space Station (ISS) mission.

This project specifically addresses several knowledge gaps related to Risks of Adverse Behavioral Conditions and Psychiatric Disorders including; Gaps 1 (Need to identify and quantify the key threats to and promoters of mission relevant behavioral health and performance during exploration class missions) and Gap 3 (Need to identify and validate measures to monitor behavioral health and performance and determine acceptable thresholds for these measures during exploration missions). Our primary goal is to identify the psychological and behavioral health symptoms with the greatest likelihood of occurrence during extended human space flight/habitation to space and to estimate associated levels of threat imposed to mission-based performance. As a final deliverable, a checklist of symptoms will be developed for implementation during an ISS mission (>6 months) in order to determine its feasibility, reliability, and facilitation of evidence-based decision making with regard to crew health, safety, and mission success.

As a first step, we will conduct extensive scientific literature reviews and interviews with subject matter experts in order to synthesize existing knowledge of the psychological and behavioral symptoms experienced in space and other extreme environments (Aim 1). Our review will directly inform the development of a comprehensive checklist of symptoms to be monitored among 8 separate cohorts (i.e., 4 Antarctic and 4 HERA cohorts) as part of a longitudinal investigation (Aim 2). Symptoms will be examined based on their point/period prevalence, severity, and duration. The checklist will also be administered (repeatedly) in conjunction with the Space Medicine Exploration Medical Condition List (SMEMCL) in order to examine concurrent and sequential overlap between psychological and physical health symptoms as means of clarifying potential etiologies. Finally, our study will extend previous research by exploring relationships among psychological health, sleep loss/dysregulation, biomarkers of stress, and performance-based outcomes (Aim 3). A comprehensive battery of cognitive and performance measures (including a perception-action coupling task) will be administered repeatedly as part of our longitudinal study. These outcomes will inform a final list of psychological/ behavioral symptoms to be examined during an extended ISS mission.

We also recently completed an initial validation study of our Mental Health Checklist (MHCL) including exploratory and confirmatory factor analyses of the checklist in a community sample and examination of reliability and convergent validity in our Antarctic sample (N=106). This manuscript is currently under review for publication (Bower, Laughlin, Simpson & Alfano, 2018).

NOTE: Element change to Human Factors & Behavioral Performance; previously Behavioral Health & Performance (Ed., 1/17/17)

Unfortunately however, these collective data ultimately serve to raise more questions than answers. Differences in collection methods, types of symptoms/reactions assessed, psychological constructs examined, and timing and duration of measurements limit conclusions that can be drawn from this research. As a result, understanding of the discrete symptoms and conditions most likely to occur during space flight and thus, ability to quantify the magnitude, probability, or consequences of such risk remains inadequate. The current project proposes to address these notable gaps in knowledge via three specific Aims. First, we will conduct extensive scientific literature reviews and interviews with subject matter experts in order to synthesize existing knowledge of the psychological and behavioral symptoms experienced in space and other extreme environments (Aim 1). Our review will directly inform the development of a comprehensive checklist of symptoms to be monitored among 6 separate cohorts (i.e., 2 Antarctic and 4 Human Exploration Research Analog (HERA) cohorts) as part of a longitudinal investigation (Aim 2). Symptoms will be examined based on their point/period prevalence, severity, and duration. The checklist will also be administered (repeatedly) in conjunction with a physical symptoms checklist in order to examine concurrent and sequential overlap between psychological and physical health symptoms as means of clarifying potential etiologies. Finally, our study will extend previous research by exploring relationships among psychological health, sleep loss/dysregulation, biomarkers of stress, and performance-based outcomes (Aim 3). A comprehensive battery of cognitive and performance measures (including a perception-action coupling task) will be administered repeatedly as part of our longitudinal study. These outcomes will inform a final list of psychological/ behavioral symptoms to be examined during an extended International Space Station (ISS) mission.

This project specifically addresses several knowledge gaps related to Risks of Adverse Behavioral Conditions and Psychiatric Disorders including; Gaps 1 (Need to identify and quantify the key threats to and promoters of mission relevant behavioral health and performance during exploration class missions) and Gap 3 (Need to identify and validate measures to monitor behavioral health and performance and determine acceptable thresholds for these measures during exploration missions). Our primary goal is to identify the psychological and behavioral health symptoms with the greatest likelihood of occurrence during extended human space flight/habitation to space and to estimate associated levels of threat imposed to mission-based performance. As a final deliverable, a checklist of symptoms will be developed for implementation during an ISS mission (>6 months) in order to determine its feasibility, reliability, and facilitation of evidence-based decision making with regard to crew health, safety, and mission success.

As a first step, we will conduct extensive scientific literature reviews and interviews with subject matter experts in order to synthesize existing knowledge of the psychological and behavioral symptoms experienced in space and other extreme environments (Aim 1). Our review will directly inform the development of a comprehensive checklist of symptoms to be monitored among 8 separate cohorts (i.e., 4 Antarctic and 4 HERA cohorts) as part of a longitudinal investigation (Aim 2). Symptoms will be examined based on their point/period prevalence, severity, and duration. The checklist will also be administered (repeatedly) in conjunction with the Space Medicine Exploration Medical Condition List (SMEMCL) in order to examine concurrent and sequential overlap between psychological and physical health symptoms as means of clarifying potential etiologies. Finally, our study will extend previous research by exploring relationships among psychological health, sleep loss/dysregulation, biomarkers of stress, and performance-based outcomes (Aim 3). A comprehensive battery of cognitive and performance measures (including a perception-action coupling task) will be administered repeatedly as part of our longitudinal study. These outcomes will inform a final list of psychological/ behavioral symptoms to be examined during an extended ISS mission.

1) We completed data collection from the 2016 HERA campaign (4 missions). We are cleaning and aggregating these data at present. Findings will be presented at the 2018 NASA Human Research Program (HRP) investigators’ workshop in January 2018 and subsequently submitted for publication. 2) Data collection in 2 Antarctic stations is ongoing with support from Dr. Jim McKeith and the Center for Polar Medical Operations. At South Pole, a total of 21 participants have been recruited, and at McMurdo, 88 participants have been recruited. Data collection will be completed in November 2017, after which data will be cleaned and analyzed prior to publication in peer-reviewed journals.

3) Our comprehensive technical report titled, “Long-Duration Space Exploration and Emotional Health: Recommendations for Conceptualizing and Evaluating Risk” received feedback from HRP staff. The overarching goals of this report were to provide an integrative summary of emotion-based outcomes from previous studies in isolated, confined, extreme (ICE) environments and to provide specific recommendations for future research. These findings have also been submitted to a peer-reviewed journal and are currently undergoing revisions prior to publication.

Unfortunately however, these collective data ultimately serve to raise more questions than answers. Differences in collection methods, types of symptoms/reactions assessed, psychological constructs examined, and timing and duration of measurements limit conclusions that can be drawn from this research. As a result, understanding of the discrete symptoms and conditions most likely to occur during space flight and thus, ability to quantify the magnitude, probability, or consequences of such risk remains inadequate. The current project proposes to address these notable gaps in knowledge via three specific Aims. First, we will conduct extensive scientific literature reviews and interviews with subject matter experts in order to synthesize existing knowledge of the psychological and behavioral symptoms experienced in space and other extreme environments (Aim 1). Our review will directly inform the development of a comprehensive checklist of symptoms to be monitored among 6 separate cohorts (i.e., 2 Antarctic and 4 Human Exploration Research Analog (HERA) cohorts) as part of a longitudinal investigation (Aim 2). Symptoms will be examined based on their point/period prevalence, severity, and duration. The checklist will also be administered (repeatedly) in conjunction with a physical symptoms checklist in order to examine concurrent and sequential overlap between psychological and physical health symptoms as means of clarifying potential etiologies. Finally, our study will extend previous research by exploring relationships among psychological health, sleep loss/dysregulation, biomarkers of stress, and performance-based outcomes (Aim 3). A comprehensive battery of cognitive and performance measures (including a perception-action coupling task) will be administered repeatedly as part of our longitudinal study. These outcomes will inform a final list of psychological/ behavioral symptoms to be examined during an extended International Space Station (ISS) mission.

This project specifically addresses several knowledge gaps related to Risks of Adverse Behavioral Conditions and Psychiatric Disorders including; Gaps 1 (Need to identify and quantify the key threats to and promoters of mission relevant behavioral health and performance during exploration class missions) and Gap 3 (Need to identify and validate measures to monitor behavioral health and performance and determine acceptable thresholds for these measures during exploration missions). Our primary goal is to identify the psychological and behavioral health symptoms with the greatest likelihood of occurrence during extended human space flight/habitation to space and to estimate associated levels of threat imposed to mission-based performance. As a final deliverable, a checklist of symptoms will be developed for implementation during an ISS mission (>6 months) in order to determine its feasibility, reliability, and facilitation of evidence-based decision making with regard to crew health, safety, and mission success.

As a first step, we will conduct extensive scientific literature reviews and interviews with subject matter experts in order to synthesize existing knowledge of the psychological and behavioral symptoms experienced in space and other extreme environments (Aim 1). Our review will directly inform the development of a comprehensive checklist of symptoms to be monitored among 8 separate cohorts (i.e., 4 Antarctic and 4 HERA cohorts) as part of a longitudinal investigation (Aim 2). Symptoms will be examined based on their point/period prevalence, severity, and duration. The checklist will also be administered (repeatedly) in conjunction with the Space Medicine Exploration Medical Condition List (SMEMCL) in order to examine concurrent and sequential overlap between psychological and physical health symptoms as means of clarifying potential etiologies. Finally, our study will extend previous research by exploring relationships among psychological health, sleep loss/dysregulation, biomarkers of stress, and performance-based outcomes (Aim 3). A comprehensive battery of cognitive and performance measures (including a perception-action coupling task) will be administered repeatedly as part of our longitudinal study. These outcomes will inform a final list of psychological/ behavioral symptoms to be examined during an extended ISS mission.

At the time of this report, we have completed data collection in 3 of 4 HERA cohorts during the 2016 campaign. Few problems have been encountered and very few missing data have occurred. We are currently preparing for the 4th and final 2016 HERA mission and have begun cleaning data for analysis.

After receiving approval from the National Science Foundation (NSF) to implement our protocol in two Antarctic stations during the 2017 winterover season, we are currently working Neal Scheibe and the Antarctic Support Team at Lockheed Martin (contracted by NSF) to finalize logistics and implement our project in two Antarctic cohorts. We are in the process of purchasing and organizing all materials for the study which will be shipped to the two Antarctic stations in October 2016. We are also working with Dr. Jim McKeith, the Antarctic Support Contractor at Universit of Texas Medical Branch (UTMB), who will lead the research support team that will oversee our project on the ice.

Unfortunately however, these collective data ultimately serve to raise more questions than answers. Differences in collection methods, types of symptoms/reactions assessed, psychological constructs examined, and timing and duration of measurements limit conclusions that can be drawn from this research. As a result, understanding of the discrete symptoms and conditions most likely to occur during space flight and thus, ability to quantify the magnitude, probability, or consequences of such risk remains inadequate. The current project proposes to address these notable gaps in knowledge via three specific Aims. First, we will conduct extensive scientific literature reviews and interviews with subject matter experts in order to synthesize existing knowledge of the psychological and behavioral symptoms experienced in space and other extreme environments (Aim 1). Our review will directly inform the development of a comprehensive checklist of symptoms to be monitored among 8 separate cohorts (i.e., 4 Antarctic and 4 Human Exploration Research Analog (HERA) cohorts) as part of a longitudinal investigation (Aim 2). Symptoms will be examined based on their point/period prevalence, severity, and duration. The checklist will also be administered (repeatedly) in conjunction with the Space Medicine Exploration Medical Condition List (SMEMCL) in order to examine concurrent and sequential overlap between psychological and physical health symptoms as means of clarifying potential etiologies. Finally, our study will extend previous research by exploring relationships among psychological health, sleep loss/dysregulation, biomarkers of stress, and performance-based outcomes (Aim 3). A comprehensive battery of cognitive and performance measures (including a perception-action coupling task) will be administered repeatedly as part of our longitudinal study. These outcomes will inform a final list of psychological/ behavioral symptoms to be examined during an extended International Space Station (ISS) mission.

This project specifically addresses several knowledge gaps related to Risks of Adverse Behavioral Conditions and Psychiatric Disorders including; Gaps 1 (Need to identify and quantify the key threats to and promoters of mission relevant behavioral health and performance during exploration class missions) and Gap 3 (Need to identify and validate measures to monitor behavioral health and performance and determine acceptable thresholds for these measures during exploration missions). Our primary goal is to identify the psychological and behavioral health symptoms with the greatest likelihood of occurrence during extended human space flight/habitation to space and to estimate associated levels of threat imposed to mission-based performance. As a final deliverable, a checklist of symptoms will be developed for implementation during an ISS mission (>6 months) in order to determine its feasibility, reliability, and facilitation of evidence-based decision making with regard to crew health, safety, and mission success.

As a first step, we will conduct extensive scientific literature reviews and interviews with subject matter experts in order to synthesize existing knowledge of the psychological and behavioral symptoms experienced in space and other extreme environments (Aim 1). Our review will directly inform the development of a comprehensive checklist of symptoms to be monitored among 8 separate cohorts (i.e., 4 Antarctic and 4 HERA cohorts) as part of a longitudinal investigation (Aim 2). Symptoms will be examined based on their point/period prevalence, severity, and duration. The checklist will also be administered (repeatedly) in conjunction with the Space Medicine Exploration Medical Condition List (SMEMCL) in order to examine concurrent and sequential overlap between psychological and physical health symptoms as means of clarifying potential etiologies. Finally, our study will extend previous research by exploring relationships among psychological health, sleep loss/dysregulation, biomarkers of stress, and performance-based outcomes (Aim 3). A comprehensive battery of cognitive and performance measures (including a perception-action coupling task) will be administered repeatedly as part of our longitudinal study. These outcomes will inform a final list of psychological/ behavioral symptoms to be examined during an extended ISS mission.

IRB approval from UH was obtained in February 2015 and from NASA in May 2015. A project coordinator was hired for the project and will begin work at UH in October 2015. The literature review is well underway and a final review paper is expected to be submitted to NASA in December 2015. The PI has completed 9 out of 10 total SME interviews, including interviews with: a NASA psychologist, a NASA psychiatrist, two NASA flight surgeons, a NASA astronaut, a psychologist involved in selection for work ICE environments, a crewmember of the 520-day Mars500 study, a scientist from NASA’s Explorations Medical Capability Unit, and a medical doctor with Antarctic winterover experience. The perception action coupling software and equipment are currently being modified to suit the HERA environment. We have also submitted the Science Requirements Document for our protocol to NASA Flight Analogue Projects (FAP) for the 2016 HERA campaign and have begun to assemble the final version of our Neurobehavioral Checklist for use in all HERA cohorts.