- PTSD is a debilitating psychological condition that affects one out of seven military veterans returning from combat.
- Psychiatric service dogs have been shown to help relieve symptoms of PTSD and help restore normal functioning in military veterans.
- A comparison of the cortisol levels in the hair of service dogs and companion dogs suggests that the service dogs do not experience more stress.
On August 25, 2021, US president Joe Biden signed into law the Puppies Assisting Wounded Servicemembers (PAWS) for Veterans Therapy Act. The legislation requires that the Secretary of Veterans Affairs establish a five-year program to provide service dogs to veterans with posttraumatic stress disorder (PTSD). This action was greeted with much acclaim by military veterans' organizations and the families of veterans. However, shortly thereafter, some people began to voice concerns about whether the use of psychiatric service dogs for PTSD sufferers might constitute a form of animal abuse.
The Problem of PTSD
Let's place this issue into context. To begin with, research shows that one out of seven military veterans who have served in active combat zones return home with symptoms of PTSD. The rates are higher for frontline fighters. Evidence of PTSD can develop in the hours, days, weeks, or even years following exposure to traumatic events.
The symptoms of PTSD can be very disruptive and include frequently occurring intrusive thoughts associated with the traumatic events that individuals experienced. Other symptoms include nightmares and flashbacks that make the person actually feel as if the traumatic events are happening all over again. This type of symptom can also bring on physical and emotional reactions, like panic attacks.
Irritable behavior is often observed. People who suffer from PTSD are regularly described as being on guard all of the time. They are jumpy and hypervigilant, and they may suffer from angry outbursts and emotional reactivity in certain situations. They frequently have difficulty sleeping and also difficulty concentrating.
There has been a lot of research done on ways of easing or eliminating PTSD, but the one that concerns us here is the use of psychiatric service dogs. These canines can be trained to interrupt emotional episodes and serve to anchor the veteran in the present. They distract the veteran from flashbacks and intrusive memories while providing a calming sense of relief from their mental distress. An ongoing series of research studies by Marguerite O’Haire and a team of researchers at the Purdue University College of Veterinary Medicine has shown that while service dogs aren't necessarily a cure for PTSD, they do help control its symptoms. Typically, the presence of such a dog is associated with reduced anger and anxiety, better sleep, and improved ability to function more normally in social situations.
What Is a PTSD Service Dog?
Training a PTSD service dog can take up to two years. The dogs are carefully selected and their repertoires of trained behaviors all depend upon the dog's constant alertness and responsiveness to the emotional and behavioral status of the patient. Thus, one thing that dogs are taught is to interrupt the veteran's ongoing behavior to let them know when they are showing signs of anxiety. They will do this with a nose bump, pawing, or some other behavior. This can help prevent the possibility of emotions cascading into a full-blown panic attack.
The dogs are trained to calm anxiety by making physical contact by placing their head in the person's lap or gently leaning against their body.
Because the PTSD sufferers are often fearful that something dangerous is about to occur, these dogs are taught to respond to the command "Block!" This causes the dog to position itself horizontally in front of the veteran to guard or protect him or simply to create increased personal space. Alternatively, they are taught to respond to "Cover!" where the dog positions itself directly behind to "watch" the veteran's back.
Even at night, the service dogs must be vigilant, and when they recognize that the veteran is having a nightmare, they are trained to gently wake them and to provide comfort.
In addition, the dogs are taught a variety of other behaviors such as greeting people and other things that may ease interactions in social settings.
Previous research has shown that dogs that are used to lower stress levels in individuals in standard therapy sessions do not themselves suffer from elevated stress levels during such de-stressing interventions. However, typically, dogs used in the more usual applications of animal-assisted therapy will only be working for an hour or two at a time. The difference between those therapy dogs and the psychiatric service dogs for PTSD sufferers is that the latter are always on call and must be vigilant and attentive 24 hours a day, seven days a week. This has caused some animal behaviorists to speculate that such work could cause a buildup of psychological stress in the service dogs.
Do PTSD Service Dogs Suffer From Long-Term Stress?
To see if service dogs for veterans with PTSD were suffering from long-term stress themselves, a research team headed by Emmy van Houtert from the Faculty of Veterinary Medicine, Utrecht University in the Netherlands conducted an innovative piece of research.
The marker that is generally used for canine stress is the cortisol concentration in the blood. Cortisol is nature's built-in alarm system. When an individual is confronted by a perceived threat their hypothalamus (a small region at the base of the brain) sets off this alarm response in the body. The resulting neural and hormonal signals cause the adrenal glands to release a surge of hormones including adrenaline and cortisol. These hormones activate the body and brain, making it easier for you to fight for your life if needed, or to quickly run away from danger. The presence of cortisol is a very useful measure of the stress that an animal or person is experiencing at any moment. However, this might not be good enough to answer the current question because what is required now is a record of the long-term stress levels experienced by the service dogs.
Here is where the researchers came up with an interesting trick. A record of the longitudinal stress levels in the service dogs can actually be found in the animal's hair. Hair cortisol is a fairly new analysis method to determine physiological stress in an individual human or animal over extended periods of time. As hair grows, the concentration of cortisol in it varies, depending upon the cortisol concentration in the blood plasma. That means that each strand of hair will contain a record of stress levels over time, and it can be retrieved through a complex chemical analysis.
This new study compared hair from two groups of dogs; the first consisted of 11 highly trained psychiatric service dogs for individuals with PTSD, and the second group comprised 19 companion dogs. All dogs were Labrador retrievers or mixed breeds that were predominantly Labrador retrievers. The service dogs had each been with their assigned veteran for at least a half year before participation.
The results of the study are really quite straightforward. There was no difference in the cortisol level in the hair taken from the two groups of dogs, leading the researchers to conclude, "This lack of difference in cortisol levels suggests that the service dogs who participated in this study did not experience more physiological stress over time than the companion dogs."
There is one important factor to remember, however, and that is that these were all specifically selected and trained service dogs, not simply emotional support dogs chosen for their sociability and companionship.
Copyright SC Psychological Enterprises Ltd.
van Houtert EAE, Endenburg N, Vermetten E and Rodenburg TB (2022): Hair Cortisol in Service Dogs for Veterans with Post-traumatic Stress Disorder Compared to Companion Dogs (CanisFamiliaris), Journal of Applied Animal Welfare Science, DOI: 10.1080/10888705.2022.2033119
Rodriguez KE, LaFollette MR, Hediger K, Ogata N and O’Haire ME (2020). Defining the PTSD Service Dog Intervention: Perceived Importance, Usage, and Symptom Specificity of Psychiatric Service Dogs for Military Veterans. Frontiers of Psychology, 11:1638. doi: 10.3389/fpsyg.2020.01638