The committee suggests convening a workshop of investigators, flight operations medical personnel, and expert clinicians who have experience in behavioral interventions for the management of mental disorders that develop during times of prolonged stress. The purpose would be to estimate the likelihood of such disorders developing during a 30-month extended mission, to identify the personality characteristics associated with a low risk for the development of such disorders, and to recommend evidence-based behavioral interventions to minimize the severity of the disorders if they do develop.

Finally, the committee notes that the BR contains no references to human sexuality, and this oversight should be corrected. Whereas the committee recognizes the task-oriented nature of both the crew and the mission, it concludes that ignoring the potential consequences of human sexuality is not appropriate when considering extended-duration missions. Areas of concern for the 30-month Mars mission include the potential psychological and physiological consequences of sexual activity, consequences that could endanger life, crew cohesion, performance, and mission success. Some risks can be eliminated but others cannot. For instance, the risk of pregnancy might be mitigated by crew selection. However, the long lead time to answer questions about the efficacy, safety, and side effects of contraceptive medications may require that studies to answer these questions be completed prior to crew selection or that other measures be used to mitigate the risk of pregnancy.

Recommendation 2.8

The committee recommends that issues of human sexuality be addressed in the BR in relation to long-duration missions such as the proposed Mars Design Reference Mission.

Psychological and Physical Impacts of Space Flight on Performance

To more fully address human behavior and performance issues during long-duration space flight, NASA must address a number of significant psychological and biological factors that will influence the ability of astronauts and crews to perform effectively. Effective performance includes the maintenance of individual high-level cognitive, communication, and physical skills and the maintenance of overall crew skills and teamwork. The latter require effective interactions with Earth-based support and recovery systems, as well as harmonious, flexible, and effective group relations among



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