AGSM Proficiency and Depression Are Associated With Success of High-G Training in Trainee Pilots.

INTRODUCTION: High-gravity (G) training is used to educate trainee pilots about anti-G straining maneuvers (AGSM) in an environment similar to that of a real fighter aircraft, and to enhance their G tolerance. The success or failure of high-G training could be multifactorial, but most previous studies have only focused on the effect of pilots' physical condition.METHODS: A total of 138 male trainee pilots participated in this study. All trainee pilots had received AGSM training from experienced instructors and then underwent centrifuge high-G training. Participants completed questionnaire surveys about body size, lifestyle, self-reported AGSM proficiency, resilience (Connor-Davidson Resilience Scale, CD-RISC), and depression level (Center for Epidemiologic Studies Depression Scale, CES-D).RESULTS: Of the 138 subjects, 100 (72.5%) successfully completed high-G training without experiencing G-induced loss of consciousness (G-LOC) within two trials; these were allocated to the success group. The remaining 38 (27.5%) subjects who completed the training after three or more attempts, or who failed to complete the training at all, were allocated to the failure group. Multivariate analyses revealed that the success of centrifuge training was positively associated with age and self-reported AGSM proficiency, and negatively associated with depression level.DISCUSSION: The success of high-G training was significantly associated with self-reported AGSM proficiency and depression level. Instructors should emphasize the importance of AGSM proficiency and offer practice-based learning to trainee pilots. In addition, they should pay attention to not only trainee pilots' physical condition, but also their psychological status.Yun C, Oh S, Shin YH. AGSM proficiency and depression are associated with success of high-G training in trainee pilots. Aerosp Med Hum Perform. 2019; 90(7):613-617.

Derealization symptoms according to the subjective visual vertical during unilateral centrifugation in patients with type 2 diabetes mellitus.

BACKGROUND: A recent study has shown variability on the perception of verticality during unilateral centrifugation among patients with type 2 diabetes mellitus; it is yet unknown if it is related to symptoms of unreality. OBJECTIVE: In patients with type 2 diabetes mellitus compared to age matched healthy volunteers, to assess depersonalization/derealization (DD) symptoms before and after unilateral centrifugation, according to the subjective visual vertical (SVV). METHODS: 47 patients with type 2 diabetes mellitus and 50 age matched healthy volunteers participated in the study. They replied to standardized questionnaires of symptoms related to balance, depression, and anxiety. Then, after neuro-otological evaluation, they completed a DD inventory before and after unilateral centrifugation (300°/s, 3.85 cm) with SVV estimation. RESULTS: Right/left asymmetric SVV during centrifugation was identified in 17 patients (36%) and no SVV change during centrifugation was identified in 6 patients (13%). Before centrifugation, patients with asymmetric SVV already reported some of the DD symptoms, while patients with no SVV change reported almost no DD symptoms. Unilateral centrifugation provoked an increase of DD symptoms in both healthy volunteers and the entire group of patients (repeated measures ANOVA, p < 0.01), except in the 6 patients with no SVV change. Before centrifugation, the DD score showed influence from the SVV subgroup and the evidence of depression (MANCoVA, p < 0.01); after centrifugation, which provoked asymmetry of the right/left utricular input, only the influence from depression persisted. No influence was observed from the characteristics of the subjects, including retinopathy, peripheral neuropathy (assessed by electromyography) or weight loss, or from the total score on the questionnaire of symptoms related to balance. CONCLUSIONS: In patients with type 2 diabetes mellitus and healthy volunteers, utricular stimulation by unilateral centrifugation may provoke DD symptoms, with an influence from depression. The results support that the aphysiological utricular input given by unilateral centrifugation may contribute to create a misleading vestibular frame of reference, giving rise to 'unreal' perceptions.

Screening and Mitigation of Layperson Anxiety in Aerospace Environments.

INTRODUCTION: Anxiety may present challenges for commercial spaceflight operations, as little is known regarding the psychological effects of spaceflight on laypersons. A recent investigation evaluated measures of anxiety during centrifuge-simulated suborbital commercial spaceflight, highlighting the potential for severe anxiousness to interrupt spaceflight operations. METHODS: To pave the way for future research, an extensive literature review identified existing knowledge that may contribute to formation of interventions for anxiety in commercial spaceflight. Useful literature was identified regarding anxiety from a variety of fields, including centrifugation, fear of flying, motion sickness, and military operations. RESULTS: Fear of flying is the most extensively studied area, with some supportive evidence from centrifugation studies. Virtual reality exposure (VRE) is as effective as actual training flight exposure (or analog exposure) in mitigation of flight-related anxiety. The addition of other modalities, such as cognitive behavioral therapy or biofeedback, to VRE improves desensitization compared to VRE alone. Motion sickness-susceptible individuals demonstrate higher trait anxiety than nonsusceptible individuals; for this reason, motion sickness susceptibility questionnaires may be useful measures to identify at-risk individuals. Some military studies indicate that psychiatric history and personality classification may have predictive value in future research. Medication countermeasures consisting of benzodiazepines may quell in-flight anxiety, but do not likely improve anxiety on repeat exposure. DISCUSSION: The scarce available literature addressing anxiety in unique environments indicates that training/repeated exposure may mitigate anxiety. Anxiety and personality indices may be helpful screening tools, while pharmaceuticals may be useful countermeasures when needed. Mulcahy RA, Blue RS, Vardiman JL, Castleberry TL, Vanderploeg JM. Screening and mitigation of layperson anxiety in aerospace environments. Aerosp Med Hum Perform. 2016; 87(10):882-889.

Measuring the ability of military aircrews to adapt to perceived stressors when undergoing centrifuge training.

This study assessed the ability of military aircrews to adapt to stressors when undergoing centrifuge training and determined what equipment items caused perceived stress and needed to be upgraded. We used questionnaires and the Rasch model to measure aircrew personnel's ability to adapt to centrifuge training. The measurement items were ranked by 611 military aircrew personnel. Analytical results indicated that the majority of the stress perceived by aircrew personnel resulted from the lightproof cockpit without outer reference. This study prioritized the equipment requiring updating as the lightproof cockpit design, the dim lighting of the cockpit, and the pedal design. A significant difference was found between pilot and non-pilot subjects' stress from the pedal design; and considerable association was discernible between the seat angle design and flight hours accrued. The study results provide aviators, astronauts, and air forces with reliable information as to which equipment items need to be urgently upgraded as their present physiological and psychological effects can affect the effectiveness of centrifuge training.