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

项目摘要/摘要 关于退伍军人的服役犬的安全性和有效性，有证据表明存在根本差距 创伤后应激障碍(PTSD)及其配偶。这种差距的持续存在代表着一个重要的 问题，因为在它被填满之前，这种动物辅助干预策略将继续被最小化为 不受支持且可能不健全的做法。尽管目前军队的心理社会康复战略 患有创伤后应激障碍的退伍军人对一些人来说是有效的，他们的辍学率相对较高，而且显著 无回复率。因此，许多退伍军人越来越多地寻求补充干预。一位批评者 需要为服役犬的功效建立概念验证，不仅对退伍军人，而且对他们的 配偶，他们也遭受巨大的心理痛苦，与服务犬一起住在家里。这个 长期研究目标是评估服务犬作为补充干预措施的安全性和有效性 以增强特殊人群的生物心理社会功能。总体目标是进行方法论研究-- 严格的随机对照试验，以量化服务犬对临床免疫缺陷的疗效。 重要的结果。中心假设是患有创伤后应激障碍的退伍军人如果被提供服务犬，将会 与社会情绪功能(社会参与、情绪)相关的创伤后应激障碍症状减少 唤醒调节(高唤醒、睡眠障碍)。进一步假设，配偶将经历 类似的结果，以减轻他们的心理痛苦，减轻他们的照顾者负担。以Strong为指导 初步数据，这些假说将通过追求三个具体目标来检验：(1)量化治疗 服务犬对社会情绪功能的功效，(2)量化服务犬对 唤醒调节，以及(3)量化犬类特征和适度的人-动物相互作用 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。这些措施将对退伍军人进行评估， 配偶，还有犬类。这种方法是创新的，因为它通过应用黄金来偏离现状- 评估疗效的标准随机对照试验方法学，招募新的生态瞬间 评估方法，以检查人与动物的相互作用，可能会缓和变化，并收集对象- 客观的生理数据，以评估服务犬引出的潜在生物途径或机制 变化。拟议的项目意义重大，因为它测试了一种使用率越来越高但测试较少的完成器- TRAIL干预，有可能解决退伍军人的一个重要康复问题 创伤后应激障碍和他们的配偶。最终，这样的知识有可能提供急需的证据基础。 用于涉及人与动物相互作用的临床护理。它将使医疗保健提供者、退伍军人和他们的粉丝- 我想知道对服务犬有什么期待，以及狗，人和互动的特点， 适度改变，开始确定这项服务对谁有效，在什么条件下有效。

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.