Preliminary Evidence Is Promising, but Challenges Remain in Providing Service Dogs to Veterans: Commentary on Preliminary Efficacy of Service Dogs as a Complementary Treatment for Posttraumatic Stress Disorder in Military Members and Veterans (O'Haire & Rodriguez, 2018)

摘要

Objective: Veterans with posttraumatic stress disorder (PTSD) are interested in service dogs to manage or reduce symptoms. Until recently, evidence was anecdotal with few research studies documenting the feasibility or benefits of service dogs for veterans. In the past year, new studies have presented preliminary evidence on the benefits of service dogs. Method: Comment on O'Haire and Rodriguez (2018). Results: Positive findings presented in O'Haire and Rodriguez (2018) and Yarborough et al. (2017) included reduced self-reported PTSD symptoms, decreased depression symptoms, improvements in relationships, and increased activity levels. In addition to the benefits, Yarborough, Stumbo, Yarborough, Owen-Smith, and Green (2018) described challenges that veterans had not expected, including the demands of long, intensive training sessions required to receive a service animal, and an increase in unwanted public attention. In light of this preliminary evidence, a critical appraisal and identification of next steps for future research are in order. In this commentary we argue that rigorous randomized controlled trials comparing veterans who receive service dogs with those who do not are due. Such trials should account for self-selection bias and some veterans' overly optimistic expectations for service dogs, both of which have not previously been controlled for in non-randomized studies to date and may present a challenge to trial validity. We also argue that future research needs an adequate long-term follow-up evaluation period and should investigate the specific mechanisms of action at work (i.e. how do service dogs improve PTSD symptoms and quality of life). Conclusions: Additional trials are needed to establish the efficacy of service dogs for veterans with PTSD.