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Task Last Updated: 08/27/2008 
Division Name: Human Research 
Program/Discipline: NSBRI 
Element/Subdiscipline: Neurobehavioral and Psychosocial Factors Team 
Project Title: Self-guided Depression Treatment on Long-duration Space Flights: A Continuation Study 
Joint Agency Name:  
PI Name: Cartreine nee Carter, James A.  PI Phone: 617-667-1507  
PI Email: jacarter@caregroup.harvard.edu  Fax: 617-667-1518 
PI Organization Type: NON-PROFIT 
Organization Name: Beth Israel Deaconess Medical Center 
PI Address 1: 330 Brookline Ave., Feldberg 867 
PI Address 2:  
PI Web Page:  
City: Boston State: MA Zip Code: 02215-5400 Congressional District: 8
Comments: Name change to Cartreine in summer 2008, per NSBRI information (11/08) 
Project Type: GROUND  Solicitation: 03-OBPR-04 
Start Date: 01/01/2005  End Date: 08/31/2009 
Fiscal Year: 2008     
No. of Post Docs: 0  No. of PhD Degrees: 0 
No. of PhD Candidates: 0  No. of Master' Degrees: 0 
No. of Master's Candidates: 1  No. of Bachelor's Degrees: 0 
No. of Bachelor's Candidates: 0  Monitoring Center: NSBRI 
Contact Monitor:   Contact Phone:  
Contact Email:      
Flight Program:  
Flight Assignment:

 
Key Personnel Changes/Previous PI:  
COI Name: COI Institution:
Buckey, Jay   Dartmouth College 
Hegel, Mark   Dartmouth College 
Locke, Steven   Harvard Medical School 
Grant/Contract No.: NCC 9-58-NBPF00404 
Performance Goal No.:  
Performance Goal Text:

 
Task Description:  Objective: Depression can present a significant threat to long-duration space missions and crews need the ability to recognize it and treat it effectively. In our current NSBRI study, Designing a Smart Medical System for Psychosocial Support on Long-duration Space flights, we are developing a prototype computer-based system that includes a module for the recognition and treatment of depression. Before being used by astronauts, this system needs to be further developed and tested for efficacy in an analog population. The countermeasure we are developing is intended for use both in pre-flight training and on orbit on the ISS, and has substantial Earth benefits. Specific aims of this proposal are:

1. Complete development of the module for recognizing and preventing depression. We will complete this module, moving from the prototype stage to a completed computer-based tool. We will modify the design based on data from our usability and acceptability study with astronauts at Johnson Space Center. We will pilot-test the module with 5 participants, and make revisions based on their input.

2. Develop the module for implementing computer-based Problem-Solving Treatment. Currently, problem-solving treatment is done using a practitioner who guides the patient through this structured therapy and follows their progress. These practitioners are trained to administer the therapy through a formalized training program that incorporates a workbook and instructional videos1. These materials are well suited for presentation via multimedia on computer to make the treatment self-guided. The PST intervention will be modified from its current video/workbook form to a computer-based form that can be used by astronauts or other professionals who are suffering from depression.

3. To evaluate the efficacy of the computer-delivered Problem-Solving Treatment (PST) module for depression in a randomized controlled trial. Hypotheses related to this aim are that, compared to a waiting-list control:

a. Individuals receiving computer-delivered PST will show a greater reduction in depression symptoms, as rated by a clinician.

b. Individuals receiving computer-delivered PST will show a greater reduction in depression, as rated by self-report.

c. A greater proportion of individuals receiving computer-delivered PST will have remitted at post-treatment.

 
Research Impact/Earth Benefits: Depression is widespread, and effective treatments are not available to all persons who have it. This computer-based depression treatment, with simple modifications and revisions, could be adapted for use in other isolated operational environments, such as polar research stations, submarines, commercial ships, oil rigs, and underwater research bases. Furthermore, even greater value could be derived by making similar psychosocial support systems available to the public in settings such as primary care practices, public and mental health centers, schools, social services offices, places of worship, military bases, prisons, and eventually at home or in any location, through broadband Internet.

Task Progress: During 2007, we scripted the depression treatment program, taped the video clips, recorded audio segments and produced the majority of the program. Approximately 100 video clips and 200 audio clips are included in the program, embedded in a highly complex, branching multimedia program. By design, the complexity is not apparent to the user. We also conducted on-camera interviews with persons who have had depression, including persons who have completed Problem-Solving Treatment (PST). Our interviewees included two military pilots and an elite marine; all of whom share their observations about depression and treatment.

Additionally, we interviewed one veteran long-duration ISS astronaut. This individual has not had depression, but did share his recommendations on how to maintain good psychological health on long-duration missions.

Work has also progressed on setting up the clinical trial, scheduled for the next two project years. We were able to gain approval to use the General Clinical Research Center (GCRC) at Beth Israel Deaconess Medical Center. The GCRC is a federally funded facility to run clinical trials. It provides some staff (research nurses) and facilities (rooms in which to use the program).

 
Bibliography Type: Description: (Last Updated: 01/24/2007)