The occurrence of an accident in space can be expected to result in fear reactions. Research on responses to fear suggests several questions of relevance to extended spaceflight. Although the various measures of fear response (physiological, self-reports, and performance) are positively correlated, the precise relationship among these measures is not well understood. The dynamics of the fear response itself also deserve attention. Several authors (Noyes and Kletti,1976; W. Smith,1966) have found a lack of understanding or a denial to be the first response to threat. We need to understand how prevalent  such denial is, the time dimension associated with denial, and the relevance of training for reducing this period of inactivity.
Fear arousal follows prescribed patterns. In general, good performance has been associated with early arousal; that is, arousal in advance of the threatening event (Fenz and Epstein, 1967,1969; Fenz and Jones, 1972). From these data Epstein (1967) has postulated a generalized pattern of emotional response in which inhibition rises steeper than excitation, allowing the person to be in control when he or she must deal with the threat.
An hypothesis has been advanced that fear arousal is at a maximum when a decision must be made. Another hypothesis might also be considered. Some data suggest that fear responses are most pronounced at those points when something is likely to go wrong, whether or not there is anything one can do about it. For instance, we know from the work of Fenz and his collaborators that the arousal of experienced jumpers is very low just before they emerge from the aircraft. Yet Ouchida (in Levanthal and Lindsley, 1972) has found that experienced jumpers report themselves to be just as fearful as novice jumpers in the few seconds before their parachutes open. Just how peak fear relates to personal decision or transition points needs further evaluation.
Experiments on sports parachuting show that experience is an important predictor of both fear response and performance. However, the relationship between experience and training has not been determined. Other training questions concern the value of generalized stress training, the feasibility of training individuals to direct their attention outward or inward (e.g., to external or internal events), and training individuals in communication and coordination skills to function in a crisis situation.
The role of personal characteristics such as birth-order and gender eventually may prove useful in understanding reactions to severely threatening situations. However, available birth- order data are not sufficiently consistent to have predictive value, and gender studies have provided only preliminary conclusions.
Not all methods of dealing with stress are equally beneficial. It has been shown that blaming or scapegoating is a common method of dissipating stress after a crisis has occurred. Yet, blaming in the space environment could be costly. The first step to control this behavior is to determine the conditions under which such behavior occurs in  isolated and confined groups, and the forms this blaming behavior takes. Conversion reactions such as shared illnesses are other undesirable methods of relieving tension following a crisis. To aid the selection process, one might explore the relationship between conversion reactions and personal styles such as general rigidity or an inflexible approach to work obligations.
Research involving realistic threat situations often has ethical implications. Over the years, attitudes about this type of research have shifted markedly toward emphasizing the rights of test subjects. Although few would argue with this development, it is doubtful that future research involving fear responses will reach the levels of realistic simulation that has occurred in the past. Future studies of fear reactions will be restricted either to manipulations of low levels of fear, or to piggyback observations of events in which fear is a naturally occurring byproduct. In order to contribute to the research needs in this area, we should make ourselves aware of those situations in which information about fear responses can be gained without subjecting the individuals involved to additional stressors.
One of the broad challenges of the future is to begin to understand which factors will foster psychological health in the space environment. From the selection perspective, we need to identify those characteristics that are particularly well suited for dealing with crises, as well as with other conditions of space. Tests which could help identify the highly stable individual would be useful in reaching this goal. We also need to identify, and find methods of dealing with, those situations which could precipitate an on-board crisis. In this regard the work role commands particular attention. Since there are few ways of diffusing the potentially devastating effects of failure in space, emphasis must be placed on assuring that every member of the crew can succeed. In this regard we need to examine both the advantages and the disadvantages of work role specialization, and, more broadly, to understand the range of skills, both personal and professional, an individual must have to be integrated successfully into a crew.
We can assume that psychological health relates to how the individual deals with stress. Andrews et al. (1978) have shown stress reactions to be related to three factors: personality characteristics, patterns of coping, and the availability of social support. The personality characteristics they suggest as pertinent (anxiety proneness, self-esteem, and expectations of control), among others, should be examined. However, both patterns of coping and social support are  concepts that, though imperfectly understood, may be more fruitful avenues of investigation. What constitutes effective patterns of coping in the space environment? What are the social supports available in space? And, what are the factors associated with quality social support?
It is possible that, in spite of efforts to promote all aspects of health, psychological incidents could occur in space. In treating such incidents, we need to understand the effects of pharmacological agents in the weightless environment. More importantly, we need to explore nonpharmacological options. Particularly intriguing are the possibilities of group therapies aboard the spacecraft and remote counseling between the spacecraft and the ground. The latter poses questions concerning the adequacy of various mediated systems (audio, audiovisual, computer) in terms of feasibility, efficacy, privacy needs, etc. (see chapter VI).
In terms of personal techniques for maintaining emotional balance, the work of Schwartz et al. (1978) suggests some interesting possibilities. Basically, these authors describe two types of anxiety response - somatic and cognitive. These investigators found that people who exercise have lower somatic anxiety than people who meditate (although it is unclear whether somatic anxiety is reduced or cognitive anxiety elevated for exercisers). Follow-on studies should include all groups (those who exercise and meditate and those who do neither) and should explore how factors which relate to the mode of anxiety influence the choice of activity. Nor is it clear that the two modes identified constitute the most significant split. Schalling, Cronholm, and Asberg (1975) have found psychic (cognitive) anxiety to be more prominent in introverts than in extroverts, whereas somatic anxiety did not distinguish along this personality dimension. This finding suggests that there may be other equally valid ways to view anxiety. The exercise-meditation data are intriguing, since they suggest a relatively direct problem/therapy relationship. However, we are far from the point where we can confidently prescribe a particular kind of activity to relieve a particular form of anxiety.
Other events that could trigger a crisis within the crew are transcendent experiences such as the breakoff phenomenon, or drug-induced behavioral change. Significant questions include the special role of space physiology in perceptual and behavioral changes. The death of a family member or crewmember could precipitate a crisis. In the area of grief management, we need to be sure that selection  procedures exclude potentially pathological grievers. A suggested area of research toward this end would include an investigation of the relationship between phobic behavior and grief avoidance.
A question of particular relevance to the mental well-being of space travelers concerns how much they should be told of negative events involving relatives and friends at home. Although this question has surfaced regularly, it has never been addressed in a systematic fashion. When incidents arose during Polaris submarine cruises, the decision to inform or withhold information from a crewmember was left to the ship's captain. This solution was judged not altogether acceptable by the crewmembers affected (Weybrew, 1980, personal communication). A decision of this kind already has been required in space. On Soyuz 6, Commander Romanenko was informed by the visiting crew that the father of his companion, Cosmonaut Grechko, had died. Romanenko decided to keep the news from Grechko until they were safely back to Earth (Oberg, 1981). No mention is made of Grechko's later response on learning of this decision. Intuition suggests that the duration of a mission should be an important variable in the decision to inform or to withhold information. If a mission is relatively brief, crewmembers might be willing to suspend their right-to-know, assuming the probability of a serious negative event to be acceptably small. However, if crewmembers were to be away for long periods of time, even negative information might be preferable to ignorance. Just what is acceptable to crewmembers, and where along the time continuum the shift occurs (assuming it does) needs to be determined.
The discussion presented here is necessarily ground-based. It uses our experiences on Earth, modified by our guesses about how space would influence our expectations, to anticipate particular problems which might arise, treatments which could be useful, and questions which suggest themselves as Important. This approach should be supplemented, whenever and to whatever extent possible, by careful observation of the space experience.