Psychological+Effects+of+Deep+Space+and+Long-Term+Space+Travel

=**Introduction**= toc

With the growing interest in human deep space exploration in both the private and public aerospace sectors, there is also a sharp increase in the psychological effects such a journey may pose. During the Space Shuttle program in the United States, “thirty-four behavioral signs and symptoms were reported among the 208 crew members who flew on 89 shuttle missions between 1981 and 1989, spending a total of 4,442.8 person-days in space.” [1] The prevalence of the noticeable psychological effects on astronauts is of great concern to engineers and scientists, who must design missions and spacecraft that must not only get astronauts to their destination alive, but also //sane//.

=Background=

** Contributing Factors **
Several factors experienced by astronauts can lead to adverse psychological states. The two primary factors are:
 * **Isolation:** Isolation, in both a physical and social context, can be defined as a state in which a person (or other social animal) experiences a near-complete lack of connection to other people and society. Isolation differs from loneliness in that isolation reflects a long-term disconnection from people and society, while loneliness reflects a temporary, short-term disconnection from people and society. Additionally, isolation differs from solitude in that solitude is a state of disconnection willfully chosen for the sake of being alone, whereas isolation is a state of disconnection that exists undesirably or as consequence of something else.
 * **Zero-Gravity and the Space Environment:** Zero gravity and the Space Environment have a significant impact on various systems in the body and have been shown to cause bone loss, muscle atrophy, cardiac dysrhythmias, and adverse vestibular states (disorientation, altered vision, etc.). [2]

=**Effects**=

** Isolation **
Data from astronauts in Low Earth Orbit, such as on the International Space Station, has shown that astronauts tend to adjust very well to life aboard the station. Additionally, studies such as HI-SEAS and Biosphere have been conducted that isolate small teams of researchers in ICE (Isolated, Confined, and Extreme) environments to understand how team dynamics and individ


 * 1) **ICE Environment Studies (HI-SEAS, Biosphere, Antarctic Winter-Over Missions)**
 * **Background:**
 * 1) //Antarctic Winter-Over Missions//: Antarctica is a very appealing place for researchers and scientists, particularly in the fields of remote sensing, atmospheric and oceanic science, and environmental science. Due to difficulties in getting aircraft in and out of Antarctica during the winter, many people stay for what is referred to as a "winter-over" mission, which typically last from 9-13 months through the Antarctic winter.
 * 2) //HI-SEAS:// The Hawaii Space Exploration Analog and Simulation (HI-SEAS) is an experiment being run by NASA, Cornell University, and the University of Hawaii in which researchers are sent in teams for several months to live in a psuedo-martian environment on the side of the Mauna Loa volcano.ual psychology are effected by such environments. One enormous source of wealth in this area is data on scientists/engineers who do winter-over missions in Antarctica. Data is missing, however, on how astronauts will adapt to the significantly more severe isolation of deep space travel inside a spacecraft, where the Earth cannot readily be seen and video calls to the family and friends on the ground becomes unavailable. In such a case, we must resort to studying the other known forms of severe isolation that people experience and look at the corresponding psychological effects. Two such cases are that of solitary confinement and submarine deployment.
 * 3) //Biosphere:// Biosphere is a research facility run by the University of Arizona located in Oracle, Arizona. Biosphere is a 3.14 acre vivarium, making it the largest closed system ever created. Biosphere is used to study the interactions between humans and closed ecosystems, and it has hosted several experiments analyzing the psychosocial effects of leaving small teams of humans together for long-periods of time (1+ years).
 * **Effects:**
 * 1) //Antarctic Winter-Over Missions//: In his paper analyzing the effects of Antarctic Winter-Over missions, Lawrence A. Palinkas noted: "Analyses of data collected from over 1,100 Americans who wintered-over between 1963 and the present are used to make the case that the process of psychosocial adaptation to isolation, confinement and extreme physical conditions exhibits four distinct characteristics. First, it is seasonal or cyclical in that variations in mood appear to be associated with the altered diurnal cycle and psychological segmentation of the mission. Second, it is situational in that concurrent measures of personality, interpersonal needs, and coping styles are better predictors of depressed mood and peer-supervisor performance evaluations than baseline measures. This is because of the unique features of the station social and physical environments and the absence of resources typically used to cope with stress elsewhere. Third, it is social in that individuals belonging to crews with a clique structure report significantly more depression, anxiety, anger, fatigue, and confusion than individuals belonging to crews with a core-periphery structure. Finally, it is “salutogenic” in that depressed mood is inversely associated with the severity of station physical environment and the winter-over experience is associated with reduced subsequent rates of hospital admissions, both supporting the existence of a positive effect for individuals seeking challenging experiences in extreme environments."[3]
 * 2) //HI-SEAS//: HI-SEAS has yet to release substantial information about their findings. To see the research being conducted, visit their website here: [|HI-SEAS].
 * 3) //Biosphere:// Studies in Biosphere found that small crews tended to split into factions over time, and people who were close friends initially had become "implacable enemies." [4] Despite the emergence of factionalism, the team was able to function extremely well in their environment. Some speculate that the oxygen decline inside the biosphere's atmosphere and the diet restrictions contributed significantly to the degradation of the team dynamics. Team members began to develop symptoms like sleep apnea, fatigue, severe hunger, and irritability.

2. **Solitary Confinement**
 * **Background**: Solitary confinement can be defined as the practice of isolating an individual from any social contact, usually in a small, artificially lit room, for a period of time ranging from days to years. The practice of solitary confinement in the United States began with the so-called “Philadelphia System” at Eastern State Penitentiary in 1829 in Philadelphia, Pennsylvania. The Penitentiary[[image:Eastern_State_Penitentiary,_Two_Story_Hall.jpg align="right" caption="Eastern State Penitentiary [23]"]] system was founded upon the Quaker belief that “prisoners isolated in stone cells with only a Bible would use the time to repent, pray and find introspection.” [5] Incarcerated people were kept in isolation to induce a state of “penitence,” or truthful regret, hence the name “Penitentiary.” Solitary confinement is a controversial practice, commonly accused of being torture, due to the significant states of psychological suffering it almost uniformly produces in every person who experiences it, whether they were previously mentally healthy or not.
 * **Effects:** In the short term, solitary confinement can produce psychological states nearly indistinguishable from the state of psychosis (LINK). Inmates in solitary confinement were found to “[fall], even after a short confinement, into a semi-fatuous condition, from which it was next to impossible to arouse them, and others became violently insane; others… committed suicide.” [5] Prominent clinical psychologist and solitary confinement research Dr. Stuart Grassian found that “the paradigmatic psychiatric disturbance [of inmates in solitary confinement] was an agitated confusional state which, in more severe cases, had the characteristics of a florid delirium, characterized by severe confusional, paranoid, and hallucinatory features, and also by intense agitation and random, impulsive, often self-directed violence.” [6] In the long term, solitary confinement was found to be uniformly ineffective at reforming prisoners, and in fact damaged people considerably. Justice Samuel Freeman Miller noted that, at Eastern State, “those who stood [solitary confinement] better were not generally reformed, and in most cases did not recover sufficient mental activity to be of any subsequent service to the community.” [5] Further discussing long term effects, Grassian noted that “many of the acute symptoms… tend to subside after release from [solitary confinement]… [but] long term effects [may] persist for decades.” He continues, stating that “these not only include persistent symptoms of post-traumatic stress disorder (such as flashbacks, chronic hypervigilance, and a pervasive sense of hopelessness), but also of lasting personality changes – especially including a continuing pattern of intolerance of social interaction leaving the individual socially impoverished and withdrawn, subtly angry and fearful when forced into social interaction.” [6]

3. **Submarine Deployment:** >
 * **Background:** Submariners spend long deployments stuck in small spaces with other people, operating in artificial light on abnormal schedules (like an 18 hour day). This makes them an excellent source of information for researchers seeking to understand the effects a long-term mission in a spacecraft may have on teams of people.
 * **Effects:** A study conducted by Thomas TL //et al.// investigated the health events that occurred among healthy members of the military population during periods of isolation, gathering data primarily from U.S. Navy Submarines. The study found a wide range of high-rate illnesses, such as: respiratory illnesses (upper respiratory infections), skin problems, symptoms and ill-defined conditions, digestive disorders, infectious conditions, sensory organ problems (ear infections and eye problems), and musculoskeletal conditions. [7] Additionally, research conducted by Lisa Kelly Tamsin //et al.// found that the circadian rhythms of sailors did not adjust to the unusual schedules they were on: despite working 18 hour days for months on end, their circadian rhythms timed in at almost exactly 24 hours. [8] This is a very significant finding because the circadian rhythm heavily influence the timing of the hormonal cycles in the body, and its disruption (which happens to astronauts exposed to real sunlight) or inability to adapt to new a new cycle could severely degrade the mental state of an individual.

Zero-Gravity and the Space Environment
= = =Conclusions=
 * **Background:** While no mission in the United States has experienced a so-called “behavioral emergency,” several Soviet Russian missions in the 1970’s and 1980’s were terminated prematurely due to the psychological state of the astronauts. In 1976, the Soyuz-21 mission to the Salyut-5 space station was terminated and the crew was brought home early after the cosmonauts began to complain about a pungent odor in the spacecraft. No such odor was ever found upon investigation, nor did other crews smell it in the spacecraft. Hallucination has been presented as a possible explanation. Additionally, the Soyuz TM-2 mission was terminated early due to apparent psycho-social factors. Psychiatrists have noted several occurrences of rage in astronauts, which was later attributed to the [[image:SOYImage4x250_0.jpg align="right" caption="Astronauts aboard the ISS [24]"]]sensory-poor environment and an inadequate ability to communicate. [9]
 * **Physio-Psychological Effects:** The physiological and psychological effects of zero-gravity and the space environment is a large portion of the field of bioastronautics. The dynamics, or motion, of a body in zero-gravity is completely different from the dynamics of a body on Earth, and the psychological effects of motion in zero-gravity is completely decoupled from the psychological effects of motion on the Earth; in other words, being resistant to motion sickness on Earth is no indication of whether that person will experience motion sickness in zero-gravity. There are several areas that zero-gravity effects physio-psychologically, such as:
 * 1) **//Vestibular System and Spatial Disorientation//** [10]: The vestibular system (the inner ear) is a sensory system that provides a sense of balance and spatial orientation for the purpose of coordinating movement. The vestibular system is coupled with the eyes and uses visual data along with sensory data from the inner ear to perform its functions. Upon entering a zero-gravity environment, the change in sensory data generated by the inner ear causes disorientation and the development of many sensory “illusions,” such as the cross-coupled Coriolis illusion, and various forms of motion sickness.The brain has complex systems for visual pattern recognition that can become disrupted by zero-gravity. For example, in a spacecraft, people interacting with each other are often oriented at differed angles from each other, and, initially, the brain has a very difficult time making sense of facial expressions from these strange angles. Such effects are adapted to rather quickly, with the longest duration of orientation impairment and/or motion sickness being ~14 days.
 * 2) **//SANS (Spaceflight Associated Neuro-ocular Syndrome)//** [11]: The zero-gravity environment causes cephalad fluid shifts in the eye and changes in intracranial pressure, which leads to vision loss and other potentially adverse health effects.
 * 3) **//Acute Physiological Effects//**: The zero-gravity environment decompresses the spine and joints, making astronauts taller, which can result in sometimes significant back and joint pain. There is also acute muscle atrophy and bone loss, which requires astronauts to exercise for long periods daily.
 * 4) **//Radiation//**: Radiation from the sun is a significant issue, but the most significant source of radiation for astronauts during deep space travel are Galactic Cosmic Rays (GCRs). GCRs have been found to potentially alter cognition during space travel and damage the central nervous system, leading to increased risks of developing degenerative neural diseases such as Alzheimer’s. [12]
 * 5) **//Neuroendocrinological Effects//**: The circadian rhythm significantly effects both mental health and the timing of other endocrine functions. While in space, the loss of an average days’ worth of sunlight significantly effects the circadian rhythm, which cascades to other effect other hormonal cycles, which can affect the psychological states of the astronauts. An astronaut on the ISS sees 16 sunsets and sunrises a day, which can heavily disrupt the circadian rhythm.
 * 6) **//Adaptation//**: The human physiology and psychology has a fairly remarkable ability to adapt to new environments. This can present in issue in long-term space travel, however, as an astronaut heading to Mars would adapt to the space environment en route, only to arrive at Mars and undergo adaptation to planetary gravity.

Isolation and the space environment pose enormous potential risks to astronauts in deep space or long-term space travel, and many risks require mitigation. The most significant risks to astronaut mental health are that of isolation and disorientation, SANS, and radiation. Other psycho-physiological effects can cause significant short-term symptoms, but are generally quickly adapted to or already have impressive mitigative systems developed, such as the exercise systems on the ISS to prevent muscle atrophy and bone loss.The space environment, in general, has been shown to be extremely strenuous on teams of people, causing interpersonal tensions and relationship degradation. Overall, the space environment is extremely challenging, and the people who embark on the first manned missions to Mars and deep space will have to be some of the healthiest, mentally robust, and most competent people humanity has to offer, and scientists, engineers, and psychologists must meticulously design missions and systems to promote human well-being during these missions.

=**References:**= [1] Slack, Kelley J., Schneiderman, Jason S., Leveton, Lauren B., Whitmire, Alexandra M., Picano, James J., “Risk of Adverse Cognitive or Behavioral Conditions and Psychiatric Disorders.” NASA JSC-CN-34203. [2] Blaber, Elizabeth, Helder Marçal, and Brendan P. Burns. “Bioastronautics: The Influence of Microgravity on Astronaut Health.” Astrobiology 10, no. 5 (June 2010): 463– 73. []. [3] Palinkas, L. A., “Group Adaptation and Individual Adjustment in Antarctica: A Summary of Recent Research,” From Antarctica to Outer Space, 1991, pp. 239–251. [4] “Biosphere 2,” Wikipedia Available: https://en.wikipedia.org/wiki/Biosphere_2#Group_dynamics:_psychology,_conflict,_and_cooperation. [5] “Timeline: Solitary Confinement in U.S. Prisons.” NPR.org. Accessed April 9, 2018. []. [6] Grassian, Stuart, (2006), Psychiatric Effects of Solitary Confinement, Washington University Journal of Lar & Policy, p. 325-384. [7] Thomas TL, Garland FC, Molé D, Cohen BA, Gudewicz TM, Spiro RT, Zahm SH. “Health of U.S. Navy submarine crew during periods of isolation.” Aviation, Space, and Environmental Medicine, Volume 74, Number 3, March 2003, pp. 260-265(6). [8] Tamsin Lisa Kelly, David F. Neri, Jeffrey T. Grill, David Ryman, Phillip D. Hunt, Derk-Jan Dijk, Theresa L. Shanahan, Charles A. Czeisler, “Nonentrained Circadian Rhythms of Melatonin in Submariners Scheduled to an 18-Hour Day.” Journal of Biological Rhythms, Vol 14, Issue 3, 1999. pp. 190-196. [9] Slack, Kelley J., Schneiderman, Jason S., Leveton, Lauren B., Whitmire, Alexandra M., Picano, James J., “Risk of Adverse Cognitive or Behavioral Conditions and Psychiatric Diso [10] MSFC, Barry Logan: “NASA - Human Vestibular System in Space.” Feature Articles. Accessed May 6, 2018. []. rders.” NASA JSC-CN-34203. [11]Brunstetter, Tyson. “Introduction to Spaceflight Associated Neuro-Ocular Syndrome (SANS) and Its Risk to NASA Astronauts,” n.d., 44. https://ntrs.nasa.gov/archive/nasa/casi.ntrs.nasa.gov/20170009173.pdf [12] Cucinotta, Francis A., Murat Alp, Frank M. Sulzman, and Minli Wang. “Space Radiation Risks to the Central Nervous System.” Life Sciences in Space Research 2 (July 1, 2014): 54–69. []. [13] Engler, S. (2018) Primary Research. [online] HI-SEAS. Available at: https://hi-seas.org/?cat=84 [Accessed 25 Feb. 2018] [14]“What Does Solitary Confinement Do To Your Mind?,” PBS Available: []. [Accessed 15 Mar. 2018] [15] Erin York Cornwell, Linda J. Waite, “Social Disconnectedness, Perceived Isolation, and Health among Older Adults.” Journal of Health and Social Behavior, Vol 50, Issue 1, pp. 31 - 48. https://doi.org/10.1177/002214650905000103 [Accessed 25 Feb. 2018] [16] Julianne Holt-Lunstad, Timothy B. Smith, Mark Baker, Tyler Harris, David Stephenson, “Loneliness and Social Isolation as Risk Factors for Mortality: A Meta-Analytic Review”, Perspectives on Psychological Science, Vol 10, Issue 2 (2015): pp. 227 - 237. [17] H. F. Harlow, R. O. Dodsworth, M. K. Harlow, Total Social Isolation in Monkeys, Proceedings of the National Academy of Sciences. July 1, 1965. 54 (1) 90-97. [18] Bond, M., “Future - How extreme isolation warps the mind,” BBC Available: http://www.bbc.com/future/story/20140514-how-extreme-isolation-warps-minds. [Accessed 12 Mar. 2018] [19] Adnan Bashir Bhatti and Anwar ul Haq, “The Pathophysiology of Perceived Social Isolation: Effects on Health and Mortality.” Ed. Alexander Muacevic and John R Adler. Cureus 9.1 (2017): e994. PMC. [20]“What Does Solitary Confinement Do To Your Mind?,” PBS Available: https://www.pbs.org/wgbh/frontline/article/what-does-solitary-confinement-do-to-your-mind/. [Accessed 15 Mar. 2018] [21] Morris, N. P., “Mental Health in Outer Space,” Scientific American Blog Network Available: https://blogs.scientificamerican.com/guest-blog/mental-health-in-outer-space/. [Accessed 15 Mar. 2018] [22] “IceCube Opens South Pole ‘Winterover’ Positions.” Accessed May 6, 2018. []. [23] “Eastern State Penitentiary.” // Wikipedia //, April 22, 2018. []. [24] “Astronaut Scott Kelly Accepts the 2015 Scientist of the Year Award from R&D Magazine.” Accessed May 6, 2018. [].  [1] Engler, S. (2018) //Primary Research.// [online] HI-SEAS. Available at: []  [Accessed 25 Feb. 2018] This page provides information on the research being conducted by multiple different groups on the participants of the HI-SEAS study. Each article given provides insight into the broad range of factors being considered and researched: everything from team-building and social cohesion in ICE (Isolated, Confined, and Extreme) environments to the development of unobtrusive health monitoring devices. [2] Erin York Cornwell, Linda J. Waite, “ Social Disconnectedness, Perceived Isolation, and Health among Older Adults.” // Journal of Health and Social Behavior //, Vol 50, Issue 1, pp. 31 - 48. [|https://doi.org/10.1177/002214650905000103]  [Accessed 25 Feb. 2018] This paper looks at a wide range of health risks brought on by various kinds of isolation, including living alone, having small social circles, infrequent social participation, and perceived lack of connection and support. By looking into multiple indicators of social isolation, the team developed scales assessing social disconnectedness and perceived isolation. [3] Grassian, Stuart, (2006), Psychiatric Effects of Solitary Confinement, Washington University Journal of Lar & Policy, p. 325-384. This study is a comprehensive overview of clinical research into the psychological effects of solitary confinement. The results are quite disturbing, almost indisputably concluding that kind of isolation experienced by those in solitary confinement will cause mental illness of some kind. This study also discusses which aspects of solitary confinement lead to the development of said mental illnesses, such as: lack of natural sunlight, uniform environment, and absence of background noise and the presence of sudden, loud noises (such as when a cell door shuts). [4] Julianne Holt-Lunstad, Timothy B. Smith, Mark Baker, Tyler Harris, David Stephenson, “Loneliness and Social Isolation as Risk Factors for Mortality: A Meta-Analytic Review”, //Perspectives on Psychological Science, Vol 10, Issue 2 (2015):// pp. 227 - 237. This study is a meta-analytic review that looks into data on mortality as it’s related to both actual and perceived loneliness, social isolation, and living alone. The study also looks into possible moderators of actual and perceived loneliness. This study concludes that there is approximately a 30% increase in mortality rates among people who are isolated and lonely, regardless of whether it was actual or perceived. [5] H. F. Harlow, R. O. Dodsworth, M. K. Harlow, Total Social Isolation in Monkeys, //Proceedings of the National Academy of Sciences. July 1, 1965.// 54 (1) 90-97. This journal paper looks at social deprivation in rhesus monkeys. The paper investigates claims that social isolation and deprivation lead to abnormal sexual development as well as a loss of control over aggressive and delinquent behaviors. The study found that prolonged isolation caused the monkeys to go into a state of shock characterized by “autistic self-hugging” and “rocking” behavior, and even a flat out refusal to eat. The paper also concluded that these effects are significant, but reversible. [6] Thomas TL, Garland FC, Molé D, Cohen BA, Gudewicz TM, Spiro RT, Zahm SH. “Health of U.S. Navy submarine crew during periods of isolation.” //Aviation, Space, and Environmental Medicine, Volume 74, Number 3, March 2003,// pp. 260-265(6). This paper investigates the health events that occurred among healthy member of the military population during periods of isolation, gathering data primarily from U.S. Navy Submarines. The study found a wide range of high-rate illnesses, such as: respiratory illnesses (upper respiratory infections), skin problems, symptoms and ill-defined conditions, digestive disorders, infectious conditions, sensory organ problems (ear infections and eye problems), and musculoskeletal conditions. [7] Tamsin Lisa Kelly, David F. Neri, Jeffrey T. Grill, David Ryman, Phillip D. Hunt, Derk-Jan Dijk, Theresa L. Shanahan, Charles A. Czeisler, “Nonentrained Circadian Rhythms of Melatonin in Submariners Scheduled to an 18-Hour Day.” //Journal of Biological Rhythms, Vol 14, Issue 3, 1999.// pp. 190-196. This paper investigates the circadian rhythm and sleep cycle of submariners put on an irregular, 18 hour work schedule (6 hours on, 12 hours off). The study found that the 18 hour schedule is too short for circadian rhythm synchronization, especially given the lack of bright lights aboard a submarine. Additionally, the team found that despite their work schedule, the sailors maintained a circadian rhythm of just over 24 hours. [8] Bond, M., “Future - How extreme isolation warps the mind,” BBC Available: [] . [Accessed 12 Mar. 2018] This article discusses the psychological effects of extreme isolation. The article looks at several examples of extreme isolation, such as that of Sarah Shourd, who was captured by Iranian troops and kept in solitary confinement for over 10,000 hours. During her time in solitary. Sarah reported numerous hallucination events, including one in which she heard someone screaming, only to have a guard come try to revive her, which caused her to realize the screams were her own. [9] Adnan Bashir Bhatti and Anwar ul Haq, “The Pathophysiology of Perceived Social Isolation: Effects on Health and Mortality//.” Ed. Alexander Muacevic and John R Adler. Cureus 9.1 (2017): e994. PMC.// This paper investigates how perceived social isolation leads to negative health outcomes. The authors performed a meta-analytical study in which they found that perceived social isolation leads to issues with the cardiovascular system, neuroendocrine system, and cognitive functioning. The authors also conclude that perceived social isolation also leads to depression, cognitive decline, and sleep problems. [10]“What Does Solitary Confinement Do To Your Mind?,” PBS Available: [] . [Accessed 15 Mar. 2018] This article discusses a broad range of impacts caused by solitary confinement. Similarly to the journal paper cited above, this article points out the numerous adverse health effects of solitary confinement, from hallucinations and panic attack to severe self-harm. The article points out that in the California prison system from 1999-2004, nearly half of all suicides came from inmates in solitary confinement. [11] Morris, N. P., “Mental Health in Outer Space,” Scientific American Blog Network Available: [] . [Accessed 15 Mar. 2018] This article discusses the mental health of astronauts as well as the systems currently in place related to astronaut mental health. The article summarizes the findings from a 160+ page document put forth by NASA outlining the risk of adverse cognitive or behavioral conditions and psychiatric disorders among astronauts. The article discusses several sample cases where astronauts mental health could have been a cause of mission failure. [12] Slack, Kelley J., Schneiderman, Jason S., Leveton, Lauren B., Whitmire, Alexandra M., Picano, James J., “Risk of Adverse Cognitive or Behavioral Conditions and Psychiatric Disorders.” NASA JSC-CN-34203. This NASA technical paper thoroughly details all known adverse cognitive or behavioral conditions and psychiatric disorders related to astronautics and isolation. It investigates signs and symptoms, predictors and contributing factors, prevention and monitoring countermeasures, and ground based evidence for said conditions and disorders. The article concludes that there is a very serious risk associated with the development of a mental condition or disorder with 1 or more years in constant spaceflight, and that mitigation is a must.