Behavioral Medicine Risks and Mitigations in Isolated, Confined, and Extreme Environments

Human spaceflight beyond low Earth orbit will present unique environmental challenges to astronauts’ operational performance and well-being. Crews will need to work and live in confined and hazardous environments for prolonged missions that involve variable workloads and limitations to privacy, food options, exercise capabilities, leisure outlets, and communication with ground support personnel and loved ones. Currently, behavioral and cognitive risks of spaceflight are mitigated by selecting exceptionally resilient crews and providing extensive individual and team skills training pre-mission, as well as in-mission crew support via a suite of countermeasures targeting sleep and performance optimization, stress management, family support, and team cohesion. However, current countermeasures are difficult or impossible to implement in long-distance exploration as they require real-time communication with Earth and routine resupply. New countermeasure approaches are needed to adapt and enhance the current complement for the new challenges ahead. NASA therefore conducts research at ground-based spaceflight analogs to aid in characterizing the behavioral and cognitive risks of living and working in isolated, confined, and extreme (ICE) operational environments. Antarctic research stations are among the few long-duration ICE analogs in existence and are therefore uniquely positioned to support behavioral medicine research to enable human exploration beyond Earth. In this review, we will discuss previous and ongoing efforts to better understand spaceflight behavioral medicine risks, as well as validate new countermeasure approaches for future missions to the moon and Mars.