ABSTRACT

Background: Animal-assisted interventions (AAI) are increasingly applied for people with post-traumatic stress disorder (PTSD) symptoms albeit its effectiveness is unclear.

Objectives: To examine the effectiveness of AAI for treating PTSD symptoms.

Method: We searched 11 major electronic databases for studies reporting quantitative data on effects of AAI for children and adults with PTSD symptoms. Of 22ʹ211 records identified, we included 41 studies with 1111 participants in the systematic review comprising eight controlled studies with 469 participants in the meta-analysis. We conducted random-effects meta-analyses with all controlled studies based on standardized mean differences (SMD), and calculated standardized mean change (SMC) as effect sizes for studies with a pre-post one-group design. Two independent researchers assessed the quality of the included studies using the NIH Study Quality Assessment Tools. The primary outcome was PTSD or depression symptom severity measured via a standardized measurement at pre- and post-intervention assessments.

Results: There was a small but not statistically significant superiority of AAI over standard PTSD psychotherapy (SMD = −0.26, 95% CI: −0.56 to 0.04) in reducing PTSD symptom severity while AAI was superior to waitlist (SMD = −0.82, 95% CI: −1.56 to 0.08). Getting a service dog was superior to waiting for a service dog (SMD = −0.58, 95% CI: −0.88 to −0.28). AAI led to comparable effects in reducing depression as standard PTSD psychotherapy (SMD = −0.03, CI: −0.88 to 0.83). Pre-post comparisons showed large variation for the reduction in PTSD symptom severity, with SMCs ranging from −0.38 to −1.64, and for depression symptom severity, ranging from 0.01 to −2.76. Getting a service dog lowered PTSD symptoms between −0.43 and −1.10 and depression with medium effect size of −0.74.

Conclusions: The results indicate that AAI are efficacious in reducing PTSD symptomatology and depression. Future studies with robust study designs and large samples are needed for valid conclusions.

摘要

背景：动物辅助干预 (AAI) 越来越多地应用于有创伤后应激障碍 (PTSD) 症状的人，尽管其有效性尚不清楚。

目的：检查 AAI 治疗 PTSD 症状的有效性。

方法：我们在 11 个主要电子数据库中搜索了报告 AAI 对患有 PTSD 症状的儿童和成人影响的定量数据的研究。在确定的 22'211 条记录中，我们纳入了 41 项研究和 1111 名参与者的系统评价，包括 8 项对照研究和 469 名参与者的荟萃分析。我们对所有基于标准化均值差 (SMD) 的对照研究进行了随机效应荟萃分析，并计算了标准化均值变化 (SMC) 作为前后一组设计研究的效应量。两名独立研究人员使用 NIH 研究质量评估工具评估了纳入研究的质量。主要结果是 PTSD 或抑郁症状的严重程度，通过干预前和干预后评估中的标准化测量来衡量。

结果：在降低 PTSD 症状严重程度方面，AAI 优于标准 PTSD 心理治疗（SMD = -0.26, 95% CI：-0.56 至 0.04），而 AAI 优于候补名单（SMD = -0.82, 95） % 置信区间：-1.56 至 0.08）。获得服务犬优于等待服务犬（SMD = −0.58，95% CI：−0.88 至 −0.28）。AAI 在减少抑郁方面的效果与标准 PTSD 心理治疗相当（SMD = -0.03，CI：-0.88 至 0.83）。前后比较显示 PTSD 症状严重程度的降低有很大差异，SMC 范围从 -0.38 到 -1.64，抑郁症状严重程度的范围从 0.01 到 -2.76。养一只服务犬可将 PTSD 症状降低至 -0.43 至 -1.10 之间，将抑郁症状降低至 -0.74 的中等效应值。

结论：结果表明 AAI 可有效减少 PTSD 症状和抑郁症。需要具有稳健研究设计和大样本的未来研究才能得出有效结论。