For Anxiety Relief in Kids, Dogs Have It Down Pat

Deborah Brauser

December 05, 2018

Interacting with dogs appears to boost mood and decrease stress levels in children and "improve clinically relevant symptoms," new research suggests.

In the study, 78 child volunteers were exposed to a stressful task and then randomly assigned to one of three 15-minute interventions. Those who were assigned to play with trained dogs (without the dogs' handlers present) showed greater improvement scores from baseline on the Positive Affect scale than those who were assigned to a soothing "tactile-stimulation control condition" consisting of a soft blanket or than those assigned to a "sit and wait" control group.

The dog-intervention group also showed significantly lower scores on the State/Trait Anxiety Inventory for Children compared with the wait group.

The researchers note in a press release that this is "one of the first large studies specifically designed to evaluate whether the impact of the dog on its own provides benefit."

"Due to the increasing popularity of animal interactions, we are really excited about this as a strategy that's efficient for improving children's mental health," principal investigator Molly K. Crossman, PhD candidate and codirector of the Yale Innovative Interactions Lab at Yale University, New Haven, Connecticut, told Medscape Medical News.

"So few of the children in need of mental health services actually receive any kind of traditional treatment, plus kids have fluctuating levels of stress from day to day. So we were interested in reaching children across the community," she said.

Future research will delve into whether benefits from this type of intervention differ between specific child groups, "but this is a good starting point," Crossman said. 

The findings were published online recently in the Journal of Clinical Child and Adolescent Psychology.  

Active Ingredient?

Although human–dog therapy teams have been available for years in healthcare settings, "previous studies only evaluated their impact when the dogs and the handlers were together," the investigators note in the release.

The dogs in the current study were also part of certified human–dog therapy teams, but the handlers stayed behind two-way mirrors during the interactions with children.

In addition, past research into the effects of animal-assisted activities (AAAs) for children have not clearly shown "whether the interactions with the animals are really the active ingredient," the investigators write.

"In other words, we cannot yet say whether the improvements observed in studies of AAAs can really be attributed to the interactions with the animals, rather than to other aspects of the interventions or to more general factors, such as engagement in any distracting or appealing activity," they add.

"It could be that it's not necessarily something special about the dog, but just that they're doing proactive coping and perhaps getting tactile stimulation from the dog," Crossman said.

To answer these questions, the researchers created three interventions, rather than having just a "dog intervention vs no intervention" design. 

Good Dog

From September 2015 through September 2016, they enrolled 78 children ages 10 to 13 years (55% girls; 56.4% white, 23.1% multiracial/multiethnic, 7.7% Hispanic/Latino, 6.4% Asian, and 5.1% black) from the community surrounding Yale.

Exclusion criteria included a fear of, or allergy to, dogs.

All participants were randomly assigned to 15 minutes of the dog intervention (n = 26), to tactile stimulation (n = 26), or to waiting (n = 26).

Tactile stimulation, such as with a fuzzy blanket, "is used a lot to help children cope with big emotions in all kinds of settings," Crossman said.

The Good Dog Foundation helped design the dog-related study protocols and helped in the dog selection process.

The eight dogs selected for the study (50% female) were trained and certified through a therapy dog organization or had completed a strict behavioral assessment. All were screened for "appropriateness" before the first interactions with the children.

Although the handlers were not in the room during the interactions, they closely observed the setting behind glass. Also, an experimenter observed from a corner of the room to ensure the safety of both the child and dog.

At baseline and after the intervention, the Positive and Negative Affect Schedule for Children, Short Form (PANAS-C-S) was administered to all participants, as was the State portion of the State/Trait Anxiety Inventory for Children. 

Salivary cortisol, an indicator of physiologic stress, was measured at baseline; at 5, 10, and 15 minutes into the intervention; and immediately after the intervention ended. 

Raises Some Questions

Results showed significantly higher scores on the Positive Affect scale of the PANAS-C-S for the children who interacted with a dog than those who received tactile stimulation (mean score difference, 2.35 points; P = .007) or than those in the wait group (mean score difference, 1.92 points; P = .025).

They also showed lower anxiety scores than the wait group (mean score difference, 3.63 points; P = .003). However, there were no significant anxiety score differences between the dog-intervention and tactile-stimulation groups (P = .065).

The latter finding raises questions "about whether this anxiolytic effect is specific to interaction with a dog, or whether tactile stimulation from any soothing object might convey a similar benefit," the investigators write.

Asked whether this was explored further, such as whether "fuzzy dogs" were more soothing than less fuzzy ones, Crossman said no.

"There's more work to be done and there are some interesting questions remaining," she said. "I'd like to look more into what the characteristics are in dogs that are best at this — or which dogs are best for whom and under what circumstances."

There were no significant between-group differences in overall physiologic arousal, as shown by levels of salivary cortisol.

In addition, negative affect "was not assessed reliably," note the researchers. 

'Persuasive Evidence'

More research is now needed "to further clarify which features of the interactions produce…benefits and the extent to which interactions with animals offer benefits that exceed the effects of other common coping strategies, activities, and interventions," the investigators write.

Still, the study "provides a carefully controlled demonstration that unstructured interactions with dogs can improve clinically relevant symptoms in children," they add.

"What's exciting is that the study gets us closer to answering the question of whether there is something special about dogs in terms of their ability to help children recover from stress," Crossman said in the release.

To Medscape Medical News, she noted that her team is also currently involved in a study assessing the role that pets can play in helping patients with borderline personality disorder, while other researchers continue to evaluate benefits for individuals with various mental illnesses.

For now, the take-home message for clinicians "is that what we're seeing with our study and more and more with other studies is persuasive evidence that these kinds of brief interactions with an unfamiliar dog can convey at least short-term benefit on our mood on a day-to-day basis," Crossman concluded.

The study was funded by the Morris Animal Foundation in partnership with the Human-Animal Bond Research Institute, the Laura J. Niles Foundation, and the Humane Society of the United States. The Good Dog Foundation helped to establish study protocols. Crossman has disclosed no relevant financial relationships.

J Clin Child Adolesc Psychol. Published online October 30, 2018. Abstract

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