AI Insight
This study examined 58 military veterans with treatment-resistant PTSD who participated in a 12-week equine-assisted intervention program involving non-trauma-focused group sessions with horses. Participants showed significant reductions in PTSD symptoms, improved sleep quality, and better quality of life that persisted for at least three months after program completion. Physiological measurements revealed adaptive stress responses during sessions with horses, particularly during free interactions, though no long-term changes in heart rate or heart rate variability were observed.
Why it matters
This research provides evidence for equine-assisted interventions as a complementary treatment option for veterans who have not responded to standard PTSD therapies. The findings suggest that interaction with horses may help veterans learn to regulate physiological stress responses, offering a promising alternative or supplement to conventional trauma-focused treatments.
IntroductionMilitary veterans are at an elevated risk of developing posttraumatic stress disorder (PTSD), while first-line trauma-focused treatments are less effective in this population. This highlights the need for novel, evidence-based complementary interventions for military veterans with treatment-resistant PTSD. Although equine-assisted interventions (EAIs) are increasingly popular and appear promising, many studies suffer from methodological issues. Therefore, further research incorporating both psychometric and physiological parameters is warranted.MethodsNine consecutive groups of eight veterans (n = 72; 58 men and 14 women) participated in this study. Due to a dropout rate of 8.33% and the exclusion of 11.11% of participants for missing more than two sessions, 58 veterans were included in the dataset. All participants had a prior PTSD diagnosis and/or a score >31 on the PTSD Checklist for DSM-5 (PCL-5) questionnaire at intake and had previous evidence-based treatment but continued to experience symptoms. The program consisted of 12 weekly non-trauma-focused group sessions and one follow-up session (week 24), all lasting from 10:00 to 15:00. Measurements were performed during baseline conditions (B), a 20-min free activity (F) focused on relaxation and social affiliative contact with the horse, and a 30-min directed activity (D) involving caretaking, groundwork, and riding.ResultsPsychometric questionnaires demonstrated a significant decrease in PTSD symptoms (PCL-5), an improvement in sleep quality (Pittsburgh Sleep Quality Index [PSQI]), and an improvement in quality of life (EuroQol 5-Dimension 5-Level questionnaire [EQ-5D-5L]), with effects persisting at least until the 3-month follow-up session. No significant differences in heart rate (HR) or heart rate variability (HRV) were observed between pre- and post-intervention. However, during EAI sessions, patterns consistent with physiological adaptation were observed, as HR decreased and HRV increased after the first week during free interactions with the horse.DiscussionIn conclusion, the EAI program was associated with long-term effects on PTSD, sleep quality, and quality of life in veterans with treatment-resistant PTSD. No structural changes in physiological parameters were found, only evidence for successful adaptation to acute stress during EAI sessions. We hypothesize that adaptation to physiological arousal during acute stress may represent a possible working mechanism of EAI.