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Brown MP, Shenk CE, Allen B, Dunning ED, Lombera MA, Bucher AM, Dreschel NA. The influence of pretreatment respiratory sinus arrhythmia dimensions on trauma-focused cognitive behavioral therapy outcomes: Findings from a randomized controlled feasibility trial. J Trauma Stress 2024. [PMID: 38743525 DOI: 10.1002/jts.23053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 02/28/2024] [Accepted: 03/21/2024] [Indexed: 05/16/2024]
Abstract
Child maltreatment is associated with respiratory sinus arrhythmia (RSA) dysregulation, a physiological indicator of emotion regulation that predicts elevated posttraumatic stress disorder (PTSD) symptoms and may be a mechanism of action for exposure-based therapies, such as trauma-focused cognitive behavioral therapy (TF-CBT). Animal-assisted therapy (AAT) has been proposed as an adjunct to TF-CBT for improving emotion regulation following maltreatment. The current study reports findings from a randomized controlled feasibility trial (N = 33; Mage = 11.79 years, SD = 3.08; 63.6% White; 66.7% female) that measured youths' resting RSA, RSA reactivity, and RSA recovery in response to a pretreatment laboratory challenge. We tested whether (a) lower pretreatment resting RSA was associated with blunted RSA during the challenge; (b) either of the pretreatment RSA dimensions predicted more severe pretreatment PTSD symptoms; and (c) either of the pretreatment RSA dimensions predicted less severe posttreatment PTSD symptoms and, as an exploratory aim, whether this was moderated by treatment group (i.e., TF-CBT vs. TF-CBT + AAT). Results from multiple linear regression indicated that, after controlling for pretreatment symptom severity, there was a large effect size for higher resting RSA predicting less severe caregiver-reported posttreatment PTSD symptoms, β = -.52, p = .058, and higher RSA during recovery predicting less severe child-reported posttreatment PTSD symptoms, β = -.70, p = .056, although these findings were not significant. These preliminary results offer important insights for future studies to investigate how the ability to regulate RSA informs which children need additional support to benefit from psychotherapeutic treatment.
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Affiliation(s)
- Michelle P Brown
- Center for the Protection of Children, The Pennsylvania State University Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA
| | - Chad E Shenk
- Department of Pediatrics, The Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Brian Allen
- Center for the Protection of Children, The Pennsylvania State University Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA
- Department of Pediatrics, The Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA
| | - Emily D Dunning
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Metzli A Lombera
- Department of Psychology, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Ashley M Bucher
- Department of Pediatrics, The Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA
| | - Nancy A Dreschel
- Department of Animal Science, The Pennsylvania State University, University Park, Pennsylvania, USA
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2
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Pandey RP, Himanshu, Gunjan, Mukherjee R, Chang CM. The Role of Animal-Assisted Therapy in Enhancing Patients' Well-Being: Systematic Study of the Qualitative and Quantitative Evidence. JMIRX MED 2024; 5:e51787. [PMID: 38606668 PMCID: PMC10986847 DOI: 10.2196/51787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 12/16/2023] [Accepted: 12/27/2023] [Indexed: 04/13/2024]
Abstract
Background Animal-assisted therapy, also known as pet therapy, is a therapeutic intervention that involves animals to enhance the well-being of individuals across various populations and settings. Objective This systematic study aims to assess the outcomes of animal-assisted therapy interventions and explore the associated policies. Methods A total of 16 papers published between 2015 and 2023 were selected for analysis. These papers were chosen based on their relevance to the research topic of animal-assisted therapy and their availability in scholarly databases. Thematic synthesis and meta-analysis were used to synthesize the qualitative and quantitative data extracted from the selected papers. Results The analysis included 16 studies that met the inclusion criteria and were deemed to be of moderate or higher quality. Among these studies, 4 demonstrated positive results for therapeutic mediation and one for supportive mediation in psychiatric disorders. Additionally, all studies showed positive outcomes for depression and neurological disorders. Regarding stress and anxiety, 3 studies indicated supportive mediation, while 2 studies showed activating mediation. Conclusions The overall assessment of animal-assisted therapy shows promise as an effective intervention in promoting well-being among diverse populations. Further research and the establishment of standardized outcome assessment measures and comprehensive policies are essential for advancing the field and maximizing the benefits of animal-assisted therapy.
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Affiliation(s)
- Ramendra Pati Pandey
- School of Health Sciences & Technology, University of Petroleum and Energy Studies, Dehradun, Uttarakhand, India
| | - Himanshu
- Graduate Institute of Biomedical Sciences, Chang Gung University, Taoyuan, Taiwan
- Master & PhD Program in Biotechnology Industry, Chang Gung University, Taoyuan, Taiwan
| | - Gunjan
- Graduate Institute of Biomedical Sciences, Chang Gung University, Taoyuan, Taiwan
- Master & PhD Program in Biotechnology Industry, Chang Gung University, Taoyuan, Taiwan
| | - Riya Mukherjee
- Graduate Institute of Biomedical Sciences, Chang Gung University, Taoyuan, Taiwan
- Master & PhD Program in Biotechnology Industry, Chang Gung University, Taoyuan, Taiwan
| | - Chung-Ming Chang
- Master & PhD Program in Biotechnology Industry, Chang Gung University, Taoyuan, Taiwan
- Department of Medical Biotechnology and Laboratory Science, Chang Gung University, Taoyuan, Taiwan
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3
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Burback L, Brémault-Phillips S, Nijdam MJ, McFarlane A, Vermetten E. Treatment of Posttraumatic Stress Disorder: A State-of-the-art Review. Curr Neuropharmacol 2024; 22:557-635. [PMID: 37132142 PMCID: PMC10845104 DOI: 10.2174/1570159x21666230428091433] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 02/19/2023] [Accepted: 02/23/2023] [Indexed: 05/04/2023] Open
Abstract
This narrative state-of-the-art review paper describes the progress in the understanding and treatment of Posttraumatic Stress Disorder (PTSD). Over the last four decades, the scientific landscape has matured, with many interdisciplinary contributions to understanding its diagnosis, etiology, and epidemiology. Advances in genetics, neurobiology, stress pathophysiology, and brain imaging have made it apparent that chronic PTSD is a systemic disorder with high allostatic load. The current state of PTSD treatment includes a wide variety of pharmacological and psychotherapeutic approaches, of which many are evidence-based. However, the myriad challenges inherent in the disorder, such as individual and systemic barriers to good treatment outcome, comorbidity, emotional dysregulation, suicidality, dissociation, substance use, and trauma-related guilt and shame, often render treatment response suboptimal. These challenges are discussed as drivers for emerging novel treatment approaches, including early interventions in the Golden Hours, pharmacological and psychotherapeutic interventions, medication augmentation interventions, the use of psychedelics, as well as interventions targeting the brain and nervous system. All of this aims to improve symptom relief and clinical outcomes. Finally, a phase orientation to treatment is recognized as a tool to strategize treatment of the disorder, and position interventions in step with the progression of the pathophysiology. Revisions to guidelines and systems of care will be needed to incorporate innovative treatments as evidence emerges and they become mainstream. This generation is well-positioned to address the devastating and often chronic disabling impact of traumatic stress events through holistic, cutting-edge clinical efforts and interdisciplinary research.
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Affiliation(s)
- Lisa Burback
- Department of Psychiatry, University of Alberta, Edmonton, Canada
| | | | - Mirjam J. Nijdam
- ARQ National Psychotrauma Center, Diemen, The Netherlands
- Department of Psychiatry, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | | | - Eric Vermetten
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
- Department of Psychiatry, New York University Grossman School of Medicine, New York, USA
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4
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Doan T, Pennewitt D, Patel R. Animal assisted therapy in pediatric mental health conditions: A review. Curr Probl Pediatr Adolesc Health Care 2023; 53:101506. [PMID: 38040610 DOI: 10.1016/j.cppeds.2023.101506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2023]
Abstract
Animal assisted therapy (AAT) has been explored as a treatment option for children with mental health disorders and associated symptoms. AAT can be implemented in inpatient, outpatient, and residential care settings. Some studies demonstrate significant improvement in symptom severity while others report only modest results. In this review, we summarize previous studies that have investigated the applications of AAT for pediatric mental health treatment, focusing on management of symptoms related to post-traumatic stress disorder, depression, anxiety, attention-deficit/hyperactivity disorder, and internet gaming disorder. Current studies on AAT and mental health care tend to lack generalizability due to being single-site studies, and comparisons between studies are difficult because studies tend to adopt different definitions of AAT. Future studies examining the effects of AAT on mental health in general and on symptoms for specific conditions are needed before AAT is widely recommended for the pediatric population.
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Affiliation(s)
- Tam Doan
- Western Michigan University Homer Stryker M.D. School of Medicine, USA.
| | - Deanna Pennewitt
- Department of Pediatrics, University of Michigan Medical School, USA
| | - Rohan Patel
- Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
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Fujimura Y, Shimura A, Morishita C, Tamada Y, Tanabe H, Kusumi I, Inoue T. Neuroticism mediates the association between childhood abuse and the well-being of community dwelling adult volunteers. Biopsychosoc Med 2023; 17:26. [PMID: 37488649 PMCID: PMC10364364 DOI: 10.1186/s13030-023-00282-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Accepted: 07/07/2023] [Indexed: 07/26/2023] Open
Abstract
BACKGROUND Previous studies reported that the experience of maltreatment in childhood reduces subjective well-being in adulthood and that neuroticism is negatively associated with subjective well-being. However, the interrelationship between childhood maltreatment, adult life events, neuroticism, and subjective well-being has not been analyzed to date. METHODS A total of 404 adult volunteers provided responses to the following questionnaires: 1) Childhood Abuse and Trauma Scale, 2) Life Experiences Survey, 3) Neuroticism Subscale of the Shortened Eysenck Personality Questionnaire-Revised, and 4) Subjective Well-Being Inventory. The path model was used to analyze possible interrelationships among these parameters. RESULTS The effect of childhood abuse on subjective well-being was indirect and was mediated by neuroticism. The effect of neuroticism on the negative, but not positive, change score on the Life Experiences Survey was significant. The indirect effect of neuroticism on subjective well-being was not significant via either negative or positive change scores. CONCLUSIONS This study demonstrated that age, subjective social status, neuroticism, and negative and positive life events were significantly associated with subjective well-being. Furthermore, using path analysis, we demonstrated the mediating role of neuroticism in the indirect effect of childhood abuse on subjective well-being.
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Affiliation(s)
- Yota Fujimura
- Department of Psychiatry, Tokyo Medical University Hachioji Medical Center, 1193 Tatemachi, Hachioji, Tokyo, 193-0998, Japan.
- Department of Psychiatry, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-Ku, Tokyo, 160-0023, Japan.
| | - Akiyoshi Shimura
- Department of Psychiatry, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-Ku, Tokyo, 160-0023, Japan
| | - Chihiro Morishita
- Department of Psychiatry, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-Ku, Tokyo, 160-0023, Japan
| | - Yu Tamada
- Department of Psychiatry, Tokyo Medical University Hachioji Medical Center, 1193 Tatemachi, Hachioji, Tokyo, 193-0998, Japan
- Department of Psychiatry, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-Ku, Tokyo, 160-0023, Japan
| | - Hajime Tanabe
- Department of Clinical Human Sciences, Graduate School of Humanities and Social Sciences, Shizuoka University, 836 Ohya, Suruga-Ku, Shizuoka, 422-8529, Japan
| | - Ichiro Kusumi
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, North 15, West 7, Kita-Ku, Sapporo, 060-8638, Japan
| | - Takeshi Inoue
- Department of Psychiatry, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-Ku, Tokyo, 160-0023, Japan
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Lodewyk K, Bagnell A, Courtney DB, Newton AS. Review: Adverse event monitoring and reporting in studies of pediatric psychosocial interventions: a systematic review. Child Adolesc Ment Health 2023. [PMID: 37463769 DOI: 10.1111/camh.12661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/31/2023] [Indexed: 07/20/2023]
Abstract
BACKGROUND Adverse event monitoring in studies of psychotherapy is crucial to clinical decision-making, particularly for weighing of benefits and harms of treatment approaches. In this systematic review, we identified how adverse events are defined, measured, and reported in studies of psychosocial interventions for children with mental disorders. METHOD Medline, PsycINFO, Embase, ProQuest Dissertations and Theses Global, and the Cochrane Library were searched from January 2011-January 2023, and Google Scholar from January 2011-February 2023. English language experimental and quasi-experimental studies that evaluated the efficacy or effectiveness of psychosocial interventions for childhood mental disorders were included. Information on the definition, assessment, and report of adverse events was extracted using a checklist based on Good Clinical Practice guidelines. RESULTS In this review, 117 studies were included. Studies most commonly involved treating anxiety disorders or obsessive-compulsive disorder (32/117; 27%); 44% of the experimental interventions tested (52/117) were cognitive behavioral therapies. Adverse events were monitored in 36 studies (36/117; 31%) with a protocol used in 19 of these studies to guide monitoring (19/36; 53%). Twenty-seven different events were monitored across the studies with hospitalization the most frequently monitored (3/36; 8%). Event severity was fully assessed in 6 studies (17%) and partially assessed in 12 studies (33%). Only 4/36 studies (11%) included assessing events for cause. CONCLUSIONS To date, adverse events have been inconsistently defined, measured and reported in psychosocial intervention studies of childhood mental health disorders. Information on adverse events is an essential knowledge component for understanding the potential impacts and risks of therapeutic interventions.
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Affiliation(s)
| | | | - Darren B Courtney
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
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Tumlin KI, Riley EN, Vsevolozhskaya O, Cull M. Lower Emotional Exhaustion among Employees Is Associated with Intentional Incorporation of Animals into Residential Care Settings. Behav Sci (Basel) 2023; 13:bs13050421. [PMID: 37232658 DOI: 10.3390/bs13050421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 05/01/2023] [Accepted: 05/10/2023] [Indexed: 05/27/2023] Open
Abstract
Secondary effects of animal-integrated programming on residential care center (RCC) staff and organizational culture are not well understood. We explored emotional exhaustion among RCC employees both in facilities that incorporated animals and those that did not incorporate animals into the therapeutic environment. We conducted a survey throughout a large midwestern RCC system in the United States to determine relationships between organizational culture, emotional exhaustion, and the intentionality by which animals were incorporated into programming. Data were analyzed by examining associations between variables of interest using chi-square or t-tests, and linear mixed-effects modeling was used to identify potential confounding effects due to differences in children served within RCCs. Staff from RCCs that used animals intentionally reported lower emotional exhaustion (p = 0.006), and higher average workplace safety (p = 0.024) and psychological safety (p < 0.001). Integrating animals into RCC programming is associated with elements of a strong organizational culture. It is possible that animal-integrated programming has a positive impact on the facility culture and workforce, and/or that RCCs with strong pre-existing cultures are more likely to use animal-integrated programming.
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Affiliation(s)
- Kimberly I Tumlin
- Department of Epidemiology and Environmental Health, College of Public Health, University of Kentucky, Lexington, KY 40506, USA
| | - Elizabeth N Riley
- Department of Health Management & Policy, College of Public Health, University of Kentucky, Lexington, KY 40506, USA
| | - Olga Vsevolozhskaya
- Department of Biostatistics, College of Public Health, University of Kentucky, Lexington, KY 40506, USA
| | - Michael Cull
- Department of Health Management & Policy, College of Public Health, University of Kentucky, Lexington, KY 40506, USA
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8
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Yosep I, Mardhiyah A, Ramdhanie GG, Sari CWM, Hendrawati H, Hikmat R. Cognitive Behavior Therapy by Nurses in Reducing Symptoms of Post-Traumatic Stress Disorder on Children as Victims of Violence: A Scoping Review. Healthcare (Basel) 2023; 11:407. [PMID: 36766982 PMCID: PMC9914721 DOI: 10.3390/healthcare11030407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 01/26/2023] [Accepted: 01/30/2023] [Indexed: 02/04/2023] Open
Abstract
Violence against children can cause psychological problems such as post-traumatic syndrome disorder (PTSD). The negative impact of violence on children is psychological and physical problems and risk of suicide. Nurses have a role to provide comprehensive nursing care such as cognitive behavior therapy for reducing PTSD symptoms. The purpose of this study was to describe the methods of cognitive behavior therapy to reduce symptoms of PTSD in children who are victims of violence. This study used the scoping review method. The databases use for the literature review in this study were CINAHL, PubMed, and Scopus. The keywords used in English were "cognitive behavioral therapy OR CBT" AND "violence OR abuse" AND "post-traumatic stress disorder OR PTSD" AND "child OR children". The inclusion criteria were full text, randomized control trial or quasi-experimental research design, English language, the sample was children, and the publication period was for the last 10 years (2013-2022). We found 10 articles discussing CBT intervention on children who experienced victim abuse to reduce symptoms of PTSD. Most of the articles in this study used randomized control trial design. Several samples in this study are from the USA. The total sample was 47-320 respondents. This study showed three methods of CBT, namely psychoeducation, self-management, and coping strategies. CBT interventions can be carried out face-to-face or online. The activities carried out by the participants were relaxing, participating in training, counseling, problem-solving discussions, and therapy to improve sleep quality. Cognitive behavioral therapy is an intervention that can be carried out to reduce the traumatic impact on child victims of violence by taking into account the characteristics and development of the children.
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Affiliation(s)
- Iyus Yosep
- Department of Mental Health, Faculty of Nursing, Universitas Padjadjaran, Bandung 40132, Indonesia
| | - Ai Mardhiyah
- Department of Pediatric Nursing, Faculty of Nursing, Universitas Padjadjaran, Bandung 40132, Indonesia
| | - Gusgus Ghraha Ramdhanie
- Department of Pediatric Nursing, Faculty of Nursing, Universitas Padjadjaran, Bandung 40132, Indonesia
| | | | - Hendrawati Hendrawati
- Department of Mental Health, Faculty of Nursing, Universitas Padjadjaran, Bandung 40132, Indonesia
| | - Rohman Hikmat
- Faculty of Nursing, Universitas Padjadjaran, Bandung 40132, Indonesia
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9
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Allen B, Brown MP. Attachment security as an outcome and predictor of response to trauma-focused cognitive-behavioral therapy among maltreated children with posttraumatic stress: A pilot study. Clin Child Psychol Psychiatry 2022:13591045221144588. [PMID: 36472223 DOI: 10.1177/13591045221144588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT) is a frontline intervention for posttraumatic stress disorder (PTSD) symptoms among maltreated children. Research suggests that active caregiver participation predicts positive treatment outcomes, but these studies are often based on the perception of the caregiver. Youth perceptions of the caregiver as a source of support who might help confront distressing memories (i.e., attachment security) and how they relate to TF-CBT treatment are unexplored. This paper uses data from a small randomized controlled feasibility trial of TF-CBT to conduct a pilot examination of whether (a) attachment security may improve through the course of TF-CBT, and (b) pre-treatment attachment security predicts response to TF-CBT for the amelioration of posttraumatic stress. Results favored the conclusion that those beginning treatment with attachment insecurity may demonstrate improvement for this outcome by the end of treatment (n = 8; t = 3.3, p = .013, Cohen's d = 1.17). However, although significant improvements were found over the course of treatment for PTSD, there was no evidence that pre-treatment attachment security predicted PTSD outcome (n = 29; ∆R2 < .01, ∆F(1,26) = .001, p = .969). The limitations of the current pilot study are discussed, as well as directions for future research.
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Affiliation(s)
- Brian Allen
- Department of Pediatrics, 12310Penn State College of Medicine, Hershey, PA, USA.,Department of Psychiatry and Behavioral Health, 12310Penn State College of Medicine, Hershey, PA, USA.,Center for the Protection of Children, 12310Penn State Children's Hospital, Hershey, PA, USA
| | - Michelle P Brown
- Department of Psychology, 2629University of South Carolina, Columbia, SC, USA
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10
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Wagner C, Grob C, Hediger K. Specific and Non-specific Factors of Animal-Assisted Interventions Considered in Research: A Systematic Review. Front Psychol 2022; 13:931347. [PMID: 35837630 PMCID: PMC9274084 DOI: 10.3389/fpsyg.2022.931347] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 06/06/2022] [Indexed: 12/05/2022] Open
Abstract
Research on animal-assisted interventions (AAIs) has increased massively in the last few years. But it is still not clear how AAIs work and how important the animal is in such interventions. The aim of this systematic review was to compile the existing state of knowledge about the working mechanisms of AAIs. We searched 12 major electronic databases for previous AAI studies with active control groups. Of 2001 records identified, we included 172 studies in the systematic review. We extracted previously published hypotheses about working mechanisms and factors that have been implicitly considered specific or non-specific in AAI research by categorizing control conditions using content analysis. We analyzed the categories using descriptive statistics. We found that 84% of the included studies mentioned a hypothesis of working mechanisms, but 16% did not define specific hypotheses. By analyzing their control conditions, we found that in most controlled studies, the animal or the interaction with the animal was implicitly considered as a specific factor for the effects of the AAI. Non-specific factors such as therapeutic aspects, social interactions, or novelty have also been controlled for. We conclude that AAI research still cannot answer the question of how and why AAIs work. To address this important research gap, we suggest using component studies with innovative control conditions and results from placebo research to address both the specific and non-specific, contextual factors of AAIs to disentangle its mechanisms. Systematic Review Registration https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=158103, identifier: CRD42020158103.
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Affiliation(s)
- Cora Wagner
- Division of Clinical Psychology and Psychotherapy, Faculty of Psychology, University of Basel, Basel, Switzerland
| | - Carmina Grob
- Division of Clinical Psychology and Psychotherapy, Faculty of Psychology, University of Basel, Basel, Switzerland
| | - Karin Hediger
- Division of Clinical Psychology and Animal-Assisted Interventions, Faculty of Psychology, University of Basel, Basel, Switzerland
- REHAB Basel, Clinic for Neurorehabilitation and Paraplegiology, Basel, Switzerland
- Department of Epidemiology and Public Health, Human and Animal Health Unit, Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- Faculty of Psychology, Open University, Heerlen, Netherlands
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11
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Respiratory Sinus Arrhythmia Change during Trauma-Focused Cognitive-Behavioral Therapy: Results from a Randomized Controlled Feasibility Trial. Res Child Adolesc Psychopathol 2022; 50:1487-1499. [PMID: 35689729 PMCID: PMC9187846 DOI: 10.1007/s10802-022-00946-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/01/2022] [Indexed: 11/22/2022]
Abstract
Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT) is a well-established treatment for pediatric posttraumatic stress disorder (PTSD). Animal-assisted therapy (AAT) has been proposed as an adjunct to TF-CBT that may improve treatment effects through enhanced targeting of affect regulation, as indexed by specific changes in the respiratory sinus arrhythmia (RSA). The current study reports results from a randomized controlled feasibility trial (N = 33; Mage = 11.79 [SD = 3.08]; 64% White; 67% female) that measured RSA during Sessions 1, 4, 8, and 12 of a twelve-session TF-CBT protocol and tested whether: 1) TF-CBT + AAT achieved higher average RSA amplitudes relative to TF-CBT alone, and 2) RSA regulation, defined as less variability around person-specific RSA slopes during treatment, explained variation in post-treatment PTSD symptoms. Multilevel modeling failed to support an effect for TF-CBT + AAT on RSA amplitudes (δ001 = 0.08, p = 0.844). However, regardless of treatment condition, greater RSA withdrawal was observed within Sessions 4 (γ11 = -.01, p < .001) and 12 (γ13 = -.01, p = .015) relative to the Session 1 baseline. The average level of RSA amplitude in Session 8 was also significantly lower compared to Session 1 (γ02 = -0.70, p = .046). Intraindividual regression models demonstrated that greater RSA regulation predicted improved PTSD symptoms at post-treatment after adjusting for pre-treatment levels (b3 = 20.00, p = .012). These preliminary results offer support for future confirmatory trials testing whether affect regulation, as indexed by changes in RSA, is a mechanism of action for TF-CBT in the treatment of pediatric PTSD.
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12
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Santaniello A, Garzillo S, Cristiano S, Fioretti A, Menna LF. The Research of Standardized Protocols for Dog Involvement in Animal-Assisted Therapy: A Systematic Review. Animals (Basel) 2021; 11:ani11092576. [PMID: 34573542 PMCID: PMC8468867 DOI: 10.3390/ani11092576] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 08/26/2021] [Accepted: 08/30/2021] [Indexed: 01/02/2023] Open
Abstract
Dogs are considered the most important species involved in animal-assisted therapy (AAT), and the scientific literature focuses on the benefits linked to the involvement of dogs in various therapeutic areas. In this study, we carried out a systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, exploring the scientific literature from the last 5 years (2016-2021) on three databases (PubMed, Scopus, and Web of Science) to highlight the characteristics of the dogs involved in AATs. Based on the scientific literature relevant to such dogs, we considered different parameters (i.e., number, age, sex, breed, temperament, methods of choice and training, health status, research goals, and activities with dogs) to include studies in our paper. After screening 4331 papers identified on the searched databases, we selected 38 articles that met the inclusion criteria. Analysis of the included articles showed that the characteristics of the dogs were neglected. Our findings indicated a lack of information about the dogs, as well as the absence of standardized and univocal criteria for dog selection, training programs, and health protocols.
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Affiliation(s)
- Antonio Santaniello
- Department of Veterinary Medicine and Animal Productions, University of Naples Federico II, 80134 Naples, Italy; (S.G.); (A.F.)
- Correspondence: (A.S.); (L.F.M.); Tel.: +39-0812536134 (A.S. & L.F.M.)
| | - Susanne Garzillo
- Department of Veterinary Medicine and Animal Productions, University of Naples Federico II, 80134 Naples, Italy; (S.G.); (A.F.)
| | - Serena Cristiano
- SInAPSi Center, University of Naples Federico II, 80133 Naples, Italy;
| | - Alessandro Fioretti
- Department of Veterinary Medicine and Animal Productions, University of Naples Federico II, 80134 Naples, Italy; (S.G.); (A.F.)
| | - Lucia Francesca Menna
- Department of Veterinary Medicine and Animal Productions, University of Naples Federico II, 80134 Naples, Italy; (S.G.); (A.F.)
- Correspondence: (A.S.); (L.F.M.); Tel.: +39-0812536134 (A.S. & L.F.M.)
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