{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T18:27:34Z","timestamp":1771612054005,"version":"3.50.1"},"reference-count":23,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2023,1,21]],"date-time":"2023-01-21T00:00:00Z","timestamp":1674259200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Background: Environmental factors of high altitude, especially hypobaric hypoxia, may directly and persistently affect human physical and mental health. Our study was designed to assess the psychological and social fitness in healthy adults permanently living at very high altitude, i.e., an average elevation of 3650 m. Methods: In our observational study, 320 participants were included, among which 218 (68.1%) had resided in such a setting for more than 20 years. Participants underwent 138 assessments, including the Self-Rating Anxiety Scale (SAS), Symptom Check List 90 (SCL-90) and the Evaluation Scale of Human Adaptation Capability (ESHAC). SAS (20 items) and SCL-90 (90 items) were used to assess psychological fitness, and the ESHAC (28 items) was used to assess social fitness. Pearson analysis was used to assess correlations and Logistic regression analysis was performed to determine independent influencing factors. Results: The highest SAS score was 80 and the mean score was 43.26 \u00b1 8.88, which was higher than the norm in China (p &lt; 0.001). Sixty (18.8%) participants showed anxiety symptoms and 14 (4.4%) had moderate or severe anxiety. The average score of SCL-90 was 140.88 \u00b1 44.77, and 96 (30.0%) participants showed SCL-90 scores \u2265160. Compared with the norm, significant differences were shown in eight of the nine SCL-90 factor scores, i.e., somatization, obsessive-compulsive, depression, anxiety, hostility, phobic anxiety, paranoid ideation, and psychoticism. The average score of ESHAC was 19.92 \u00b1 4.54, and 114 (35.6%) participants did not reach the qualifying standard. Significant correlations were observed between the SAS score, SCL-90 total and factor scores, and ESHAC scores. The Logistic regression analysis showed that being born at very high altitude was an independent influencing factor (AOR = 2.619; 95% CI, 1.629\u20134.211; p &lt; 0.001) after controlling for other factors. Conclusion: Permanently living at very high altitude can influence the psychological and social fitness of healthy adults.<\/jats:p>","DOI":"10.3390\/ijerph20032013","type":"journal-article","created":{"date-parts":[[2023,1,23]],"date-time":"2023-01-23T02:01:02Z","timestamp":1674439262000},"page":"2013","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Assessment of Psychological and Social Fitness in Healthy Adults Permanently Living at Very High Altitude"],"prefix":"10.3390","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3477-5886","authenticated-orcid":false,"given":"Chun","family":"Gao","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, China-Japan Friendship Hospital, Beijing 100029, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jizong","family":"Ciren","sequence":"additional","affiliation":[{"name":"Research Center for Physical Fitness at High Altitude, Public Cultural Service Center, Chengguan District Culture and Tourism Bureau, Lhasa 850000, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dan","family":"Wang","sequence":"additional","affiliation":[{"name":"Evaluation Research Center, Renmin University of China, Beijing 100872, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhaohui","family":"Zhang","sequence":"additional","affiliation":[{"name":"Research Center for Physical Fitness at High Altitude, Public Cultural Service Center, Chengguan District Culture and Tourism Bureau, Lhasa 850000, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruidong","family":"Ge","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, China-Japan Friendship Hospital, Beijing 100029, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Li\u2019e","family":"Yan","sequence":"additional","affiliation":[{"name":"Nursing Department, China-Japan Friendship Hospital, Beijing 100029, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,1,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"915995","DOI":"10.3389\/fnhum.2022.915995","article-title":"The human brain in a high altitude natural environment: A review","volume":"16","author":"Zhang","year":"2022","journal-title":"Front Hum. 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