Under development for astronauts on extended missions, the system will assist in preventing, assessing and managing social and psychological problems. But, with some modifications, the system has the potential to benefit everyone -- whether living and working in extreme environments, submarines or oil rigs, or on a farm, in a suburb or big city.

"Researchers have shown that people are often more comfortable revealing sensitive information to a computer, rather than to a clinician, and they are more likely to acknowledge problems using computer-based assessments," said Dr. James Carter, a researcher on the National Space Biomedical Research Institute's (NSBRI) neurobehavioral and psychosocial factors team.

"The stresses of long-duration space flight such as separation from family, loss of privacy and limited social outlets can lead to mood disturbances, loss of sleep, conflict, work problems and, potentially, depression," said Carter, who serves as senior researcher at the Interactive Media Laboratory at Dartmouth Medical School and is a licensed clinical psychologist. He has co-produced an NIH-funded interactive media program that teaches cancer patients how to manage the side effects of cancer treatments.

A virtual space station will serve as the setting for the program, which will provide assessment, treatment, prevention and education.

The program will integrate graphics, audio and video multimedia designed to create a realistic environment.

The prototype will include three modules for users -- conflict management, treatment of mild depression and psychological self-assessment. The goal is to prevent these problems from occurring, but if they do, crewmembers will have the program on board to provide assistance.

"The system will help crewmembers recognize and deal with problems early on," Carter explained. "Mild to moderate problems will be highlighted although the program will address clinical problems, such as depression, as well. It is not designed to offer pharmaceutical advice. Further modules can be developed and evaluated as new needs are identified."

"Ideally, the program will be added to the training astronauts go through before a mission," said Dr. Jay Buckey, Jr., project co-investigator and principal subject-matter expert. Now a physician at Dartmouth, Buckey served extensively in the space program and flew as a payload specialist on the STS-90 Neurolab mission. "The program will help users identify and be alert for signs of depression and diffuse any conflicts that could arise."

The depression module will use problem-solving therapy to help users work through life problems that can contribute to more serious depression, such as work or interpersonal issues.

The program will help users identify the problem, possible solutions, pros and cons for each solution and specific steps to take. It will also help the user develop a personalized plan for solving the problem. The user can then go back to the program to determine if progress is being made. If no progress is identified, the user can change their plan of action.

The conflict-resolution module will involve computer simulations of hypothetical problems during long-duration space flights, in order to learn an approach to conflict management. Users will watch a video simulation and will be asked to choose a response.

The choice is then played out, allowing the user to determine whether it was the best response or to go back and make a different decision. In this way, users can learn from their actions.

Once developed, each module will undergo testing by current and former astronauts, ground-crew personnel and subject-matter experts.

The project is complemented by NSBRI teams looking at other space health concerns such as bone loss, cardiovascular changes, muscle wasting, balance and orientation problems, and radiation exposure.

While focusing on space health issues, the Institute will quickly transfer the solutions to Earth patients suffering from similar conditions. The NSBRI is funded by NASA.

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