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

Abstract

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.

Service Dogs for Veterans and Military Members With Posttraumatic Stress Disorder

“…for potential benefits remain unknown, prior research has identified an association between the service dog's trained tasks and the presence of psychosocial functioning as well as potential stress hormone pathways via the cortisol awakening response in veterans. [15][16][17]21,54 Service dog partnerships were also associated with a loss of clinician PTSD diagnosis. 55 Given that participants also had unrestricted access to usual care, study findings support suggestions from prior research that service dog partnerships should take place in combination with other evidence-based care.…”

“…These results are notable given the relatively short follow-up period (3 months) compared with the typical service dog partnership length (≥8 years). Although specific mechanisms for potential benefits remain unknown, prior research has identified an association between the service dog’s trained tasks and the presence of psychosocial functioning as well as potential stress hormone pathways via the cortisol awakening response in veterans …”

“…Based on standardized effect size, service dog partnership was associated with medium to large improvements in most areas of psychosocial functioning, including quality of life, well-being, and life satisfaction. Decreases in social participation after service dog partnership could be attributed to adverse experiences (or anticipation of adverse experiences), such as access denials and stigma when accompanied by a service dog in public …”

“…Although specific mechanisms for potential benefits remain unknown, prior research has identified an association between the service dog’s trained tasks and the presence of psychosocial functioning as well as potential stress hormone pathways via the cortisol awakening response in veterans. 15 , 16 , 17 , 21 , 54 …”

“…To our knowledge, the present trial represents the largest nationwide study to date to compare service dog partnerships with usual care alone and is the first National Institutes of Health–funded study to investigate service dog partnerships for military service–related PTSD. Prior publications have reported spouse, 11 , 12 , 13 qualitative, 14 biological, 15 canine, 16 and ecological momentary assessment 17 data streams. The objective of this trial was to estimate the associations between service dog partnerships and self-reported and clinician-rated PTSD symptom severity, depression, anxiety, and psychosocial functioning after 3 months of intervention among veterans.…”