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Leveton, Lauren B.

Publications and source records attributed to Leveton, Lauren B..

Risk of Adverse Cognitive or Behavioral Conditions and Psychiatric Disorders: Evidence Report

In April 2010, President Obama declared a space pioneering goal for the United States in general and NASA in particular. "Fifty years after the creation of NASA, our goal is no longer just a destination to reach. Our goal is the capacity for people to work and learn and operate and live safely beyond the Earth for extended periods of time, ultimately in ways that are more sustainable and even indefinite." Thus NASA's Strategic Objective 1.1 emerged as "expand human presence into the solar system and to the surface of Mars to advance exploration, science, innovation, benefits to humanity, and international collaboration" (NASA 2015b). Any space flight, be it of long or short duration, occurs in an extreme environment that has unique stressors. Even with excellent selection methods, the potential for behavioral problems among space flight crews remain a threat to mission success. Assessment of factors that are related to behavioral health can help minimize the chances of distress and, thus, reduce the likelihood of adverse cognitive or behavioral conditions and psychiatric disorders arising within a crew. Similarly, countermeasures that focus on prevention and treatment can mitigate the cognitive or behavioral conditions that, should they arise, would impact mission success. Given the general consensus that longer duration, isolation, and confined missions have a greater risk for behavioral health ensuring crew behavioral health over the long term is essential. Risk, which within the context of this report is assessed with respect to behavioral health and performance, is addressed to deter development of cognitive and behavioral degradations or psychiatric conditions in space flight and analog populations, and to monitor, detect, and treat early risk factors, predictors and other contributing factors. Based on space flight and analog evidence, the average incidence rate of an adverse behavioral health event occurring during a space mission is relatively low for the current conditions. While mood and anxiety disturbances have occurred, no behavioral emergencies have been reported to date in space flight. Anecdotal and empirical evidence indicate that the likelihood of an adverse cognitive or behavioral condition or psychiatric disorder occurring greatly increases with the length of a mission. Further, while cognitive, behavioral, or psychiatric conditions might not immediately and directly threaten mission success, such conditions can, and do, adversely impact individual and crew health, welfare, and performance.

Slack, Kelley J.↗

Risk of Performance Decrements and Adverse Health Outcomes Resulting from Sleep Loss, Circadian Desynchronization, and Work Overload

Sleep loss, circadian desynchronization, and work overload occur to some extent for ground and flight crews, prior to and during spaceflight missions. Ground evidence indicates that such risk factors may lead to performance decrements and adverse health outcomes, which could potentially compromise mission objectives. Efforts are needed to identify the environmental and mission conditions that interfere with sleep and circadian alignment, as well as individual differences in vulnerability and resiliency to sleep loss and circadian desynchronization. Specifically, this report highlights a collection of new evidence to better characterize the risk and reveals new gaps in this risk.

Evans-Flynn, Erin↗

Risk of Adverse Cognitive or Behavioral Conditions and Psychiatric Disorders

The NASA commitment to human space flight includes continuing to fly astronauts on the ISS until it is decommissioned as well as possibly returning astronauts to the moon or having astronauts venture to an asteroid or Mars. As missions leave low Earth orbit and explore deeper space, BHP supports and conducts research to enable a risk posture that considers the risk of adverse cognitive or behavioral conditions and psychiatric disorders “acceptable given mitigations,” for pre-, in, and post-flight.The Human System Risk Board (HSRB) determines the risk of various mission scenarios using a likelihood (per person per year) by consequences matrix examining those risks across two categories—long term health and operational (within mission). Colors from a stoplight signal are used by HSRB and quickly provide a means of assessing overall perceived risk for a particular mission scenario. Risk associated with the current six month missions on the ISS are classified as “accepted with monitoring” while planetary missions, such as a mission to Mars, are recognized to be a “red” risk that requires mitigation to ensure mission success.Currently, the HSRB deems that the risk of adverse cognitive or behavioral conditions and psychiatric outcomes requires mitigation for planetary missions owing to long duration isolation and radiation exposure (see Table 1). While limited research evidence exists from spaceflight, it is well known anecdotally that the shift from the two week shuttle missions to the six month ISS missions renders the psychological stressors of space as more salient over longer duration missions. Shuttle astronauts were expected just to tolerate any stressors that arose during their mission and were successful at doing so (Whitmire et al, 2013). While it is possible to deal with stressors such as social isolation and to live with incompatible crewmembers for two weeks on shuttle, “ignoring it” is much less likely to be a successful coping mechanism on station. For the longer missions of the ISS, astronauts require a larger, more robust set of coping skills and more psychological support. Evidence of this are the number of BHP’s Operational Psychology (Op Psy) staff who have been awarded silver Snoopys by long duration astronauts†, in the statements of praise for the Op Psy and Family Support Office teams, and in the written and oral statements from flown astronauts regarding difficulty of longer missions and how much Op Psy helped.

Slack, Kelley J.↗

Performance Data Report: Space Medicine Division, Human Research Program, Behavioural Health and Performance Research Element

This report is the result of a collaborative effort between NASA?s Behavioral Health & Performance (BHP) Research and Operations Group to investigate and determine the availability of data pertaining to behavioral performance (and other pertinent variables) that have been collected by the laboratories at NASA?s Johnson Space Center. BHP?s Operations and Research groups collaborated to systematically identify what types of performance data are needed in relevant BHP performance domains and also to conduct structured interviews with NASA personnel to identify which data do or do not exist currently (and for instances where such data exist, to evaluate the type, quality, accessibility, and confidentiality of those data). The authors defined outcome categories of performance that encapsulate BHP performance domains, mapped BHP Research Risks and Gaps onto those performance outcome categories, and identified and prioritized indicators for each outcome category. The team identified key points of contact (subject matter experts [SMEs]) as potential interviewees, created a template for structured interview questions about sources and accessibility of performance data, and coordinated and conducted structured interviews with the SMEs. The methodology, results, and implications of this effort, as well as forward work needed, are discussed in this report.

Shea, Camille↗

Behavioral Health and Performance (BHP) Work-Rest Cycles

BHP Program Element Goal: Identify, characterize, and prevent or reduce behavioral health and performance risks associated with space travel, exploration and return to terrestrial life. BHP Requirements: a) Characterize and assess risks (e.g., likelihood and consequences). b) Develop tools and technologies to prevent, monitor, and treat adverse outcomes. c) Inform standards. d) Develop technologies to: 1) reduce risks and human systems resource requirements (e.g., crew time, mass, volume, power) and 2) ensure effective human-system integration across exploration mission.

Leveton, Lauren B.↗

Co-Operative Advances in Behavioral Health and Performance Research and Operations

In organizations that engage in both operations and applied research, with operational needs guiding research questions and research informing improved operations, the ideal goal is a synergy of ideas and information. In reality, this ideal synergy is often lacking. Real-time operational needs driving day-to-day decisions, lack of communication, lag time in getting research advances plugged into operations can cause both areas to suffer from this gap between operations and research. At Johnson Space Center, the Behavior Health and Performance group (BHP) strives to bridge this gap by following a Human Research Program framework: Expectations of future operational needs identify the knowledge gaps; the gaps in turn guide research leading to a product that is transitioned into operations. Thus, the direction those of us in research take is in direct response to current and future needs of operations. Likewise, those of us in operations actively seek knowledge that is supported by evidence-based research. We make an ongoing effort to communicate across the research and operations gap by working closely with each other and making a conscious effort to keep each other informed. The objective of the proposed panel discussion is to demonstrate through the following presentations the results of a successful collaboration between research and operations and to provide ASMA members with more practical knowledge and strategies for building these bridges to serve our field of practice well. The panel will consist of six presenters from BHP operations, internal BHP research, and external research instigated by BHP who together represent the entire BHP Research Transition to Operations Framework

VanderArk, Stephen T.↗

Psychosocial Characteristics of Optimum Performance in Isolated and Confined Environments (ICE)

The Behavioral Health and Performance (BHP) Element addresses human health risks in the NASA Human Research Program (HRP), including the Risk of Adverse Behavioral Conditions and the Risk of Psychiatric Disorders. BHP supports and conducts research to help characteristics and mitigate the Behavioral Medicine risk for exploration missions, and in some instances, current Flight Medical Operations. The Behavioral Health and Performance (BHP) Element identified research gaps within the Behavioral Medicine Risk, including Gap BMed6: What psychosocial characteristics predict success in an isolated, confined environment (ICE)? To address this gap, we conducted an extensive and exhaustive literature review to identify the following: 1) psychosocial characteristics that predict success in ICE environments; 2) characteristics that are most malleable; and 3) specific countermeasures that could enhance malleable characteristics.

Palinkas, Lawrence A.↗

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.↗

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.↗

The Critical Path Roadmap Project: Biomedical Risk Reduction for Extended Spaceflight

Human exploration of space requires an understanding of the risks to which crews will be exposed during such missions, and the mitigation of those risks to the fullest extent practical. This becomes a greater imperative as we prepare for interplanetary expeditions involving long periods in weightlessness in transit to and then from the destination (a planet, such as Mars, or perhaps a point in space, such as the Lagrangian point L2), and exposure to the unique environment of the destination itself. We need to know, more definitively, what the risks are to human health, safety, and performance, and how to prevent or counteract them throughout all phases of a long duration mission. The Johnson Space Center's Space and Life Sciences Directorate and the National Space Biomedical Research Institute (NSBRI) have implemented an effort to identify the most critical risks confronting humans on such mission and the types of research and technology efforts required to mitigate and otherwise reduce the probability and severity of those risks. This paper describes the "Critical Path Roadmap Project" to define, assess and prioritize the risks and present the results of the assessment with an emphasis on the research and technology priorities to meet the challenge of long duration human spaceflight mission.

Charles, John B.↗

ISS Utilization and Countermeasure Validation: Implementing the Critical Path Roadmap to Reduce Uncertainties of Extended Human Spaceflight Expeditions

Human exploration of space requires the ability to understand and mitigate risks to crews exposed to the conditions associated with such missions. This becomes a greater imperative as we prepare for interplanetary expeditions involving humans who will be subjected to long transit periods in microgravity as they travel to a distant planet such as Mars, embark and live on the planet's surface for an extended time, and finally, return to the 1 g environment of Earth. We need to know, more definitively, what the human health, safety, and performance risks are, and how to prevent or counteract them throughout all phases of a long duration mission. The Johnson Space Center's Space and Life Sciences Directorate along with the National Space Biomedical Research Institute (NSBRI) have been engaged in a strategic planning effort that identifies the most critical risks confronting humans who will venture forth on such missions and the types of research and technology efforts required to mitigate and otherwise reduce the probability and/or severity of those risks. This paper describes the unique approach used to define, assess and prioritize the risks and presents the results of the assessment with an emphasis on the research and technology priorities that will help us to meet the challenge of long duration human spaceflight missions.

Leveton, Lauren B.↗

Life sciences and Mars exploration

The major life science considerations for Mars exploration missions are discussed. Radiation protection and countermeasures for zero gravity are discussed. Considerations of crew psychological health considerations and life support systems are addressed. Scientific opportunities presented by manned Mars missions are examined.

Sulzman, Frank M.↗

USSR Space Life Sciences Digest, issue 16

This is the sixteenth issue of NASA's USSR Life Sciences Digest. It contains abstracts of 57 papers published in Russian language periodicals or presented at conferences and of 2 new Soviet monographs. Selected abstracts are illustrated with figures and tables from the original. An additional feature is the review of a book concerned with metabolic response to the stress of space flight. The abstracts included in this issue are relevant to 33 areas of space biology and medicine. These areas are: adaptation, biological rhythms, bionics, biospherics, body fluids, botany, cardiovascular and respiratory systems, developmental biology, endocrinology, enzymology, exobiology, gastrointestinal system, genetics, gravitational biology, habitability and environmental effects, hematology, human performance, immunology, life support systems, man-machine systems, mathematical modeling, metabolism, microbiology, musculoskeletal system, neurophysiology, nutrition, operational medicine, perception, personnel selection, psychology, radiobiology, reproductive biology, and space biology.

Hooke, Lydia Razran↗