Table of Contents

All Sources are listed under their tags in the top right hand side of the blog page
1. Concept Map
2. Encyclopedia Articles
3. Irrelevant Sources
4. Relevant Bibliography
5. Research Outline
6. Research Question and Statement
7. Title Page
8. Journal Entries

Below on the Blog Archive is a complete individual list of all postings.  Citation for photo is at the bottom of the blog.

Journal Entries

Journal Entry, September 22-28, 2014,

My first thought when I saw the assignment (find two encyclopedias or dictionaries and research your topic) was to find a psychology encyclopedia.  I first attempted to find one such book at the Undergraduate library, they possessed none.  Then I went to Davis Library, where I found an encyclopedia about trauma and psychology.  I thought this would give the perfect explanation about PTSD but I was wrong.  This encyclopedia was much too specific and contained no entry about PTSD in general.  Then I tried another, “The Corsini Encyclopedia of Psychology” which yielded the desired results.  I was able to glean the information needed quickly after the book was located. 

            After I found Information on PTSD I set out to find information on Psychiatric Service Dogs, or Therapy dogs, as is the more general term.  I first went to the UNC Library website and checked their catalog.  My first search term was encyclopedia dog, which yielded the book The international encyclopedia of dogs, it was in the Undergraduate library, so after some internal debating I packed up my laptop and went to the other library.  This Encyclopedia yielded no results, it was disappointing.  I then tried the online portion of the library, library.unc.edu then too E-research by discipline, then too encyclopedias, which yielded no results.  I then went back to the homepage and retyped encyclopedia dog I scanned the results and tried a few that lead me nowhere.  I then tried the search term, encyclopedia animal.  Which lead me to a book review which lead me to the book “NATIONAL GEOGRAPHIC ANIMAL ENCYCLOPEDIA” which seemed promising but lead me nowhere.  I then called it quits for the day and decided to try again tomorrow. 

            After some procrastination I tried a different approach to my problem, instead of searching for “Psychiatric Service Dogs”, I simply searched for “Dog”, it might not be the best for my project, but service dogs specifically for psychiatric use are a relatively new phenomenon, in fact most of the articles on this subject have been written no earlier than 2013.  However, this search did yield results and I have decided to use them.  After going to the UNC library website I typed in “animal encyclopedia” and limited the search to online resources, and clicked on the first link that caught my eye, specifically the “encyclopedia of animals” and then went to the “Dog” entry.  This was a decent encyclopedic entry and I have decided to use it. 

_________________________________________________________________________________

Journal Entry; Annotated Non-Relevant Bibliography. 

          I started this assignment in a mindset of, oh crap I have three other projects due all in the same two days.  That being said I did try my best to make this look presentable.  Most of the articles I nixed in the prior assignment was because of the singularly militaristic view point they were written in.  It’s not a bad thing, but I already had so much from that one perspective that they just started being redundant.  As I’m writing this I just realized that I should probably ask my dad for advice on this project.  He was in the K9 division in the air force for a couple years in the 70’s, and trained Schutzhund dogs for a while after that. 

          The hardest part of this assignment was getting enough sources that weren’t websites.  There are a lot of blogs and such that talk about PSDs, but I couldn’t just use them in the assignment. 

          The research is not as hard as I thought it might be, more and more people are starting to write about this subject, so there is plenty of anecdotal evidence that this treatment works.  The difficult part of this research is that there are no peer-reviewed research papers about PSDs.  However I still think that my research is convincing. 

          The topic itself is still interesting to me, so I still like researching it.  My only qualm is that no one else seems to realize how helpful these dogs can be for people.  To me, once you hear about it, it almost seems like common sense.  When I was about 7 my mom’s doctors thought she had cancer, fortunately it was just an odd piece of fat, but none the less for about a month after I hear about it I was terrified.  But my two dogs were always there for me, Lilly used to walk up to me and just sit down on my lap when I was particularly scared, and I would always feel better because of her.  So by the same stroke, why can’t people whose brain is literally always telling them that they should be afraid feel better too when they have that same reassurance from a dog.  That’s why I’ve persisted with this topic, it seems like it could really help a lot of people who desperately need it.  

Until Tuseday

Montalván, Luis Carlos, and Bret Witter. Until Tuesday: A Wounded Warrior and the Golden Retriever Who Saved Him. New York: Hyperion, 2011. Print.

My Border Collie, Rowena

My Border Collie, Rowena

 Gerquest, Heather. "My Border Collie, Rowena: Trials & Tribulations of a Psychiatric Service Dog & Her Handler." : WHAT IS A SERVICE DOG? N.p., n.d. Web. 29 Nov. 2014.

Dogs enlisted to help veterans with PTSD may be harder to come by

Dogs enlisted to help veterans with PTSD may be harder to come by



Adams, John S. "Dogs Enlisted to Aid Veterans with PTSD Harder to Come By?" USATODAY.COM. USA Today, 7 June 2012. Web. 02 Nov. 2014. Annotation: 

THE DOGS OF WAR: EBSCOhost

THE DOGS OF WAR: EBSCOhost

THE MENTAL TOLL OF WAR HAS THE ARMY SEARCHING FOR NEW WAYS TO HEAL BROKEN SOLDIERS. THEIR BEST THERAPISTS MAY BE ONES THAT TRAVEL ON FOUR LEGS

THE WORD SPREADS IN LOW VOICES: "He made it past the sushi!"

Soldiers from the Warrior Transition Battalion have gathered in a parking lot at Fort Stewart in Georgia. They're watching through the windows of the base PX, where Caroline, a psychiatric service dog, is guiding Sergeant Jeff Mitchell past the Asian takeout and down the crowded cereal aisle.

No big deal, you say? Maybe not for you.

The last time Mitchell attempted to enter the commissary, he had barely made it past the plate glass doors before dropping to the linoleum, folding into a fetal ball, and melting down.

NOT LONG AGO I spent time with some of the bravest men and women in the United States. They were all veterans of overseas wars and had returned home physically and mentally battered. Some, like Mitchell, were so traumatized that they could not leave their barracks. Others would become spooked by, say, a fireworks display, or the shadows cast by a highway overpass, or the bright lights of a crowded grocery store. Still others had lashed out with words and fists at their fellow GIs or even their officers. War had changed them, beaten them down.

Then they met their psychiatric service dogs.

At Fort Stewart, the U.S. Army has been pairing specially trained dogs with soldiers suffering post-traumatic stress disorder, or PTSD. On the face of it, the pilot program seems to be working: I watched haunted men brighten as canine trainees bounded toward them. Lieutenant Colonel William Reitemeyer, a buff, hard-bitten combat veteran and the commander of the base's Warrior Transition Battalion, told me, "It's almost like there are electric currents coursing through the leashes, connecting the minds of the soldiers with the minds of their dogs."

Reitemeyer realizes that the army's medical community has, as he puts it, "made mistakes." It's made plenty, in fact, as evidenced by reports in 2007 about care at Walter Reed Army Medical Center. So to do a better job at healing bodies and minds, the army created 29 Warrior Transition Units (WTUs) here and in Europe. The dogs are an experiment within the WTUs. "I was skeptical of this dog idea at first, but I'm willing to try anything," Reitemeyer says. "I want to help thousands of wounded soldiers. But if I help just one, I'll consider this program a success."

And many soldiers need the help. According to a 2008 Rand Corporation study, nearly 14 percent of the 1.6 million soldiers, sailors, airmen, and marines deployed to Iraq and Afghanistan may have PTSD. Without treatment, the study notes, combat veterans experience increasing trouble with social interactions and their ability to maintain relationships. In that sense, Jeff Mitchell's story is tragically typical.

A member of the howitzer battery of the 2nd Squadron of the 3rd Armored Cavalry Regiment, Mitchell was twice deployed to Iraq. In 2003, he described his first firelight in a letter to his mother: "The first explosion shook everything and the shock waves caused ripples in the ground as if you threw a stone into a pond. I saw a civilian running from the blast; he was hurled 200 feet into the air. [There were] earth-rattling explosions, huge balls of fire and mushroom clouds, and red, white and orange pieces of burning metal blown into the sky. We are all lucky to be alive."

He encountered roadside IEDs hidden in deflated soccer balls and dead animals. And then he went through it all again, during a second deployment to Tal Afar, north of Baghdad. More combat. More IEDs. Mitchell returned to the United States in 2006 plagued with flashbacks and hallucinations; he battered his girlfriend when she woke him from a nightmare. He became too anxious even to leave his barracks.

After his medical discharge, he returned to his parents' home in Atlanta, entered his old bedroom, shut out the light, and locked the door. He found a liquor store that delivered. He became, in military jargon, a "cave dweller." And he remained that way until he met Caroline.

"ARE YOU GOING TO TRAIN THAT DOG or just play with it?"

It is not a question; it's a human bark, directed at a petite National Guard specialist. She's supposed to be training a dog named Drake to sit and stay. But she's clearly just enjoying the interaction. That in itself is a relief; I've barely heard the young woman speak. In Iraq, she had become separated from her unit and ended up spending several days alone in the desert before being rescued and returned to her comrades.

The man barking at her, Terry Henry, is the executive director of Paws4Vets. He's a retired military man with a history of PTSD himself; his first career was as an air force counterintelligence operative. Henry's manner is 100 percent drill sergeant, right down to his salt-and-pepper brush cut, thick as otter fur. And, okay, he can seem like a real prick, especially in his manner with these vulnerable people. He admits that his first loyalty is to his service dogs.

The idea to launch the organization came a dozen years ago from Henry's daughter, Kyria. The 12-year-old had been visiting nursing homes and geriatric hospital patients with her golden retriever. Suddenly the frail, ill senior citizens were engaging with the dog, with one another, and with staff, as they never had before. In what Henry calls "a blindingly idiotic idea," he quit his lucrative job as a telecommunications executive and threw himself into uniting dogs with people who needed them.

His first visits were to children's hospitals and schools. The work was so successful and rewarding that Henry began buying and breeding puppies, training them especially for these sorts of interactions and then introducing them to kids with mental or physical disabilities. Demand for trained therapy dogs was high, so he reached out to prison wardens for inmate volunteers to teach the dogs rudimentary commands. More than 75 inmates in five facilities are now training Henry's dogs.

Henry saw miracles. A child with severe learning disabilities learned to count and recite the alphabet when she had a dog for a companion; another with cerebral palsy began to walk with a dog's help. Why couldn't his dogs help combat vets with physical and/or psychological disorders? In early 2010 Henry received the go-ahead to unleash his dogs at Fort Stewart.

Drury, B. (2011). THE DOGS OF WAR. Men's Health, 26(8), 168-195.

Canine Comfort Vets' Best Friends: EBSCOhost

Canine Comfort Vets' Best Friends: EBSCOhost

SHARI DUVAL'S K9S FOR WARRIORS HELPS VETERANS WITH POST-TRAUMATIC STRESS DISORDER BY GIVING THEM CALMING COMPANIONS: TRAINED DOGS RESCUED FROM SHELTERS

When Shari Duval's son Brett Simon returned home in 2005 after nine months in Iraq, the previously outgoing Army-contracted dog handler was a changed man. "I thought I was going to lose him to suicide, he was that despondent," says Duval, 68, a grandmother of 10 from Ponte Vedra Beach, Fla. She was researching post-traumatic stress disorder when she hit upon an idea: helping her son and others by together starting a service-dog program for struggling vets. Now 43 and married with a 6-year-old son, Brett says, "It's been a life-changer."

Not just for him. The nonprofit K9s for Warriors (k9sforwarriors.org), aided by 500 volunteers, has paired 96 vets with canine companions—nearly all of them rescue dogs trained by Brett. "Dogs are really good about helping [reduce] anxiety," says psychologist Tracy Stecker of the Dartmouth Psychiatric Research Center. She says the dogs' vigilance makes the vets feel protected, and their unconditional love develops trust.

No one knows that better than retired Marine Capt. Jason Haag. After three tours of duty, he shut out his wife and kids, sleeping with a gun under his pillow in a darkened basement. A little more than a year after getting his 2-year-old German shepherd Axel, he has reconnected with his family and has coached baseball for his sons, 11 and 8. "Axel hit the reset button," says Haag, 33, who still gets counseling but has reduced his medication for anxiety and depression. "Thank God for a dog."

ALEX BROWN, 28, & SKIP, LOUISVILLE, KY.

"He was as broken as I was," says the retired Army specialist. "We had to learn together. Every day is a battle for me, but I don't go through it alone anymore."

STEPHANIE GENSICKE, 26, & CHINOOK, JACKSONVILLE, N.C.

A sexual assault survivor, the retired Marine is now a college student studying nursing. "Nothing would have changed without Chinook."

AMY LUTENBACHER, 26, & MACY MAE, NECEDAH, WIS.

"When I start to have an anxiety attack, I'll pet her, and that grounds me," says the retired Air Force airman. "She's given me my life back."

LEROY JOHNSTON, 31, & APACHE, 29 PALMS, CALIF.

"My issues are large open spaces," says the Marine. "He walks me through and basically says, 'Hey, Dad, I'm going to get you there.'"

JOSE GONZALEZ, 28, & SADIE, YORK, S.C.

"The only time I left the house was to go to the doctor," says the retired Marine. With Sadie at his side, "there is hope that things will get better."

DAVID MOORE, 47, & WILCO, NEWNAN, GA.

In providing a dog to soften the stress, Moore's wife, Cara, says Duval and Simon "have saved my husband's life, and they have saved our family."

JAIME LEON, 36, & SHADOW, FT. BENNING, GA.

With every nightmare, says the Army sergeant, "she would nuzzle my hand and wake me. That's when I decided I didn't need medication anymore."

JASON HAAG, 33, & AXEL, FREDERICKSBURG, MD.

"Axel helped me wind down and take my foot off the gas," says the retired Marine. "I can enjoy life again."

TRUESDELL, J. (2013). Canine Comfort Vets' Best Friends. People, 80(25), 98.

The Early Years: EBSCOhost

The Early Years


 Ritchie, E. C., & Amaker, R. J. (2012). The Early Years. U.S. Army Medical Department Journal, 5-7.

Bringing Dogs to Heal

Bringing Dogs to Heal (Full Citation)
Times: Bringing Dogs to Heal  (Full article)


Thompson, M. (2010). Bringing Dogs to Heal. Time, 176(21), 54-57.This article talks about PSD for helping veterans with PTSD.  

Inseparable

Inseparable


Faw, C. H. (2014). Inseparable. (Order No. 1556502, Corcoran College of Art + Design). ProQuest Dissertations and Theses, , 63. Retrieved from http://search.proquest.com/docview/1539559939?accountid=14244. (1539559939). 

Surf Dog Ricochet

Surf Dog Ricochet

 Ivison, Patrick. "So, You Want a PTSD Service Dog?" Surf Dog Ricochet. N.p., 30 Aug. 2013. Web. 07 Nov. 2014.

Nonprofit 'Stiggy's Dogs' Trains Companions For Veterans Living With PTSD

http://www.huffingtonpost.com/2013/07/16/ptsd-therapy-dogs_n_3607535.html

Lutz, Angela. "Nonprofit 'Stiggy's Dogs' Trains Companions For Veterans Living With PTSD (PHOTOS)." Huffington Post 16 July 2013: n. pag. Web. 7 Nov. 2014.

Exploring the experiences of living with psychiatric service dogs for veterans with posttraumatic stress disorder

Exploring the experiences of living with psychiatric service dogs for veterans with posttraumatic stress disorder



Newton, R. (2014). Exploring the experiences of living with psychiatric service dogs for veterans with posttraumatic stress disorder. (Order No. 1557029, Adler School of Professional Psychology). ProQuest Dissertations and Theses, , 106. Retrieved from http://search.proquest.com/docview/1545896388?accountid=14244. (1545896388).

Canine Assistants

Canine Assistants

"Canine Assistants." Canine Assistants. Canine Assistants, n.d. Web. 07 Nov. 2014.

Annotated Irrelevant Sources

1.     http://www.canineassistants.org/ "Canine Assistants." Canine Assistants. Canine Assistants, n.d. Web. 07 Nov. 2014.
This is an organization devoted to providing assistance dogs to those with physical and psychological problems.  This program also has volunteer opportunities and some basic information about PSD.The reason this was rejected was because they don’t provide dogs for people with PTSD.  

2.     Newton, R. (2014). Exploring the experiences of living with psychiatric service dogs for veterans with posttraumatic stress disorder. (Order No. 1557029, Adler School of Professional Psychology). ProQuest Dissertations and Theses, , 106. Retrieved from http://search.proquest.com/docview/1545896388?accountid=14244. (1545896388).
This study was about the experiences PTSD patients with PSD as a part of their mental health care routine. There were 6 participants and they participated in phone interviews for the researcher.  The paper went on to say that it found 5 major impressions and 12 minor impressions. The main impressions include 1 symptom reduction, 2 increased connection to others, 3 training experiences, and 4 negative aspects of owning the dog, and 5 hope for more recognition of PSDs. This is important for both mental health professionals who are considering recommending PSDs to their clients and for dog training professionals who are considering creating a training program for veterans with PTSD.I chose not to use this article because of the small sample size. 

3.     Ivison, Patrick. "So, You Want a PTSD Service Dog?" Surf Dog Ricochet. N.p., 30 Aug. 2013. Web. 07 Nov. 2014.
This webpage is run by a person with a PSD and is about the pros and cons of owning a PSD.  It goes over some facts about PSD and the process of getting one. The reason I decided not to go with the blog is that I am leery of the credibility of the blog. 

4.     Lutz, Angela. "Nonprofit 'Stiggy's Dogs' Trains Companions For Veterans Living With PTSD (PHOTOS)." Huffington Post 16 July 2013: n. pag. Web. 7 Nov. 2014.
This article is an anecdotal review of a veterans and their PSD, and the organization which provided him the dog.  This article also provides pictures of the dogs and their handlers. The reason I did not use this article is because of the shear amount of anecdotal evidence I already have.  But the dog pictures are cute and it was kind of hard to discard them.  

5.     Faw, C. H. (2014). Inseparable. (Order No. 1556502, Corcoran College of Art + Design). ProQuest Dissertations and Theses, , 63. Retrieved from http://search.proquest.com/docview/1539559939?accountid=14244. (1539559939). 
“Inseparable” is about the love a PSD and their handler share, this multimedia presentation focused on military members with PTSD and no other type of PTSD sufferer.  It especially focuses on Ryan Major and his PSD Theodore.  Major lost both his legs in an attack in Iraq when he was 22 years old.  He was then diagnosed with PTSD and Traumatic Brain Injury.  Major got Theo through Paws 4 Liberty, a PSD training program for Veterans.  Major states that his life has greatly improved because of Theodore. The reason I decided not to use this Thesis is because the multi-media part of it kind of scared me off.  I haven’t dealt with that before in a paper.  Also because I already have lots of Anecdotal evidence that this treatment works. 

6.     Thompson, M. (2010). Bringing Dogs to Heal. Time, 176(21), 54-57.This article talks about PSD for helping veterans with PTSD.  
This article also talks about the US veteran’s administration and Army launching studies to see whether they could be an effective tool.  Apparently veterans who spent 30 minutes with dog’s anxiety levels fell twice as much as when they did art of music therapy.  This article also talks about the pros and cons of only using dogs trained by ADI certified schools.  The reason I didn’t use this article is that it goes over much of the same information that I already have.  Plus it is very military centric, I’m trying to stay away from too much military evidence since PTSD can come from anywhere.  


7.     Gerquest, Heather. "My Border Collie, Rowena: Trials & Tribulations of a Psychiatric Service Dog & Her Handler." : WHAT IS A SERVICE DOG? N.p., n.d. Web. 29 Nov. 2014.

This Blog is an opinion piece that gives the authors thoughts on Psychiatric Service animals, it is supported by dictionary definitions and  photos of people and their PSD.  The reason I chose not to use this blog is because it contains mostly knowledge that I already have from other sources.  

8.     Ritchie, E. C., & Amaker, R. J. (2012). The Early Years. U.S. Army Medical Department Journal, 5-7.
This journal article looks at the uses of dogs in the theater of battle to help the service members manage stress and to generally keep in mental health.  This article also looks at the more technical side of the program, how to keep the dogs healthy, how to measure their effectiveness, etc. The reason I did not use this article was because it looked at the prevention of PTSD and my research is more about the prevention of PTSD. 

9.     TRUESDELL, J. (2013). Canine Comfort Vets' Best Friends. People, 80(25), 98.
This article is a brief explanation of a nonprofit organization, K9s for warriors, and the mother son team that started it.  This article is full of anecdotal evidence that dogs can help returning service members return to a normal life. The reason I did not use this article is because it does not say is the dogs used are ADI certified, and from the readings I would guess not.  That means that the dogs are not officially PSD’s.  Though these dogs obviously helped these people this article does not fit the exact parameters of my research question. 

10.  Drury, B. (2011). THE DOGS OF WAR. Men's Health, 26(8), 168-195.
This article looks at the treatment of PTSD and other psychological maladies with the help of PSD.  It uses personal experiences and also talks about the army’s Pilot program with these dogs, where trained dogs are paired up with veterans. As well as explaining where the founder, Terry Henry, got the idea in the first place. The reason I chose not to use this article is because it is solely focused on the military side, many of the articles I used were already about military members and though this is a great article I didn’t want to add another.  

Dogs Become New Treatment for a War that Never Ends (Op-Ed)

Dogs Become New Treatment for a War that Never Ends (Op-Ed)

Woods, Vanessa "Dogs Become New Treatment for a War that Never Ends (Op-Ed)" LiveScience. TechMedia Network, 10 Sept. 2013. Web. 02 Nov. 201

Editor's Commentary. The special talents of psychiatric service dogs: EBSCOhost

Editor's Commentary. The special talents of psychiatric service dogs: EBSCOhost



Fritz, G. K. (2011). Editor's Commentary. The special talents of psychiatric service dogs. Brown University Child & Adolescent Behavior Letter, 27(10), 8.

African American Post Traumatic Stress Disorder Association.

http://www.aaptsdassn.org/information/

"African American Post Traumatic Stress Disorder Association - What Is PTSD?" African American Post Traumatic Stress Disorder Association - What Is PTSD? African American Post Traumatic Stress Disorder Association, n.d. Web. 02 Nov. 2014.

Assistance Dogs International

Assistance Dogs International

"Assistance Dogs International.". Assistance Dogs International Inc., n.d. Web. 02 Nov. 2014.

Animal-assisted therapy for United States veterans with Posttraumatic Stress Disorder

Animal-assisted therapy for United States veterans with Posttraumatic Stress Disorder



Moore, A. (2014). Animal-assisted therapy for united states veterans with posttraumatic stress disorder (Order No. 3580509). Available from ProQuest Dissertations & Theses Full Text. (1535703205). Retrieved from http://search.proquest.com/docview/1535703205?accountid=14244

The Role of Service Dog Training in the Treatment of Combat-Related PTSD

The Role of Service Dog Training in the Treatment of Combat-Related PTSD  (link)

In response to the critical need for adjunctive treatments for soldiers with refractory forms of mental injury -- primarily posttraumatic stress disorder (PTSD) -- the US military is developing complementary and alternative medicine (CAM) techniques, including animal-assisted intervention (AAI). ^1,2

CAM modalities include therapies such as yoga, meditation, and creative art therapies, shown to have an effect on the mind's capacity to regulate the brain and body's response to social and environmental challenges by reducing stress and enhancing the immune function through the release of the neuropeptide oxytocin by the brain.

Olff et al³ suggest PTSD symptom treatment would be improved by increasing endogenous levels of oxytocin through optimizing of social support. Studies show that dogs can provide such an optimization of social support and that positive interactions with dogs may offer a safe, effective, and relatively inexpensive way to increase endogenous levels of oxytocin and other important anti-stress agents in humans.

Role of Oxytocin

Oxytocin is a well-established modulator of a pro-social, anti-stress brain network with the potential to modulate symptoms of PTSD such as: anxiety, including fear response and hyperarousal; interpersonal difficulties/social isolation; physical pain; and sleep disturbances. Human oxytocin research has shown that oxytocin can increase our sense of trust, empathy, and optimism and even increase our response to hypnosis. In rodents, central administration of oxytocin enhanced acupuncture's analgesic effects. Studies also suggest that oxytocin is a central mediator of the placebo effect. ^4--7

Several studies show that friendly, social interaction with dogs increases blood and urine levels of oxytocin in humans.^8--12 These human-dog, contact-induced effects gain particular significance in light of a recent brain imaging study which showed that peripheral increases in oxytocin correspond with concurrent activation of the oxytocin brain centers that control the human stress response. ¹³

Oxytocin neurons originate in the hypothalamus and connect to the major brain centers that control behavior and emotion. Oxytocin modulates the hypothalmic-pituitary-adrenal axis (HPA axis), the locus coeruleus, the central amygdala (CeA) and other arousal centers of the central nervous system to attenuate stress-induced neuroendocrine activity. Oxytocin receptor-expressing neural circuits in the CeA connect to the medial prefrontal cortex to suppress neurons that produce the freezing reaction to fear, while promoting risk assessment and exploratory response to frightening stimulus.

Oxytocin has also been shown to modulate the serotonin system and reduce levels of cytokines, adrenocorticotropic hormone, and cortisol. All of these brain systems and neurochemical responses have shown to be functionally important in PTSD.^14--21

With respect to pain and sleep disturbances, oxytocin has been shown to modulate pain in humans and has been shown to impact sleep patterns in animal studies.^22--24 Oxytocin has also been shown to be a powerful antioxidant that can bolster the immune system and protect against sepsis.^25,26

One dose of oxytocin given to war veterans with PTSD demonstrated decreased physiologic responding to provoked combat memories.²⁷ Oxytocin in humans, has been shown to enhance the processing of positive social information compared to negative information, increase a sense of trust in others, reverse the effect of aversive conditioning of social stimuli, enhance the buffering effect of social support on stress responsiveness, and reduce the stress response in people with a history of early trauma. ²⁸

This same pro-social/anti-stress response has also been observed in service members with PTSD who train service dogs. As we will demonstrate, shaping the behaviors of service dogs requires the focused nurturing social attention towards dogs that has been shown to naturally increase oxytocin blood levels in humans.

There are many potential uses of animals in support for service members and veterans. The reminder of this article shows one program which has great promise. Others are covered in more detail in Canine-Assisted Therapy in Military Medicine .¹

Warrior Canine Connection

The Warrior Canine Connection (WCC) is a nonprofit organization, based in Brookeville, MD, that enlists "wounded warriors" with PTSD and traumatic brain injury (TBI) in the training of service dogs for fellow veterans as a therapeutic intervention. WCC currently has dogs in training at several military treatment facilities (Walter Reed National Military Medical Center, Fort Belvoir, and National Intrepid Center of Excellence) and the Palo Alto Veterans Administration (VA) Healthcare System.

Occupational therapists utilize some of these programs as therapeutic "work therapy" internships with the goal to facilitate a purposeful and meaningful occupational intervention that builds skill sets for functional independence. The program engages service members in a healing mission, instructing soldiers with PTSD and TBI on how to train service dogs for fellow veterans with physical and psychological injuries.

WCC's training philosophy is based on positive methods of shaping behaviors and the premise that mastering the skills and patience required to train a service dog helps the WCC trainers regain control of their own emotions, focus their attention, and improve their social competence and overall sense of well-being.

Since beginning this therapeutic intervention model, very promising responses to this program from both active-duty service members involved in the current conflicts, as well as veterans have been observed by clinical staff (see Sidebar).

The WCC training was developed by a social worker and service dog trainer, Rick Yount, MS, LSW, to address all three symptom clusters associated with PTSD: re-experiencing, avoidance/numbing, and increased arousal. The interventions in the program are targeted to remediate each category of these symptoms as follows.

Re-experiencing

Procedures used in training service dogs require the trainer to focus on the dog's point of view of the present, in order to recognize the "teachable moments" when instruction will be most effectively processed and retained. The presence of the dog during a stressful situation or encounter changes the context of the arousal event and anchors the trainer in the present, reminding the service member or veteran that they are no longer in dangerous circumstances. If the patient/trainee does experience a trigger for symptoms, the presence of the dog can lower anxiety levels.

Avoidance and Numbing

Service dog training requires that the dog is exposed to a wide range of experiences in the community. This also creates opportunities for the soldier-trainer to reintegrate into civilian life. As part of the training, the service members are responsible for teaching the dogs that the world is a safe place. Through that process, the PTSD-affected soldiers must convince themselves of the same.

For example, the soldier-trainers are taught to praise and treat the dogs when they hear a car backfire or other startling events. Rather than turning inward to ruminate on their past trauma, they must get outside of their own heads to focus on the dogs and their mission to help another veteran.

Additionally, the dogs can help offer veterans who often isolate themselves from society, opportunities to experience positive interactions with members of the community. The training program requires soldiers who have likely "numbed" their feelings to instead demonstrate positive emotion, such as praising the dogs to successfully teach them. Many program participants have reported that this use of positive emotion has significantly improved their family dynamics as their children respond to this positive "parenting" strategy.

In order to shape the behavior of a service dog, trainers with PTSD must also overcome their emotional and affective numbness in order to heighten their tone of voice, bodily movements, and capacity for patience so that they can deliver their commands with positive, assertive clarity of intention and confidence. In doing this, trainers soon discover they can earn their dog's attention and best guide them to the correct response.

The dog's success must then be rewarded with emotionally-based praise. The WCC training technique allows the trainers to experience rewarding positive emotional stimulation and social feedback. The basic daily needs of a service dog involve structured activities that also bring the trainer and dog into the kind of close nurturing contact that further creates a behavioral and psychological antidote to social avoidance.

Hyperarousal

WCC service dogs are bred to be responsive to human emotions and needs. Their sensitivity to and reflection of their trainer's emotional state provides immediate and accurate measures of the trainer's projected emotion. This also challenges the trainer to overcome his or her tendency for startle reactions so that he or she can relay a sense of leadership and positive feedback when their young dogs are faced with environmental challenges such as cars backfiring or being approached by strangers.

WCC service dogs are also bred to be affectionate and have a low-arousal temperament that puts their trainers "at ease." With these dogs at their sides, trainers perceive greater relaxation and social competence and are able to shift out of their hyper-vigilant, defensive mode into a relaxed state that makes them ready and able to connect with others.

Representative Cases in Animal-Assisted Therapy

Case 1

A Marine injured by 13 separate improvised explosive device (IED) detonations during his multiple tours in Operation Iraqi Freedom and Operation Enduring Freedom had been in a PTSD treatment program for several weeks but was not responding despite a myriad of behavioral and pharmacological interventions.

He sat in the corner with his sunglasses on, occasionally twitching his head from side to side in a tic-like manner. His peers were hesitant to interact with him due to his body language and lack of response to their attempts to connect with him.

An 8-month-old golden retriever repeatedly nudged his arm, intent on making a new friend. Although the Marine rejected the dog's first several attempts, the pup's persistence paid off and soon was able to elicit a smile from the Marine. Noticing the emerging connection, the treatment staff asked the Marine if he would consider helping to train the dog to help a fellow veteran. His commitment to helping other warriors along with his interest in the dogs prompted him to participate in the service dog training program.

Within 2 days of working in the program, he began to smile and bond with the dog. His involvement led to his first positive interactions with staff and fellow veterans. Instead of leaving the PTSD program without successfully completing it, he was able to finish the entire program and process his trauma through the support of his dog, peers, and treatment team. Through training the service dog, the Marine learned to teach the dog to associate loud noises with praise and treats. To do this, he had to challenge his automatic thoughts about his own triggers in order to convince the dog that the world around him was a safe place.

Case 2

A young Marine Sergeant was referred to the WCC program as part of his treatment for PTSD and TBI. He endorsed difficulty sleeping, isolating, regulating his emotions, and parenting his 4-year-old daughter. The Marine reported a love for dogs and jumped at the chance to participate in WCC. He specifically focused on using his "praise voice" when marking and reinforcing desired behaviors, and while regulating his emotions when correcting unwelcome behaviors.

The Marine was offered an opportunity to keep the dog overnight after he developed a bond and sufficient skills to handle the dog. The next day, he reported a significant improvement in his quality of sleep. The dynamics between him and his daughter also showed improvement following the dog's overnight stay.

The Marine was encouraged to use the same positive techniques of using praise and patience with his daughter. He reported that learning to train the service dog had a profound impact on his parenting style. Rather than focusing on his daughter's mistakes, he began to look for opportunities to praise her and set her up for success. He now has his own service dog and is working with his local VA to develop a service dog program in his local area.

Conclusion

These cases demonstrate the effects service dog training as a purpose-driven intervention have on the symptoms of PTSD and mild TBI and how such a program can facilitate psychological and social improvement, and functional independence. They also indicate that the focus, intention, and nurturing social contact involved in shaping the behavior of young service dogs may be acting as a potent agonist of neurophysiological systems know to be dysregulated in PTSD.

A number of studies now show that human-dog interactions, such as those used to train service dogs, naturally increase circulating oxytocin levels in people. Further research is required to establish the psychological and behavioral effectiveness of the service dog training model and to investigate the underlying physiological mechanisms that support the observed reductions of PTSD symptoms.

Identifying a potent, safe, natural method of stimulating the anti-stress/pro-social oxytocin brain network is very important since there is no US Food and Drug Administration-approved oxytocin drug available at this time. A stronger scientific understanding of cause and effects of therapy dog training will provide scientific, objective guidelines for the appropriate training for therapy animals and policies that regulate how and when therapy animals may be used to help service members and veterans.

Sidebar

Sidebar

Anecdotal Reports of Improvement in PTSD by WCC Participants

Increased patience, impulse control, emotional regulation.

Improved ability to display affect, decrease in emotional numbness.

Improved sleep.

Decreased depression, increase in positive sense of purpose.

Decrease in startle responses.

Decrease in pain medications.

Increased sense of belongingness/acceptance.

Increase in assertiveness skills.

Improved parenting skills and family dynamics.

Less war stories and more in the moment thinking.

Lowered stress levels, increased sense of calm.

WCC = Warrior Canine Connection.

Footnote

Disclosure: The views expressed in the article are those of the author(s) and do not necessarily represent the official views/position of the Department of Defense, US Army, or the US Army Medical Command.

References

1. The United States Army Medical Department Journal. Canine-Assisted Therapy in Military Medicine. 2012. Available at: www.cs.amedd.army.mil/FileDownload-public.aspx?docid=73e8d2aa-1a2a-467d-b6e3-e73652da8622. Accessed May 29, 2013.

2. Department of Defense. DoD Human Animal Bond Principles and Guidelines. Washington DC: US Dept of the Army. 2003. Available at: www17.us.archive.org/stream/ost-military-medical-tbmed4/tbmed4_djvu.txt. Accessed May 29, 2013.

3. Olff M , Langeland W , Witteveen A , Denys D , . A psychobiological rationale for oxytocin in the treatment of the posttraumatic stress disorder. CNS Spectr. 2010; 15(8):436--444.

4. Heinrichs M , von Dawas B , Domes G , . Oxytocin, vasopressin, and human social behavior. Front Neuroendocrinol. 2009; 30(4):548--557 10.1016/j.yfrne.2009.05.005.

5. Uvnas-Moberg K , . The Oxytocin Factor: Tapping the Hormone of Calm, Love and Healing. Cambridge, MA: De Capo Press; 2003.

6. Bello D , White-Traut R , Schwertz D , Pournajafi-Nazarloo H , Carter CS , . An exploratory study of neurohormonal responses of healthy men to massage. J Altern Complement Med. 2008; 14(4):387--394 10.1089/acm.2007.0660.

7. Bryant RA , Hung L , Guastella AJ , Mitchell PB , . Oxytocin as a moderator of hypnotizability. Pscyhoneuroendocrinology. 2012; 37(1):162--166 10.1016/j.psyneuen.2011.05.010.

8. Odendaal JS , Meintjes RA , . Neurophysiological correlates of affiliative behaviour between humans and dogs. Vet J. 2003; 165(3):296--301 10.1016/S1090-0233(02)00237-X.

9. Nagasawa MT , Kikusui T , Onaka T , Ohta M , . Dog's gaze at its owner increases owner's urinary oxytocin during social interaction. Horm Behav. 2008; 55(3):434--441 10.1016/j.yhbeh.2008.12.002.

10. Miller SC , Kennedy C , DeVoe D , Hickey M , Nelson T , Kogan L , . An examination of changes in oxytocin levels in men and women before and after interaction with a bonded dog. Anthrozoos. 2009; 22(1):31--42 10.2752/175303708X390455.

11. Handlin L , Hydbring-Sandberg E , Nilsson A , Ejdeback M , Jansson A , Uvnas-Moberg K , . Short-term interaction between dogs and their owners: effects of oxytocin, cortisol, insulin and heart rate. Anthrozoos. 2011; 24(3):301--15 10.2752/175303711X13045914865385.

12. Handlin L , Nillson A , Ejdeback M , Hybring-Sandberg E , Uvnas-Moberg K , . Associations between psychological characteristics of the human-dog relationship and oxytocin and cortisol levels. Anthrozoos. 2012; 25(2):215--228 10.2752/175303712X13316289505468.

13. Strathearn L , Fongay P , Amico J , Montague PR , . Adult attachment predicts maternal brain and oxytocin response to infant cues. Psychoneuro-pharmacology. 2009; 34(13):2655--2666 10.1038/npp.2009.103.

14. Marazziti D , Catena Dell'osso C , . The role of oxytocin in neuropsychiatric disorders. Curr Medicinal Chem. 2008; 15(7):698--704 10.2174/092986708783885291.

15. Petersson M , Uvnas-Moberg K , Erhardt S , Engberg G , . Oxytocin increases locus coeruleus alpha 2-adrenoreceptor responsiveness in rats. Neurosci Lett. 1998; 255(2):115--118 10.1016/S0304-3940(98)00729-0.

16. Knobloch HS , Charlet A , Hoffman LC , Evoked axonal oxytocin release in the central amygdala attenuates fear response. Neuron. 2012; 73(3):553--566 10.1016/j.neuron.2011.11.030.

17. Parker KJ , Kenna HA , Zietzer J , Preliminary evidence that plasma oxytocin levels are elevated in major depression. Psychiatry Res. 2010; 178(2):359--362 10.1016/j.psychres.2009.09.017.

18. Stein M B , McAllister TW , . Exploring the convergence of posttraumatic stress disorder and mild traumatic brain injury. Am J Psychiatry. 2009; 166(7):768--776 10.1176/appi.ajp.2009.08101604.

19. Armony JL , Corbo V , Clement M , Brunet A , . Brain imaging studies have shown enhanced activity of the amygdala in individuals with PTSD. Am J Psychiatry. 2005; 162:1961--1963 10.1176/appi.ajp.162.10.1961.

20. Eaton J L , Roache L , Nguyen KN , Organizational Effects of Oxtyocin on Serotonin Innervation. Dev Psychobiol. 2021; 54(1):92--97 10.1002/dev.20566.

21. Dabrowsa J , Hazra R , Ahem TH , Neuroanotomical evidence for reciprocal regulation of the corticotrophin-releasing factor and oxytocin systems in the hypothalamus and the bed nucleus stria terminalis of the rat: implication for balancing stress and affect. Psychoneuroendocrinology. 2001; 36(9):1312--1326 10.1016/j.psyneuen.2011.03.003.

22. Yang J , . Intrathecal administration of oxytocin induces analgesia in low back pain involving the endogenous opiate peptide system. Spine (Phil Pa 1976). 1994; 19(8):867--871 10.1097/00007632-199404150-00001.

23. Singer T , Snozzi R , Bird G , Effects of oxytocin and prosocial behavior on brain responses to direct and vicariously experienced pain. Emotion. 2008; 8(6):781--791 10.1037/a0014195.

24. Lancel M , Kromer S , Neumann ID , . Intracerebral oxytocin modulates sleep-wake behavior in male rats. Regulatory Peptides. 2003; 114(2--3):145--152 10.1016/S0167-0115(03)00118-6.

25. Iseri SO , Sener G , Saglam B , Gedek N , Ercan F , Yegen BC , . Oxytocin protects against sepsis-induced multiple organ damage: role of neutrophils. J Surg Res. 2005; 126(1):73--81 10.1016/j.jss.2005.01.021.

26. Moosmann B , Behl C , . Secretory peptide hormones are biochemical antioxidants: structural-activity relationship. Mol Pharmacol. 2002; 61(2):260--268 10.1124/mol.61.2.260.

27. Pitman RK , Orr SP , Lasko NB , . Effects of intra-nasal vasopressin and oxytocin on physiologic responding during personal combat imagery in Vietnam veterans with posttraumatic stress disorder. Psychiatry Res. 1993; 48(2):107--117 10.1016/0165-1781(93)90035-F.

28. Striepens N , Kendrick K , Maier W , Hurlemann R , . Prosocial effects of oxytocin and clinical evidence of its therapeutic potential. Front Neuroendocrinol. 2011; 32(4):426--450 10.1016/j.yfrne.2011.07.001.

AuthorAffiliation

Rick Yount, MS, LSW, is Executive Director, Warrior Canine Connection, Brookeville, MD. COL (ret) Elspeth Cameron Ritchie, MD, MPH, is Chief Medical Officer, Department of Mental Health, Washington, DC. LTC Matthew St. Laurent, MS, OTR, is Chief, Occupational Therapy, Department of Rehabilitation, Walter Reed National Military Medical Center, Bethesda, MD. COL Perry Chumley, DVM, MPH, Diplomate ACVPM, is an Army Veterinarian. Meg Daley Olmert is Director of Research, Warrior Canine Connection, Brookeville MD.

Address correspondence to: Rick Yount, MS, LSW, Executive Director, Warrior Canine Connection, 23222 Georgia Avenue, Brookville, MD 20833; email: rick@warriorcanineconnection.org.

Illustration

Valerie, a golden retriever, demonstrates her ability to connect with a Marine at the National Intrepid Center of Excellence.

Image courtesy of Rick Yount, MS, LSW.

Ron, a 9-month-old Labrador retriever, is trained by a Marine Sergeant to open doors at the National Intrepid Center of Excellence.