Sports Medicine

, Volume 16, Issue 2, pp 97–125 | Cite as

Effects of Altitude on Mood, Behaviour and Cognitive Functioning

A Review
  • Michael S. Bahrke
  • Barbara Shukitt-Hale
Review Article


Alterations in psychological mood, personality, behaviour and cognitive functioning associated with altitude have been recognised for many years. Psychological and behavioural changes resulting from the effects of hypoxia often include increases in euphoria, irritability, hostility and impairment of neuropsychological functions such as vision and memory. There is limited research to indicate that some decrements may persist for up to a year, or longer, after return to lower elevation. However, generalisations of the effects of altitude on mood, behaviour and cognitive function are complicated by differences between studies including the specific tasks or dimensions measured, methods of measurement, degree of altitude, duration of exposure and types of participants. There also appear to be wide individual differences in the response to altitude sojourns. Investigations designed to measure symptoms and mood changes during actual mountain climbs are needed, since most of the systematic research has been conducted in altitude chambers. The extent to which these simulations can be generalised to actual altitude settings remains to be documented.


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  1. Adler HF, Burkhardt WL, Ivy AC, Atkinson AJ. Effect of various drugs on psychomotor performance at ground level and at simulated altitudes of 18 000 feet in a low pressure chamber. Journal of Aviation Medicine 21: 221–236, 1950PubMedGoogle Scholar
  2. Armstrong HG. A special form of psychoneurosis appearing in airplane pilots. Journal of the American Medical Association 106: 1347–1354, 1936Google Scholar
  3. Armstrong HG, Heim JW. Effects of repeated daily exposure to anoxemia. Journal of Aviation Medicine 9: 92–96, 1938Google Scholar
  4. Arregui A, Cabrera J, Leon-Velarde F, Paredes S, Viscarra D, et al. High prevalence of migraine in a high-altitude population. Neurology 41: 1668–1670, 1991PubMedGoogle Scholar
  5. Bagby E. The psychological effects of oxygen deprivation. Journal of Comparative Psychology 1: 97–113, 1921Google Scholar
  6. Banderet LE, Burse RL. Effects of high terrestrial altitude on military performance. In Gal & Mangelsdorff (Eds) Handbook of military psychology, John Wiley & Sons Ltd, London, dy1991Google Scholar
  7. Banderet LE, Lieberman HR. Treatment with tyrosine, a neurotransmitter precursor, reduces environmental stress in humans. Brain Research Bulletin 22: 759–762, 1989PubMedGoogle Scholar
  8. Barach AL. The treatment of heart failure by continuous oxygen therapy. Anesthesiology and Analgesia 14: 79–88, 1935Google Scholar
  9. Barach AL. The effect of low and high oxygen tensions on mental functioning. Journal of Aviation Medicine 12: 30–38, 1941Google Scholar
  10. Barach AL. Impairment in emotional control produced both by lowering and raising the oxygen pressure in the atmosphere. Medical Clinics of North America 28: 704–718, 1944Google Scholar
  11. Barach AL, Kagan J. Disorders of mental functioning produced by varying the oxygen tension of the atmosphere. Psychosomatic Medicine 2: 53–67, 1940Google Scholar
  12. Barcroft, J. Mountain sickness. Nature 114: 90–92, 1924Google Scholar
  13. Berry DTR, Webb WB, Block AJ, Bauer RM, Switzer DA. Nocturnal hypoxia and neuropsychological variables. Journal of Clinical and Experimental Neuropsychology 8: 229–238, 1986PubMedGoogle Scholar
  14. Billings CE. Evaluation of performance using the Gedye task. Aerospace Medicine 45: 128–131, 1974PubMedGoogle Scholar
  15. Bills AG. Blocking in mental fatigue and anoxemia compared. Journal of Experimental Psychology 20: 437–452, 1937Google Scholar
  16. Birmingham Medical Research Expeditionary Society Mountain Sickness Study Group. Acetazolamide in control of acute mountain sickness. Lancet 1: 180–183, 1981Google Scholar
  17. Bradwell AR, Wright AD, Winterborn M, Imray C. Acetazolamide and high altitude diseases. International Journal of Sports Medicine 13 (Suppl. 1): S63–S64, 1992PubMedGoogle Scholar
  18. Cahoon RL. Vigilance performance under hypoxia. Journal of Applied Psychology 54: 479–483, 1970PubMedGoogle Scholar
  19. Cahoon RL. Simple decision making at high altitude. Ergonomics 15: 157–164, 1972PubMedGoogle Scholar
  20. Carson RP, Evans WO, Shields JL, Hannon JP. Symptomatology, pathophysiology, and treatment of acute mountain sickness. Federation Proceedings 28: 1085–1091, 1969PubMedGoogle Scholar
  21. Carver RP, Winsmann FR. Effect of high elevation upon physical proficiency, cognitive functioning and subjective symptomatology. Perceptual and Motor Skills 26: 223–230, 1968PubMedGoogle Scholar
  22. Cavaletti G, Garavaglia P, Arrigoni G, Tredici G. Persistent memory impairment after high altitude climbing. International Journal of Sports Medicine 11: 176–178, 1990PubMedGoogle Scholar
  23. Cavaletti G, Moroni R, Garavaglia P, Tredici G. Brain damage after high-altitude climbs without oxygen. Lancet 1: 101, 1987PubMedGoogle Scholar
  24. Cavaletti G, Tredici G. Effects of exposure to low oxygen pressure on the central nervous system. Sports Medicine 13: 1–7, 1992PubMedGoogle Scholar
  25. Clark CF, Heaton RK, Wiens AN. Neuropsychological functioning after prolonged high altitude exposure in mountaineering. Aviation Space and Environmental Medicine 54: 202–207, 1983Google Scholar
  26. Collins WE, Mertens HW. Age, alcohol, and simulated altitude: effects on performance and breathalyzer scores. Aviation Space and Environmental Medicine 59: 1026–1033, 1988Google Scholar
  27. Collins WE, Mertens HW, Higgins EA. Some effects of alcohol and simulated altitude on complex performance scores and breathalyzer readings. Aviation Space and Environmental Medicine 58: 328–332, 1987Google Scholar
  28. Consolazio CF, Matoush LO, Nelson RA. Energy metabolism in maximum and submaximum performance at high altitudes. Federation Proceedings 25: 1380–1385, 1966PubMedGoogle Scholar
  29. Coward FA. Mountain sickness as observed in the Andes. Journal of the South Carolina Medical Association 2: 123–125, 1906Google Scholar
  30. Crow TJ, Kelman GR. Psychological effects of mild hypoxia. Journal of Physiology 24: 204, 1969Google Scholar
  31. Crow TJ, Kelman GR. Effect of mild acute hypoxia on human short-term memory. British Journal of Anaesthesia 43: 548–552, 1971PubMedGoogle Scholar
  32. Crow TJ, Kelman GR. Psychological effects of mild acute hypoxia. British Journal of Anaesthesia 45: 335–337, 1973PubMedGoogle Scholar
  33. Crowley JS, Wesensten N, Kamimori G, Devine J, Iwanyk E, et al. Effect of high terrestrial altitude and supplemental oxygen on human performance and mood. Aviation Space and Environmental Medicine 63: 696–701, 1992Google Scholar
  34. Cudaback DD. Four-km altitude effects on performance and health. Publications of the Astronomical Society of the Pacific 96: 463–477, 1984Google Scholar
  35. Denison DM, Ledwith F, Poulton EC. Complex reaction times at simulated cabin altitudes of 5000 feet and 8000 feet. Aerospace Medicine 37: 1010–1013, 1966PubMedGoogle Scholar
  36. Dunlap K. Medical studies in aviation: IV. Psychologic observations and methods. Journal of the American Medical Association 71: 1392–1393, 1918Google Scholar
  37. Dusek ER, Hansen JE. Biomedical study of military performance at high terrestrial elevation. Military Medicine 134: 1497–1507, 1969PubMedGoogle Scholar
  38. Editorial. ‘Brutal’ year for climbers on Alaska’s Mt McKinley. USA Today, June 29: 4A, 1992aGoogle Scholar
  39. Editorial. The fatal attraction of Mount McKinley. USA Today, July 31: 4D, 1992bGoogle Scholar
  40. Ernsting J. The 10th Annual Harry G. Armstrong Lecture: prevention of hypoxia — acceptable compromises. Aviation Space and Environmental Medicine 49: 495–502, 1978Google Scholar
  41. Ernsting J. Mild hypoxia and the use of oxygen in flight. Aviation Space and Environmental Medicine 55: 407–410, 1984Google Scholar
  42. Evans WO. Measurement of subjective symptomatology of acute high altitude sickness. Psychological Reports 19: 815–820, 1966PubMedGoogle Scholar
  43. Evans WO, Consolazio CF. Effects of high altitude on performance of three different types of work. Perceptual and Motor Skills 25: 41–50, 1967PubMedGoogle Scholar
  44. Evans WO, Robinson SM, Horstman DH, Jackson RE, Weiskopf RB. Amelioration of the symptoms of acute mountain sickness by staging and acetazolamide. Aviation Space and Environmental Medicine 47: 512–516, 1976Google Scholar
  45. Evans WO, Witt NF. The interaction of high altitude and psychotropic drug action. Psychopharmacologia 10:184–188, 1966PubMedGoogle Scholar
  46. Ewing R, McCarthy D, Gronwall D, Wrightson P. Persisting effects of minor head injury observable during hypoxic stress. Journal of Clinical Neuropsychology 2: 147–155, 1980Google Scholar
  47. Ferrazzini G, Maggiorini M, Kriemler S, Bartsch P, Oelz O. Successful treatment of acute mountain sickness with dexamethasone. British Medical Journal 294: 1380–1382, 1987PubMedGoogle Scholar
  48. Figarola TR, Billings CE. Effects of meprobamate and hypoxia on psychomotor performance. Aerospace Medicine 37: 951–954, 1966PubMedGoogle Scholar
  49. Fine BJ. Personality traits as related to symptomatology and running performance at altitude under normal and drug (aceta-zoleamide) conditions. Perceptual and Motor Skills 27: 975–990, 1968PubMedGoogle Scholar
  50. Fine BJ, Kobrick JL. Effects of altitude and heat on complex cognitive tasks. Human Factors 20: 115–122, 1978Google Scholar
  51. Finesinger JE. The spirogram in certain psychiatric disorders. American Journal of Psychiatry 100: 159–169, 1943Google Scholar
  52. Finesinger JE, Lindemann E, Brazier MAB, Chappie ED. The effect of anoxia as measured by the electroencephalogram and the interaction chronogram of psychoneurotic patients. American Journal of Psychiatry 103: 738–748, 1947PubMedGoogle Scholar
  53. Forster HV, Soto RJ, Dempsey JA, Hosko MJ. Effect of sojourn at 4,300 m altitude on electroencephalogram and visual evoked response. Journal of Applied Physiology 39: 109–113, 1975PubMedGoogle Scholar
  54. Forster PJG. Effect of different ascent profiles on performance at 4,200m elevation. Aviation Space and Environmental Medicine 56: 758–764, 1985Google Scholar
  55. Forwand SA, Landowne M, Follansbee JN, Hansen JE. Effect of acetazolamide on acute mountain sickness. New England Journal of Medicine 279: 839–845, 1968PubMedGoogle Scholar
  56. Fowler B, Paul M, Porlier G, Elcombe DD, Taylor M. A re-evaluation of the minimum altitude at which hypoxic performance decrements can be detected. Ergonomics 28: 781–791, 1985PubMedGoogle Scholar
  57. Fowler B, Porlier G. The threshold for hypoxia effects on perceptual-motor performance. Human Factors 29: 61–66, 1987PubMedGoogle Scholar
  58. Fowles R, Loeb PD. The interactive effect of alcohol and altitude on traffic fatalities. Southern Economic Journal 59: 108–112, 1992Google Scholar
  59. Fulco CS, Rock PB, Reeves JT, Trad LA, Young PM, et al. Effects of propranolol on acute mountain sickness (AMS) and well-being at 4300 meters of altitude. Aviation Space and Environmental Medicine 60: 679–683, 1989Google Scholar
  60. Gerathewohl SJ. Method for the analysis of psychomotor performance under hypoxia. Journal of Aviation Medicine 22: 196–207, 1951PubMedGoogle Scholar
  61. Gibson GE, Pulsinelli W, Blass JP, Duffy TE. Brain dysfunction in mild to moderate hypoxia. American Journal of Medicine 70: 1247–1254, 1981PubMedGoogle Scholar
  62. Gill MB, Poulton EC, Carpenter A, Woodhead MM, Gregory MHP. Falling efficiency at sorting cards during acclimatization at 19 000 feet. Nature 203: 436, 1964PubMedGoogle Scholar
  63. Glaisher J, Flammarion C, De Fonvielle E, Tissander G. Ascents from Wolverhampton. In Glaisher (Ed) Travels in the air, Lippincott, Philadelphia, 1871Google Scholar
  64. Gray GW, Bryan AC, Frayser R, Houston CS, Rennie IDB. Control of acute mountain sickness. Aerospace Medicine 42: 81–84, 1971PubMedGoogle Scholar
  65. Green RG, Morgan DR. The effects of mild hypoxia on a logical reasoning task. Aviation Space and Environmental Medicine 56: 1004–1008, 1985Google Scholar
  66. Greene R. Mental performance in chronic anoxia. British Medical Journal 1: 1028–1031, 1957PubMedGoogle Scholar
  67. Hackett PH, Rennie D. The incidence, importance, and prophylaxis of acute mountain sickness. Lancet 2: 1149–1155, 1976PubMedGoogle Scholar
  68. Haldane JS, Kellas AM, Kennaway EL. Experiments on acclimatisation to reduced atmospheric pressure. Journal of Physiology 53: 183–206, 1919Google Scholar
  69. Haldane JS, Priestley JG. Respiration, 2nd ed., Yale University Press, New Haven, 1935Google Scholar
  70. Hansen JE, Harris CW, Evans WO. Influence of elevation of origin, rate of ascent and a physical conditioning program on symptoms of acute mountain sickness. Military Medicine 132: 585–592, 1967PubMedGoogle Scholar
  71. Heath D, Williams DR. Life at high altitude, University Park Press, Baltimore, 1979Google Scholar
  72. Heber AR. Some effects of altitude on the human body. Lancet 1: 1148–1150, 1921Google Scholar
  73. Herr RD. High altitude and the central nervous system. New England Journal of Medicine 322: 1821–1822, 1990Google Scholar
  74. Hertzman M, Orlansky J, Seitz CP. Personality organization and anoxia tolerance. Psychosomatic Medicine 6: 317–331, 1944Google Scholar
  75. Hertzman M, Seitz CP, Orlansky J. Stability of personality under anoxia. Journal of General Psychology 52: 65–73, 1955Google Scholar
  76. Himwich HE. Brain metabolism and cerebral disorders, Williams and Wilkins, Baltimore, 1951Google Scholar
  77. Hornbein TF. Long term effects of high altitude on brain function. International Journal of Sports Medicine 13 (Suppl. 1): S43–S45, 1992PubMedGoogle Scholar
  78. Hornbein TF, Townes BD, Schoene RB, Sutton JR, Houston CS. The cost to the central nervous system of climbing to extremely high altitude. New England Journal of Medicine 321: 1714–1719, 1989PubMedGoogle Scholar
  79. Horstman DH, Weiskopf R, Robinson S. The nature of the perception of effort at sea level and high altitude. Medicine and Science in Sports and Exercise 11: 150–154, 1979Google Scholar
  80. House JL, Joy RJT. Performance of simulated military tasks at high altitude. Perceptual and Motor Skills 27: 471–481, 1968PubMedGoogle Scholar
  81. Hultgren HN. High altitude medical problems. Western Journal of Medicine 131: 8–23, 1979PubMedGoogle Scholar
  82. Hultgren H, Spickard W. Medical experiences in Peru. Stanford Medical Bulletin 18: 76–95, 1960Google Scholar
  83. Jason GW, Pajurkova EM, Lee RG. High-altitude mountaineering and brain function: neuropsychological testing of members of a Mount Everest expedition. Aviation Space and Environmental Medicine 60: 170–173, 1989Google Scholar
  84. Jobe JB, Shukitt-Hale B, Banderet LE, Rock PB. Effects of dexa-methasone and high terrestrial altitude on cognitive performance and affect. Aviation Space and Environmental Medicine 62: 727–732, 1991Google Scholar
  85. Johnson TS, Rock PB. Current concepts: acute mountain sickness. New England Journal of Medicine 319: 841–845, 1988PubMedGoogle Scholar
  86. Kassirer MR, Von Pelejo Such R. Persistent high-altitude headache and ageusia without anosmia. Archives of Neurology 46: 340–341, 1989PubMedGoogle Scholar
  87. Katz IR. Is there a hypoxic affective syndrome? Psychosomatics 23: 846–853, 1982PubMedGoogle Scholar
  88. Kelman GR, Crow TJ. Impairment of mental performance at a simulated altitude of 8000 feet. Aerospace Medicine 40: 981–982, 1969PubMedGoogle Scholar
  89. Kelman GR, Crow TJ, Bursill AE. Effect of mild hypoxia on mental performance assessed by a test of selective attention. Aerospace Medicine 40: 301–303, 1969PubMedGoogle Scholar
  90. Kennedy RS, Dunlap WP, Banderet LE, Smith MG, Houston CS. Cognitive performance deficits in a simulated climb of Mount Everest: Operation Everest II. Aviation Space and Environmental Medicine 60: 99–104, 1989Google Scholar
  91. Kobrick JL. Effects of exposure to 12 800 feet and acetazolamide on visual performance. Perceptual and Motor Skills 27: 939–944, 1968PubMedGoogle Scholar
  92. Kobrick JL, Appleton B. Effects of extended hypoxia on visual performance and retinal vascular state. Journal of Applied Physiology 31: 357–362, 1971PubMedGoogle Scholar
  93. Kobrick JL, Crohn E, Shukitt B, Houston CS, Sutton JR. Operation Everest II: lack of an effect of extreme altitude on visual contrast sensitivity. Aviation Space and Environmental Medicine 59: 160–164, 1988Google Scholar
  94. Kobrick JL, Dusek ER. Effects of hypoxia on voluntary response time to peripherally located visual stimuli. Journal of Applied Physiology 29: 444–448, 1970PubMedGoogle Scholar
  95. Kobrick JL, Sampson JB. New inventory for the assessment of symptom occurrence and severity of high altitude. Aviation Space and Environmental Medicine 50: 925–929, 1979Google Scholar
  96. Kobrick JL, Zwick H, Witt CE, Devine JA. Effects of extended hypoxia on night vision. Aviation Space and Environmental Medicine 55: 191–195, 1984Google Scholar
  97. Koller EA, Bischoff M, Buhrer A, Felder L, Schopen M. Respiratory, circulatory and neuropsychological responses to acute hypoxia in acclimatized and nonacclimatized subjects. European Journal of Applied Physiology and Occupational Physiology 62: 67–72, 1991PubMedGoogle Scholar
  98. Ledwith F. The effects of hypoxia on choice reaction time and movement time. Ergonomics 13: 465–482, 1970PubMedGoogle Scholar
  99. Levine BD, Yoshimura K, Kobayashi T, Fukushima M, Shibamoto T, et al. Dexamethasone in the treatment of acute mountain sickness. New England Journal of Medicine 321: 1707–1713, 1989PubMedGoogle Scholar
  100. Lowson JP. The effects of deprivation of oxygen upon mental processes. British Journal of Psychology 13: 417–434, 1923Google Scholar
  101. Mackintosh JH, Thomas DJ, Olive JE, Chesner IM, Knight RJE. The effect of altitude on tests of reaction time and alertness. Aviation Space and Environmental Medicine 59: 246–248, 1988Google Scholar
  102. Magni G, Rupolo G, Simini G, DeLeo D, Rampazzo M. Aspects of the psychology and personality of high altitude mountain climbers. International Journal of Sport Psychology 16: 12–19, 1985Google Scholar
  103. Malhotra MS, Mathew L. Effect of prolonged stay at altitude (4000 m) on autonomic balance. Aerospace Medicine 45: 869–872, 1974PubMedGoogle Scholar
  104. Malhotra MS, Selvamurthy W, Purkayastha SS, Mukherjee AK, Mathew L, et al. Responses of the autonomic nervous system during acclimatization to high altitude in man. Aviation Space and Environmental Medicine 47: 1076–1079, 1976Google Scholar
  105. Mazess RB, Picon-Reategui E, Thomas B, Little MA. Effects of alcohol and altitude on man during rest and work. Aerospace Medicine 9: 403–406, 1968Google Scholar
  106. McFarland RA. The psychological effects of oxygen deprivation (anoxemia) on human behavior. Archives of Psychology 145: 1–135, 1932Google Scholar
  107. McFarland RA. Psycho-physiological studies at high altitude in the Andes: I. The effects of rapid ascents by aeroplane and train. Comparative Psychology 23: 191–225, 1937aGoogle Scholar
  108. McFarland RA. Psycho-physiological studies at high altitude in the Andes: II. Sensory and motor responses during acclimatization. Comparative Psychology 23: 227–258, 1937bGoogle Scholar
  109. McFarland RA. Psycho-physiological studies at high altitude in the Andes: III. Mental and psycho-somatic responses during gradual adaptation. Comparative Psychology 24: 147–187, 1937cGoogle Scholar
  110. McFarland RA. Psycho-physiological studies at high altitude in the Andes: IV. Sensory and circulatory responses of the Andean residents at 17 500 feet. Comparative Psychology 24: 189–220, 1937dGoogle Scholar
  111. McFarland RA. The internal environment and behaviour. American Journal of Psychiatry 97: 858–877, 1941Google Scholar
  112. McFarland RA. Human factors in relation to the development of pressurized cabins. Aerospace Medicine 12: 1303–1318, 1971Google Scholar
  113. McFarland RA, Barach AL. The response of psychoneurotics to variations in oxygen tension. American Journal of Psychiatry 93: 1315–1341, 1937Google Scholar
  114. McFarland RA, Dill DB. A comparative study of the effects of reduced oxygen pressure on man during acclimatization. Journal of Aviation Medicine 9: 18–38, 1938Google Scholar
  115. McFarland RA, Evans JN. Alterations in dark adaptations under reduced oxygen tensions. American Journal of Physiology 127: 37–50, 1939Google Scholar
  116. Mcintosh IB, Prescott RJ. Acetazolamide in prevention of acute mountain sickness. Journal of International Medical Research 14: 285–287, 1986PubMedGoogle Scholar
  117. Milledge JS. Acute mountain sickness. Thorax 38: 641–645, 1983PubMedGoogle Scholar
  118. Milledge JS, Beeley JM, Broome J, Luff N, Pelling M, et al. Acute mountain sickness susceptibility, fitness and hypoxic ventilatory response. European Respiratory Journal 4: 1000–1003, 1991PubMedGoogle Scholar
  119. Milne D, Gray D. Evidence bearing on the generalizability of laboratory findings relating to high-altitude mountaineering. Perceptual and Motor Skills 57: 172–174, 1983PubMedGoogle Scholar
  120. Missoum G, Rousnet E, Richalet J-P. Control of anxiety and acute mountain sickness in Himalayan mountaineers. International Journal of Sports Medicine 13 (Suppl. 1): S37–S39, 1992PubMedGoogle Scholar
  121. Nelson M. Psychological testing at high altitudes. Aviation Space and Environmental Medicine 53: 122–126, 1982Google Scholar
  122. Nelson TO, Dunlosky J, White DM, Steinberg J, Townes BD, et al. Cognition and metacognition at extreme altitudes on Mount Everest. Journal of Experimental Psychology 119: 367–374, 1990PubMedGoogle Scholar
  123. Newman HW. The effect of altitude on alcohol tolerance. Quarterly Journal of Studies on Alcohol 10: 398–403, 1949PubMedGoogle Scholar
  124. Nicholson AN, Wright CM. Effect of mild hypoxia on delayed differentiation in the monkey (Macaca mulatta). Experimental Neurology 47: 535–543, 1975PubMedGoogle Scholar
  125. Oelz O, Regard M. Physiological and neuropsychological characteristics of world-class extreme-altitude climbers. American Alpine Journal 83-86, 1988Google Scholar
  126. Olive JE, Waterhouse N. Birmingham Medical Research Expeditionary Society 1977 Expedition: psychological aspects of acute mountain sickness. Postgraduate Medical Journal 55: 464–466, 1979PubMedGoogle Scholar
  127. Pandit JJ. Altitude induced illness. British Medical Journal 304: 1633–1634, 1992PubMedGoogle Scholar
  128. Pandolf KB, Sawka MN, Gonzalez RR. Human performance physiology and environmental medicine at terrestrial extremes, Benchmark Press, Indianapolis, 1988Google Scholar
  129. Paton S. Medical studies in aviation: VII. Effects of low oxygen pressure on the personality of the aviator. Journal of the American Medical Association 71: 1399–1400, 1918Google Scholar
  130. Pearson RG, Neal GL. Operator performance as a function of drug, hypoxia, individual and task factors. Aerospace Medicine 41: 154–158, 1970PubMedGoogle Scholar
  131. Petajan JH. Neuropsychological acclimatization to high altitude. Journal of Human Evolution 2: 105–115, 1973Google Scholar
  132. Petiet CA, Townes BD, Brooks RJ, Kramer JH. Neurobehav-ioural and psychosocial functioning of women exposed to high altitude in mountaineering. Perceptual and Motor Skills 67: 443–452, 1988PubMedGoogle Scholar
  133. Phillips LW, Griswold RL, Pace N. Cognitive changes at high altitude. Psychological Reports 13: 423–430, 1963Google Scholar
  134. Pigman EC. Acute mountain sickness: effects and implications for exercise at intermediate altitudes. Sports Medicine 12: 71–79, 1991PubMedGoogle Scholar
  135. Pollard AJ. Altitude induced illness. British Medical Journal 304: 1324–1325, 1992PubMedGoogle Scholar
  136. Pollard A, Clarke C. Deaths during mountaineering at extreme altitude. Lancet 1: 1277, 1988PubMedGoogle Scholar
  137. Prigatano GP, Parsons O, Wright E, Levin DC, Hawryluk G. Neuropsychological test performance in mildly hypoxemic patients with chronic obstructive pulmonary disease. Journal of Consulting and Clinical Psychology 51: 108–116, 1983PubMedGoogle Scholar
  138. Pugh LGC, Ward MP. Some effects of high altitude on man. Lancet 2: 1115–1121, 1956Google Scholar
  139. Ravenhill TH. Some experiences of mountain sickness in the Andes. Journal of Tropical Medicine and Hygiene 16: 313–320, 1913Google Scholar
  140. Regard M, Oelz O, Brugger P, et al. Persistent cognitive impairment in climbers after repeated exposure to extreme altitude. Neurology 39: 210–213, 1989PubMedGoogle Scholar
  141. Reeves JT, Jokl P, Cohn JE. Performance of Olympic runners at altitudes of 7350 and 5350 feet. American Review of Respiratory Diseases 92: 813–816, 1965Google Scholar
  142. Ricketts HT, Adams WR, Alving AS, Bay EB, Bryan H, et al. The effects of mild anoxia on neuromuscular coordination in skilled investigators. Journal of Aviation Medicine 16: 429–431, 1945PubMedGoogle Scholar
  143. Roach RC, Larson EB, Hornbein TF, Houston CS, Bartlett S, et al. Acute mountain sickness, antacids, and ventilation during rapid, active ascent of Mount Rainier. Aviation Space and Environmental Medicine 54: 397–401, 1983Google Scholar
  144. Russell RW. The effects of mild anoxia on simple psychomotor and mental skills. Journal of Experimental Psychology 38: 178–187, 1948PubMedGoogle Scholar
  145. Ruttledge H. Everest: the unfinished adventure, Hodder and Stoughton, London, 1933Google Scholar
  146. Ryn Z. Psychopathology in alpinism. Acta Medica Polona 12: 453–467, 1971PubMedGoogle Scholar
  147. Ryn Z. Psychopathology in mountaineering — mental disturbances under high-altitude stress. International Journal of Sports Medicine 9: 163–169, 1988PubMedGoogle Scholar
  148. Sampson JB, Cymerman A, Burse RL, Maher JT, Rock PB. Procedures for the measurement of acute mountain sickness. Aviation Space and Environmental Medicine 54: 1063–1073, 1983Google Scholar
  149. Sampson JB, Kobrick JL. The environmental symptoms questionnaire: revisions and new field data. Aviation Space and Environmental Medicine 51: 872–877, 1980Google Scholar
  150. Schlaepfer TE, Bartsch P, Fisch HU. Paradoxical effects of mild hypoxia and moderate altitude on human visual perception. Clinical Science 83: 633–636, 1992PubMedGoogle Scholar
  151. Schull WJ, Goldsmith RI, Clench J, Ferrell RE, Barton SA, et al. 2,3-diphosphoglycerate and night vision. Aviation Space and Environmental Medicine 52: 41–44, 1981Google Scholar
  152. Scow J, Krasno LR, Ivy AC. The immediate and accumulative effects on psychomotor performance of exposure to hypoxia, high altitude and hyperventilation. Journal of Aviation Medicine 21: 79–87, 1950PubMedGoogle Scholar
  153. Selvamurthy W, Saxena RK, Krishnamurthy ML, Suri ML, Mal-hotra MS. Changes in EEG pattern during acclimatization to high altitude (3500m) in man. Aviation Space and Environmental Medicine 49: 968–971, 1978Google Scholar
  154. Sharma VM, Malhotra MS. Ethnic variations in psychological performance under altitude stress. Aviation Space and Environmental Medicine 47: 248–251, 1976Google Scholar
  155. Shaima VM, Malhotra MS, Baskaran AS. Variations in psychomotor proficiency during prolonged stay at high altitude. Ergonomics 18: 511–516, 1975Google Scholar
  156. Shephard RJ. Physiological changes and psychomotor performance during acute hypoxia. Journal of Applied Physiology 9: 343–351, 1956PubMedGoogle Scholar
  157. Shipton E. Upon that mountain, Hodder and Stoughton, London, 1943Google Scholar
  158. Shukitt BL, Banderet LE. Mood states at 1600 and 4300 meters terrestrial altitude. Aviation Space and Environmental Medicine 59: 530–532, 1988Google Scholar
  159. Shukitt BL, Banderet LE, Sampson JB. The environmental symptoms questionnaire: corrected computational procedures for the alertness factor. Aviation Space and Environmental Medicine 61: 77–78, 1990Google Scholar
  160. Shukitt-Hale B, Banderet LE, Lieberman HR. Relationships between symptoms, moods, performance, and acute mountain sickness at 4700 meters. Aviation Space and Environmental Medicine 62: 865–869, 1991Google Scholar
  161. Shukitt-Hale B, Rauch TM, Foutch R. Altitude symptomatology and mood states during a climb to 3630 meters. Aviation Space and Environmental Medicine 61: 225–228, 1990Google Scholar
  162. Singh I, Khanna PK, Srivastava MC, Lai M, Roy SB, et al. Acute mountain sickness. New England Journal of Medicine 280: 175–184, 1969PubMedGoogle Scholar
  163. Smith GM. The effect of prolonged mild anoxia on sleepiness, irritability, boredom, and other subjective conditions. Journal of General Psychology 35: 239–250, 1946PubMedGoogle Scholar
  164. Smith MH, Sharkey BJ. Altitude training: who benefits? Physician and Sportsmedicine 12: 48–62, 1984Google Scholar
  165. Stamper DA, Kinsman RA, Evans WO. Subjective symptomatology and cognitive performance at high altitude. Perceptual and Motor Skills 31: 247–261, 1970PubMedGoogle Scholar
  166. Stamper DA, Sterner RT, Kinsman RA. Symptomatology subscales for the measurement of acute mountain sickness. Perceptual and Motor Skills 33: 735–742, 1971PubMedGoogle Scholar
  167. Tichauer ER. Operation of machine tools at high altitudes. Ergonomics 6: 51–72, 1963Google Scholar
  168. Tissandier G. Le voyage à grande hauteur du ballon ‘Le Zénith’. Nature, Paris 3: 337–344, 1875Google Scholar
  169. Townes BD, Horbein TF, Schoene RB, Sarnquist FH, Grant I. Human cerebral function at extreme altitude. In West & Lahiri (Eds) High altitude and man, American Physiological Society, Bethesda, 1984Google Scholar
  170. Tune GS. Psychological effects of hypoxia: a review of certain literature from the period 1950 to 1963. Perceptual and Motor Skills 19: 551–562, 1964PubMedGoogle Scholar
  171. Vaernes RJ, Owe JO, Myking O. Central nervous reactions to a 6.5-hour altitude exposure at 3048 meters. Aviation Space and Environmental Medicine 55: 921–926, 1984Google Scholar
  172. Van Liere EJ, Stickney JC. Hypoxia, University of Chicago Press, Chicago, 1963Google Scholar
  173. Waldfogel S, Finesinger JE, Verzeano M. The effect of low oxygen on psychologic performance tests in psychoneurotic patients and normal controls. Psychosomatic Medicine 12: 244–249, 1950PubMedGoogle Scholar
  174. Ward MP, Milledge JS, West JB. High altitude medicine and physiology, University of Pennsylvania Press, Philadelphia, 1989Google Scholar
  175. West JB. Do climbs to extreme altitude cause brain damage? Lancet 2: 387–388, 1986PubMedGoogle Scholar
  176. West JB, Lahiri S. High altitude and man, American Physiological Society, Bethesda, 1984Google Scholar
  177. White AJ. Cognitive impairment of acute mountain sickness and acetazolamide. Aviation Space and Environmental Medicine 55: 598–603, 1984Google Scholar
  178. Wilmer WH, Berens C. Medical studies in aviation: V. The effect of altitude on ocular functions. Journal of the American Medical Association 71: 1394–1398, 1918Google Scholar
  179. Wright AD, Jones GT, Fletcher RF, Mackintosh JH, Bradwell AR. The environmental symptoms questionnaire in acute mountain sickness. Aviation Space and Environmental Medicine 56: 572–575, 1985Google Scholar
  180. Xun W, Yin-shan C, Liang-gui G, Lan-hua S. EEG characteristics of healthy adults living at higher elevations. Clinical Electroencephalography 23: 52–57, 1992Google Scholar
  181. Young AJ, Cymerman A, Pandolf KB. Differentiated ratings of perceived exertion are influenced by high altitude exposure. Medicine and Science in Sports and Exercise 14: 223–228, 1982PubMedGoogle Scholar

Copyright information

© Adis International Limited 1993

Authors and Affiliations

  • Michael S. Bahrke
    • 1
    • 2
  • Barbara Shukitt-Hale
    • 1
    • 2
  1. 1.Sport Psychology LaboratoryUniversity of Wisconsin-MadisonMadisonUSA
  2. 2.Department of PsychologyBoston UniversityBostonUSA

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