Biopsychosocial Effect of Service Dog Training on Post-traumatic Stress (PTS) and Post Concussive Symptoms

Preliminary clinical evidence suggests that Service Members with symptoms of post-traumatic stress disorder (PTSD) or Post Traumatic Stress (PTS) who participate in the Service Dog Training Program (SDTP) report improved physical and psychological outcomes, including those with overlapping symptoms associated with traumatic brain injury (TBI) and post-concussion symptoms (PCS). Since 2011, over 3,000 injured Service Members have participated in the SDTP. The program entails teaching Service Members how to train service dogs. Participation in this program helps injured Service Members develop skills, such as attention and discipline, which are needed to successfully shape the dog's behavior and are translatable to other social settings. Further, participation in the program appears to enhance the participants' well-being, quality of life, and relationship with significant others, including their children. Moreover, Service Members (SM) who participate in the SDTP report being motivated to participate in the program for the chance of helping other wounded warriors, who will be the recipients of the dogs that they train. Despite the reported anecdotal benefits from the SDTP, there has been a lack of prospective controlled research studies that examine the efficacy of the program or the biological basis as to how it may be helpful to improve the underlying disease. This study intends to examine the psychological, social, and biological effects of the SDTP combined with standard of care for individuals with symptoms of Post-Traumatic Stress (PTS), including those with overlapping TBI and persistent Post-Concussive Symptoms (PCS). This study will also seek to identify potential psychological, physiological, and/or biological factors that may influence the degree of response from this noninvasive intervention, as well as its potential impact on disease/symptom modification. Further, for those subjects with family members, it will seek to share data with a parallel study ongoing at the University of Maryland to evaluate the effects of the SDTP on family member stress levels, relationship satisfaction, communication evaluate the effects of the SDTP on family member stress levels, relationship satisfaction, communication and parenting. To accomplish these aims the researchers will recruit DEERS eligible medical beneficiaries who are experiencing PTS and PCS symptoms. Up to 156 participants will be recruited in the National Capital Region (NCR) for a ten-week longitudinal pre-post study, in which each participant will serve as their own control. Additionally, up to 104 participants will be recruited for a three-week longitudinal parallel randomized study will be available for participants recruited through the National Intrepid Center of Excellence (NICoE) 4-week Intensive Outpatient Program (IOP). Each participant in the active group will train a service dog using methods that facilitate a relationship between the trainer and dog for the gradual shaping of desired behavior. Self-report measures of behavioral symptoms will be given weekly throughout participation in this study. Biological measures, including blood collection, HR, BP, etc. will be collected at baseline, during the three-week training follow-up, during the six-week training follow-up (NCR participants only), and at a three-month post-training followup (optional for NICoE IOP participants). The researchers will also be collecting self-report assessments from the participant, observational reports from an Occupational Therapist (OT) and electronic health records to track healthcare utilization and social skills (i.e. communication). The study is being carried out in collaboration with the Center for Neuroscience and Regenerative Medicine (CNRM). Under this collaboration, the study will use the CNRM Core Resources including the CNRM Biorepository. Data stored and shared within the CNRM Data Repository will be coded, and upon destruction of the Master List, de-identified.