Service Dogs Help Traumatized Veterans Heal

Sept. 3 (HealthDay News) -- Iraq war veteran Jennifer Pacanowski was unaware that she was racing dangerously down the freeway at 85 miles an hour when she felt a wet nose nudge her elbow.

She immediately slowed down.

The wet nose belonged to Boo, Pacanowski's 110-pound Bull Mastiff, warning her that her anxiety levels were rising, a dangerous state given that Pacanowski has post-traumatic stress disorder (PTSD) from her experiences as a medic in the war.

Boo, who turned 1 in August, has been with Pacanowski, helping her deal with the world since last December.

"Sometimes I forget where I am and will go back to the war in Iraq. He brings me back to reality and makes me realize that I can't run people off the road. It's a frequent thing with PTSD to have road rage," said Pacanowski, who returned to the United States at the end of 2004 and now lives in northeastern Pennsylvania. "He's a comfort. I also know I'm not alone, and people can't just sneak up on me without his knowledge."

Boo is one of a team of "psychiatric service dogs" being used all over the country to help people with various mental health issues, including bipolar disorder, schizophrenia, anxiety disorders and, perhaps most notably, PTSD.

"If a dog observes when a person with PTSD is escalating, the dog will be able to signal that they are escalating and, given it's so early in process, the person can manage and even prevent the escalation," explained Joan Gibbon Esnayra, president and founder of the Psychiatric Dog Service Association.

The dogs have been in service for about 12 years and while patients and professionals alike know they work wonders, there has been no real empirical evidence of their value.

That's where the U.S. Department of Defense comes in. It's starting a 12-month study to find out exactly how the dogs help by comparing soldiers with PTSD who have dogs with a similar group of soldiers without a dog. Researchers will measure changes in symptoms and medication use.

"We want to provide evidence for something we know observationally and help create a movement towards the use of psychiatric service dogs," said lead investigator Craig T. Love, senior study director at Westat, a research corporation in Rockville, Md. "It's time to make a change."

"A recent survey showed that 82 percent of patients with PTSD who were assigned a dog had a decrease in symptoms, and 40 percent had a decrease in the medications they had to take," added Dr. Melissa Kaime, director of the Congressionally Directed Medical Research Program (CDMRP), who spoke at a telebriefing last month. "I fully expect this will be positive trial."

Details of this and several other studies being funded by CDMRP are to be presented this week at the Military Health Research Forum in Kansas City.

Other research includes creating a "virtual supermarket" environment to help veterans with both PTSD and mild traumatic brain injury (mTBI) cope with a return to civilian life.

Veterans with these conditions can have trouble adapting from being in a combat zone to being at home, where seemingly mundane daily events can prove jarring.

"These soldiers have challenges and difficulties when they have buttons that can be pushed and, when they are pushed, there's no calling it back," explained Dr. Charles E. Levy, lead investigator on this trial and chief of physical medicine and rehabilitation at the North Florida/South Georgia Veterans Health System. "This is [a virtual] environment where people could have a chance to basically practice life skills without the consequences of failure."

Levy decided on a grocery store because it "offers challenges of planning, challenges of finding the stuff once you decide what you're going to get, managing money," he said. "While all this may seem trivial, it's actually not trivial to many of the people we're seeing. Daily planning can be a challenge if you're distracted all the time or if you're nervous around crowds."

The virtual environment will be populated with grocery carts pushed by other shoppers (some loud, some not) and soldiers will have to deal with a collision of shopping carts, said Levy, adding that the prototype is not yet finished.

Other researchers will be trying to develop a more effective helmet for combat, and others are seeing if mifepristone, known as "the abortion pill," can help men and women with chronic, multi-symptom illness from the 1990-91 Gulf War.

"It's exactly the same medication [as that used in abortions]. Safety studies have been done and we don't anticipate any issue with that," Kaime said.


SOURCES: Joan Gibbon Esnayra, president and founder, Psychiatric Dog Service Association; Charles E. Levy, M.D., chief, physical medicine and rehabilitation, North Florida/South Georgia Veterans Health System; Craig T. Love, Ph.D., senior study director, Westat, Rockville, Maryland; Jennifer Pacanowski, Henryville, Pa.; Aug. 5, 2009, telebriefing with Capt. Melissa Kaime, M.D., director, Congressionally Directed Medical Research Program, Fort Detrick, Md.

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