Characterizing veteran and PTSD service dog teams: Exploring potential mechanisms of symptom change and canine predictors of efficacy.

Psychiatric service dogs are an emerging complementary intervention for posttraumatic stress disorder (PTSD). Initial evidence suggests that partnership with a service dog may be related to less PTSD symptom severity. However, it remains unclear how or why this might occur. To address this gap, we conducted a longitudinal investigation of 82 post-9/11 military members or veterans and their PTSD service dogs to (1) evaluate service dog characteristics as potential predictors of efficacy, (2) assess dog and human characteristics as potential predictors of veteran-dog bond, and (3) explore potential mechanisms for mental health outcomes. Aim 1 results demonstrated that most service dog characteristics did not predict veterans' mental health outcomes, but lower service dog excitability was associated with less PTSD symptom severity at follow-up. Aim 2 results showed that closer dog-veteran relationships were associated with less excitable dog temperament. Aim 3 results indicated that worse mental health at follow-up was associated with greater use of the specifically trained PTSD service dog task to initiate a social greeting ("make a friend"), whereas better mental health was related to less use of dominance-based training methods, lower perceived emotional/logistical costs of service dog partnership, and closer veteran-dog relationships. More frequent use of the trained service dog task to signal when someone approaches from behind (cover/watch back) was associated with greater anxiety, but less PTSD symptom severity. Overall, veterans spent an average of 82% of their time with service dogs (assessed via Bluetooth proximity between dog collar and veteran smartphone), and most frequently asked their service dogs to perform the trained task for calming their anxiety (calm/comfort anxiety). The present study provides subjective and objective metrics of the heterogeneity among veteran-service dog dyads while also suggesting which of the assessed metrics might be potential mechanisms involved in the intervention.

Perspectives on facility dogs from pediatric hospital personnel: A qualitative content analysis of patient, family, and staff outcomes.

An increasing number of children's hospitals feature full-time resident facility dogs, which are specially trained to work alongside pediatric healthcare professionals to improve the patient experience. This qualitative study aimed to describe the role that facility dogs play in the lives of patients, families, and hospital staff. A total of N = 73 pediatric healthcare professionals that worked with 46 facility dogs across 17 children's hospitals in the US completed a set of open-ended questions in an online survey. Responses were analyzed via a conventional thematic analysis and organized into themes and sub-themes. Facility dogs were described to benefit pediatric healthcare professionals' daily lives through improving stress and wellbeing, staff relationships, and job-related morale. Negative impacts included increased burdens and responsibilities in the workplace. Facility dogs were also described to benefit patients and families by helping build rapport, providing a comforting presence and positive resource, and normalizing the hospital environment. In conclusion, facility dog programs were found to be a promising complementary intervention to benefit both staff as well as and patients and families. Future research is warranted to examine short-term and long-term implications of facility dog programs for staff, patient, and family wellbeing.

Expectations versus experiences of veterans with posttraumatic stress disorder (PTSD) service dogs: An inductive conventional content analysis.

[Correction Notice: An Erratum for this article was reported in Vol 14(3) of Psychological Trauma: Theory, Research, Practice, and Policy (see record 2022-33825-001). In this article, the length of time in which service dogs had been paired with Veterans was reported incorrectly in the third paragraph under the "Participants" heading of the "Methods" section whereby the sentence "Participants with a service dog had received their PTSD service dog an average of 51.5 months prior to participating in the study (range = 3-121.7 months, SD = 33.3)." should have read "Participants with a service dog had received their PTSD service dog an average of 20.9 months prior to participating in the study (range = 1.2-46.23 months, SD = 13.18)." All versions of this article have been corrected.] Objective: The objective of this study was twofold: to describe the benefits and drawbacks of a posttraumatic stress disorder (PTSD) service dog from the perspective of Veterans with service dogs and to compare these reports to the expectations of Veterans who were on a waitlist for a PTSD service dog. Method: A total of 128 U.S. post-9/11 Veterans with PTSD were recruited from a nonprofit service dog provider (K9s for Warriors), including n = 69 with a PTSD service dog and n = 59 on the waitlist. Participant responses to open-ended survey questions were analyzed with conventional content analysis and classified into 214 codes across six subthemes, creating three larger themes. A subset (20%) of the data was independently coded to establish interrater reliability (Cohen's κ = .804). Frequency data were used to compare theme and subtheme prevalence between groups. Results: Veterans' experiences and expectations were centered on the effects the service dogs had on Veteran mental health, human-dog interaction, and the associated drawbacks. Although the majority of Veterans reported benefits from their service dogs, the findings revealed that Veterans on the waitlist more frequently mentioned benefits than those with a service dog. Study findings suggest that the drawbacks expected from service dogs differ from the drawbacks experienced. Conclusion: Understanding expectations versus experiences provides critical information for mental health professionals who are informing Veterans on individualized interventions for PTSD. This knowledge will enable professionals to temper expectations and educate Veterans on specific benefits and drawbacks so that they have a more rounded view of PTSD service dogs. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Dogs Supporting Human Health and Well-Being: A Biopsychosocial Approach.

Humans have long realized that dogs can be helpful, in a number of ways, to achieving important goals. This is evident from our earliest interactions involving the shared goal of avoiding predators and acquiring food, to our more recent inclusion of dogs in a variety of contexts including therapeutic and educational settings. This paper utilizes a longstanding theoretical framework- the biopsychosocial model- to contextualize the existing research on a broad spectrum of settings and populations in which dogs have been included as an adjunct or complementary therapy to improve some aspect of human health and well-being. A wide variety of evidence is considered within key topical areas including cognition, learning disorders, neurotypical and neurodiverse populations, mental and physical health, and disabilities. A dynamic version of the biopsychosocial model is used to organize and discuss the findings, to consider how possible mechanisms of action may impact overall human health and well-being, and to frame and guide future research questions and investigations.

The effects of facility dogs on burnout, job-related well-being, and mental health in paediatric hospital professionals.

AIMS AND OBJECTIVES: To examine the effect of working with a facility dog on paediatric healthcare professionals' work-related burnout, job perceptions and mental health. BACKGROUND: Due to their roles caring for ill children and distressed families, paediatric healthcare professionals often experience substantial depression and burnout. According to prior research, facility dogs in children's hospitals may provide significant benefits to paediatric patients. However, their potential effects on healthcare professionals have been minimally explored. DESIGN: A cross-sectional design was used in adherence to the STROBE checklist. METHOD: Among 130 participants, n = 65 paediatric healthcare professionals working with a facility dog were compared to n = 65 control participants matched on age, gender identity, job position category and pet ownership. Hierarchical regression assessed the effect of working with a facility dog on standardised self-report measures of work-related burnout, job perceptions and mental health. RESULTS: For work-related burnout, working with a facility dog was associated with higher perceived personal accomplishment, but had no effect on emotional exhaustion. With respect to job perceptions, working with a facility dog was associated with more positive job descriptions and lower intention to quit, but not with perceptions about co-workers or workplace social support. Finally, in relation to mental health, working with a facility dog was associated with more positive emotions, better perceived mental health and less depression, but had no effect on anxiety. CONCLUSION: Findings suggest that facility dogs may be related to several benefits for healthcare professionals' work-related burnout, job perceptions and mental health, but that they do not influence all components of these areas. RELEVANCE TO CLINICAL PRACTICE: The present research functions to inform personnel in paediatric hospitals with existing facility dog programmes on the scope of their effects, in addition to shaping the expectations of hospitals considering the addition of a facility dog programme.

The effect of a service dog on salivary cortisol awakening response in a military population with posttraumatic stress disorder (PTSD).

Recent studies suggest a therapeutic effect of psychiatric service dogs for military veterans with posttraumatic stress disorder (PTSD), but are limited by self-report biases. The current study assessed the effect of PTSD service dogs on the salivary cortisol awakening response (CAR) and arousal-related functioning in a population of military veterans with PTSD. Participants included 73 post-9/11 military veterans with PTSD including 45 with a service dog and 28 on the waitlist to receive one. Saliva samples were collected on two consecutive weekday mornings at awakening and 30 min later to quantify the cortisol awakening response (CAR) and its area under the curve (AUCi) in addition to standardized survey measures of anxiety, anger, sleep quality and disturbance, and alcohol abuse. There was a significant main effect of having a service dog on both the CAR and the AUCi, with individuals with a service dog exhibiting a higher CAR and AUCi compared to those on the waitlist. Results also revealed that those with a service dog reported significantly lower anxiety, anger, and sleep disturbance as well as less alcohol abuse compared to those on the waitlist, with medium to large effect sizes. Although those with a service dog reported significantly less PTSD symptom severity, CAR was not significantly associated with PTSD symptoms within or across group. In conclusion, results indicate that the placement of a PTSD service dog may have a significant positive influence on both physiological and psychosocial indicators of wellbeing in military veterans with PTSD. Although clinical significance cannot be confirmed, a higher CAR/AUCi among those with a service dog may indicate better health and wellbeing in this population. Future within-subject, longitudinal research will be necessary to determine potential clinical significance and impact of individual differences.

Preliminary efficacy of service dogs as a complementary treatment for posttraumatic stress disorder in military members and veterans.

OBJECTIVE: 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. (PsycINFO Database Record