Psychological Profile of Aviators and Flight Aspirants with High-Risk and Self-Harm Behavior

BACKGROUND: 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. CASE SERIES: 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. DISCUSSION: 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.