{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T10:35:42Z","timestamp":1787567742131,"version":"build-2736575974"},"reference-count":51,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T00:00:00Z","timestamp":1787529600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Regional Innovation Cooperation Project of Sichuan province","award":["2025YFHZ0261"],"award-info":[{"award-number":["2025YFHZ0261"]}]},{"name":"Central Government-Guided Local Projects in the Xizang Autonomous Region","award":["XZ202501YD0015"],"award-info":[{"award-number":["XZ202501YD0015"]}]},{"name":"Science and Technology Plan Project of Xizang Autonomous Region","award":["XZ202401ZY0106"],"award-info":[{"award-number":["XZ202401ZY0106"]}]},{"name":"Science and Technology Plan Project of Xizang Autonomous Region","award":["XZ202401ZY0011"],"award-info":[{"award-number":["XZ202401ZY0011"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Behav. Sci.","Behavioral Sciences"],"abstract":"<jats:p>High-altitude hypoxia is associated with sleep disruption, affective fluctuation, and changes in cognitive performance, yet prior findings remain markedly heterogeneous in both direction and magnitude. To clarify this variability, this structured narrative review synthesizes evidence from systematic reviews, meta-analyses, and key empirical studies on psychological and cognitive adaptation to high-altitude hypoxia, with a particular focus on personality and related traits. The review is organized along three axes: exposure context and characterization (real-altitude field\/residential exposure, hypobaric chambers, normobaric hypoxia, expedition settings, and dose alignment), exposure duration and time course, and outcome domains spanning sleep\/fatigue, affective adaptation, and cognitive performance. Across the literature, cognitive effects appear domain-specific and strongly conditioned by exposure dose, temporal stage, and task characteristics, whereas sleep disturbance during the early acclimatization period emerges as one of the more consistent findings and appears closely intertwined with anxiety-related responses. Although direct personality-related evidence remains limited and uneven, the available findings can be organized into a testable trait\u2013process\u2013outcome framework that distinguishes candidate associations with relatively more direct evidence from mechanism-informed hypotheses. Neuroticism\/emotional stability and anxiety-related traits have received comparatively more direct empirical investigation than other personality domains, but the available evidence is insufficient to regard them as established predictors of high-altitude adaptation. The roles of conscientiousness, resilience\/hardiness, extraversion, agreeableness, and openness remain more tentative and are better treated as targets for prospective testing. We therefore propose that personality-related dispositions may influence adaptation-relevant outcomes through candidate processes involving threat appraisal, coping, resource regulation, and social interaction. We conclude that future research should strengthen exposure dose characterization, specify the boundary conditions for generalizing across real-altitude, hypobaric-chamber, normobaric hypoxia, and expedition settings, and adopt longitudinal, multilevel, and ecologically valid designs to test personality-related pathways more rigorously.<\/jats:p>","DOI":"10.3390\/bs16091464","type":"journal-article","created":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T09:20:02Z","timestamp":1787563202000},"page":"1464","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Personality-Related Traits and Psychological and Cognitive Outcomes Under High-Altitude Hypoxia: A Trait\u2013Process\u2013Outcome Framework"],"prefix":"10.3390","volume":"16","author":[{"given":"Yuan","family":"Li","sequence":"first","affiliation":[{"name":"Xizang Autonomous Region Key Laboratory for High Altitude Brain Science and Environmental Acclimatization, Xizang University, Lhasa 850000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shurong","family":"Jia","sequence":"additional","affiliation":[{"name":"Xizang Autonomous Region Key Laboratory for High Altitude Brain Science and Environmental Acclimatization, Xizang University, Lhasa 850000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tong","family":"Wu","sequence":"additional","affiliation":[{"name":"Xizang Autonomous Region Key Laboratory for High Altitude Brain Science and Environmental Acclimatization, Xizang University, Lhasa 850000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinxia","family":"Cheng","sequence":"additional","affiliation":[{"name":"Xizang Autonomous Region Key Laboratory for High Altitude Brain Science and Environmental Acclimatization, Xizang University, Lhasa 850000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hailin","family":"Ma","sequence":"additional","affiliation":[{"name":"Xizang Autonomous Region Key Laboratory for High Altitude Brain Science and Environmental Acclimatization, Xizang University, Lhasa 850000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hao","family":"Li","sequence":"additional","affiliation":[{"name":"Xizang Autonomous Region Key Laboratory for High Altitude Brain Science and Environmental Acclimatization, Xizang University, Lhasa 850000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"29","DOI":"10.3109\/00207459008994241","article-title":"Subjective and objective sleepiness in the active individual","volume":"52","author":"Gillberg","year":"1990","journal-title":"International Journal of Neuroscience"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1186\/s41073-019-0064-8","article-title":"SANRA\u2014A scale for the quality assessment of narrative review articles","volume":"4","author":"Baethge","year":"2019","journal-title":"Research Integrity and Peer Review"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"97","DOI":"10.2165\/00007256-199316020-00003","article-title":"Effects of altitude on mood, behaviour and cognitive functioning","volume":"16","author":"Bahrke","year":"1993","journal-title":"Sports Medicine"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1016\/S1389-9457(00)00065-4","article-title":"Validation of the Insomnia severity index as an outcome measure for insomnia research","volume":"2","author":"Bastien","year":"2001","journal-title":"Sleep Medicine"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"388","DOI":"10.1016\/j.jad.2022.08.079","article-title":"Prevalence of depression and depressive symptoms at high altitudes: A systematic review and meta-analysis","volume":"317","year":"2022","journal-title":"Journal of Affective Disorders"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1038\/s41398-019-0510-x","article-title":"The onset of sleep disturbances and their associations with anxiety after acute high-altitude exposure at 3700 m","volume":"9","author":"Bian","year":"2019","journal-title":"Translational Psychiatry"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Bliemsrieder, K., Weiss, E. 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