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服务犬对创伤后应激障碍(PTSD)军人唾液皮质醇觉醒反应的影响。

The effect of a service dog on salivary cortisol awakening response in a military population with posttraumatic stress disorder (PTSD).

机构信息

Center for the Human-Animal Bond, Department of Comparative Pathobiology, College of Veterinary Medicine, Purdue University, West Lafayette, USA.

T. Denny Sanford School of Social and Family Dynamics, Arizona State University, Tempe, AZ, USA; Institute for Interdisciplinary Salivary Bioscience Research, University of California, Irvine, Irvine, CA, USA.

出版信息

Psychoneuroendocrinology. 2018 Dec;98:202-210. doi: 10.1016/j.psyneuen.2018.04.026. Epub 2018 Apr 27.

Abstract

Recent studies suggest a therapeutic effect of psychiatric service dogs for military veterans with posttraumatic stress disorder (PTSD), but are limited by self-report biases. The current study assessed the effect of PTSD service dogs on the salivary cortisol awakening response (CAR) and arousal-related functioning in a population of military veterans with PTSD. Participants included 73 post-9/11 military veterans with PTSD including 45 with a service dog and 28 on the waitlist to receive one. Saliva samples were collected on two consecutive weekday mornings at awakening and 30 min later to quantify the cortisol awakening response (CAR) and its area under the curve (AUCi) in addition to standardized survey measures of anxiety, anger, sleep quality and disturbance, and alcohol abuse. There was a significant main effect of having a service dog on both the CAR and the AUCi, with individuals with a service dog exhibiting a higher CAR and AUCi compared to those on the waitlist. Results also revealed that those with a service dog reported significantly lower anxiety, anger, and sleep disturbance as well as less alcohol abuse compared to those on the waitlist, with medium to large effect sizes. Although those with a service dog reported significantly less PTSD symptom severity, CAR was not significantly associated with PTSD symptoms within or across group. In conclusion, results indicate that the placement of a PTSD service dog may have a significant positive influence on both physiological and psychosocial indicators of wellbeing in military veterans with PTSD. Although clinical significance cannot be confirmed, a higher CAR/AUCi among those with a service dog may indicate better health and wellbeing in this population. Future within-subject, longitudinal research will be necessary to determine potential clinical significance and impact of individual differences.

摘要

最近的研究表明,精神科服务犬对创伤后应激障碍(PTSD)的退伍军人具有治疗作用,但受到自我报告偏差的限制。本研究评估了 PTSD 服务犬对 PTSD 退伍军人群体唾液皮质醇觉醒反应(CAR)和唤醒相关功能的影响。参与者包括 73 名 9/11 后患有 PTSD 的退伍军人,其中 45 名有服务犬,28 名在等待接受服务犬。连续两个工作日早晨在觉醒时和 30 分钟后采集唾液样本,以定量皮质醇觉醒反应(CAR)及其曲线下面积(AUCi),以及焦虑、愤怒、睡眠质量和干扰以及酒精滥用的标准化调查测量。是否有服务犬对 CAR 和 AUCi 都有显著的主要影响,有服务犬的个体与等待名单上的个体相比,CAR 和 AUCi 更高。结果还表明,与等待名单上的个体相比,有服务犬的个体报告的焦虑、愤怒和睡眠干扰明显较低,酒精滥用也较少,具有中到大的效应量。尽管有服务犬的个体报告的 PTSD 症状严重程度显著降低,但 CAR 与组内或组间的 PTSD 症状均无显著相关性。总之,结果表明,PTSD 服务犬的安置可能对 PTSD 退伍军人的生理和社会心理幸福感指标产生显著的积极影响。虽然无法确定临床意义,但服务犬组中较高的 CAR/AUCi 可能表明该人群的健康状况和幸福感更好。未来需要进行个体内、纵向研究,以确定个体差异的潜在临床意义和影响。

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