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- Title
Service Dogs for Veterans and Military Members With Posttraumatic Stress Disorder: A Nonrandomized Controlled Trial.
- Authors
Leighton, Sarah C.; Rodriguez, Kerri E.; Jensen, Clare L.; MacLean, Evan L.; Davis, Louanne W.; Ashbeck, Erin L.; Bedrick, Edward J.; O'Haire, Marguerite E.
- Abstract
This nonrandomized controlled trial examines subjectively and objectively assessed posttraumatic stress disorder (PTSD) symptom severity, anxiety, depression, and psychosocial functioning among US veterans with vs without a psychiatric service dog. Key Points: Question: For military members and veterans with posttraumatic stress disorder (PTSD), is a partnership with a trained psychiatric service dog associated with lower PTSD symptom severity, lower anxiety, lower depression, and greater psychosocial functioning? Findings: In this nonrandomized controlled trial of 156 military members and veterans with PTSD, the addition of a service dog to usual care was associated with lower PTSD symptom severity, lower anxiety, and lower depression after 3 months of intervention. Meaning: Findings of this trial suggest that trained psychiatric service dogs may be an effective complement to usual care for military service–related PTSD. 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
- Subjects
UNITED States; TREATMENT of post-traumatic stress disorder; PREVENTION of mental depression; PSYCHOTHERAPY; PET therapy; SERVICE animals; MENTAL health; SUICIDAL ideation; RESEARCH funding; CLINICAL trials; DOGS; TREATMENT effectiveness; DESCRIPTIVE statistics; SEVERITY of illness index; CLASSIFICATION of mental disorders; LONGITUDINAL method; ODDS ratio; VETERANS; QUALITY of life; CONFIDENCE intervals; DATA analysis software; ANXIETY disorders; MILITARY personnel; REGRESSION analysis; WELL-being; SOCIAL isolation; EVALUATION
- Publication
JAMA Network Open, 2024, Vol 7, Issue 6, pe2414686
- ISSN
2574-3805
- Publication type
Article
- DOI
10.1001/jamanetworkopen.2024.14686