Quantifying the efficacy and role of service dogs for military veterans with PTSD and their spouses

量化服务犬对患有创伤后应激障碍 (PTSD) 的退伍军人及其配偶的功效和作用

• 批准号: 9322806
• 负责人: Marguerite Elizabeth O'Haire
• 金额: $ 26.56万
• 依托单位: PURDUE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-05-01 至 2019-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9322806
• 关键词: Address; Animals; Anxiety; Arousal; Behavior; Biological; Blinded; Canis familiaris; Caregiver Burden; Characteristics; Clinical; Control Groups; Data; Development; Dropout; Ecological momentary assessment; Emotional; Empirical Research; Ensure; Family; Funding; Goals; Gold; Health; Health Personnel; Home environment; Human; Hydrocortisone; Ice; Individual; Intervention; Knowledge; Measures; Methodology; Military Personnel; Mission; Moods; National Institute of Child Health and Human Development; Outcome; Participant; Pathway interactions; Pattern; Physiological; Population; Post-Traumatic Stress Disorders; Productivity; Protocols documentation; Public Health; Publishing; Quality of life; Randomized Controlled Trials; Rehabilitation therapy; Reporting; Research; Review Literature; Role; Safety; Salivary; Services; Severities; Sleep; Sleep disturbances; Spouses; Standardization; Surveys; Sympathetic Nervous System; Symptoms; Temperament; Testing; Training; Treatment Efficacy; United States National Institutes of Health; Validation; Veterans; actigraphy; active control; arm; base; behavior observation; biopsychosocial; clinical care; emotional experience; evidence base; experience; hypothalamic-pituitary-adrenal axis; improved; innovation; named group; novel; psychological distress; psychosocial rehabilitation; rehabilitation strategy; response; social; social engagement; standard care; therapy outcome; treatment group; trial design; vigilance

PROJECT SUMMARY/ABSTRACT A fundamental gap exists in evidence regarding the safety and efficacy of service dogs for military veterans with posttraumatic stress disorder (PTSD) and their spouses. Continued existence of this gap represents an important problem, because until it is filled, this animal-assisted intervention strategy will continue to be minimized as an unsupported and potentially unsound practice. Although current psychosocial rehabilitation strategies for military veterans with PTSD are effective for some individuals, they have relatively high dropout numbers and significant non-response rates. As a result, many veterans are increasingly seeking complementary interventions. A critical need exists to establish proof-of-concept for the efficacy of service dogs not only for veterans but also for their spouses, who also suffer from substantial psychological distress and live in the home with the service dogs. The long-term research goal is to evaluate the safety and efficacy of service dogs as a complementary intervention to enhance biopsychosocial functioning in special populations. The overall objective is to conduct a methodolog- ically rigorous, randomized controlled trial to quantify the therapeutic efficacy of service dogs on clinically-im- portant outcomes. The central hypothesis is that military veterans with PTSD who are provided service dogs will experience reduced PTSD symptoms related to socio-emotional functioning (social participation, mood) and arousal modulation (hyper-arousal, sleep disturbance). It is further hypothesized that spouses will experience similar outcomes to ameliorate their psychological distress and reduce their caregiver burden. Guided by strong preliminary data, these hypotheses will be tested by pursing three specific aims: (1) quantify the therapeutic efficacy of service dogs for socio-emotional functioning, (2) quantify the therapeutic efficacy of service dogs for arousal modulation, and (3) quantify the canine characteristics and human-animal interactions that moderate outcomes. Assessments will consist of ecological momentary assessment, objective physiological assessment, blinded clinician ratings, standardized surveys, and behavioral observation. Measures will assess the veterans, spouses, and canines. The approach is innovative because it departs from the status quo by applying gold- standard randomized controlled trial methodology to evaluate efficacy, enlisting novel ecological momentary assessment methodology to examine human-animal interactions that may moderate change, and collecting ob- jective physiological data to evaluate potential biological pathways, or mechanisms, by which service dogs elicit change. The proposed project is significant because it tests an increasingly used but poorly tested complemen- tary intervention that has the potential to address an important rehabilitation problem for military veterans with PTSD and their spouses. Ultimately, such knowledge has the potential to provide a much-needed evidence base for clinical care involving human-animal interaction. It will enable health care providers, veterans, and their fam- ilies to know what to expect from service dogs, as well as the canine, human, and interaction characteristics that moderate change to begin to determine for whom this service is effective and under what conditions.

项目摘要/摘要 有一个基本差距存在证据，证明了服务犬对退伍军人的安全性和功效 创伤后应激障碍（PTSD）及其配偶。持续存在这一差距代表着一个重要的 问题，因为在填补之前，这种动物辅助干预策略将继续将 不受支持的且潜在的不健全的实践。尽管目前为军事的社会心理康复策略 具有PTSD的退伍军人对某些人有效，他们的辍学数量相对较高，并且很大 无响应率。结果，许多退伍军人越来越多地寻求互补的干预措施。批判 存在需要建立服务犬功效的概念证明，不仅对退伍军人，而且还为其 配偶也遭受了严重的心理困扰，并与服务犬住在家里。这 长期研究目标是评估服务犬的安全性和功效作为互补干预 增强特殊人群中的生物心理社会功能。总体目的是进行方法论 严格的随机对照试验，以量化服务犬对临床IM-的治疗功效 体育成果。中心假设是提供服务犬的PTSD的退伍军人将 经验减少了与社会情感功能（社会参与，情绪）和 唤醒调制（超阳性，睡眠障碍）。进一步假设配偶会经历 相似的结果可以改善他们的心理困扰并减轻照顾者负担。在强者的指导下 初步数据，这些假设将通过追求三个特定目的来检验：（1）量化治疗性 服务犬对社会情感功能的功效，（2）量化服务犬的治疗功效 唤醒调制，（3）量化中度的犬类特征和人类相互作用 结果。评估将包括生态瞬时评估，客观生理评估， 盲目的临床医生评级，标准化调查和行为观察。措施将评估退伍军人， 配偶和犬。这种方法具有创新性，因为它通过应用金来偏离现状 标准的随机对照试验方法，以评估功效，招募新的生态瞬间 评估方法学以检查可能中度变化并收集观察的人动物相互作用 评估潜在的生物学途径或机制的生理数据，服务犬会引起该途径 改变。该提出的项目很重要，因为它测试了越来越多但测试量较低的补充 - 有可能解决重要退伍军人的重要康复问题的干预措施 PTSD及其配偶。最终，这种知识有可能提供急需的证据基础 用于涉及人动物相互作用的临床护理。它将使医疗保健提供者，退伍军人及其家族能够 ilies知道对服务犬以及犬，人类和互动特征的期望 中等变化开始确定该服务对谁有效以及在什么条件下。