Service Dogs for Veterans and Military Members With Posttraumatic Stress Disorder: A Nonrandomized Controlled Trial.

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. Trial Registration: ClinicalTrials.gov ID: NCT03245814.

A Preliminary Analysis of Psychiatric Service Dog Placements and Sleep Patterns of Partners of Veterans With PTSD.

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.

Observation of human-animal interaction for research (OHAIRE) behavior coding in a randomized control trial of children with attention-deficit hyperactivity disorder (ADHD) and a canine-assisted intervention.

Introduction: Diagnosed in about 10% of children in the United States, attention-deficit hyperactivity disorder (ADHD) is characterized by symptoms including inattention, hyperactivity, and impulsivity. Traditional interventions, such as pharmacological and psychological interventions, are often used in conjunction with integrative health options, such as animal-assisted interventions. The objective of this manuscript is to report behavior coding findings from a randomized control trial of children with ADHD. Methods: As part of a larger randomized control trial focused on the efficacy of combining a canine-assisted intervention (live therapy dog or control stuffed dog) with cognitive behavioral therapy for children with ADHD, the current manuscript focuses on video-captured behavior observations (n = 35 children, approximately 322 minutes of data). Data were extracted and coded using the Observation of Human-Animal Interaction Research (OHAIRE) Coding System. Behavior codes are reported as summary scores for the following domains: animal social interaction and human social interaction (further separated into human-adult social interaction and human-peer social interaction). Repeated measures mixed models analyses were performed using SAS PROC GLIMMIX to evaluate group differences and change across the study period. Results: There were no significant differences in how much children interacted with the live therapy dogs versus control stuffed dogs. With respect to human-to-human social interactions, children showed greater increases over time in human-directed social interactions in the presence of live therapy dogs compared to stuffed dogs (p = .020). Over the course of the 12-week intervention, children increased in interactions with both adults (p = .006) and their peers (p = .014); however, there were more increases over time in adult-directed social interactions in the live animal condition compared to the control stuffed animal condition (p < 0.0001). Discussion & conclusions: Findings suggest changes in social interaction when participating in this canine-assisted intervention, specifically greater increases in human-to-human social interactions over time when a live therapy dog is present compared to a control stuffed dog. Children appear to engage relatively equally with both live and stuffed dogs; however, the impact of animals on human socialization differs based on if a live animal is present. Future studies should consider incorporating behavior coding analysis into studies of canine-assisted interventions to identify how human-animal interactions may be moderators or mechanisms for psychosocial outcomes.

The effects of service dogs for children with autism spectrum disorder and their caregivers: a cross-sectional study.

Introduction: Service dogs are an increasingly popular complementary intervention for children with autism spectrum disorder. However, despite increasing demand, there remains a lack of empirical research on their potential benefits. The purpose of this study was to evaluate the effects of service dogs on children with autism and their caregivers. Methods: A total of N = 75 families of children with autism were recruited from a non-profit service dog provider in the US, including n = 39 families previously placed with a service dog and n = 36 families engaging in usual care while on the waitlist. Caregivers completed an online survey containing both self- and proxy-report standardized measures of child, caregiver, and family functioning. Linear regressions modeled the relationship between service dog presence and survey outcomes, controlling for relevant child and caregiver covariates. Results: Results indicated that having a service dog was associated with significantly better child sleep behaviors, including better sleep initiation and duration and less sleep anxiety/co-sleeping with medium effect sizes. However, service dog presence was not significantly related to child withdrawal, negative emotionality, emotional self-control, hyperactivity, irritability, and lethargy with small effect sizes. For caregivers, having a service dog was not significantly related to standardized measures of caregiver strain, sleep disturbance, depression, or the impact of the child's condition on family functioning with small effect sizes. Supplemental matched case-control analyses confirmed these findings. Discussion: In conclusion, service dogs were found to positively impact sleep behaviors among children with autism, but may not uniformly relate to other areas of child and caregiver wellbeing. Prospective longitudinal designs, larger sample sizes able to detect small effects, and studies that measure sleep using objective methods are needed to build on these findings.

The cortisol awakening response in a 3 month clinical trial of service dogs for veterans with posttraumatic stress disorder.

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, ß = 1.46, p = 0.046) and absolute increase (AINC, ß = 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.

PTSD service dogs foster resilience among veterans and military families.

Military deployment and reintegration challenges permeate the lives and relationships of Veterans, their spouses, and their families. Among these challenges, 23% of post-9/11 Veterans have been diagnosed with posttraumatic stress disorder (PTSD). Psychiatric service dogs have been found to help clinically alleviate PTSD symptoms when used as a complementary intervention. However, minimal research exists that explores the role of the service dog as a mechanism for cultivating resilience within the military family system. Researchers utilized a qualitative, constant comparative approach to analyze self-reported experiences of 101 individuals, including Veterans (n = 67) and their spouses (n = 34). Analyzed through the framework of the Theory of Resilience and Relational Load (Afifi et al., 2016), findings suggest complex communication processes that facilitate relational and family adaptation. These processes encompassed (a) the role of the service dog in building emotional reserves, (b) relational load introduced when caring for the service dog, and (c) the service dog's facilitation of relational maintenance behaviors among family members that contributed to communal orientation. Based on the results of this qualitative analysis, researchers suggest educational interventions where service dog trainers and mental health practitioners can incorporate relational maintenance strategies and family-focused approaches to integrating service dogs as military family members.

Psychiatric service dog placements are associated with better daily psychosocial functioning for military veterans with posttraumatic stress disorder.

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 (ß = 0.42, p < .05), better affect (negative affect: ß = -2.64, p < .001; positive affect: ß = 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 (ß = 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).

Service dogs for autistic children and family system functioning: a constant comparative analysis.

Introduction: Service dog placements for autistic children are growing in popularity, yet findings to date are mixed. Moreover, no study to date has examined these placements through the lens of a recognized theoretical model. The purpose of this study is twofold: to explore experiences reported by caretakers of autistic children involved in a service dog program, and to contextualize findings within an established theoretical framework. Methods: A total of n = 50 caretakers of autistic children (n = 38 with and n = 12 without a service dog) were recruited through the national non-profit service dog provider Canine Companions. Participants completed an online survey through Qualtrics which asked open-ended questions about their experiences, both negative and positive. Results: Constant comparative analysis identified two high level themes, nested within a family systems approach framework: (1) Enhancing social functioning of the family system unit and (2) Fostering stability and strength within family system subunits. These themes interacted holistically to foster and reinforce family system resilience. Placements led to greater social inclusion for children and their families, acted as a highly individualized intervention, and decreased experiences of judgement and stigma. Perceived as members of the family, service dogs may coregulate with the autistic child and family members and can be a source of joyful connection within the family. Discussion: Results highlighted the service dog's influence on the entire family (beyond the autistic child). Implications for service dog organizations suggest it may be helpful to account for family-wide impacts throughout the placement process. High standards on the part of provider organizations may minimize negatives, optimizing outcomes for both humans and canines. Ultimately, findings enrich our understanding of service dog interventions for autistic children.

Animal-Assisted Interventions for Autism Spectrum Disorder: A Systematic Review of the Literature from 2016 to 2020.

In the last five years, the literature on animal-assisted intervention (AAI) for Autism Spectrum Disorder (ASD) has doubled in size from 42 studies prior to 2015 to 85 studies (cumulative total assessed in 2020). Horses remain the most commonly researched animal for AAI, followed by dogs. The most commonly researched outcome was social interaction, across 21 studies. Though the quantity of studies has increased, issues with methodological rigor remain. Results highlight the need for a continued focus on methodological rigor as well as refining the structure of animal-assisted interventions, addressing the welfare needs of the animals involved, and continuing to establish an evidence base of both significant and nonsignificant findings for AAI for individuals with ASD.

Benchmarking Enrichment Efforts in the US & Canada Across Species and Enrichment Categories.

Enrichment is important for animal welfare and data quality. Provision of enrichment opportunities varies between species and enrichment category. However, data benchmarking these differences does not exist. Our objective was to characterize enrichment provision and associated factors across species in the US and Canada. Personnel who work with research animals (n = 1098) in the US and Canada voluntarily responded to online promotions and completed a survey about enrichment used for the species they worked with most, their control of and wish for more enrichment, stress or pain in the animals they worked the most with, and demographics. All participants (except those working with rats) received the same questionnaire regardless of species to allow objectivity, as the effects of many enrichment items on some species have not yet been determined. The questionnaire asked about enrichments that were beneficial to at least one species. The provision of enrichment was allocated into 2 outcome variables: diversity and frequency per enrichment category. Results showed a significant interaction between enrichment category and species. Generally, physical, nutritional, and sensory enrichments were provided less often than social enrichment. In addition, nonhuman primates received more diverse and more frequent enrichment than did other species (twice as much as rats and mice). Enrichment was provided less frequently by personnel who wished they could do more than the status quo. Both enrichment frequency and diversity were higher in respondents from Canada, those who had more control over provision, and those who had been in the field longer. While our results cannot be used to determine the quality of enrichment provided to various species, they do provide information on current enrichment practices in the US and Canada and identify differences in implementation by species and enrichment category. The data also indicate provision of enrichment is influenced by factors such as country and individual control over enrichment. This information can also be used to identify areas for greater enrichment efforts for some species (for example, rats and mice) and categories, with the ultimate goal of improving animal welfare.

Circumscribed interests in autism: Can animals potentially re-engage social attention?

BACKGROUND: Circumscribed interests (CI) in autism are highly fixated and repetitive interests, generally centering on non-social and idiosyncratic topics. The increased salience of CI objects often results in decreased social attention, thus interfering with social interactions. Behavioural, biomarker and neuroimaging research points to enhanced social functioning in autistic children in the presence of animals. For instance, neuroimaging studies report a greater activation of reward systems in the brain in response to animal stimuli whereas eye-tracking studies reveal a higher visual preference for animal faces in autistic individuals. This potentially greater social reward attached to animals, introduces the interesting and yet unexplored possibility that the presence of competing animal stimuli may reduce the disproportionately higher visual attention to CI objects. METHOD: We examined this using a paired-preference eye-tracking paradigm where images of human and animal faces were paired with CI and non-CI objects. 31 children (ASD n = 16; TD n = 15) participated in the study (3391 observations). RESULTS: Autistic children showed a significantly greater visual attention to CI objects whereas typical controls showed a significantly greater visual attention to social images across pairings. Interestingly, pairing with a CI object significantly reduced the social attention elicited to human faces but not animal faces. Further, in pairings with CI objects, significantly greater sustained attention per visit was seen for animal faces when compared to human faces. CONCLUSIONS: These results thus suggest that social attention deficits in ASD may not be uniform across human and animal stimuli. Animals may comprise a potentially important stimulus category modulating visual attention in ASD.

Benefits and challenges of mobility and medical alert service dogs for caregivers of service dog recipients.

PURPOSE: Mobility and medical alert service dogs are an assistive technology for individuals with disabilities or chronic conditions. Informal caregivers of individuals with disabilities are subject to physical and emotional stress due to their responsibilities. Understanding how service dogs, an increasingly common assistive technology, may add to or subtract from caregiver stress is crucial for promoting caregiver well-being. The purpose of this study was to analyze caregiver accounts to understand their perspective on benefits and challenges they face with mobility and medical alert service dogs. MATERIALS AND METHODS: Open ended survey responses from 117 caregivers of service dog recipients (N = 72 with a service dog, N = 45 on the waitlist) were analysed through a conventional content analysis. RESULTS: Four major themes were found regarding caregiver and service dog: Family Benefits, Caregiver Benefits, Assistance Through Service Dog's Training, and Drawbacks. CONCLUSIONS: Findings suggest that benefits and challenges of mobility and medical service dogs extend beyond the service dog recipient, affecting the caregiver and other family members as well. Future studies should further explore this interaction to determine the best way to support caregivers of individuals with disabilities.IMPLICATIONS FOR REHABILITATIONMobility and medical alert service dogs are increasingly partnered with individuals with disabilities or chronic diseases as an assistive technology but few studies have focussed on the experience of the caregivers of service dog recipients. Caregivers of individuals with disabilities or chronic diseases may be subject to both psychological and physiological stressors as a result of their caregiver duties.Results found that caregivers perceive both benefits to themselves and to their families in terms building a bond with the animal that helps to reduce worry and offers emotional support. The most commonly mentioned drawbacks include general maintenance of the service dog, grooming needs and travel restrictions.This research is important in order to offer appropriate support to caregivers of individuals with disabilities.

Assistance dogs for military veterans with PTSD: A systematic review, meta-analysis, and meta-synthesis.

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.

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.

Posttraumatic stress disorder service dogs and the wellbeing of veteran families.

Background: Benefits and challenges associated with service dogs for veterans with posttraumatic stress disorder (PTSD) may extend beyond veterans to their families. Objective: The purpose of the current study is to evaluate the impact of veterans' PTSD service dogs on spouses and families in a parallel-group, longitudinal design with assessments at baseline and three months follow-up. Method: A total of 88 United States military veteran spouses completed a survey composed of multiple standardized measures at baseline and three months later. In the intervention group (n = 48), veterans received service dogs shortly after baseline while the waitlist control group (n = 40) did not. Results: Linear regression analyses demonstrated significantly lower caregiver satisfaction, higher caregiver burden and higher participation in life activities among spouses who had service dogs in their homes compared to those on the waitlist. Though not significant, small effect sizes were present among additional measures. Conclusion: Results suggest that although previous literature demonstrates service dogs may offer significant improvements for veterans, spouses and children may not experience those same benefits. Clinicians should consider how to prepare veteran spouses and families for integrating service dogs into their home. Future studies should explore family-focused approaches for service dog integration, defining an optimal strategy for the benefit of the entire family. 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.

Antecedentes: Los beneficios y desafíos asociados con los perros de asistencia para veteranos con trastorno de estrés postraumático (TEPT) pueden extenderse más allá de los veteranos a sus familias. Objetivo: El propósito del estudio actual es evaluar el impacto de los perros de asistencia en el TEPT de cónyuges y familias de veteranos en un diseño longitudinal de grupos paralelos con evaluaciones al inicio y a los tres meses de seguimiento. Método: Un total de 88 cónyuges de veteranos militares de los Estados Unidos completaron una encuesta compuesta por múltiples medidas estandarizadas al inicio y tres meses después. En el grupo de intervención (n = 48), los veteranos recibieron perros de asistencia poco después del inicio, mientras que el grupo de control en lista de espera (n = 40) no lo hizo. Resultados: Los análisis de regresión lineal demostraron una satisfacción del cuidador significativamente menor, una mayor carga del cuidador y una mayor participación en las actividades de la vida entre los cónyuges que tenían perros de asistencia en sus hogares, comparado con los que estaban en la lista de espera. Aunque no significativos, pequeños tamaños de efecto estuvieron presentes entre las medidas adicionales. Conclusión: Los resultados sugieren que aunque la literatura previa demuestra que los perros de asistencia pueden ofrecer mejorías significativas para los veteranos, es posible que las cónyuges y sus hijos no experimenten los mismos beneficios. Los clínicos deben considerar cómo preparar a las cónyuges y familias de veteranos para integrar perros de asistencia en sus hogares. Los estudios futuros deberían explorar enfoques centrados en las familias para la integración del perro de asistencia, definiendo una estrategia óptima para el beneficio de toda la familia.

Quantifying the emotional experiences of partners of veterans with PTSD service dogs using ecological momentary assessment.

The objective of this study was to investigate the day-to-day experiences of positive and negative emotions among partners of veterans assigned service dogs for posttraumatic stress disorder (PTSD). As part of a larger clinical trial, a total of N = 87 partners of post-9/11 veterans with PTSD were recruited from a nonprofit service dog provider and participated in an ecological momentary assessment (EMA) protocol. The sample included partners of veterans who received a PTSD service dog after baseline (n = 48, treatment group) and partners of veterans on the waitlist for a service dog (n = 39, control group). Data were collected twice daily for two weeks at baseline and again at follow-up three months later, for approximately 56 assessments per participant (28 at baseline, 28 at follow up). Participants completed an average of 84% of questionnaires at baseline (n = 23.6) and 86% (n = 24.1) at follow-up. A total of 3780 EMA questionnaires were collected among partners for this analysis. Data were analyzed using a generalized linear mixed model. Three months following baseline, partners of veterans with service dogs reported statistically significant higher levels of positive emotions than the control partners (p = .01, d = 0.39) with small-to-medium effect sizes for each individual positive emotion. No statistically significant differences were reported for negative emotions (p = .77, d = 0.21). This study quantitatively identifies higher levels of positive emotion in partners who are cohabitating with a PTSD service dog compared to those partners who remained on the waitlist. Given the influence that positive emotions have on well-being and coping, findings suggest that the influence of service dogs may go beyond veterans to influence their cohabitating partners.

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).

Correction: The effects of assistance dogs on psychosocial health and wellbeing: A systematic literature review.

[This corrects the article DOI: 10.1371/journal.pone.0243302.].

The Effect of a PTSD Service Dog on Military Veterans' Medication Regimens: A Cross-Sectional Pilot Study.

Recent research suggests that service dogs may have clinically-relevant benefits for military veterans with posttraumatic stress disorder (PTSD). However, the effects of PTSD service dogs on veterans' medication use has been largely unexplored. The objective of this study was to quantify the effect of PTSD service dogs on medication use among a population of military veterans with PTSD. In a cross-sectional design, United States post-9/11 military veterans with PTSD were recruited from a single service dog provider including veterans living with a PTSD service dog (n = 52) and veterans on the waitlist (n = 44). Both populations of veterans received treatment as usual. Participants completed an online survey of self-reported medication regimens and medication changes. Regression models quantified the effect of having a service dog on physical health, mental health, pain, and sleep medications while controlling for confounding variables (age, sex, relationship status, traumatic brain injuries, and physical health). Results indicated that there were no significant effects of having a service dog on overall self-reported medication use nor any specific medication category (p's > 0.06). However, veterans with a service dog were more likely than those on the waitlist to report that their doctor had decreased dosage or removed medications since getting their service dog. The results of this preliminary cross-sectional research should be interpreted with caution, as future within-subject and pharmacy-verified research is necessary to understand the causality of these findings.