Behavioral health & cognition
Also: BMed risk
Isolation & ConfinementRadiationBehavioral Health & SleepNeurological & CognitiveSelection & CertificationIn-flightPostflight RecoveryLifetime SurveillanceLEO long-durationMars transit & surfaceTerrestrial analogPublicClinicianResearcher
- No in-flight behavioral problem has reached a diagnostic threshold, but symptoms do occur. NASA's estimate of about 0.62 per person-year on the ISS is probably low. ◆◆◇◇ Low · F E
- Polar analogs show psychiatric disorders in about 5% of people. That suggests the risk is real for long, isolated missions such as Mars. ◆◆◆◇ Moderate · A
- NASA rates this risk as requiring mitigation for long missions. The main tools today are selection, monitoring and psychological support. ◆◆◆◆ High · E
Proposed certainty (◆ High → ◇ Very low) and evidence-type tags: F flight · A analog · M model/animal · C computational · E expert/operational/standards. AI-proposed, pending reviewer confirmation. How to read the grades.
NASA risk title (verbatim)
Risk of Adverse Cognitive or Behavioral Changes and Psychiatric Disorders Leading to In-mission Health and Performance and Long-term Health Effects
NASA short title: Behavioral Health · HRP element: Human Factors and Behavioral Performance (HFBP) · Status: Active [current research ongoing] [1]
What it is
This risk covers changes in mood, behavior and thinking (cognition), up to psychiatric disorders, that could affect a crew member during a mission or for years afterward [1]. It now also covers the brain effects of space radiation. NASA folded the former separate radiation central nervous system risk into this one [1].
Current evidence
- Mild (sub-diagnostic) behavioral health problems have been reported on several long missions. No in-flight case has reached a diagnostic threshold, even though some were linked to lost mission objectives or an early return [1].
- NASA estimates behavioral health symptoms on the International Space Station (ISS) at about 0.62 per person-year and says this is likely an underestimate [1].
- In Antarctic stations, at least 4.5% of people develop a psychiatric disorder [1]. A Lancet review put the figure at about 5% of polar expedition members meeting DSM-IV or ICD criteria [4].
- Analog studies suggest symptoms may rise faster after about 5–6 months (preliminary) [1]. In the 520-day Mars-500 simulation, the six crew members responded very differently from one another [5].
- MRI shows brain position and shape changes after long flights. Narrowing of the central sulcus was seen in 17 of 18 long-duration astronauts versus 3 of 16 short-duration astronauts [6]. What this means for thinking or long-term health is unknown [1].
- Cognitive studies in flight are small: a 2014 review found 11 long-duration studies totaling 42 people. The evidence neither strongly supports nor rules out specific deficits [7]. Animal work suggests radiation might cause short-term cognitive effects, but how well this applies to humans is uncertain [1].
NASA’s risk posture
NASA scores each risk for each design reference mission (DRM) as likelihood × consequence (LxC). Both run from 1 (lowest) to 5 (highest) on the HSRB’s 5×5 matrix [1][3]. Each score comes with a disposition, such as “Accepted”, “Requires Characterization” or “Requires Mitigation”. These ratings were last approved by NASA’s Human System Risk Board (HSRB) in 7/2024 [1].
| Mission | Duration | In-mission (operations) | Long-term health |
|---|---|---|---|
| LEO | Short (under 30 d) | 4x1 · Accepted with Monitoring | 1x3 · Accepted with Monitoring |
| LEO | Long (30 d–1 yr) | 5x2 · Requires Mitigation | 2x3 · Accepted with Monitoring |
| Lunar orbit | Short | 4x2 · Requires Characterization | 1x3 · Accepted with Monitoring |
| Lunar orbit | Long | 5x2 · Requires Mitigation | 2x3 · Requires Characterization |
| Lunar orbit + surface | Short | 4x2 · Requires Characterization | 1x3 · Accepted with Monitoring |
| Lunar orbit + surface | Long | 5x2 · Requires Mitigation | 2x3 · Requires Characterization |
| Mars preparatory | Under 1 yr | 5x3 · Requires Mitigation | 2x3 · Requires Characterization |
| Mars planetary | 730–1,224 d | 5x3 · Requires Mitigation | 2x5 · Requires Mitigation |
Copied from the Human Research Roadmap on 2026-10-14. Ratings change. Check the live record before citing.
Open knowledge gaps
NASA lists 8 knowledge gaps for this risk, 8 of them open as of 2026-10-14 [1]. Each gap ID links to its page on the Human Research Roadmap (HRR).
Show NASA’s gap list (verbatim)
| Gap | NASA gap statement | Status |
|---|---|---|
| BMed-101 | Identify, quantify, and validate key selection factors for requisite performance on increasingly Earth-independent, long-duration, autonomous, and/or long-distance exploration missions | Open |
| BMed-102 | Identify and characterize key C/P/Psy/N outcome measures (biomarkers) and domains of relevance that are at risk due to spaceflight environmental stressors in exploration class missions and determine validated thresholds for identified biomarkers of adverse C/P/Psy/N outcomes to enable mission objectives and identify indicators of risk before progression to clinical levels of impairment. | Open |
| BMed-103 | Identify validated, evidence-based countermeasures to prevent or treat adverse C/P/Psy/N conditions caused by single or combined exposures to spaceflight environmental stressors. | Open |
| BMed-104 | Identify design features and requirements of the habitat/vehicle and mission architecture to mitigate stressors impacting C/P/Psy/N health. | Open |
| BMed-105 | Identify validated medical or dietary countermeasures to mitigate spaceflight environmental stressors impacting C/P/Psy/N health. | Open |
| BMed-106 | Identify effective strategies to maintain personal relations/interactions to mitigate adverse C/P/Psy/N outcomes during increasingly Earth-independent long duration missions. | Open |
| BMed-107 | Determine long-term changes and risks to astronaut health post-mission that retrospectively predicts individual susceptibility to adverse C/P/Psy/N outcomes and informs countermeasure implementation in current and future crews. | Open |
| BMed-108 | Identify and characterize the potential impacts of combined spaceflight environmental stressors to inform both validated threshold limits and countermeasure for adverse C/P/Psy/N outcomes. | Open |
See also Open questions.
Active countermeasure research
- Monitoring and early detection. NASA is developing ways to monitor cognitive and behavioral health during long missions and to detect early warning signs [1].
- Countermeasures. NASA is developing ways to maintain behavioral health in isolated, confined and highly autonomous missions. These are tested in ground analogs before flight [1].
- An integrated approach. NASA’s research plan treats three stressors together because they are thought to interact: space radiation, isolation and confinement, and altered gravity [1].
Project-level detail, including status, investigators and results, is in the NASA Task Book and on each HRR gap page.
Clinical articles
For practical, clinic-facing guidance, see:
Evidence profile
- Overall certainty
- ◆◆◇◇ Low (proposed)
- Evidence types
- F · Flight dataA · Terrestrial analogE · Expert / operational / standards
- Literature through
- 2026-10-14
- NASA source
- Human Research Roadmap risk page (last published 05/13/25; read 2026-10-14)
Requirements referenced 4
| Requirement | Title | Plain-language meaning |
|---|---|---|
| [V1 3001] | Selection and Recertification | Psychological as well as medical selection and annual recertification. |
| [V1 4011] | Mission Cognitive Status | Pre-, in- and post-mission behavioral health and cognitive status assessed. |
| [V1 6004] | Behavioral Health and Performance Provisions | Psychological/behavioral health support programs for crew and families. |
| [V1 6010]–[V1 6011] | Private Psychological Conferences | Routine PPCs; psychological information transmitted privately. |
IDs as published in NASA-STD-3001 Vol. 1 Rev C (2023-09-15) and NASA-STD-3001 Vol. 2 Rev F (2026-07-14). NASA-STD-3001 binds NASA programs; it is not a regulation for commercial flights. Paraphrased. Standards quick reference.
References 7
- NASA Human Research Roadmap. Risk record: “Risk of Adverse Cognitive or Behavioral Changes and Psychiatric Disorders Leading to In-mission Health and Performance and Long-term Health Effects”. Accessed 2026-10-14. humanresearchroadmap.nasa.gov/Risks/?i=99 NASA E
- NASA Human Research Program. Evidence report for the Behavioral Medicine risk (approved February 10, 2025). humanresearchroadmap.nasa.gov/evidence/reports/HRP-ER-BMED-H… NASA E
- Antonsen EL, et al. Updates to the NASA human system risk management process for space exploration. NPJ Microgravity. 2023;9:72. doi:10.1038/s41526-023-00305-z PMID:37679359 Peer-reviewed E
- Palinkas LA, Suedfeld P. Psychological effects of polar expeditions. Lancet. 2008;371(9607):153–163. doi:10.1016/S0140-6736(07)61056-3 PMID:17655924 Peer-reviewed A
- Basner M, et al. Psychological and behavioral changes during confinement in a 520-day simulated interplanetary mission to Mars. PLoS One. 2014;9(3):e93298. doi:10.1371/journal.pone.0093298 PMID:24675720 Peer-reviewed A
- Roberts DR, et al. Effects of spaceflight on astronaut brain structure as indicated on MRI. N Engl J Med. 2017;377(18):1746–1753. doi:10.1056/NEJMoa1705129 PMID:29091569 Peer-reviewed F
- Strangman GE, Sipes W, Beven G. Human cognitive performance in spaceflight and analogue environments. Aviat Space Environ Med. 2014;85(10):1033–1048. doi:10.3357/ASEM.3961.2014 PMID:25245904 Peer-reviewed F
Machine-checked on 2026-10-14: each URL resolved, each DOI's title/journal/year matched via Crossref, and claims were checked against the source text (abstract or full NASA page). Human verification against full text is still required before review. NASA documents are U.S. Government works (public domain) and are summarized with attribution; journal articles are summarized, not reproduced.
Article info
- Authors
- Pending (AI-assisted draft)
- Reviewer
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- Last reviewed
- Pending review
- Literature through
- 2026-10-14
- AI-assisted
- Yes (disclosed)
- COI
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- License
- CC BY-SA 4.0
- Use
- Educational only · Disclaimer
- Cite this version
- Pending first edition