Psychosocial Support for
Long-duration Space Crews
James A. Cartreine, PhD
29 September 2009

This work was supported by the NSBRI through NASA NCC 9-58.

Virtual Space Station
Research Team
James A. Cartreine, PhD Raphael D. Rose, PhD
Harvard Medical School University of California, Los Angeles
Jay C. Buckey, MD Michelle G. Craske, PhD
Astronaut/Dartmouth Medical School University of California, Los Angeles
Mark T. Hegel, PhD Douglas C. Johnson, PhD
Dartmouth Medical School U.S. Naval Health Research Center
Leonard Greenhalgh, PhD Walter Sipes, PhD
Tuck School of Business, Dartmouth College NASA-Johnson Space Center
Ellen Goldberger, JD Gary Beven, MD
Mount Ida College NASA-Johnson Space Center
Steven E. Locke, MD Leroy Chaio, PhD
Harvard Medical School Astronaut (Retired)
Albert W. Holland, PhD
NASA-Johnson Space Center

Life on the
International Space Station

Tier 1 Threats to Long-duration
Missions
• Radiation
• Bone & Muscle loss
• Psychosocial Problems

• Worldwide, depression is now the leading
cause of disability and in wealthier nations,
such as NZ, Australia and the USA
• Mental health problems account for 4 of
the 10 leading causes of lost productivity
--World Health Organization 2006

Absenteeism + Presenteeism in the USA
12-month Workplace
Prevalence Days Missed Cost
Bipolar
Disorder 1.1% 96.2M $14.1B
Major
Depression 6.4% 225.0M $36.6B
7.5% 321.2M $50.7B
Kessler et al., 2006. Am J Psychiatry 163:9

Challenge to:
• Prevent
• Detect
• Assess
• Treat
...psychosocial problems in space (and here)

Some requirements…
• Modular • Useable
• Updateable • Credible
• Secure • Ethical
• Evidence-based • Relevant
• Self-directed • Interrelated
• Brief • Engaging

Virtual Space Station Demonstration

Study 1 (2001 - 2005)
PI: Cartreine
• Background interviews with (N=13)
• Architecture
• Sample content
• Usability and acceptability testing (N=11)

Study 2 (2005 - 2009)
PI: Cartreine
• Build out depression intervention
• Formative evaluation with depression patients
• Formative evaluation in Antarctica
• Randomized controlled clinical trial in Boston

Study 3 (2009 - 2013)
PI: Cartreine
• Build out conflict intervention
• Open trial with first responders

UCLA Study (2008 - 2012)
PI: Raphael D. Rose, PhD
• Build out stress & anxiety management
training
• Randomized controlled clinical trial with
US Navy pilots

Massachusetts General Hospital Study
(2008 - 2012) PI: Gary Strangman, PhD
• Infrared and MRI brain imaging of “VSS
patients”
• Revise depression treatment
• Randomized controlled clinical trial:
Self-treatment vs. antidepressants

Thank you
jcart@caregroup.harvard.edu