Although the majority of American households includes a pet,
it is only recently that we have begun to explore the
relationship between people and their pets and the possible
physical and emotional benefits of that relationship. Early
surveys reported a strong psychological and emotional
attachment between people and their pets, and the term
human-animal bond emerged to represent this attachment.
Studies revealed that most pet owners view their pets as
both enhancing the quality of family life by minimizing
tension between family members and enhancing their owner's
compassion for living things (Barker, 1993; Pet Theories,
1984; Voith, 1985). Using a projective technique to
investigate owners' closeness to their pet dogs, Barker and
Barker (1988, 1990) found that dog owners were as
emotionally close to their dogs as to their closest family
member. They reported that more than one-third of the dog
owners in their study were actually closer to their dogs
than to any human family member.
Benefits of Pet Ownership
With documentation of the strong human-companion animal bond
came studies of how pet ownership may affect physical and
mental health. Friedmann et al. (1980) conducted one of the
first such studies, which compared the survival rates of pet
owners and non-pet owners following a myocardial infarction
(MI). Controlling for exercise, the investigators found a
significantly higher survival rate, one year post-MI, for
pet owners. Other studies supporting a cardiovascular
benefit associated with pet ownership followed; they are
summarized by Patronek and Glickman (1993). Perhaps the
largest cardiovascular study of pet owners conducted to date
involved over 5,700 participants taking part in a
cardiovascular screening program in Australia (Anderson et
al., 1992). The results showed that male pet owners had
significantly lower systolic blood pressure, and
triglyceride and cholesterol levels than males who did not
own pets. The study also showed that, of females over the
age of 40, those who owned pets had lower systolic blood
pressure and triglyceride levels than those who did not.
Other researchers have examined the relationship between pet
ownership and more general health factors. Serpell (1991)
compared adults before and after they acquired a pet, and
found a decrease in minor health problems for pet owners.
Examining reported health and morale in older adults living
in the community, Lago et al. (1989) found pet ownership and
attitudes toward pets to be significant predictors of these
variables. Siegel (1990) compared physician utilization of
Medicare recipients experiencing stressful life events and
found lower utilization among pet owners compared to those
who did not own pets. Allen et al. (1991) reported that
females had lowered stress levels when their dogs were
present compared with the presence of a human best friend or
control condition.
Professionals working with children have also written about
the benefits of pet ownership. Erikson's (1963) stages of
psychosocial development provide a useful framework for
considering potential benefits. Pets may contribute to the
development of 1) a child's basic sense of trust through the
pet's constancy, security, reliability, love and affection,
and ability to serve as a transitional object; 2) a sense of
autonomy and initiative through the pet's serving as an
active playmate and promoting exploration of the
environment, and encouraging patience and self-control; 3) a
sense of industry through the pet's trainability and
response to the child's basic commands; and 4) a sense of
identity through the pet's serving as a companion and
confidant, and providing social and emotional support (Blue,
1986; Brown et al., 1996; Bryant, 1990; Robin and ten
Bensel, 1990). Others have focused on specific qualities
that may be enhanced in children growing up in pet-owning
households. Some researchers have found that children with
pets score higher on measures of empathy, self-esteem and
self-concept than those who do not. (Poresky and Hendrix,
1990; Van Houtte and Jarvis, 1995).
Focusing on a clinical population, Barker et al. (1997)
showed the strong supportive role of pets in the childhood
of sexual abuse survivors. In this retrospective study, they
found that, in some cases, the pet was the only reported
supportive entity in the survivor's childhood. In sexual
abuse survivors, Nebbe (1998) reports that survivors with a
strong human-animal bond in childhood report less abusive
behavior as adults, and lower anger levels than those
lacking a strong bond.
Other researchers have investigated the effects of
introducing previously unknown companion animals into health
care settings. These activities have ranged from simple
visitation by a pet and its owner, to the purposeful
inclusion of animals in patient treatment. This
animal-assisted therapy has been shown to facilitate the
achievement of therapeutic goals.
Animal Visitation
Studies have found that simply having an animal present or
visiting is beneficial to children and adults in some health
care situations. Friedmann et al. (1983) observed reductions
in children's blood pressure levels when a dog was present
during a mildly stressful task. More recently, Wells (1998)
found that the presence of a dog during potentially painful
medical procedures reduced chronically ill children's
physiological and psychological levels of distress.
Similarly, Nagengast et al. (1993) found children's levels
of distress during physical examinations were lower when a
companion animal was present in the room.
Such findings have also been reported for adults. Katcher et
al. (1984) reported reduced blood pressure levels for adults
watching an aquarium. Others have addressed the positive
influence of animals in acute care settings, nursing homes
and rehabilitation settings, as well as in psychiatric
settings (Barba, 1995; Brickel, 1980; Voelker, 1995). In
nursing homes, residents have been found to be less
depressed following animal visits (Francis et al., 1985).
Patients hospitalized on a psychiatric service have been
found to have better group attendance and fewer psychiatric
symptoms when caged birds are present (Beck et al., 1986),
and increased positive socialization has been found for
Alzheimer's patients when a dog was present (Batson et al.,
1995).
Animal-Assisted Therapy (AAT)
While receiving heightened media attention in recent years,
AAT can be traced back to at least the 18th century when
hippotherapy, or therapeutic horseback riding, was used as a
medical intervention for improving postural control, joint
disturbance, coordination and basic balance (Depauw, 1983).
In addition to these physical benefits, hippotherapy has
also been noted to improve feelings of self-worth and power
as patients are freed from the mechanical supports of
wheelchairs and crutches, and are able to move about on a
powerful animal (Blue, 1986). Today, horses are also used in
psychotherapy to assist patients in improving ego strength,
self-confidence and social competence (Schneidhacker, 1994).
An early report of the potential of AAT in mental health
care was provided by Boris Levinson, M.D., a Canadian child
psychiatrist who included his dog in therapy sessions
(1962). Based on his observations of the interaction between
his child patients and the dog during therapy sessions, he
reported that the dog served as a communication link,
provided the child with a sense of security in the therapy
setting and quickened the therapy process. Levinson found
that AAT worked well with children who were nonverbal,
inhibited, autistic, schizophrenic, withdrawn,
obsessive-compulsive or culturally disadvantaged. He found
the dog particularly beneficial in helping to strengthen
autistic children's contact with reality. A more recent and
controlled study of autistic children and AAT reported
increased social response by children to both animal and
therapist (Campbell and Katcher, 1992).
An AAT/nature education program was found to be therapeutic
for children in residential treatment for
attention-deficit/hyperactive and conduct disorders (Katcher
and Wilkins, 1994). The results of this controlled study
indicated the AAT program was effective in decreasing
agitated and aggressive behavior, improving cooperation with
instructors, engaging students in learning, and in improving
behavioral control in regular classrooms.
Others have also addressed the potential therapeutic role of
companion animals with other psychiatric populations such as
those with dissociative disorders, Alzheimer's disease,
dementia and other chronic mental illnesses (Arnold, 1995;
Corson and Corson, 1978; Fritz et al., 1995; Hundley, 1991).
The role of companion animals in psychotherapy, and their
ability to serve as a clinical bridge, has also been
described by Barker et al. (1997), Draper et al. (1990) and
Mallon (1992). Based on clinical observations, such authors
assert the ability of companion animals to demonstrate
acceptance by allowing themselves to be petted, to reduce
the threat of the therapy setting by their presence, and to
serve as a distraction while patients discuss painful
material.
A recent study documented the anxiolytic effect of
animal-assisted therapy with hospitalized psychiatry
patients (Barker and Dawson, 1998). Using a controlled,
cross-over design, the researchers compared patients'
anxiety levels following AAT and following traditional
therapeutic recreation (TR) activities. Results revealed
significant reductions in anxiety following AAT for patients
with mood disorders, psychotic disorders and other
disorders. For the comparison group, only patients with mood
disorders showed significant reductions in anxiety.
Interestingly, the reduction in anxiety levels for the
psychotic patients following AAT was twice as great as that
found following TR. The researchers speculate that AAT may
be less threatening than traditional group activities, that
the physical contact such as hugging and petting the dog may
result in the same physiological and psychological
reductions in stress that have been reported for nonclinical
populations, and that the dog may serve as an entertaining
distraction.
Although the majority of published studies of AAT involve
dogs, other species have been noted to have beneficial
effects as well. Several studies have noted the positive
effect for mentally challenged children interacting with
marine animals. Benefits of interacting with rehabilitated
dolphins, sea turtles and fish were reported by Klingel
(1993) to include progress toward, and attainment of,
treatment goals and improved self-concept, as well as
enjoyable recreational experiences. Nathanson and de Faria
(1991) studied the orienting nonverbal and verbal responses
of children with mental disabilities interacting in water
with dolphins or in water with favorite toys away from
dolphins. They report more significant improvements in
hierarchical cognitive responses when children interacted
with the dolphin. They also note the dolphin interaction
produced both a greater number and higher level of responses
than the interactions without the dolphins.
Summary
As with any new field of inquiry, initial reports of the
benefits of interacting with companion animals were
primarily anecdotal or case reports. Based on such reports,
studies of efficacy that often involved small sample sizes
and a lack of controls were undertaken. As evidence has
continued to accumulate, more rigorous controlled studies
are being conducted, resulting in the emergence of a
significant body of literature supporting the therapeutic
value of the human-companion animal interaction in specific
circumstances. However, more research is needed-particularly
well-designed outcome studies of AAT programs and
longitudinal studies of pet ownership-in order to increase
our understanding of the human-companion animal interaction
and the potential benefits to quality of life.
Dr. Barker is an associate professor of psychiatry, internal
medicine, and anesthesiology at the Medical College of
Virginia at Virginia Commonwealth University and an adjunct
professor of small animal clinical sciences at
Virginia-Maryland Regional College of Veterinary Medicine.
She has published numerous papers on the human-companion
animal interaction.
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