Assistance Dogs – PTSD
Background: This study explored the dynamics of veteran/service dog partnerships by gathering the perspectives of veterans with a history of post-traumatic stress disorder and/or traumatic brain injury.
Methods: Exploratory qualitative methods (focus groups and individual interviews) were used to investigate veteran/service dog relationships related to community involvement, family and friend relationships, self-care, work, and leisure. Nine male veterans, Paws, and Stripes program graduates participated. Data were audio recorded and transcribed by two research team members who used qualitative analytic software to manage and code the data. The full research team discussed themes and reached consensus on the themes that emerged from analysis.
Results: Five themes emerged about the perceived benefit of veteran/service dog relationship: Secluded but Seeking Society (moving from isolation to reconnection); Opening Opportunities (navigating daily life); Bridging the Gap (facilitating social opportunities); and Reclaiming Life (transforming sense of worth and purpose). An overarching theme, Calming Catalyst, connected the other four themes.
Conclusions: Veterans in this study reported that their goal was to reclaim and develop key aspects of their lives and they perceived service dogs as a support in their transition from isolation to reintegration. This study found that service dogs supported the veterans to meet their goal.
Implications for rehabilitation
There are a significant number of veterans with post-traumatic stress disorder and/or traumatic brain injury who are facing life challenges including self-care, securing work, participating in leisure activities, and integrating into the community.
Service dogs are an emerging intervention used to assist veterans with reintegration into civilian life.
There is a need for professionals to be aware of potential benefits of service dog/veteran partnerships.
Based on our findings, veterans could benefit from being paired with a service dog to facilitate their successful return to community life.
Service dogs (SDs) are gaining attention for their benefits on the mental health of military veterans, especially related to posttraumatic stress disorder (PTSD). However, little is known about veterans’ experiences with SDs in relation to recovery from substance use harms. In fact, the role of animals in human recovery from substance use harms is nearly unexplored. To address this gap, we examined if and how SDs support veterans in recovery, including any potential challenges they may face. We adopted a descriptive, qualitative, patient-oriented design and conducted 16 semi-structured interviews with Canadian veterans living with PTSD, who had a SD, and who identified as in or seeking recovery. We applied the Substance Abuse and Mental Health Services Administration’s (SAMHSA) four dimensions supporting a life in recovery to our analysis (community, home, health, purpose) and explored how these dimensions pertain to the veteran–SD relationship. We found that all veterans perceived their SDs as an important support, impacting all four of SAMHSA’s dimensions of recovery through a sense of connection. Veterans described a mutual bond with their SDs and that they helped them build social capital with other humans in their community. Veterans also highlighted that their SDs helped them feel safer and more comfortable in public spaces, which encouraged them to get out of their homes more regularly. SDs enabled veterans to manage their substance use by promoting physical, mental, and emotional health and wellbeing and by offering meaning in veterans’ lives. However, veterans described challenges related to SD regulation and legislation, which hindered their ability to participate in meaningful daily activities and contributed to a sense of disconnection. Overall, veterans in our study described numerous ways in which their SDs supported a life in recovery from substance use harms. However, our findings suggest that improved public education and policy are necessary to legitimize SDs and ensure that the benefits of these animals are fully recognized.
As the human–animal bond is increasingly recognized as therapeutic, the role of animals, most frequently canines, grows. A contemporary pairing of animals and humans can be found inside prisons. While the dogs trained by inmates are most frequently adopted out to the community, today dogs are being trained to assist veterans with post-traumatic stress disorder (PTSD) as part of a grass roots effort to fulfill the mental health needs of veterans. The growing number of veterans with PTSD and concomitant issues including addiction, unemployment, homelessness, and crime, makes the mental healthcare issues of veterans a social problem. The civilian-led effort to provide veterans with dogs is a continuation of the public’s involvement with the proliferation of prison-based animal programs. While this next generation of animal programs has overwhelming community support, it also suffers from similar limitations as its predecessors. With no universal agreement as to the training methods or level of skills needed by the dogs, their efficacy at lessening the symptoms of veterans’ PTSD remains largely unknown.
Abstract
Assistance dogs for people with Posttraumatic Stress Disorder (PTSD) support their handlers by performing tasks that are supposed to mitigate the effects of their mental disability. This study examined the Quality of Life (QoL) of PTSD-assistance dogs’ handlers in Austria and Germany using a qualitative online questionnaire based on the Capability Approach. To correspondingly explore whether the involved assistance dogs experience distress triggered by their daily schedules, we measured their salivary cortisol values. These were compared to the cortisol levels of companion dogs without special tasks, as well as diabetic-signal dogs that have a similar workload. Our results showed that people suffering from PTSD-symptoms can improve their QoL with the aid of their assistance dog. However, being accompanied by an assistance dog creates new social barriers. Surprisingly, we found significantly lower salivary cortisol levels in PTSD-assistance dogs compared to the control groups. We conclude that a positive relationship between PTSD-assistance dogs and their handlers can reduce stress on both sides, and that training well tuned to the requirements of an assistance dog can prevent stress in their daily lives.
No Abstract available
The manuscript, Sleep–wake dynamics in veteran–service dog dyads: An exploration of overnight concordance, describes the shared sleep experience in human–canine dyads and whether shared sleep varies by the quality of their bond [1]. The underlying premise is that the unique bond between veterans and service dogs may mimic the shared sleep experience of human bonds. That is, beyond the direct impact of the physical presence of others, sleep–wake patterns appear to be coordinated in close human relationships. This phenomenon is likely a function of the attachment system [2]. At its inception, the attachment system described biological and emotional characteristics of the infant/child–caregiver bond, but we now know that the attachment system is active across the lifespan, and across varying types of bonds [3]. A defining feature of the human attachment system is coregulation, or coordination, of biological and behavioral systems, including the sleep and circadian system [2].
Coordination of sleep can be operationalized as sleep–wake concordance, the proportion of agreement in sleep and wake across a shared rest period. For example, couples are sleep–wake concordant about 75% of the night, which is more than would be expected by chance [4]. Other studies indicate some degree of concordance across multiple sleep parameters (e.g. duration, sleep timing) and various dyads in a shared household (e.g. parent–child, couples, siblings) [5–9]. However, we know little of the concordance between humans and other species that share a living space, and we know little about the role of non-human companions in reducing vigilance and arousal (i.e. downregulation), which is required for good sleep [10].
This chapter first reviews the research-based information about the benefits of pets, especially for the most vulnerable people, and then addresses the practical implementation of this expanding research. The positive psychosocial effects of human/animal relationships engage interest, arising from firsthand experiences with pet animals and scientific curiosity, as well as the practical questions concerning how best to include pets as an adjunct for treatment for an autistic child or a paraplegic veteran, or to enhance the quality of life of an elderly person in an assisted-living facility. Despite the ever-growing research literature on the psychosocial effects of animals, a significant gap remains between that knowledge base and implementing it into treatment or support services for psychosocially vulnerable people. This chapter suggests that to enjoy the positive effects, a relationship with an animal should be individually tailored to the psychosocial characteristics of the person. Epidemiological studies of entire communities identify subcultures where certain individual circumstances, neighborhoods, geographical features, or special situations are associated with beneficial or adverse health parameters. Employing epidemiological methods with statistical representation of the entire community offers a view of the context, including the community’s affluence, geography, age, gender, and ethnicity of pet-owning participants. The new development will spearhead the creation and availability of curricular resources and enhance the number of people prepared to provide leadership in the area of human/animal interaction, bringing research into practice.
The aim of this pilot study was to evaluate the effectiveness of two specialized Australian PTSD assistance dog programs in reducing PTSD and mental health symptoms over a one-year period. A total of 44 participants who were partnered with an assistance dog were analysed. Using an intent to treat analysis, compared to the baseline measures, all mental health outcomes exhibited statistically significant reductions in scores at the 3-month follow-up, and persisted at the 6-month, and 12-month follow-up. When comparing baseline to 3-month follow-up the effect size (Cohen’s d) was strongest for stress (d = 0.993), followed by PTSD (d = 0.892), anxiety (d = 0.837). Analyses among those who also completed the waitlist-baseline assessment (n = 23) showed slight reductions in stress and depression prior to receiving their dog (whilst waiting for their dog). However, larger reductions were yielded across all mental health measures when comparing waitlist-baseline to 3-month follow-up.
Accordion content.
There are over 18.8 million veterans of the United States of America’s Armed Forces. After military service veterans may find it difficult transitioning back to civilian life. Veterans reintegrating may experience physical and psychological challenges related to their military service. For many, a successful role change takes considerable time and determination. In order to ease their transition, veterans are using the assistance of service dogs to aid in symptom management and assist with positive reintegration into civilian life. Service dogs are highly trained animals that help individuals perform life tasks to assist with physical and psychological challenges. The purpose of this qualitative study was to give voice to the experiential viewpoints of veterans who utilize service dogs. Guided by the theoretically informed method of interpretation— interpretive phenomenological analysis (IPA)—the researchers uncovered the veterans’ perspectives, which provided meaningful insight into their lives with a service dog. Semi-structured interviews were conducted with veterans (n = 21) who utilized a service dog. The interviews lasted approximately one hour and were video or audio recorded. The most salient themes that emerged from the interviews were grouped into four superordinate themes: Procurement, psychosocial functioning, value, and detriments. Results suggest that service dogs improved veterans’ physical and psychological health, provided a coping resource and a form of social support, and supported sustaining their independence. Veterans’ right to privacy and the public’s lack of knowledge and understanding of legal accommodation requirements via the Americans with Disabilities Act (ADA) were perceptible. Implications for policy, practice, and research, are discussed.
Research on the post-deployment reintegration needs of women veterans is limited. Non-traditional support may enhance mental health. Relationships with animals and volunteering may aid those with post-traumatic stress disorder (PTSD). Using the biopsychosocial model, we examined whether participation in an 8-week service dog training program (SDTP) affected telomere length (TL), heart rate variability (HRV), PTSD symptom severity, perceived stress, and anxiety in female veterans with PTSD, as well as whether combat exposure influenced these relationships. Female veterans (ages 32–72, M = 45.9, SD = 11.8) with PTSD were randomized to either the SDTP group (n = 13) or a comparison group (n = 15) that received dog training video content. The interventions lasted one hour weekly for 8 weeks. Outcomes were assessed pre-, mid-, and post-intervention. Linear mixed models with random intercepts examined changes from pre- to post-intervention and compared changes by group and combat exposure. TL changes differed [F(1,11.65) = 3.543, p = 0.085] by intervention. In the SDTP group, TL increased, indicating reduced cellular senescence (i.e., slower biological aging), whereas TL decreased in the CI group. Combat exposure moderated these changes [F(1,12.36) = 5.41, p = 0.038]. HRV changed by intervention group [F(1,389.08) = 10.623, p = 0.001]. HRV decreased (stress increased) in the SDTP group but not in the CI group. Combat exposure did not moderate HRV changes. PTSD symptom severity [F(1,48.04) = 19.22, p < 0.001], perceived stress [F(1,48.48) = 14.65, p < 0.001], and anxiety [F(1,47.30) = 6.624, p = 0.013] decreased significantly from pre- to post-interventions; the decreases did not differ by intervention or combat exposure.
Introduction: Psychiatric service dogs are increasingly being sought out by military veterans as a complementary intervention for posttraumatic stress disorder (PTSD). After receiving a service dog, many veterans continue training their service dog at home. Our objective was to explore the associations between training methods, PTSD severity, service dog behavior, and the veteran-service dog bond in a population of military veterans with PTSD.
Methods: Post-9/11 military veterans with PTSD who had received a psychiatric service dog were recruited from a national service dog provider. A total of 111 veterans (M = 40.1 ± 8.3 years, 80% male) participated in an online survey regarding frequency of training methods, PTSD symptom severity, service dog behavior, and the human-animal bond. Service dogs were predominately Labrador Retriever purebreds or mixes of various breeds (66% male) and mostly obtained from shelters or rescues (58%). Training methods were divided into five categories: positive reinforcement (e.g., physical praise), negative punishment (e.g., ignoring the dog), positive punishment (e.g., verbal correction), dominance (e.g., alpha roll), and bond-based (e.g., co-sleeping). Data were analyzed using general linear models.
Results: Veterans self-reported using all five categories of training methods at least once a month. More frequent use of positive punishment was associated with less closeness with their service dog (p = 0.02), more fear (p = 0.003), less eye contact (p < 0.0001), and less trainability (p = 0.04). More frequent use of positive reinforcement was associated with higher closeness to their service dog (p = 0.002) and perceived increased attachment behavior (p = 0.002) and playfulness (p = 0.002). More frequent use of bond-based methods was associated with higher closeness to their service dog (p = 0.02). PTSD severity was not significantly associated with reported dog behavior, temperament, or veteran-service dog closeness.
Conclusion: Military veterans with PTSD service dogs reported using many training methods that were associated with different outcomes. In general, the reported use of positive reinforcement or bond-based training methods were associated with reporting more positive outcomes while the reported use of positive punishment was associated with reporting more negative outcomes. Educating service dog organizations and recipients about the impacts of training methods could be beneficial for service dog efficacy and welfare.
Abstract
Psychiatric assistance dogs for military veterans with posttraumatic stress disorder (PTSD) currently make up over 19% of assistance dog partnerships globally. We conducted a systematic review of the literature relating to these partnerships, with specific aims to (1) summarize their characteristics, (2) evaluate the quality of existing evidence, and (3) summarize outcomes. A total of 432 records were independently screened (Cohen’s kappa = 0.90). Of these, 41 articles (29 peer-reviewed publications and 12 unpublished dissertations) met inclusion criteria. Data extraction was conducted to address the research aims, including a meta-analysis (quantitative outcomes) and meta-synthesis (qualitative outcomes). All peer-reviewed publications on the topic of psychiatric assistance dogs for veterans with PTSD were published within the last five years. The majority of included articles were quantitative (53%), 41% were qualitative, and 6% employed mixed methods. Mean methodological rigor scores were 80% for peer reviewed articles and 71% for dissertations, where higher scores represent more rigorous methodology. Quantitative articles reported significant improvements in the domains of PTSD severity, mental health, and social health. Impacts on physical health and global quality of life appear inconclusive. Meta-analysis (9 articles) revealed that partnership with an assistance dog had a clinically meaningful, significant, and large effect on PTSD severity scores (g = −1.129; p<0.0001). Qualitative meta-synthesis identified two third order constructs: (1) Impact on the individual: mental & physical health and (2) Impact beyond the individual: building relationships & connection. This synthesis of increasingly prevalent research on assistance dogs for veterans with PTSD provides support for the impact of this complementary and integrative health intervention on PTSD symptom severity, and signs of meaningful improvements in adjacent domains including mental and social health. Gaps between quantitative and qualitative findings, along with the need to report greater demographic detail, highlight key opportunities for future research.
Objective: Psychiatric service dog placements may benefit psychosocial functioning for veterans with posttraumatic stress disorder (PTSD), however, these effects have never been examined directly in daily life. This nonrandomized longitudinal clinical trial quantified the efficacy of psychiatric service dogs for daily psychosocial functioning among N = 168 veterans with PTSD using ecological momentary assessment (EMA). Method: EMA data were collected twice daily for 2 weeks at each assessment period (0 and 3 months), totaling 9,408 survey responses (2 Assessments × 14 Days × 2 Prompts × 168 Participants). Results: At follow-up, regression analysis identified associations between service dog placement and better perceived social interaction quality (β = 0.42, p < .05), better affect (negative affect: β = −2.64, p < .001; positive affect: β = 2.44, p < .001), and lower odds of panic attacks (OR = 0.68, p < .05). Social participation results were mixed: placements were associated with greater activity participation (β = 3.21, p < .001) but lower odds of being away from home (OR = 0.77, p < .05), indicating possible support for anecdotes that public stigma is an obstacle to community participation. Conclusions: Results further revealed that the service dog’s trained tasks may be particularly important for social functioning outcomes, and the service dog’s presence for emotional functioning outcomes. Findings highlight a need for education surrounding service dog etiquette and reveal potential mechanisms underlying psychiatric service dog placements. (PsycInfo Database Record (c) 2023 APA, all rights reserved)
Importance: Military members and veterans (hereafter, veterans) with posttraumatic stress disorder (PTSD) increasingly seek psychiatric service dogs as a complementary intervention, yet the effectiveness of service dogs is understudied.
Objective: To estimate the associations between psychiatric service dog partnership and self-reported and clinician-rated PTSD symptom severity, depression, anxiety, and psychosocial functioning after 3 months of intervention among veterans.
Design, setting, and participants: This nonrandomized controlled trial used standardized and validated assessment instruments completed by participants and administered by blinded clinicians. Recruitment, eligibility screening, and enrollment were conducted between August 2017 and December 2019. Veterans were recruited using the database of an accredited nonprofit service dog organization with constituents throughout the US. Participants were veterans with a PTSD diagnosis; they were allocated to either the intervention group (n = 81) or control group (n = 75). Outcome assessments were performed at baseline and at the 3-month follow-up. Data analyses were completed in October 2023.
Interventions: Participants allocated to the intervention group received a psychiatric service dog for PTSD, whereas those allocated to the control group remained on the waiting list based on the date of application submitted to the service dog organization. Both groups had unrestricted access to usual care.
Main outcomes and measures: The primary outcomes were PTSD symptom severity, depression, and anxiety after 3 months, and the secondary outcomes were psychosocial functioning, such as quality of life and social health. The self-reported PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) was used to measure symptom severity, and the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5) was used to assess PTSD diagnosis (score range for both instruments: 0-80, with higher scores indicating greater PTSD symptoms).
Results: The 156 participants included in the trial had a mean (SD) age of 37.6 (8.3) years and included 117 males (75%), 17 Black or African American individuals (11%), 30 Hispanic individuals (19%), and 117 White individuals (76%). Compared with the control group, the intervention group had significantly lower PTSD symptom severity based on the PTSD Checklist for DSM-5 mean (SD) score (41.9 [16.9] vs 51.7 [16.1]; difference in means, -11.5 [95% CI, -16.2 to -6.6]; P < .001) and the CAPS-5 mean (SD) score (30.2 [10.2] vs 36.9 [10.2]; difference in means, -7.0 [95% CI, -10.8 to -4.5]; P < .001) at 3 months. The intervention group also had significantly lower depression scores (odds ratio [OR], 0.45 [95% CI, 0.23-0.86]; difference in means, -3.3 [95% CI, -6.8 to -0.6]), anxiety (OR, 0.25 [95% CI, 0.13-0.50]; difference in means, -4.4 [95% CI, -6.9 to -2.1]), and most areas of psychosocial functioning (eg, social isolation: OR, 0.34 [95% CI, 0.18-0.64]).
Conclusions and relevance: This nonrandomized controlled trial found that compared with usual care alone, partnership with a trained psychiatric service dog was associated with lower PTSD symptom severity and higher psychosocial functioning in veterans. Psychiatric service dogs may be an effective complementary intervention for military service-related PTSD.
Study objectives: Sleep disturbances are well-documented for veterans with posttraumatic stress disorder. Increasingly, veterans are turning to service dogs for assistance. Service dogs may positively influence veteran sleep. However, there is a need for research that considers bidirectional sleep interactions at the dyad level. Our objective was to investigate overnight sleep-wake dynamics in veteran-service dog dyads.
Methods: Fifty-six veteran-service dog dyads contributed data for analysis. Standardized questionnaires were captured at baseline (veteran well-being, prior to service dog partnering) and at 3-month follow-up (dyad bond and well-being). Fourteen days of actigraphy (1 min epochs) and ecological momentary assessment (twice daily) were collected at follow-up. We calculated sleep-wake concordance (percent agreement; 0% to 100%) and activity concordance (Stuart-Kendall Tau-c; -1.0 to 1.0) from 650 nights of actigraphy data, including 289 749 min-level observations.
Results: Based on a nightly average, veteran-service dog dyads had 79% sleep-wake concordance (range 63% to 88%) and 0.04 activity concordance (range -0.02 to 0.15). Service dogs exhibited higher sensitivity to veteran wakefulness (28%; range 9% to 82%) than veterans to service dogs (11%; range 4% to 21%). Regression analyses found no consistent relationships between concordance and measures of veteran-service dog bond or well-being.
Conclusions: Veteran-service dog dyads demonstrate sleep-wake concordance rates comparable to those reported in other close relationships (e.g. mother-infant, couples), and service dogs appear more sensitive to veteran wakefulness than the other way around. This novel investigation offers a framework for future research on human-service dog overnight dynamics, emphasizing the mutual attunement of veterans and their service dogs. Statement of Significance This study explores high-fidelity overnight sleep-wake dynamics in an interspecies context, focusing on veteran-service dog dyads. We analyzed data simultaneously collected from both the humans and service dogs. We found that these unique partnerships exhibited sleep-wake concordance (e.g. alignment in sleep and wake episodes) at rates similar to other close relationships, such as couples as well as parents and children. However, concordance was not associated with self-reported bond strength, veteran well-being, or service dog well-being. Future research should explore concurrent physiological measures (e.g. heart rate, blood pressure, respiration rate, skin temperature, and cortisol levels), which may provide more sensitive indicators of stress and well-being. Overall, our findings enhance our understanding of the complex overnight dynamics of service dog teams.
Approximately 300,000 Post-9/11 veterans are identified as having post-traumatic stress disorder in this country but it’s estimated that only 1 in 3 asks for help. For those who do, different kinds of therapy can help to manage the after effects of trauma. As Veteran Voices reporter and Wright State student veteran Allison Loy has found, many veterans find comfort and support from pets.
When studying the roles and experiences of a service dog team, it is imperative that the animal-human bond be considered in this process. As the demand and acknowledgement of service dogs for mental health and veterans with PTSD continues to grow, it is important that academic research be conducted in order to not only maximize the benefits to the human and reduce the attitudinal and systemic barriers faced by the service dog team, but also to ensure the well-being of the service dog themselves. This major research paper will show that although individuals who share their lives with service dogs experience many mental health benefits as a result of their partnership, they have to face various attitudinal and systemic barriers in exchange for that benefit. The objectives of the study were to: engage with four persons who share their lives with service dogs in order to discuss and reflect upon the mental health impact of the animal-human bond, to engage significant others view of the mental health impact of service dogs, to explore systemic and attitudinal barriers faced by persons with service dogs, to generate and disseminate current knowledge regarding the mental health benefits of human-animal bonding in general and service dogs and human companions more specifically, and lastly to influence national service dog acceptance and policy. Through conducting a literature review as well as a qualitative phenomenological study, which interviewed human companions who share their lives with service dogs and their significant others, five themes regarding the animal-human bond and mental health were uncovered: that the journey to obtaining a service dog is a lengthy and sometimes complex process; that overall having a service dog for mental health difficulties or PTSD can be a positive experience; that the bond of the dog and human in the service dog Running head: AT BOTH ENDS OF THE LEASH 2 team is quite strong, that there are indeed mental health benefits to being partnered with a service dog; and lastly in order to receive the benefits of having a service dog the teams must face some attitudinal and systemic barriers in exchange. The paper ends with a discussion on the areas of recommendations regarding service dog research and policy in Canada.
Posttraumatic stress disorder (PTSD) can have corrosive impacts on family relationships and individual functioning. Emerging evidence has shown that psychiatric service dogs may be an effective complementary treatment for military veterans with PTSD, benefiting veterans’ mental and social health. However, few studies have examined the effects of psychiatric service dogs on the family members of veterans, specifically their partners. Mixed-methods data from 60 veteran-partner dyads examined individual and relationship functioning among partners of veterans paired with a service dog (service dog group; n = 37) and those awaiting placement (waitlist group; n = 23). While there were no statistically significant differences across groups, the effect sizes for group differences suggested that partners in the service dog group (relative to those on the waitlist) may experience higher levels of resilience and companionship, and lower levels of anger, social isolation, and work impairment. A topical survey of partner qualitative data within the service dog group indicated that service dogs provided more benefits than challenges. Partners reported improvements in veteran functioning, family relationships, and partners’ quality of life. Results, although preliminary, suggest that psychiatric service dogs may provide modest positive experiences for some veteran family systems.
HIGHLIGHTS
Though service dogs may improve wellbeing for veterans with posttraumatic disorder, families of veterans may not experience those same benefits. Researchers and clinicians should consider how to best prepare veteran families for integrating service dogs into their homes.
Though posttraumatic stress disorder (PTSD) service dogs are trained specifically for veterans, recent studies have demonstrated that their impact may go beyond veterans themselves (McCall, Rodriguez, Wadsworth, Meis, & O’Haire, 2020; Nieforth, Craig, Behmer, MacDermid Wadsworth, & O’Haire, 2021). PTSD service dogs may provide both benefits and challenges for veteran families.
Partners of veterans diagnosed with posttraumatic stress disorder (PTSD) are at risk of a variety of challenges, and it is unknown whether psychiatric service dogs are disruptive to their sleep or provide similar benefits that are seen in the limited literature on veterans. As part of a larger clinical trial examining the efficacy of psychiatric service dogs for veterans with PTSD and their families, this study focused on sleep patterns of veterans’ partners (n = 88), incorporating both subjective (clinically validated self-report surveys) and objective sleep measures (actigraphy). Linear regression was used to analyze differences in relation to group (intervention versus control) at follow-up, controlling for baseline score. Results revealed no significant differences between groups for both the subjective surveys (p = 0.15; p = 0.75) and the objective actigraphy measures (p = 0.06–0.98). This suggests that psychiatric service dogs are not disruptive, nor do they provide any benefits to partner sleep. Partners had sleep patterns on par with national norms at baseline and remained at such levels at follow up. Ultimately, using both subjective and objective measures, we found no impact of psychiatric service dogs on the sleep of veterans’ partners.
Abstract
Recent literature suggests that service dogs may be a valuable complementary intervention option for posttraumatic stress disorder (PTSD) among military veterans due to the potential influence on stress response dysregulation. The aim of this short-term longitudinal study was to quantify the impact of service dogs in US military veterans with PTSD with particular attention to the cortisol awakening response. A sub aim of the study was to empirically evaluate the physiological effects of PTSD service dogs on veteran partners. We conducted a clinical trial (ID: NCT03245814) that assessed the cortisol awakening response for 245 participants at baseline and 3 months follow-up across an intervention group (service dog: veterans n = 88, partners n = 46) and control group (usual care: n = 73, partners n = 38). A total of N = 161 veterans and N = 84 partners collected whole saliva samples via a passive drool collection immediately upon waking, 30 min after waking, and 45 min after waking on three consecutive weekdays at baseline and again at follow-up. Mixed model repeated measures (MMRM) with a fixed effect of the intervention group (service dog or control) were utilized. Covariates considered for the model included time of awakening, sleep duration, sleep efficiency, prior day experiences (measured via ecological momentary assessment), traumatic brain injury, age, gender, race, ethnicity, socioeconomic status, smoking status, alcohol use, physical health, and body mass index. A total of 3951 salivary samples were collected (veterans: 2613, partners: 1338). MMRM results demonstrated that veterans with a service dog had a statistically significant higher cortisol awakening response, including the area under the curve with respect to both increase (AUCi, β = 1.46, p = 0.046) and absolute increase (AINC, β = 0.05, p = 0.035). Results were not statistically significant for partners. Findings suggest that veterans with service dogs have a higher, less blunted CAR in comparison to veterans receiving usual care alone. In veterans with a blunted morning cortisol response, service dog placement could help boost their morning cortisol response.
Psychiatric service dogs are an emerging complementary treatment for military members and veterans with posttraumatic stress disorder (PTSD). Yet despite anecdotal accounts of their value, there is a lack of empirical research on their efficacy. The current proof-of-concept study assessed the effects of this practice. Method: A nonrandomized efficacy trial was conducted with 141 post-9/11 military members and veterans with PTSD to compare usual care alone (n = 66) with usual care plus a trained service dog (n = 75). The primary outcome was longitudinal change on The PTSD Checklist (PCL; Weathers, Litz, Herman, Huska, & Keane, 1993), including data points from a cross-sectional assessment and a longitudinal record review. Secondary outcomes included cross-sectional differences in depression, quality of life, and social and work functioning. Results: Mixed-model analyses revealed clinically significant reductions in PTSD symptoms from baseline following the receipt of a service dog, but not while receiving usual care alone. Though clinically meaningful, average reductions were not below the diagnostic cutoff on the PCL. Regression analyses revealed significant differences with medium to large effect sizes among those with service dogs compared with those on the waitlist, including lower depression, higher quality of life, and higher social functioning. There were no differences in employment status, but there was lower absenteeism because of health among those who were employed. Conclusion: The addition of trained service dogs to usual care may confer clinically meaningful improvements in PTSD symptomology for military members and veterans with PTSD, though it does not appear to be associated with a loss of diagnosis.
Approximately 1 in 5 returning service members from Iraq and Afghanistan report symptoms of Post-Traumatic Stress Disorder (PTSD) (Tanielian & Jaycox, 2008), and 22 percent of veterans suffering from PTSD also report symptoms of Social Anxiety Disorder (SAD). Mental health disorders such as PTSD have been shown to reduce the overall self-perceived quality of life in Vietnam veterans (Hansson, 2002). The effectiveness of using animals in therapeutic settings for mental health disorders has proven to be successful, specifically demonstrated to be therapeutic and beneficial in treating disorders such as anxiety and PTSD (Chandler, 2005). It is unclear whether veterans who own a pet would report fewer symptoms of PTSD and SAD and perceive a higher quality of life than veterans who do not own a pet. This study examined the relationship between companion dog ownership on veteran mental health and perceived quality of life. Seventy nine veterans (58 male, 21 female) were recruited from Facebook’s veterans groups who completed an online survey gathering information on dog ownership, symptoms of PTSD and SAD, perceived quality of life, and several demographics. No significant relationships were observed between these variables after conducting Pearson’s r correlational analyses. However, a significant correlation was found between veterans who have an “indifferent” view of pet dogs and levels of SAD. Implications of the findings are discussed in how to design future studies that research the relationship between the human-animal bond and mental health disorders in returning service members.
This dissertation looked at the impact of receiving and training a service dog on combat veterans with PTSD using Robert Stake’s collective case study model. Interviews were conducted with fifteen combat veterans diagnosed with PTSD participating in a 14 week program for receiving and training their own service dog. The goal of the study was to explore the veterans’ experience of the training program, as well as determine any effect on their PTSD symptoms. The data obtained through this research study may enhance the field of psychology by providing an alternative treatment modality for PTSD which may be more acceptable to veterans than other, more traditional treatments. This study concluded the training and receipt of a service dog demonstrated effective results for diminishing PTSD symptoms, and may be an alternative solution for those who may not be comfortable seeking help in a more traditional manner. This form of treatment may also serve as a gateway to enable veterans to participate more successfully in other evidence-based treatment modalities as their symptoms of PTSD lessen.
Post-traumatic stress disorder (PTSD) is a pervasive disorder among both current and ex-serving Australian Defence Force (ADF) members. Studies have shown current psychological and pharmacological treatments for PTSD are suboptimal in veterans, with high dropout rates and poor adherence to treatment protocols. Therefore, evaluating complementary interventions, such as assistance dogs, is needed for veterans who may not receive the ultimate benefit from traditional therapies. The present longitudinal mixed-method study examined the effectiveness of Operation K9 assistance dogs among sixteen veterans with PTSD, specifically, their effects on suicidality, PTSD, depression, and anxiety from baseline to 12 months post-matching. Self-reported measures were completed prior to receiving their dog (baseline) and at three time points (3, 6, and 12 months) following matching. The Clinician-Administered PTSD Scale for DSM-5 was used to assess the severity of every PTSD case. Veterans participated in a semi-structured interview 3 months post-matching. Whilst there was a reduction in the proportion of veterans reporting any suicidality, there was no significant change in the probability of veterans reporting suicidality between time points. There was a significant effect of time on PTSD, depression, and anxiety symptoms. Three major themes emerged from qualitative data analysis: life changer, constant companion, and social engagement. Qualitative data suggest assistance dogs can have a positive impact on important areas of daily life and support veterans in achieving some of the prerequisites for health, including access to services, transport, education, employment, and development of new and diverse social and community connections. Connections were key in improving health and wellbeing. This study exemplifies the power of human–animal relationships and adds emphasis to the need to take these seriously and create supportive healthy environments for veterans with PTSD. Our findings could be used to inform public health policy and service delivery, in line with the Ottawa Charter action areas and indicate that for veterans with PTSD, assistance dogs may be a feasible adjunct intervention.
Objective
This qualitative research was conducted to add to the body of knowledge that supports the benefits of service dogs (SDs), as a tertiary treatment modality, to veterans with post‐traumatic stress disorder (PTSD) and/or traumatic brain injury (TBI).
Methods
This grounded theory research design utilized open‐ended, semi‐structured interviews with veterans (n = 10) who were using SDs as a treatment modality for PTSD and/or TBI. Transcripts were analyzed using NVivo qualitative software until data saturation was achieved.
Results
Results from the data analysis identified 4 major themes with concurrent subthemes. The most prominent themes were functional status, impact of a SD, recognition of symptoms of PTSD and/or TBI by the SD, and barriers and challenges to the acquisition of a SD. Participants reported that the SD increased socialization and was a positive adjunct to treatment modalities for PTSD and/or TBI.
Conclusions
Our study highlights the benefits of using a SD as a tertiary treatment for PTSD and/or TBI in veterans. Veterans in our study articulated the benefits of using a SD as a tertiary treatment option, and the need to make this a standard treatment option for all veterans who suffer from PTSD and/or TBI.
Introduction: An increasingly common complement to PTSD treatment for veterans involves the use of a service dog (SD). There is a lack of regulation surrounding SDs in Canada, which can make it difficult to research SDs as differences in training and access can lead to different outcomes for veteran handlers, and can prevent clear insight into the effect of the SD on their lives. In this case, focusing on the lived experience of the veteran handlers can allow us to see the benefits of working with a SD, by allowing veterans to share their first-hand knowledge. Methodology: Interpretative Phenomenological Analysis (IPA), as outlined by Smith et al. (2022), was chosen as it is suitable for developing insight into the lived/living experience of the veteran handlers, allowing them to describe and make sense of their personal experiences with their SD and the overall impact on their daily lives. Results: Veterans feel very close to their SD, expressing sentiments of unconditional love and trust, and close bonds built on mutual respect and care. Although not expressly asked about in the interviews, many veterans have brought up the need for industry standardization for SDs, in terms of training and regulatory protections, across Canada, to ensure that SDs are properly trained and that public access for SDs is protected. Principal Conclusions and Implications for Field: Sharing first-hand stories of the beneficial impact of SDs on veterans’ lives contributes valuable insights for research on SDs as well as offering hope and practical insights for veterans considering a SD for themselves. These benefits, and the negative impact on veterans from the lack of standardization, points to the need for industry regulation in Canada. References: Smith, J. A., Flowers, P., & Larkin, M. (2022). Interpretative phenomenological analysis : theory, method and research (2nd ed.).
There is a long history of service dog usage to assist people with physical disabilities (e. g., dogs for the blind, deaf, and disabled). In comparison, however, relatively little empirical research has been conducted into the use of service or emotional support dogs for people with psychiatric disabilities (e. g., PTSD, bipolar disorder, anxiety disorder and schizophrenia). Given this research shortfall, the present study sought to provide insights into the post-war dog ownership experiences of contemporary veterans from the Iraq and Afghanistan fields of engagement, particularly in relation to the differences adopted dogs have made to the veterans’ readjustment back into society. In this regard, reporters’ media accounts of the experiences of veterans with PTSD and the general public’s social media response comments were subjected to a triangulated three-phase content analysis to explore the role dogs seemingly play in helping contemporary veterans to readjust to civilian life. The core theme to emerge from the study was one of: “‘Nudging them back to reality’: Toward a growing public acceptance of the role dogs fulfill in ameliorating contemporary veterans’ PTSD symptoms.” In light of the difficulties of interpreting the accounts of veterans through the filter of media coverage and social commentary, this core finding may prove to provide insights into how contemporary veterans diagnosed with PTSD utilize the assistance of dogs to help deal with their fundamental human needs for safety, affiliation, and succourance. Finally, the difficulties associated with dogs as therapeutic agents are discussed.
Posttraumatic Stress Disorder (PTSD) is one of the most commonly occurring disabilities among the Veteran population, as 20% of Operation Iraqi Freedom/Operation Enduring Freedom Veterans have a diagnosis of PTSD. This disorder is associated with work-related difficulties, being that PTSD is linked to exacerbated rates of unemployment and missed work days. The use of service dogs for Veterans with PTSD may improve workplace success by the dog’s performance of tasks specific to de-escalation of the handler’s PTSD symptomology, providing a structured schedule to aid in military-to-civilian transition and transition to life with a disability, and fostering of a friendly, supportive workplace environment. Limitations of current knowledge of service dog benefits and areas for future research will be discussed.
The therapeutic application of human–animal interaction has gained interest recently. One form this interest takes is the use of service dogs as complementary treatment for veterans with Post-Traumatic Stress Disorder (PTSD). Many reports on the positive effect of PTSD Service Dogs (PSDs) on veterans exist, though most are indirect, anecdotal, or based on self-perceived welfare by veterans. They therefore only give a partial insight into PSD effect. To gain a more complete understanding of whether PSDs can be considered an effective complementary treatment for PTSD, a scoping literature review was performed on available studies of PSDs. The key search words were ‘dog’, ’canine’, ‘veteran’, and ‘PTSD’. This yielded 126 articles, of which 19 matched the inclusion criteria (six empirical studies). Recurrent themes in included articles were identified for discussion of methodology and/or results. It was found that results from most included studies were either applicable to human–animal interaction in general or other types of service animals. They therefore did not represent PSDs specifically. Studies which did discuss PSDs specifically only studied welfare experience in veterans, but used different methodologies. This lead us to conclude there is currently no undisputed empirical evidence that PSDs are an effective complementary treatment for veterans with PTSD other than reports on positive welfare experience. Additionally, the lack of development standardization and knowledge regarding welfare of PSDs creates risks for both human and animal welfare. It is therefore recommended that a study on the effect of PSDs be expanded to include evaluation methods besides self-perceived welfare of assisted humans. Future studies could include evaluations regarding human stress response and functioning, ideally conducted according to validated scientific methodologies using objective measurement techniques to identify the added value and mechanisms of using PSDs to assist treatment of PTSD in humans.
Tori Stitt has dedicated most of her adult life to the armed services. After attending college on a Reserve Officers’ Training Corps scholarship, she was commissioned as a naval officer and accepted a position working on a guided-missile destroyer [1]. Due to the familiarity she developed in working with the sophisticated electronic equipment, she was recruited to join an army battalion in Iraq, where her technical skills would be used to remotely detect or jam roadside bombs. Although Tori was excited about the opportunity to be so close to combat, her experiences left her traumatized. Amidst the chaotic episodes of exploding bombs, enemy fire, and tense bomb-search patrols, Lieutenant Stitt found herself frozen with terror and confusion, and, within in a few months, toughened and exhausted. While in Iraq, Tori began having nightmares and problems sleeping, withdrawing from others socially, and, soon, drinking to cope with her psychological issues. Upon returning to the United States when her tour of duty was over, her drinking intensified and her mental anguish grew so great that she began contemplating suicide.
Treatment for her substance abuse and for her posttraumatic stress disorder (PTSD) helped Lieutenant Stitt to regain some semblance of control over her life, but she continued to struggle with nightmares, flashbacks, and social isolation. In search of another outlet to help her cope with her ongoing problems, she sought relief through a tried-and-true resource: a dog. This was not simply any dog, however; this was a trained service dog, a golden retriever named Devon that Tori procured from a local service dog organization for $3,000. Devon has been immensely beneficial for Tori, who notes, “It doesn’t matter what bad things are going on, I can pet Devon, give him a hug, and they turn around 180 degrees.” When Tori is nervous or anxious, Devon stands close to her or places his paw in her lap. Should she thrash about in her sleep because of a nightmare, Devon wakes her up by licking her face. And because he is a dog, Tori has to take Devon for walks, which forces her to leave her home and, on occasion, interact with people.
Hundreds of thousands of veterans who have served in the most recent wars in Iraq and Afghanistan are returning from their tours of duty with myriad physical and mental injuries that have reawakened the public’s consciousness of the long-term consequences that combat can have [2]. Whether the injury sustained is from shrapnel, a roadside bomb, or witnessing carnage, the pain and suffering of servicewomen and men is real and, for many, chronic. But the relief available is not necessarily the same for all veterans, particularly when it comes to the rehabilitative care offered by service dogs. Veterans who return home with physical impairments that hamper their mobility have the opportunity to obtain service dog benefits (which include financial assistance with veterinary expenses, the costs for obtaining and training a dog, and the costs of equipment required for the dog to perform its tasks) covered by the United States Department of Veterans Affairs (VA). Yet for those veterans whose injuries are psychological in nature, no service canine benefits are bestowed by the VA. I will discuss just how and why this inequality exists in federal law and the actions being taken both within the federal government and outside of the political arena to address it.
Romantic partners are often key supports for veterans diagnosed with posttraumatic stress disorder (PTSD). However, a PTSD diagnosis among veterans is often associated with lower relationship satisfaction and quality. To help reduce their PTSD symptomology, some veterans are more regularly relying on the help of service dogs (SDs). Relatively little is known about how SDs affect romantic relationships and veterans’ romantic partners. The current mixed-methods preliminary study explored the psycho-social effects of SDs on veterans’ romantic relationships and their partners from the romantic partners’ perspective. Romantic partners of veterans (N = 27) completed the Partnership Questionnaire and seven partners completed interviews. Scale results indicated overall low relationship quality, with relatively lower scores for couples’ tenderness/intimacy and togetherness/ communication, and higher scores for their quarreling. Interview results indicated there were perceived relationship problems due to the veterans’ PTSD, but there were some relationship improvements since the SD had been supporting the veteran, including decreased quarreling and increased tenderness/intimacy and togetherness/communication. Romantic partners reported experiencing less resentment and stress, and increased relaxation, calmness, patience, happiness, and hope for the future because of the SDs. This study suggests that SDs can influence other aspects of veterans’ lives beyond their disability, such as helping veterans reconnect with their romantic partners (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Post-traumatic stress disorder (PTSD) is associated with decreased executive functioning due to an imbalance in the frontal-amygdala circuit. Researchers theorize that an overactive amygdala increases the demand for regulating stress-related responses, thus depleting the prefrontal cortex of the limited resources needed for executive functions such as working memory. We hypothesized that working memory performance in people with PTSD could be partially restored by the presence of their dog, potentially working as a stress buffer. This study investigated the effect of the presence of a dog on working memory performance in police officers (n = 49) either with PTSD (n = 25) or without PTSD (n = 24), using behavioral and electrophysiological measures. Working memory performance was assessed on a 1-back task, both in the presence and absence of the participants’ companion or service dog. We measured event-related potentials (ERPs), with a focus on the N2 and P3 components. The results show that police officers with PTSD exhibited improved working memory performance in the presence of their dog, as evidenced by enhanced task performance and a larger N2 component amplitude to target stimuli compared with when the dog was absent. In contrast, the police officers without PTSD showed, in the absence of the dog, a better task performance and a larger N2. The findings suggest that the presence of a dog enhances working memory performance in police officers with PTSD.
Posttraumatic stress disorder is associated with autonomic hyperarousal often shown to involve elevated resting heart rate and, simultaneously if somewhat paradoxically, reduced physical activity. Both are risk factors for cardiovascular disease and so may contribute to its elevated prevalence in persons with this diagnosis. Epidemiological studies have observed dog owners to exhibit lower rates of cardiovascular disease. Non-randomized between-group studies have found service dog companionship to be associated with increased physical activity and with lower resting heart rate. A challenge to research in this area is its vulnerability to selection biases in group assignment which could lead to over-estimation of advantages or disadvantages associated with pet or service dog contact and companionship. The current study executed a within-subjects design investigating physical activity and heart rate in a sample of U.S. military Veterans engaged in residential treatment for PTSD and a concurrent service animal training intervention. A mean of 37 days of continuously-recorded day-time physical activity and heart rate were obtained from 45 participants. On days when they had custody of a familiar service-dog-in-training, participants exhibited increased physical activity accompanied by a small reduction in concurrent, activity-adjusted heart rate. Though observed in a specialized context, these short-term findings align with prior observations of lowered risk of cardiovascular disease in association with pet dog ownership. Extended longitudinal designs will be necessary to determine whether such short-term effects truly mediate lowered long-term risk.
Objectives:
This study examined needs related to posttraumatic stress disorder (PTSD), assistance by service dogs, and feasibility of data collection among veterans receiving service dogs.
Methods:
Questionnaires assessed PTSD-related needs and services performed or expected to be performed by service dogs among 78 veterans who had or were on a wait list for a service dog (average age, 42; women, 31%). Analyses compared pre-post characteristics among 22 veterans who received a service dog as part of the study (91% follow-up; average follow-up=3.37±2.57 months).
Results:
Veterans reported that the most important services performed were licking or nudging veterans to help them “stay present,” preventing panic, and putting space between veterans and strangers. High follow-up rates and improvements in outcomes with moderate to large effect sizes among recipients of study-provided dogs suggest further study is warranted.
Conclusions:
Service dogs may be feasible supports for veterans with PTSD; randomized clinical trials are needed to assess effectiveness.
Objective: Veterans with posttraumatic stress disorder (PTSD) are increasingly seeking service dogs to help them manage trauma-related symptoms, yet literature describing service dog use in this population is scant. The goal of this study was to document the benefits and challenges experienced by veterans with service dogs trained to assist with PTSD-related needs. Method: Participants were veterans (N = 41) with service dogs, and their caregivers (n = 8), recruited through community-based service dog training agencies. We conducted in-depth interviews and observed training sessions as part of a larger study, and used thematic analysis to characterize data. Results: Veterans reported that service dogs reduced hypervigilance by alerting and creating boundaries, and disrupted nightmares, improving sleep quality and duration. Dogs also helped veterans turn their attention away from invasive trauma-related thoughts. Additional reported benefits included improved emotional connections with others, increased community participation and physical activity, and reduced suicidal impulses and medication use. Demands of training, adjustment to life with a service dog, and delayed benefits were challenging for many veterans and caregivers. Conclusions and Implications for Practice: Veterans report that service dogs help reduce PTSD symptoms and facilitate recovery and realization of meaningful goals. Service dogs may be a reasonable option for veterans who are reluctant to pursue or persist with traditional evidence-based treatments. Additional rigorous research on the effectiveness of service dogs for this population is warranted. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
No Abstract available
In response to the critical need for adjunctive treatments for soldiers with refractory forms of mental injury — primarily posttraumatic stress disorder (PTSD) — the US military is developing complementary and alternative medicine (CAM) techniques, including animal-assisted intervention (AAI).1,2
CAM modalities include therapies such as yoga, meditation, and creative art therapies, shown to have an effect on the mind’s capacity to regulate the brain and body’s response to social and environmental challenges by reducing stress and enhancing the immune function through the release of the neuropeptide oxytocin by the brain.
Olff et al3 suggest PTSD symptom treatment would be improved by increasing endogenous levels of oxytocin through optimizing of social support. Studies show that dogs can provide such an optimization of social support and that positive interactions with dogs may offer a safe, effective, and relatively inexpensive way to increase endogenous levels of oxytocin and other important anti-stress agents in humans.
Valerie, a golden retriever, demonstrates her ability to connect with a sailor at the National Intrepid Center of Excellence. Image courtesy of Rick Yount, MS, LSW.
Oxytocin is a well-established modulator of a pro-social, anti-stress brain network with the potential to modulate symptoms of PTSD such as: anxiety, including fear response and hyperarousal; interpersonal difficulties/social isolation; physical pain; and sleep disturbances. Human oxytocin research has shown that oxytocin can increase our sense of trust, empathy, and optimism and even increase our response to hypnosis. In rodents, central administration of oxytocin enhanced acupuncture’s analgesic effects. Studies also suggest that oxytocin is a central mediator of the placebo effect.4–7
Several studies show that friendly, social interaction with dogs increases blood and urine levels of oxytocin in humans.8–12 These human-dog, contact-induced effects gain particular significance in light of a recent brain imaging study which showed that peripheral increases in oxytocin correspond with concurrent activation of the oxytocin brain centers that control the human stress response.13
Oxytocin neurons originate in the hypothalamus and connect to the major brain centers that control behavior and emotion. Oxytocin modulates the hypothalmic-pituitary-adrenal axis (HPA axis), the locus coeruleus, the central amygdala (CeA) and other arousal centers of the central nervous system to attenuate stress-induced neuroendocrine activity. Oxytocin receptor-expressing neural circuits in the CeA connect to the medial prefrontal cortex to suppress neurons that produce the freezing reaction to fear, while promoting risk assessment and exploratory response to frightening stimulus.
Oxytocin has also been shown to modulate the serotonin system and reduce levels of cytokines, adrenocorticotropic hormone, and cortisol. All of these brain systems and neurochemical responses have shown to be functionally important in PTSD.14–21
With respect to pain and sleep disturbances, oxytocin has been shown to modulate pain in humans and has been shown to impact sleep patterns in animal studies.22–24 Oxytocin has also been shown to be a powerful antioxidant that can bolster the immune system and protect against sepsis.25,26
One dose of oxytocin given to war veterans with PTSD demonstrated decreased physiologic responding to provoked combat memories.27 Oxytocin in humans, has been shown to enhance the processing of positive social information compared to negative information, increase a sense of trust in others, reverse the effect of aversive conditioning of social stimuli, enhance the buffering effect of social support on stress responsiveness, and reduce the stress response in people with a history of early trauma.28
This same pro-social/anti-stress response has also been observed in service members with PTSD who train service dogs. As we will demonstrate, shaping the behaviors of service dogs requires the focused nurturing social attention towards dogs that has been shown to naturally increase oxytocin blood levels in humans.
There are many potential…
