Brain Health in Space: Behavioral Health, Performance and Countermeasures for Spaceflight
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Individualized Behavioral Health Monitoring Tool
Behavioral health risks during long-duration space exploration missions are among the most difficult to predict, detect, and mitigate. Given the anticipated extended duration of future missions and their isolated, extreme, and confined environments, there is the possibility that behavior conditions and mental disorders will develop among astronaut crew. Pulsar Informatics, Inc., has developed a health monitoring tool that provides a means to detect and address behavioral disorders and mental conditions at an early stage. The tool integrates all available behavioral measures collected during a mission to identify possible health indicator warning signs within the context of quantitatively tracked mission stressors. It is unobtrusive and requires minimal crew time and effort to train and utilize. The monitoring tool can be deployed in space analog environments for validation testing and ultimate deployment in long-duration space exploration missions.
Mollicone, Daniel↗
Overview of NASA Behavioral Health and Performance Standard Measures
NASA’s Human Research Program (HRP) is developing a set of “Standard Measures” for use in spaceflight and spaceflight analog environments to monitor the risks of long-duration missions on human health and performance, including behavioral health, individual and team performance, and social processes. Based on measures selected, developed, and tested under the NASA-funded Behavioral Core Measures project (PI: D.F. Dinges) as well as other projects from NASA’s Human Factors & Behavioral Performance research portfolio, NASA’s Behavioral Health & Performance (BHP) Laboratory is further evaluating the operational feasibility, acceptability, and validity of a multidisciplinary suite of objective, subjective, behavioral, and biological measures for monitoring monitor behavioral health, individual and team performance, and social processes over time. The inaugural generation of the NASA Behavioral Health & Performance (BHP) Standard Measures includes a neurocognitive test battery, actigraphy, physical proximity sensors, cardiovascular monitors, and subjective self-reports of mood, depression, and various team and social processes and performance outcomes.
Roma, P. G.↗
Behavioral Health Program Element
The project goal is to develop behavioral health prevention and maintenance system for continued crew health, safety, and performance for exploration missions. The basic scope includes a) Operationally-relevant research related to clinical cognitive and behavioral health of crewmembers; b) Ground-based studies using analog environments (Antarctic, NEEMO, simulations, and other testbeds; c) ISS studies (ISSMP) focusing on operational issues related to behavioral health outcomes and standards; d) Technology development activities for monitoring and diagnostic tools; and e) Cross-disciplinary research (e.g., human factors and habitability research, skeletal muscle, radiation).
Leveton, Lauren B.↗
Behavioral Health Support of NASA Astronauts for International Space Station Missions
Two areas of focus for optimizing behavioral health and human performance during International Space Station missions are 1) sleep and circadian assessment and 2) behavioral medicine. The Mir experience provided the opportunity to examine the use and potential effectiveness of tools and procedures to support the behavioral health of the crew. The experience of NASA has shown that on-orbit performance can be better maintained if behavioral health, sleep, and circadian issues are effectively monitored and properly addressed. For example, schedules can be tailored based upon fatigue level of crews and other behavioral and cognitive indicators to maximize performance. Previous research and experience with long duration missions has resulted in the development and upgrade of tools used to monitor fatigue, stress, cognitive function, and behavioral health. Self-assessment and objective tools such as the Spaceflight Cognitive Assessment Tool have been developed and refined to effectively address behavioral medicine countermeasures in space.
Sipes, Walter↗
Impacts of Space Crop Production on Astronaut Behavioral Health
An overview of the behavioral health impacts of our Veggie research to date.
Gioia D Massa↗
An operational approach to long-duration mission behavioral health and performance factors
NASA's participation in nearly 10 yr of long-duration mission (LDM) training and flight confirms that these missions remain a difficult challenge for astronauts and their medical care providers. The role of the astronaut's crew surgeon is to maximize the astronaut's health throughout all phases of the LDM: preflight, in flight, and postflight. In support of the crew surgeon, the NASA-Johnson Space Center Behavioral Health and Performance Group (JSC-BHPG) has focused on four key factors that can reduce the astronaut's behavioral health and performance. These factors are defined as: sleep and circadian factors; behavioral health factors; psychological adaptation factors; and human-to-system interface (the interface between the astronaut and the mission workplace) factors. Both the crew surgeon and the JSC-BHPG must earn the crewmember's trust preflight to encourage problem identification and problem solving in these four areas. Once on orbit, the crew medical officer becomes a valuable extension of the crew surgeon and BHPG on the ground due to the crew medical officer's constant interaction with crewmembers and preflight training in these four factors. However, the crew surgeon, BHPG, and the crew medical officer need tools that will help predict, prevent, monitor, and respond to developing problems. Objective data become essential when difficult mission termination decisions must be made. The need for behavioral health and performance tool development creates an environment rich for collaboration between operational healthcare providers and researchers. These tools are also a necessary step to safely complete future, more autonomous exploration-class space missions.
Review↗
Behavioral Health and Performance Operations and Research in Human Spaceflight
There are two distinct functions of the Behavioral Health and Performance (BHP) specialists at NASA Johnson Space Center (JSC), with a shared goal of promoting optimal performance during all mission phases, beginning with selection to the NASA Astronaut Corps through training for and completing a spaceflight mission. The BHP Operations team is active in areas such as selection, training, routine behavioral healthcare services, and work-rest schedule. The BHP Laboratory is engaged in research in space and analog platforms to address the risks and other challenges associated with future deep space missions. Their research focuses on topics that align with the NASA Human Research Program’s Human Factors Behavioral Performance Element goals. This panel will provide details of recent work by BHP Operations and the BHP Laboratory at NASA JSC, and will demonstrate their shared goals, and contributions toward, optimizing performance and maintaining the behavioral health and well-being of astronauts during all mission phases.In 2020-2021, NASA engaged another astronaut applicant screening process to identify its 23rd group of astronaut candidates. The BHP Operations team completed a significant amount of work to evaluate applicants and provide valuable input to the Astronaut Selection Board and the Aerospace Medical Board. One presentation will provide an overview of the work completed by BHP; and one presentation will discuss a critical competency important for successful job performance of the astronauts – Team Orientation. The former will summarize aspects of BHP’s Select-in and Select-out process and provide lessons learned for future selection cycles; the latter will briefly discuss the competencies of BHP’s applicant screening work, with focus on the importance of Team Orientation and the challenges of its measure. A third presentation will provide an overview of BHP’s current fatigue management work with astronauts and mission-critical operators at JSC (e.g., flight directors, pilots), and provide a look at the direction these fatigue management services may take in future exploration missions. Two other presentations will focus on the research completed by the BHP Lab to measure in a standardized way the critical aspects of behavioral health and well-being. One of the presentations will provide an overview of the Exploration Measures being collected during all space and analog missions, and the importance these objective measures have for future research and operations. The final presentation will summarize analyses completed with these measures, as they have been harmonized across both ISS and Analog missions.
Gary Beven↗
Veggie on Ice: The Effects of Plant Production on Human Behavioral Health Long-Duration Antarctic Overwintering Missions
Exploration class missions pose an increased risk of adverse crew behavioral health and psychiatric conditions. Identifying and developing effective and efficient countermeasure strategies are necessary to maintain crew health and performance. Previous studies (VEG-04A and VEG-04B) in the Veggie vegetable-production system on the International Space Station have evaluated the behavioral health effects of caring for plants as a potential countermeasure for crew stresses in spaceflight. The presence of plants can augment sensory stimulation (visual, tactile, and olfactory), provide a psychological link to Earth, reduce stress, and increase happiness. However, further research is needed to understand this strategy for longer-duration missions in isolated, confined, extreme (ICE) environments. The Neumayer III Station in Antarctica is one such environment that hosts a small crew for fourteen-month missions, of which eight to nine months are the remote overwintering phase. Neumayer III also features EDEN ISS, a greenhouse facility with 12.5 m2 plant cultivation space that, like Veggie, currently supplements the crew diet with a variety of fresh produce. Up to nine crew members of the 2021 overwintering mission will complete behavioral health surveys that are designed to capture enjoyment and time spent conducting various plant-related activities, sensory stimulation, and active and passive psychological effects of having live plants and available fresh food in an ICE environment. Data will be collected once pre-mission, up to ten times in-mission at monthly increments, and once post-mission. This study aims to quantify the impact of plant care as a countermeasure strategy for human spaceflight and Antarctic exploration missions.
J M Bunchek↗
Behavioral health in Antarctica: implications for long-duration space missions
Ideally, evidence from long-duration spaceflight should be used to predict likely occurrences of behavioral health events and for planning management strategies for such events. With small numbers of space travelers, and limited long-duration missions of a year or more, Earth analogues and simulations must be used as the evidence base, despite such analogues lacking microgravity, radiation, rapidly altering photoperiodicity, and fidelity to space. Antarctic health data are reviewed and an assessment made of the likely frequency of behavioral health events. Based on the Antarctic evidence, the likelihood of behavioral health problems in space is low. However, such cases may be serious and of high consequence, placing considerable demands on the mission crew and ground support to achieve a successful outcome, given the availability of pharmaceuticals and resources.
Review↗
A critical strategy: ensuring behavioral health during extended-duration space missions
No abstract available
Review↗
Behavioral Health and Performance Operations During the Space Shuttle Program
Prior to the Columbia STS 107 disaster in 2003, the Johnson Space Center s Behavioral Health and Performance Group (BHP) became involved in Space Shuttle Operations on an as needed basis, occasionally acting as a consultant and primarily addressing crew-crew personality conflicts. The BHP group also assisted with astronaut selection at every selection cycle beginning in 1991. Following STS 107, an event that spawned an increased need of behavioral health support to STS crew members and their dependents, BHP services to the Space Shuttle Program were enhanced beginning with the STS 114 Return to Flight mission in 2005. These services included the presence of BHP personnel at STS launches and landings for contingency support, a BHP briefing to the entire STS crew at L-11 months, a private preflight meeting with the STS Commander at L-9 months, and the presence of a BHP consultant at the L-1.5 month Family Support Office briefing to crew and family members. The later development of an annual behavioral health assessment of all active astronauts also augmented BHP s Space Shuttle Program specific services, allowing for private meetings with all STS crew members before and after each mission. The components of each facet of these BHP Space Shuttle Program support services will be presented, along with valuable lessons learned, and with recommendations for BHP involvement in future short duration space missions
Beven, G.↗
Behavioral Health Benefits of the ISS Pick-and-Eat Crop Growth System
Summary: We summarize findings related to assessing the pick-and-eat salad-crop productivity and acceptability of the ISS food system as a countermeasure to maintain behavioral health in long-duration spaceflight. BACKGROUND Plants are a potential countermeasure for the stresses of living in space. Caring for plants and eating fresh food have been shown to serve as a psychological benefit for previous astronauts and for others in analogous environments such as Antarctica [1,2]. Gardening can be therapeutic in terrestrial settings [3]. These effects may carry over or be more pronounced in austere environments such as spaceflight. It can reduce stress and increase sensory stimulation and enjoyment [2]. Growing crops may offer astronauts meaningful and engaging work as they care for living things in an austere environment away from Earth’s nature and as they provide sustenance for their crew. We examined the extent to which interacting with plants (e.g., tending to, consuming) was related to behavioral health outcomes in long-duration space missions. METHOD Participants were 27 astronauts that interacted with the plant system VEG-04, VEG-05, and HRF-VEG (VEG-03 I-L, PH-04). In total, there were 106 in-flight observations. Participants completed monthly measures of mood and well-being, enjoyment and time spent performing specific crop growth and consuming the plants, meaningfulness, performance, connections with others and the Earth, desire to work with and eat plants, and experiences with struggling or dying plants. Higher ends of the 7-point Likert scale indicated more positive outcomes, lower ends of the scale were anchored with more negative outcomes, and the scale midpoints indicated neutral positions. Participants selected a specific survey version based on whether they interacted with the plant system(s) or not, and we included only the scores from the crewmembers that participated in any given activity. RESULTS & DISCUSSION Results indicated that participants generally rated tasks related to the plants and crop growth as enjoyable. Consuming the harvested plants and voluntary viewing were the most enjoyable activities. Tending to the plants was reported as moderately enjoyable, indicating BHP benefits from this work task. The BHP impacts of whether the task was engaging, meaningful, supported well-being, or was demanding for a crewmember were generally positive and increased over time. As shown in the Figure, working with plants was reported as more engaging, meaningful, and beneficial to well-being over time, while the demand from the task was moderate to low and consistent over time. Engaging, meaningful, and supporting well-being were strongly, positively correlated with each other, which is consistent with research that suggests engaging and meaningful work can support well-being. Plant activities such as voluntary viewing, watering, harvesting, and consuming, were positively related to task engagement and meaning, and enjoyment and well-being. Findings suggest that working with plants and consuming them can be a behavioral health countermeasure for long-duration spaceflight. REFERENCES [1] Schlacht I, et al. (2020) Impact of plants in isolation: The EDEN-ISS…in Antarctica. In Advances in Human Factors of Transportation, Washington DC. [2] Vessel E, Russo S (2015) Effects of reduced sensory stimulation and…countermeasures…. NASA/TM-2015-218576. [3] Odeh R, Guy C (2017) Gardening for therapeutic people-plant interactions during LDSM. Open Agriculture, 2(1), 1-13. ACKNOWLEDGEMENTS This research was supported by the Human Health and Performance Contract NNJ15HK11B, and NASA grant MTL #1075 (PI G.D. Massa).
countermeasure↗
Behavioral Health Benefits of the ISS Pick-and-Eat Crop Growth System
Summary: We summarize findings related to assessing the pick-and-eat salad-crop productivity and acceptability of the ISS food system as a countermeasure to maintain behavioral health in long-duration spaceflight. BACKGROUND Plants are a potential countermeasure for the stresses of living in space. Caring for plants and eating fresh food have been shown to serve as a psychological benefit for previous astronauts and for others in analogous environments such as Antarctica [1,2]. Gardening can be therapeutic in terrestrial settings [3]. These effects may carry over or be more pronounced in austere environments such as spaceflight. It can reduce stress and increase sensory stimulation and enjoyment [2]. Growing crops may offer astronauts meaningful and engaging work as they care for living things in an austere environment away from Earth’s nature and as they provide sustenance for their crew. We examined the extent to which interacting with plants (e.g., tending to, consuming) was related to behavioral health outcomes in long-duration space missions. METHOD Participants were 27 astronauts that interacted with the plant system VEG-04, VEG-05, and HRF-VEG (VEG-03 I-L, PH-04). In total, there were 106 in-flight observations. Participants completed monthly measures of mood and well-being, enjoyment and time spent performing specific crop growth and consuming the plants, meaningfulness, performance, connections with others and the Earth, desire to work with and eat plants, and experiences with struggling or dying plants. Higher ends of the 7-point Likert scale indicated more positive outcomes, lower ends of the scale were anchored with more negative outcomes, and the scale midpoints indicated neutral positions. Participants selected a specific survey version based on whether they interacted with the plant system(s) or not, and we included only the scores from the crewmembers that participated in any given activity. RESULTS & DISCUSSION Results indicated that participants generally rated tasks related to the plants and crop growth as enjoyable. Consuming the harvested plants and voluntary viewing were the most enjoyable activities. Tending to the plants was reported as moderately enjoyable, indicating BHP benefits from this work task. The BHP impacts of whether the task was engaging, meaningful, supported well-being, or was demanding for a crewmember were generally positive and increased over time. As shown in the Figure, working with plants was reported as more engaging, meaningful, and beneficial to well-being over time, while the demand from the task was moderate to low and consistent over time. Engaging, meaningful, and supporting well-being were strongly, positively correlated with each other, which is consistent with research that suggests engaging and meaningful work can support well-being. Plant activities such as voluntary viewing, watering, harvesting, and consuming, were positively related to task engagement and meaning, and enjoyment and well-being. Findings suggest that working with plants and consuming them can be a behavioral health countermeasure for long-duration spaceflight. REFERENCES [1] Schlacht I, et al. (2020) Impact of plants in isolation: The EDEN-ISS…in Antarctica. In Advances in Human Factors of Transportation, Washington DC. [2] Vessel E, Russo S (2015) Effects of reduced sensory stimulation and…countermeasures…. NASA/TM-2015-218576. [3] Odeh R, Guy C (2017) Gardening for therapeutic people-plant interactions during LDSM. Open Agriculture, 2(1), 1-13. ACKNOWLEDGEMENTS This research was supported by the Human Health and Performance Contract NNJ15HK11B, and NASA grant MTL #1075 (PI G.D. Massa).
behavioral health↗
Behavioral Health and Performance Element: Tools and Technologies
This slide presentation reviews the research into the Behavioral Health and Performance (BHP) of the Human Research Program. The program element goal is to identify, characterize and prevent or reduce behavioral health and performance risks associated with space travel, exploration, and return to terrestrial life. To accomplish this goal the program focuses on applied research that is designed to yield deliverables that reduce risk. There are several different elements that are of particular interest: Behavioral Medicine, Sleep, and team composition, and team work. In order to assure success for NASA missions the Human Research Program develops and validate the standards for each of the areas of interest. There is discussion of the impact on BHP while astronauts are on Long Duration Missions. The effort in this research is to create tools to meet the BHP concerns, these prospective tools are reviewed.
Leveton, Lauren B.↗
NASA Human Research Program Behavioral Health and Performance Element (BHP)
The goal of NASA BHP is to identify, characterize, and prevent or reduce behavioral health and performance risks associated with space travel, exploration, and return to terrestrial life. The NASA Behavioral Health and Performance Operations Group (BHP Ops) supports astronauts and their families before, during, and after a long-duration mission (LDM) on the ISS. BHP Ops provides ISS crews with services such as preflight training (e.g., psychological factors of LDM, psychological support, cross-cultural); preflight, in-flight, and postflight support services, including counseling for astronauts and their families; and psychological support such as regular care packages and a voice-over IP phone system between crew members and their families to facilitate real-time one-on-one communication.
Whitmire, Sandra↗
Risk of Performance and Behavioral Health Decrements Due to Inadequate Cooperation, Coordination, and Psychosocial Adaptions within a Team
The Risk of Performance and Behavioral Health Decrements Due to Inadequate Cooperation, Coordination, Communication, and Psychosocial Adaptation within a Team (the Team Risk) is primarily performance-focused, with a secondary emphasis on behavioral health outcomes resulting from team performance and interpersonal interactions. Monitoring tools, measures, and countermeasures are aimed at enhancing team processes and team composition configurations to optimize team performance and functioning. Long-duration exploration missions (LDEMs) will include major challenges that could affect team performance, including social isolation, physical confinement, a small and diverse crew, communication delays between crew and ground, limited or no crew rotation or evacuation options, limited or no resupply, and a high-consequence environment. Each of these conditions will affect the crew’s coordination, cooperation, psychological well-being, and performance. Although the International Space Station (ISS) remains important for studies that require spaceflight testing and validation, the current conditions on the ISS do not adequately mimic the exploration environment that is required for National Aeronautics and Space Administration (NASA) teams research, and thus access to terrestrial or ground-based analogs of LDEM conditions is paramount. The emphasis on analogs for research is reflected in this updated evidence review of the Team Risk, and includes data from studies conducted at isolated, confined, extreme (ICE) environments (e.g., Antarctic stations), and from several mission simulation analogs such as the Human Exploration Research Analog (HERA) (HERA Experiment Information Package, 2014), also known as isolated, confined, controlled (ICC) environments. These studies have characterized many team factors regarding LDEMs, and the Team Risk has now matured from risk characterization to focusing more on countermeasure development. Because spaceflight evidence for team-level research is lacking, no reliable data is available to quantify the impact of team-level variables on individual and team-level outcomes during spaceflight missions. Until recently, no systematic attempt had been undertaken to measure the performance effects of team cohesion, team composition, team training, or team-related psychosocial adaptation during spaceflight. The Team Risk is a relatively young research area for NASA, with substantial growth only since the 2000s, and with limited access to spaceflight performance data. As a result, spaceflight evidence is lacking to identify specifically what team composition, level of training, amount of cohesion, or quality of psychosocial adaptation is necessary to reduce the risk of performance errors in space. However, astronaut journals and interviews and reports from spaceflight subject matter experts (SMEs) provide testimonies that team performance during spaceflight is important for mission success and to maintain crew health. Team spaceflight data is now being collected as part of the Spaceflight Standard Measures task (Clement, 2021)—a set of core measurements related to many human spaceflight risks that are collected from astronauts before, during, and after long-duration missions. The team-related standard measures focus on team cohesion, team performance, group living, team climate, and team processes. Collection of standard measures data is ongoing and published data is not yet available. Finally, although spaceflight evidence is lacking, evidence gleaned from ground studies and spaceflight analog studies will help close the gaps outlined in the Team Risk. Ground-based studies provide quantitative evidence for team functioning in ICE environments. Academic research on teams has produced dozens of meta-analyses that can be used to understand the general relationships among team inputs (e.g., team member characteristics and skills, job context), team processes, and emergent states (e.g., coordination, communication, cooperation, cohesion, trust, shared cognition), and team outcomes (e.g., effectiveness, errors, adaptation). Teams are complex, incorporating individual characteristics of team members, but also existing at a level that is greater than the sum of its parts. Therefore, the Team Risk must be integrated with other individual-focused NASA Human Research Program (HRP) risks, including Behavioral Medicine (BMed), Sleep, and Human-Systems Integration Architecture (HSIA), and emerging research indicates more integration may needed between the Team Risk and the physiologically oriented risks. Much of this integration occurs through the Human Systems Risk Board (HSRB). A lack of team functioning may be a stressor in some circumstances, but the team often acts as a countermeasure. For example, support for team leaders and teammates can facilitate individual functioning and encourage psychological and physically healthy behaviors and attitudes. However, more research is needed regarding teams during LDEMs and the remaining gaps in the research are described in the current report.
Lauren Blackwell Landon↗
2014 Behavioral Health and Performance Standing Review Panel
The 2014 Behavioral Health and Performance (BHP) Standing Review Panel (from here on referred to as the SRP) met for a site visit in Houston, TX on December 17 - 18, 2014. The SRP reviewed the updated research plan for the Risk of Performance Errors Due to Fatigue Resulting from Sleep Loss, Circadian Desynchronization, Extended Wakefulness, and Work Overload (Sleep Risk) and also received a status update on the Risk of Adverse Behavioral Conditions and Psychiatric Disorders (BMed Risk) and the Risk of Performance Decrements Due to Inadequate Cooperation, Coordination, Communication, and Psychosocial Adaptation within a Team (Team Risk).
Steinberg, Susan↗