Aerospace medicine and human performance最新文献

{"title":"Medical Events During Centrifuge Training in the Republic of Singapore Air Force: A 10-Year Analysis.","authors":"Yi Hui To, Jia Hao Alvin Woo, Jason Weizheng Low, Brian See, Jonathan Kwong","doi":"10.3357/AMHP.6829.2026","DOIUrl":"https://doi.org/10.3357/AMHP.6829.2026","url":null,"abstract":"<p><strong>Introduction: </strong>The Republic of Singapore Air Force uses the Human Training Centrifuge (HTC) to train aircrew in effective anti-G straining maneuvers and improve G tolerance. Training comprises computer-controlled (open-loop) profiles for trainees and dynamic flight simulation (closed-loop) profiles for trained aircrew, where simulated aerial combat maneuvers allow for pilot-controlled G onset rates. This study investigated medical incidents related to HTC usage in aviation physiology training.</p><p><strong>Methods: </strong>A retrospective audit was conducted of 8013 HTC runs over 10 yr (2014-2023), during which 103 medical incident reports were documented. Data was collected through incident report forms and analyzed using descriptive statistics and statistical tests to compare training profile outcomes.</p><p><strong>Results: </strong>Musculoskeletal injuries were the most prevalent (76.70%), with back pain being the predominant condition within this category (41.77%). Other conditions included cardiovascular (13.59%) and ophthalmological (3.88%) events. There were 3 medical incidents out of 955 (0.314%) closed-loop profiles, compared to 100 in 7058 (1.42%) open-loop profiles. Among reported incidents, 35 aircrew (33.98%) had significantly related past medical history. Post-incident, 73 aircrew (70.87%) completed centrifuge training eventually and returned to flying.</p><p><strong>Discussion: </strong>HTC training demonstrates a favorable safety profile with low complication rates, and most affected aircrew completed their training requirements successfully. The yearly reported incidents of medical events post-HTC have shown a general downward trend. Compared with open-loop training profiles, closed-loop training provides dual benefits of providing realistic scenarios while allowing aircrew to control G exposure parameters, resulting in significantly lower medical complications while achieving training objectives. To YH, Woo JHA, Low JW, See B, Kwong J. Medical events during centrifuge training in the Republic of Singapore Air Force: a 10-year analysis. Aerosp Med Hum Perform. 2026; 97(5):308-315.</p>","PeriodicalId":7463,"journal":{"name":"Aerospace medicine and human performance","volume":"97 5","pages":"308-315"},"PeriodicalIF":0.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147759609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of Thoracolumbar Spinal Fracture Caused by an Aircraft Accident.","authors":"Ferhat Harman, Yahya Guvenc, Can Kivrak, Efecan Cekic, Sedat Dalbayrak, Evren Aydogmus, Emre Korkmaz, Ender Sarioglu","doi":"10.3357/AMHP.6473.2026","DOIUrl":"https://doi.org/10.3357/AMHP.6473.2026","url":null,"abstract":"<p><strong>Introduction: </strong>Aircraft crashes are infrequent but often associated with high mortality, morbidity, and only a limited number of survivors. These events are classified as high-energy traumas as aircraft typically maintain significant vertical and horizontal speeds at impact. The forces generated can produce a wide range of injuries, from soft tissue damage to fractures, with particular concern for neurological injury. Due to the low number of survivors, few studies in the literature specifically address spinal injury patterns.</p><p><strong>Methods: </strong>We retrospectively evaluated thoracolumbar spinal injuries sustained in the aircraft accident that occurred in Istanbul on February 5, 2020. A total of 22 patients with thoracolumbar fractures were transferred to 4 different healthcare centers. Data were analyzed for age, sex, fracture level and morphology, neurological status, treatment methods, and radiological imaging findings.</p><p><strong>Results: </strong>There were 47 spinal injuries identified in 22 patients. Multiple-level fractures were observed in 12 patients. Four had neurological deficits (all American Spinal Injury Association Impairment Scale-D). According to the Thoracolumbar Injury Classification and Severity Score system, seven injuries in six patients were unstable and required surgery. Posterior decompression and stabilization were performed in six patients and vertebroplasty in one. Of the remaining patients, 10 were treated with a brace, and 5 were managed conservatively with pain palliation and supportive care.</p><p><strong>Discussion: </strong>Understanding and analyzing the data from this accident is essential for improving passenger and crew safety and may contribute to preventing morbidity and mortality in future aircraft crashes with changes and adjustments to seat and seatbelt design. Harman F, Guvenc Y, Kivrak C, Cekic E, Dalbayrak S, Aydogmus E, Korkmaz E, Sarioglu E. Management of thoracolumbar spinal fracture caused by an aircraft accident. Aerosp Med Hum Perform. 2026; 97(5):333-336.</p>","PeriodicalId":7463,"journal":{"name":"Aerospace medicine and human performance","volume":"97 5","pages":"333-336"},"PeriodicalIF":0.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147759597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of a Platform for In Vitro Hemodynamic Measurements in Varying Gravity Profiles.","authors":"Cyril Mani, Kevin Bates, Rosaire Mongrain, Richard L Leask","doi":"10.3357/AMHP.6823.2026","DOIUrl":"https://doi.org/10.3357/AMHP.6823.2026","url":null,"abstract":"<p><strong>Introduction: </strong>Understanding cerebrovascular flow under varying gravity is critical to mitigating flight risks such as acceleration-induced near-loss-of-consciousness and, at higher loads, gravity-induced loss-of-consciousness. While in vivo studies offer insight into carotid responses during gravitational transitions and microgravity, detailed vascular flow mapping remains limited by imaging constraints. This work presents a novel in vitro carotid bifurcation model enabling high-resolution analysis of flow behavior across static and transient gravity profiles and orientations, focusing on mechanisms driving cerebral hypoperfusion.</p><p><strong>Methods: </strong>The platform uses a patient-derived polydimethylsiloxane carotid model perfused with a glycerol-water blood analog seeded with tracer particles. Flow was tracked using a high-speed camera and particle image velocimetry. Parabolic flight experiments spanned 0 Gz, +1 Gz, and \"push-pull\" +2 Gz transitions in supine and vertical orientations. Velocity, vorticity, wall shear stress, and recirculation dynamics were derived from the velocity fields.</p><p><strong>Results: </strong>Flow behavior depended on gravity and orientation. Under 0 Gz, separation points were stable at 3.6-3.8 mm downstream of the apex. With increasing Gz, they shifted upstream to 1.22 mm in vertical +2 Gz. Recirculation height increased by 22% (+1 Gz supine), 40% (+1 Gz vertical), and 62% (+2 Gz vertical) vs. 0 Gz. Peak wall shear stress increased by 19% from 0 Gz to +1 Gz supine, 59% from supine to vertical at +1 Gz, and reached 4.02 Pa in +2 Gz vertical. Vorticity declined with +Gz, indicating reduced rotational fluid motion.</p><p><strong>Discussion: </strong>This in vitro platform advances cerebrovascular hemodynamics research under varying gravity, enabling analysis of phenomena difficult to capture in vivo. It enables controlled study of flow phenomena, orientation effects, and validation of computational models. Mani C, Bates K, Mongrain R, Leask RL. Development of a platform for in vitro hemodynamic measurements in varying gravity profiles. Aerosp Med Hum Perform. 2026; 97(5):316-326.</p>","PeriodicalId":7463,"journal":{"name":"Aerospace medicine and human performance","volume":"97 5","pages":"316-326"},"PeriodicalIF":0.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147759467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Black Hole Approach and The Italian Experience.","authors":"Luigi Cacciapuoti, Laura Piccardi, Marcello Paolillo, Matilde Grieco, Mariagrazia Vittorini, Paola Verde","doi":"10.3357/AMHP.6740.2026","DOIUrl":"https://doi.org/10.3357/AMHP.6740.2026","url":null,"abstract":"<p><strong>Introduction: </strong>Spatial disorientation poses a significant hazard to aviators, particularly during low-visibility conditions, such as nocturnal operations or adverse weather scenarios. Visual illusions, exacerbated by the absence of external references, can mislead pilots into incorrect judgments of aircraft orientation, potentially resulting in catastrophic consequences. Perrone's black hole approach theory describes how lateral reference loss distorts perceived approach angles during landing.</p><p><strong>Methods: </strong>This study systematically assessed black hole approach risk at 119 Italian civil and military airports using Perrone's visual slant misperception formula to calculate apparent glide path angles. Airports were categorized into four risk levels: low (2-4°), moderate (4-6°), medium (6-8°), and high (>8°).</p><p><strong>Results: </strong>Analysis revealed that nine airports (7.6% of total) presented medium to high risk (descent angles ≥6°) yet lacked Precision Approach Path Indicator (PAPI) systems as of February 2025. Further investigation demonstrated that none of these airports are authorized for nighttime operations; thus, primary black hole approach conditions are avoided.</p><p><strong>Discussion: </strong>These findings raise questions about whether airports lack PAPI systems because night operations are not authorized or whether the absence of visual aids drives operational limitations. Results underscore the critical importance of comprehensive pilot training in recognizing and recovering from spatial disorientation, relying on onboard instruments, and implementing advanced guidance systems. The analysis highlights the role of visual aids, such as PAPI and the Instrument Landing System, in ensuring flight safety and demonstrates the need for standardized risk assessment protocols that integrate airport physical characteristics with operational context and available safety infrastructure. Cacciapuoti L, Piccardi L, Paolillo M, Grieco M, Vittorini M, Verde P. The black hole approach and the Italian experience. Aerosp Med Hum Perform. 2026; 97(5):375-378.</p>","PeriodicalId":7463,"journal":{"name":"Aerospace medicine and human performance","volume":"97 5","pages":"375-378"},"PeriodicalIF":0.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147759693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Follow-Up of Helicopter Pilots Using Monocular Helmet Displays Shows No Anisometropia.","authors":"Simon J W M Cornelissen, Maurits de Jong, Maarten B Jalink","doi":"10.3357/AMHP.6754.2026","DOIUrl":"https://doi.org/10.3357/AMHP.6754.2026","url":null,"abstract":"<p><strong>Introduction: </strong>Pilots of multiple rotary-wing platforms of the Royal Netherlands Air and Space Force operate with monocular helmet-mounted displays (HMDs) that project flight or weapon symbology over the right eye. In particular, AH-64 Apache pilots continuously use the Integrated Helmet and Display Sight System, whereas AS532 Cougar pilots use a monocular HMD mainly during degraded visual environments. Although these systems are calibrated to project imagery at optical infinity, incorrect calibration may induce accommodation. There is concern that prolonged monocular accommodation could lead to myopization and, ultimately, anisometropia.</p><p><strong>Methods: </strong>Longitudinal aeromedical screening data from Dutch rotary-wing pilots were retrospectively analyzed over a 12-yr period (2012-2023). In total, 336 pilots with 3,169 ophthalmological screenings were included. Apache and Cougar pilots constituted the experimental groups and were compared with pilots from other rotary-wing platforms without monocular HMD use. Anisometropia was defined as a ≥1 diopter difference in spherical equivalent between both eyes.</p><p><strong>Results: </strong>Among Apache (N = 126) and Cougar (N = 62) pilots, only 1 case of anisometropia was identified, occurring in an Apache pilot with prior refractive surgery and without progression over time. In the control group (N = 150), 2 cases of anisometropia were observed, 1 of which was present at baseline.</p><p><strong>Discussion: </strong>These longitudinal data show no evidence that prolonged use of monocular HMD is associated with the development of permanent anisometropia in rotary-wing pilots. Cornelissen SJWM, de Jong M, Jalink MB. Long-term follow-up of helicopter pilots using monocular helmet displays shows no anisometropia. Aerosp Med Hum Perform. 2026; 97(5):372-374.</p>","PeriodicalId":7463,"journal":{"name":"Aerospace medicine and human performance","volume":"97 5","pages":"372-374"},"PeriodicalIF":0.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147759541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diabetic Ketoacidosis Reported from U.S. Navy Submarines, 2021-2024.","authors":"David M Monroe, James P Earley","doi":"10.3357/AMHP.6758.2026","DOIUrl":"https://doi.org/10.3357/AMHP.6758.2026","url":null,"abstract":"<p><strong>Background: </strong>Type 1 diabetes mellitus (T1DM) is a complex systemic condition that poses unique challenges for diagnosis and management in military environments, particularly on submarines where access to standard medical resources is limited.</p><p><strong>Case series: </strong>This case series examines three instances of a first diagnosis of T1DM among active duty male U.S. Navy submariners, highlighting the challenges of managing this condition in austere military environments. Case 1 involves a 27-yr-old experiencing gastrointestinal symptoms during deployment and found to have diabetic ketoacidosis (DKA) complicated by renal failure and pancreatitis. Case 2 features a 22-yr-old presenting with weakness and fatigue on board leading to a diagnosis of DKA and pancreatitis. In Case 3, a 20-yr-old initially treated for pilonidal disease later manifests classic T1DM symptoms, leading to delayed diagnosis despite increased access to care in port.</p><p><strong>Discussion: </strong>These cases underscore the importance of early recognition and intervention, particularly in environments with limited medical resources. Delays in communication and access to higher echelons of care further compound the challenges of managing T1DM and DKA on submarines. To address these issues, the Naval Undersea Medical Institute has developed protocols to empower medical personnel in diagnosing and managing T1DM in such settings. By sharing these experiences, this report aims to improve awareness and preparedness for managing T1DM in submarines, ultimately enhancing the care provided to patients in austere military environments. Monroe DM, Earley JP. Diabetic ketoacidosis reported from U.S. Navy submarines, 2021-2024. Aerosp Med Hum Perform. 2026; 97(5):379-383.</p>","PeriodicalId":7463,"journal":{"name":"Aerospace medicine and human performance","volume":"97 5","pages":"379-383"},"PeriodicalIF":0.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147759515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Join a Committee!","authors":"Anthony Wagstaff","doi":"10.3357/AMHP.PP9705.2026","DOIUrl":"https://doi.org/10.3357/AMHP.PP9705.2026","url":null,"abstract":"","PeriodicalId":7463,"journal":{"name":"Aerospace medicine and human performance","volume":"97 5","pages":"307"},"PeriodicalIF":0.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147759517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Microgravity-Induced Ocular Changes Assessed by Optical Coherence Tomography.","authors":"Merna Raafat Roshdy, Mina Botros, Abanoub Mokhles, Weronika Matwiejuk, Antonia R Keriakos","doi":"10.3357/AMHP.6777.2026","DOIUrl":"https://doi.org/10.3357/AMHP.6777.2026","url":null,"abstract":"<p><strong>Introduction: </strong>Long-duration space missions pose a risk to visual health due to cephalad fluid shifts in microgravity; this can affect ocular structures, causing decreased astronaut performance in addition to long-term side effects. Understanding these changes is essential for developing effective countermeasures against spaceflight-associated neuro-ocular syndrome. We reviewed how head-down tilt (HDT)-a terrestrial analog of microgravity-affects ocular parameters measured by optical coherence tomography (OCT) and intraocular pressure (IOP).</p><p><strong>Methods: </strong>Seven databases were searched through May 2025 for studies involving human subjects undergoing HDT at any angle or duration with OCT-based outcomes: total retinal thickness (TRT), retinal nerve fiber layer thickness (RNFLT), and choroidal thickness. Two reviewers extracted data and assessed risk of bias using ROBINS-I v2.</p><p><strong>Results: </strong>There were 11 studies (133 subjects) which met inclusion criteria. Mild HDT (∼6°) caused moderate IOP elevation (+2-4 mmHg) and slight TRT thickening over several days. Prolonged HDT (15-65 d) produced cumulative TRT (+35-54 µm) and RNFLT (+2-7 µm) increases, with occasional choroidal folds. Steeper tilts (-10° to -15°) triggered rapid IOP rises (up to +7 mmHg) and acute choroidal thickness changes. Post-HDT recovery was often incomplete, with delayed normalization of TRT and RNFLT.</p><p><strong>Discussion: </strong>HDT-induced changes in IOP and OCT parameters support the role of cephalad fluid shifts in disrupting cranial venous outflow and causing ocular structural changes. Future research should standardize methodology with longer follow-up periods to improve the translational relevance of findings to spaceflight-associated neuro-ocular syndrome. Roshdy MR, Botros M, Mokhles A, Matwiejuk W, Keriakos AR. Microgravity-induced ocular changes assessed by optical coherence tomography. Aerosp Med Hum Perform. 2026; 97(5):362-371.</p>","PeriodicalId":7463,"journal":{"name":"Aerospace medicine and human performance","volume":"97 5","pages":"362-371"},"PeriodicalIF":0.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147759581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using Galvanic Vestibular Stimulation to Null and Enhance Real-World Motion Perception.","authors":"Gaurav N Pradhan, Raquel C Galvan-Garza, Jamie M Bogle, Alison M Perez, Sarah E Kingsbury, Jan Stepanek, Michael J Cevette","doi":"10.3357/AMHP.6655.2026","DOIUrl":"https://doi.org/10.3357/AMHP.6655.2026","url":null,"abstract":"<p><strong>Introduction: </strong>Directional galvanic vestibular stimulation (GVS) influences the vestibular neural firing rate to provide sensations of yaw, pitch, or roll in the absence of real motion. However, there is also great interest in using GVS to actively modulate motion perception during physical movement in dynamic, real-world contexts. The purpose of this study is to evaluate the effectiveness of GVS in either nulling or enhancing full-body yaw and pitch perceptions of a subject seated upright in a rotating chair.</p><p><strong>Methods: </strong>Using a randomized, counter-balanced design, 20 subjects completed yaw-right and pitch-forward sessions in a motion-controlled chair on the same day. During each rotational chair session (yaw-right and pitch-forward), there were three GVS conditions tested: additive (GVS current sent in the same direction of rotation), nulling (GVS current sent in the opposite direction of rotation), and no GVS (control condition; no GVS during rotation).</p><p><strong>Results: </strong>After subjects reliably marked the speed of chair rotation at baseline, in the no GVS condition, there were statistically significant differences detected in the perceived self-motion shown through the joystick position in both the additive (+60%) and nulling (-100%) conditions during yaw-right chair rotation and in the additive (+67%) condition during pitch-forward.</p><p><strong>Discussion: </strong>This research establishes a foundation for applying GVS at higher stimulation levels in multiaxis motion scenarios to enhance and null self-motion perception in operational moving environments. These findings provide further evidence that vestibular signals can be artificially manipulated to influence perceptual outcomes, encouraging applications in motion simulation, balance training, and sensorimotor research. Pradhan GN, Galvan-Garza RC, Bogle JM, Perez AM, Kingsbury SE, Stepanek J, Cevette MJ. Using galvanic vestibular stimulation to null and enhance real-world motion perception. Aerosp Med Hum Perform. 2026; 97(5):344-353.</p>","PeriodicalId":7463,"journal":{"name":"Aerospace medicine and human performance","volume":"97 5","pages":"344-353"},"PeriodicalIF":0.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147759702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychological Profile of Aviators and Flight Aspirants with High-Risk and Self-Harm Behavior.","authors":"Sowgandhi N Chaturvedula, Yashvir S Dahiya, Anudeep Uppuluri, Maalvika Bhuvansunder, Shahin Sonali","doi":"10.3357/AMHP.6782.2026","DOIUrl":"https://doi.org/10.3357/AMHP.6782.2026","url":null,"abstract":"<p><strong>Background: </strong>In a high-stakes context like aviation, deliberate self-harm (DSH) warrants attention, as it may signal underlying psychological vulnerabilities. Understanding the psychological risk profiles of civil aviators and aspirants with DSH is therefore crucial for ensuring aviation safety. A dearth of research in this area has prompted the need for profiling psychological risk factors for DSH and high-risk behavior in civil aviation to ensure fitness to fly. The current paper is a review of six cases assigned for DSH referred to the qualified examiner.</p><p><strong>Case series: </strong>A retrospective case series of six individuals (four females and two males; five aircrew aspirants and one active aviator) with a history of DSH who were referred for psychological assessment by the civil aviation authority to ascertain fitness to fly. Clinical interviews, mental status examinations, and personality assessments were analyzed to explore their underlying traits and coping mechanisms. Psychological risk factors for DSH included adolescent onset, gender, and personality traits such as impulsivity, emotional instability, external locus of control, low compliance and trust, emotional distress, and vacillating opinions. Operational and training stressors also contributed.</p><p><strong>Discussion: </strong>DSH reflects primary psychological vulnerabilities marked by impulsivity, emotional dysregulation, and maladaptive coping. Integrating demographic, personality, and defense mechanism factors with operational and training stressors in psychological screening can help flag at-risk individuals. Strengthening early assessment is crucial for excluding those unfit for piloting and ensuring flight safety. Hence it is recommended that case-by-case psychological clearance is carried out for high-risk and DSH candidates. Chaturvedula SN, Dahiya YS, Uppuluri A, Bhuvansunder M, Sonali S. Psychological profile of aviators and flight aspirants with high-risk and self-harm behavior. Aerosp Med Hum Perform. 2026; 97(5):384-388.</p>","PeriodicalId":7463,"journal":{"name":"Aerospace medicine and human performance","volume":"97 5","pages":"384-388"},"PeriodicalIF":0.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147759557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}