Tuesday, January 31, 2023

Study Supports Use of Emotional Support, Service Dogs for Veterans With PTSD

Eighteen months after being paired with an emotional support or service dog, veterans with posttraumatic stress disorder (PTSD) continued to report improvements in overall functioning and quality of life, a report in Psychiatric Services in Advance has found.

While emotional support dogs can provide comfort to their handlers, service dogs for PTSD receive additional training in a variety of tasks specific to assisting individuals with PTSD (for example, turning on lights in a dark room and providing space between the individual and an approaching person), wrote Joan T. Richerson, M.S., D.V.M., of the VA Tennessee Valley Health Care System and colleagues. The researchers wanted to know whether veterans who were paired with service dogs for PTSD might experience greater therapeutic benefits than those paired with emotional support dogs.

Richerson and colleagues randomly assigned veterans who had been diagnosed with PTSD to receive either a service dog or emotional support dog. Emotional support dogs and service dogs were required to pass the American Kennel Club Canine Good Citizen and Assistance Dogs International Public Access tests. In addition, service dogs were taught to perform tasks specific to a handler’s PTSD (turn on lights in dark room; enter rooms and sweep the perimeter; bring objects; and stand in front or behind the handler, respectively, to provide space between the handler and a person approaching from front or back).

After an observation period during which the randomized participants were asked to complete a dog care course, 97 participants received a service dog, and 84 received an emotional support dog. Over 18 months, the researchers evaluated the study participants’ level of disability and health-related quality of life, using the World Health Organization Disability Assessment Scale II (WHODAS 2.0) and the Veterans RAND 12-Item Health Survey (VR-12 physical and mental scores). They also collected data on participants’ PTSD symptoms, health care use, and more.

Among the findings:

  • WHODAS 2.0 scores fell in both groups from three months after pairing with the dogs to 18 months (indicating less disability).
  • VR-12 mental scores in both groups increased from baseline to 18 months (indicating improvement in quality of life). There was no significant difference in VR-12 physical scores over time.
  • PTSD Checklist for DSM-5 (PCL-5) scores in both groups fell over the course of the study (indicating improvement in PTSD symptoms).

“Some separation in [PCL-5] scores between the groups started to appear at 9 months, with scores for the service dog group decreasing more than those for the emotional support dog group,” the authors noted.

Receipt of a service dog compared with receipt of an emotional support dog did not significantly affect VA costs for any category of care or VA health care use, except for outpatient substance use disorder treatment, the authors continued.

“Future work should examine mechanisms by which a service or emotional support dog has an impact on patient functioning, such as by directly reducing PTSD symptoms (e.g., arousal or avoidance), indirectly reducing symptoms through improved treatment engagement (e.g., in psychotherapy) or adherence (e.g., to pharmacotherapy), or by enabling veterans to overcome challenging situations in the presence of such symptoms.”

For related information, see the Psychiatric Research & Clinical Practice article “A Qualitative Exploration of the Use of Service Dogs in Veterans with Post Traumatic Stress Disorder and Traumatic Brain Injury.”

(Image: iStock/LuPa Creative)

Biden to End Public Health Emergency Declaration in May

The COVID-19 public health emergency (PHE) will end on Thursday, May 11, the Biden Administration announced yesterday.

The administration’s decision to end the national emergency and PHE on May 11 will result in the end of multiple federal flexibilities affecting health care programs, including regulatory and statutory flexibilities provided by HHS and other Departments. This is a developing story; more information will be provided to APA members tomorrow.


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