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Published: 12 April 2022

Pet ownership and psychological well-being during the COVID-19 pandemic

Catherine E. Amiot 1 ,
Christophe Gagné 1 &
Brock Bastian 2

Scientific Reports volume 12 , Article number: 6091 ( 2022 ) Cite this article

29 Citations

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Epidemiology

The question of pet ownership contributing to human well-being has received mixed empirical evidence. This contrasts with the lay intuition that pet ownership contributes positively to wellness. In a large representative sample, we investigate the differences that may exist between pet vs. non-pet owners in terms of their well-being during the COVID-19 pandemic, and examine among different sociodemographic strata, for whom pet ownership can be more vs. less beneficial. A cross-sectional questionnaire survey was conducted among Canadian adults (1220 pet owners, 1204 non-pet owners). Pet owners reported lower well-being than non-pet owners on a majority of well-being indicators; this general pet ownership effect held when accounting for pet species (dogs, cats, other species) and number of pets owned. Compared to owners of other pets, dog owners reported higher well-being. When examining the effect of pet ownership within different socioeconomic strata, being a pet owner was associated with lower well-being among: women; people who have 2 + children living at home; people who are unemployed. Our results offer a counterpoint to popular beliefs emphasising the benefits of pets to human wellness during the COVID-19 pandemic and confirm the importance of accounting for sociodemographic factors to further understand the experience of pet ownership.

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Introduction.

The experience of pet ownership exists across many epochs, cultures, and socioeconomic strata 1 . In many occidental countries, such the U.S., Canada, and Australia, a majority (i.e., around 60%) of people live with pets 2 , 3 , 4 . It is commonly assumed that the presence of animals is beneficial to human wellness 5 , 6 , 7 , 8 , and this intuition possibly contributed to the increased interest in pet ownership 9 and demand for adopting a pet observed in Canada during the COVID-19 pandemic 10 . Yet, the scientific literature is divided on the relationship between pet ownership and human health and well-being: Whereas some studies have confirmed the existence of a positive association, others have uncovered null associations or have found a negative relationship (for reviews, see 11 , 12 , 13 , 14 ). What is needed is rigorous and generalizable evidence to either support or refute these general claims. To this end, the current study drew on a large representative sample of Canadians to investigate the relationship between pet ownership and psychological well-being during the COVID-19 pandemic. We also aimed to provide nuance, by focusing on sociodemographic differences in order to better understand for whom pet ownership may be more or less beneficial at times of high stress, therefore providing an ecologically valid test of the stress buffering effects of pet ownership.

A contested association between pet ownership and human wellness

Studies conducted across a wide range of scientific disciplines have investigated whether the presence of pets is associated with human health and well-being 11 , 15 . The general assumption has been that people benefit from the presence of pets 5 , 16 . Yet, the association between the presence of animals and human wellness is complex and contested. Indeed, some studies have uncovered positive associations between the presence of pets and human well-being. For example, in prospective studies, new dog owners reported a significant increase in self-esteem, and children were visited more often by their friends one month following the acquisition of the new pet 17 . In a one-year longitudinal study, older adults who owned a pet maintained participation in more daily activities compared to the non-pet owners 18 . Large epidemiological studies have also revealed that pet owners report fewer physician visits compared to statistically matched non-pet owners 19 , 20 ; see also 21 , 22 . In experimental studies, hypertensive stockbrokers who were randomly assigned to a pet ownership condition showed, 6 months later, smaller increases in blood pressure during a stressful task compared to non-pet participants 23 . And pet owners whose pet was made physically or cognitively present (i.e., recalled to memory) reported higher aspirations and greater feelings of capability and self-efficacy in attaining personal goals compared to those who were not in the presence of, nor thinking about, their pet 24 .

In contrast, other studies have uncovered negative links between the presence of pets and human well-being. For example, in large epidemiological studies, pet owners were found to report lower psychological well-being (e.g., higher anxiety, depression) and perceived health compared to non-pet owners 21 , 25 , 26 , 27 . Among older Canadian adults, pet owners were less likely than non-owners to report being satisfied with their life 28 . Finally, some studies have found non-significant associations between pet ownership and well-being. For instance, in a 6-month prospective study, new pet owners did not report a reduction in their loneliness compared to non-pet owners 29 . Depression levels were also similar for pet and non-pet owners in a nine-year longitudinal study 30 , and in a large population-based study conducted among older adults 31 . Overall, the relationship between pet ownership and wellbeing is far from straightforward.

Accounting for sociodemographic factors

A growing number of studies are finding that pet owners are not equivalent to non-pet owners in terms of sociodemographic characteristics, with pet owners often from advantaged and majority backgrounds compared to non-pet owners 25 , 32 . This can potentially lead to an inflation of the positive association, found in some studies, between pet ownership and human wellness 19 , 33 . In fact, studies that account for sociodemographic factors (e.g., SES, ethnicity, education) have found that such controls attenuate and even erase any positive association between pet ownership and human wellness 33 , 34 , 35 , 36 .

To address these methodological issues and provide a systematic and strong test for the role of pets in predicting higher human well-being, the current study recruited a representative sample of Canadian pet owners and non-pet owners; quotas were also used to recruit a relatively equal number of pet and non-pet owners. In addition, poststratification weights are used, which adjust for each subgroup’s (i.e., pet vs. non-pet owners) representativeness relative to the overall Canadian population. Together, these methodological and statistical procedures allow for the improved generalization of findings, and ensure that comparisons of pet vs. non-pet owners are not confounded by sociodemographic differences.

Drawing on data stratified by sociodemographics also allowed us to examine for which subgroups pets are more or less beneficial (see 37 ). Indeed, the psychological experience of caring for a pet during a stressful event like a global pandemic may be moderated by social dis/advantage. While on the one hand pet ownership may buffer the stress associated with disadvantage, on the other it may generate added stress, exacerbating vulnerabilities resulting from social inequalities and disadvantage 38 . This could be particularly the case during events such as COVID-19. Indeed, sociodemographic factors have impacted on how people have experienced the COVID-19 pandemic 39 , with some social groups more adversely impacted than others 40 , 41 , 42 .

The current study

The current study contributes to the current literature in two ways: first, we examine the relationship between pet ownership and well-being drawing on a representative sample, thereby responding to recent calls for more inclusive and diverse research samples when investigating human-pet relations 37 , 38 , 43 , 44 . Second, we draw on sociodemographic factors to determine who is more vs. less likely to benefit from the presence of pets during a highly stressful life experience (i.e., the COVID-19 pandemic). These factors have been identified as theoretically relevant to understanding human-animal relations in general 11 and as important in research comparing pet and non-pet owners, e.g., 32 , 33 , 38 , and have been found relevant for the experience of the COVID-19 pandemic 40 , 41 . These factors include: gender, age, area lived in and dwelling type, as well as important indicators of socioeconomic status (i.e., income, employment status) and family size (i.e., number of children living at home). We investigate these associations at a time of high stress, thereby allowing for a critical examination of the role of pets as either buffering stress and isolation or contributing to it by adding an additional source of strain. Given the contradictory prior findings as well as the particularly novel nature of the context in which this study was conducted—i.e., the current COVID-19 pandemic—we adopted an exploratory perspective with respect to the association between pet ownership and psychological well-being; no specific a priori hypothesis is put forward concerning the expected direction of this association.

Participants and sociodemographic factors

Data from a total of 2424 participants were analysed, which included 49.5% (1200/2424) males and 50.2% (1218/2424) females (6 indicated ‘other’ for their gender). Whereas 2006 participants (82.8%) completed the questionnaire in English, 418 (17.2%) completed it in French. Approximately 50% of the sample were older than 50 years. More details on the sociodemographic characteristics of the total sample and of the pet and non-pet owner subgroups are presented in Supplementary Table S1 .

As can be seen in Table S1 , a significantly higher proportion of female respondents were pet owners compared to non-pet owners. Additionally, compared to non-pet owners, a significantly higher proportion of pet owners were found in the 35–39 and 50–54 age groups, but lower proportions were found in the 65 + age groups. A significantly higher proportion of pet owners compared than non pet owners completed the questionnaire in French. Also compared to non-pet owners, a significantly higher proportion of pet owners held a college-level diploma, but lower proportions held a university degree (i.e., Bachelor’s or Master’s). In terms of living arrangements and area, and compared to non-pet owners, higher proportions of pet owners lived in a house or in the countryside, and lower proportions lived in an apartment/condo or in the city. In terms of employment, a higher proportion of pet owners compared to non-pet owners worked full-time. As per ethnicity, a higher proportion of pet owners compared to non-pet owners were Caucasian/White, but lower proportions were of Black/African Canadian or of Asian ethnicities. In terms of marital status, and compared to non-pet owners, a higher proportion of pet owners were in a common-law union, but lower proportions were divorced or single. Many of the differences observed between pet and non-pet owners on these sociodemographic variables align with prior research, e.g., 25 , 32 ; the higher percentage of pet owners in common-law unions observed in our study could be due to the generally higher prevalence of this type of relationship, which is also considered to be a committed type of relationship, in Canada. When conducting these X 2 and t-test analyses on the weighted data, these differences became non-significant, confirming that the poststratification weight employed in the current study allowed to ensure that comparisons of pet vs. non-pet owners are not confounded by sociodemographic differences.

Overall comparison of pet and non-pet owners on the well-being measures

As seen in Table 1 , pet owners were found to report lower well-being on 5 of the dependent measures in the ANOVAs. Specifically, pet owners reported lower vitality, lower life satisfaction, and lower presence of life meaning, and higher loneliness compared to non-pet owners. Pet owners were also found to experience higher COVID-related impacts compared to non-pet owners.

Although the current study was designed to specifically compare pet and non-pet owners (i.e., through the use of quotas and the poststratification weight variable), in line with prior research which had investigated the specific effects of cat and dog ownership on human psychological well-being, e.g., 33 , 45 , we also investigated whether the pet vs. non-pet owners effects on psychological well-being remain when taking into account the differences between pet species. Specifically, effect coded variables were created to account for the impact of owning these species of pets on well-being. These effect coded variables were then included as covariates in a series of hierarchical multiple regressions (i.e., entered in Block 1) to test if the general pet ownership effects (coded: 0 = non-pet owners; 1 = pet owners; entered in Block 2) reported in Table 1 hold when accounting for the effects of owning dogs, cats, and other types of pets. Specifically, the first effect coded variable (labeled ‘dog ownership’) compared the effect of owning at least one dog (coded as + 1) vs. the effect of owning other types of pets (coded as − 1); non-pet owners in this effect coded variable had a score of zero. The second effect coded variable (labeled ‘cat ownership’) compared the effect of owning at least one cat (coded as + 1) vs. the effect of owning other types of pets (coded as − 1); non-pet owners again had a score of zero. In addition to these effect coded variables, the number of pets participants currently owned was also included as a covariate in Block 1 of the hierarchical multiple regressions. All of the models overall accounted for significant proportions of variance in the well-being measures ( R 2 s ranged from 0.004 to 0.014; p s ranged from 0.045 to 0.000).

In these regressions, the general pet ownership effect remained a significant predictor, of: loneliness ( β = 0.06, p = 0.028), life satisfaction ( β = − 0.08, p = 0.001), presence of life meaning ( β = − 0.09, p = 0.000), and COVID-related impacts ( β = 0.07, p = 0.006). While pet ownership was not a significant predictor of vitality ( β = − 0.03, p = 0.328) in these analyses, it become a significant predictor of stress ( β = 0.06, p = 0.036). Addition of the pet ownership variable in Block 2 also resulted in significant increments in R 2 s for the models predicting: loneliness ( R 2 Δ = 0.002, p = 0.028), life satisfaction ( R 2 Δ = 0.004 , p = 0.001), presence of life meaning ( R 2 Δ = 0.005, p = 0.000), stress ( R 2 Δ = 0.002, p = 0.036), and COVID-related impacts ( R 2 Δ = 0.003, p = 0.006), but not in the model predicting vitality ( R 2 Δ = 0.000, p = 0.328) .

In terms of the covariates, the dog ownership variable was associated significantly with: vitality ( β = 0.09, p = 0.000), loneliness ( β = − 0.06, p = 0.012), life satisfaction ( β = 0.07, p = 0.003), and COVID-related impacts ( β = − 0.09, p = 0.000), but it had no significant effects on: presence of life meaning ( β = 0.04, p = 0.090) and stress ( β = − 0.001, p = 0.959). Hence, compared to owners of other (non dog) pets, dog owners reported higher vitality and life satisfaction, but lower loneliness and COVID-related impacts. The cat ownership variable was not significantly associated with the psychological well-being measures (vitality: β = − 0.02, p = 0.369; loneliness: β = 0.03, p = 0.314; life satisfaction: β = − 0.03, p = 0.322; presence of life meaning: β = − 0.01, p = 0.734; stress: β = 0.05, p = 0.051; COVID-related impacts: β = − 0.04, p = 0.092). Number of pets owned also was not significantly associated with the well-being measures (vitality: β = − 0.05, p = 0.097; loneliness: β = 0.01, p = 0.656; life satisfaction: β = 0.02, p = 0.374; presence of life meaning: β = 0.03, p = 0.216; stress: β = − 0.03, p = 0.269; COVID-related impacts: β = − 0.00, p = 0.951). As a block (Block 1), these covariates accounted for significant proportions of variance in the models predicting: vitality ( R 2 Δ = 0.014, p = 0.000), loneliness ( R 2 Δ = 0.008, p = 0.000), life satisfaction ( R 2 Δ = 0.008, p = 0.000), and COVID-related impacts ( R 2 Δ = 0.006, p = 0.002), but not in the models predicting: presence of life meaning ( R 2 Δ = 0.002, p = 0.137) and stress ( R 2 Δ = 0.002, p = 0.147).

Comparing pet and non-pet owners at different levels of the sociodemographic variables

The next series of ANOVAs, presented in Tables 2 , 3 , 4 , 5 , 6 , 7 and 8 , explored the possible differences between pet and non-pet owners at the different levels of the sociodemographic variables. For these analyses, we focused specifically on the comparison of pet and non-pet owners, allowing us to use the poststratification weight variable. The analyses revealed a number of moderators of the main effects presented above.

As seen in Table 2 , gender had significant main effects on vitality, stress, and COVID-related impacts: women reported lower vitality but higher stress and COVID-related impacts compared to men. These results align with those of prior epidemiological studies conducted among the Canadian population 46 , 47 . Five significant interactions also emerged. In terms of vitality, whereas male pet owners and male non-pet owners did not differ in their levels of vitality ( F (1, 2413) = 0.17, p = 0.684, η 2 p = 0.000), female pet owners reported lower vitality compared to female non-pet owners ( F (1, 2413) = 12.14), p < 0.001, η 2 p = 0.005). The same pattern was observable on the loneliness measure, with male pet owners and male non-pet owners showing no difference in loneliness ( F (1, 2410) = 0.05, p = 0.827, η 2 p = 0.000), whereas female pet owners reported higher loneliness compared to female non-pet owners ( F (1, 2410) = 15.25, p < 0.001, η 2 p = 0.006). On the life satisfaction measure, male pet owners and male non-pet owners showed no difference ( F (1, 2410) = 1.81, p = 0.179, η 2 p = 0.001), whereas female pet owners reported lower life satisfaction compared to female non-pet owners ( F (1, 2410) = 31.44, p < 0.001, η 2 p = 0.013). For the presence of life meaning, again male pet owners and male non-pet owners showed no difference ( F (1, 2411) = 0.58, p = 0.445, η 2 p = 0.000), whereas female pet owners reported lower presence of life meaning compared to female non-pet owners ( F (1, 2411) = 15.09, p < 0.001, η 2 p = 0.006). Finally, female pet owners reported experiencing higher COVID-related impacts than female non-pet owners ( F (1, 2413) = 13.60, p < 0.001, η 2 p = 0.006), whereas males did not differ, whether they were pet owners or non-pet owners, in terms of COVID-related impacts ( F (1, 2413) = 0.17, p = 0.678, η 2 p = 0.000). We return to a conceptual discussion of these results, which may be due to the increased strain associated with pet ownership experienced by certain strata of the Canadian population during the COVID-19 pandemic, in the Discussion section below.

Main effects of age emerged on all of the dependent variables (see Table 3 ), globally showing higher well-being among seniors (65 +), followed by adults (25–64), and then by young adults (18–24), in the paired comparisons (all p s ≤ 0.029). This pattern emerged on: vitality ( M s = 4.53, 4.25, 3.99; SD s = 1.39, 1.27, 1.29, respectively); loneliness ( M s = 2.12, 2.28, 2.42; SD s = 0.59, 0.52, 0.42, respectively); life satisfaction ( M s = 4.70 4.40, 4.20; SD s = 1.59, 1.38, 1.32, respectively); presence of life meaning ( M s = 5.06, 4.59, 4.28; SD s = 1.41, 1.26, 1.31, respectively); stress ( M s = 2.49, 2.81, 3.05; SD s = 0.66, 0.56, 0.47, respectively); and COVID-related impacts ( M s = 3.18, 3.56, 3.90; SD s = 1.25, 1.27, 1.24, respectively). These age differences align with prior research 48 . One interaction emerged on the COVID-related impacts variable, revealing that adult pet owners reported higher COVID-related impacts compared to adult non-pet owners ( F (1, 2417) = 10.35, p = 0.001, η 2 p = 0.004). Similarly, senior pet owners reported higher COVID-related impacts compared to senior non-pet owners ( F (1, 2417) = 7.16, p = 0.008, η 2 p = 0.003), although this difference was attenuated in this age group. In contrast, among young adults, pet owners were found to report lower COVID-related impacts compared to non-pet owners ( F (1, 2417) = 6.13, p = 0.013, η 2 p = 0.003), suggesting that owning a pet may buffer against the stress generated by the COVID context for younger people.

Area lived in

Area lived in was associated with five of the dependent variables (see Table 4 ), globally showing in the paired comparisons (all relevant p s ≤ 0.043), that people living in the countryside and in the suburbs reported higher well-being compared to people living in the city. This pattern emerged on loneliness ( M s = 2.23, 2.23, 2.29; SD s = 0.60, 0.54, 0.51, respectively); life satisfaction ( M s = 4.70 4.56, 4.28; SD s = 1.48, 1.45, 1.37, respectively); presence of life meaning ( M s = 4.78, 4.71, 4.58; SD s = 1.38, 1.33, 1.28, respectively); and stress ( M s = 2.68, 2.72 2.83; SD s = 0.70, 0.61, 0.55, respectively). These main effects observed for area align with findings showing that being surrounded by nature, which is generally more accessible when living in the countryside and the suburbs, is associated with higher well-being 49 . For the COVID-related impacts variable, people in the city reported experiencing higher levels of stress ( M = 3.64; SD = 1.30), followed by people living in the suburbs ( M = 3.48; SD = 1.23), and by people living in the countryside ( M = 3.21; SD = 1.29). Only one significant interaction emerged, on presence of life meaning, showing that non-pet owners living in the city and in the countryside reported higher presence of life meaning compared to pet owners living in the city ( F (1, 2415) = 6.17, p = 0.013, η 2 p = 0.003) and in the countryside ( F (1, 2415) = 16.32, p < 0.001, η 2 p = 0.007).

Dwelling type

As seen in Table 5 , dwelling type also had significant main effects on all dependent measures: Participants living in a house reported higher vitality ( M = 4.33; SD = 1.31), life satisfaction ( M = 4.58; SD = 1.40), and presence of life meaning ( M = 4.73; SD = 1.32), but lower loneliness ( M = 2.23; SD = 0.54), stress ( M = 2.74; SD = 0.62), and COVID-related impacts ( M = 3.45; SD = 1.29) compared to people living in an apartment or condo ( M s = 4.13, 4.06, 4.44, 2.34, 4.52, 2.83, 3.49, 3.71; SD s = 1.28, 1.40, 1.28, 0.50, 1.26, 0.54, 1.12, 1.24, respectively). These dwelling type main effects align with prior research 50 . Only one significant interaction emerged on vitality, showing that pet owners living in an apartment or condo reported lower vitality compared to non-pet owners living in an apartment or condo ( F (1, 2419) = 16.94, p < 0.001, η 2 p = 0.007); participants who live in a house did not differ whether they are pet owners or non-pet owners in their levels of vitality ( F (1, 2419) = 0.06, p = 0.804, η 2 p = 0.000). This suggests a generally modest role for dwelling type in moderating the experience of pet ownership.

Gross yearly family income

Main effects of income emerged on all dependent variables (see Table 6 ), globally showing, in the paired comparisons, higher well-being as the income category increased, with the most consistent significant increase observed between the 0-99 K and the 100 K-199 K categories (all relevant p s < 0.001 in the paired comparisons). This pattern emerged on: vitality ( M s = 4.22, 4.47, 4.56; SD s = 1.36, 1.11, 1.58, respectively for 0-99 K, 100 K-199 K, and 200 K + , with a significant difference between the 0-99 K and the 100 K-199 K categories: p < 0.001); loneliness ( M s = 2.32, 2.15, 2.03; SD s = 0.54, 0.44, 0.69, respectively, with significant differences between the 0-99 K and the 100 K-199 K categories: p < 0.001, and the 100 K-199 K and 200 K + categories: p = 0.013); life satisfaction ( M s = 4.28 4.79, 5.15; SD s = 1.45, 1.20, 1.57, respectively, with significant differences between the 0-99 K and the 100 K-199 K categories: p < 0.001, and the 100 K-199 K and 200 K + categories: p = 0.003); presence of life meaning ( M s = 4.57, 4.86, 5.04; SD s = 1.35, 1.10, 1.69, respectively, with a significant difference between the 0-99 K and the 100 K-199 K categories: p < 0.001); stress ( M s = 2.81, 2.66, 2.66; SD s = 0.61, 0.53, 0.75, respectively, with a significant difference between the 0-99 K and the 100 K-199 K categories: p < 0.001); and COVID-related impacts ( M s = 3.60, 3.31, 3.52; SD s = 1.36, 1.06, 1.33, respectively, with a significant difference between the 0-99 K and the 100 K-199 K categories: p < 0.001). These income effects align with prior research showing a positive association between SES (including income) and well-being 51 , 52 . Two interactions reached significance. In terms of loneliness, pet owners in the 100-199 K income category reported higher loneliness than non-pet owners in this income category ( F (1, 2203) = 13.83, p < 0.001, η 2 p = 0.006); pet and non-pet owners did not differ in their levels of loneliness in the two other income categories (0-99 K: F (1, 2203) = 0.80, p = 0.372, η 2 p = 0.000; 200 K + : F (1, 2203) = 0.06, p = 0.802, η 2 p = 0.000. The interaction observed on the COVID-related impacts variable revealed that pet owners in the 0-99 K income category reported experiencing higher COVID-related impacts compared to non-pet owners in this income category ( F (1, 2207) = 20.51, p < 0.001, η 2 p = 0.009); pet and non-pet owners did not differ in their levels of experiencing COVID-related impacts in the other two income categories (100 K-199 K: F (1, 2207) = 1.80, p = 0.180, η 2 p = 0.001; 200 K + : F (1, 2207) = 3.44, p = 0.064, η 2 p = 0.002). This last finding also points to a possible strain effect associated with pet ownership and experienced more by certain segments of the Canadian population during the COVID-19 pandemic; it will be further discussed in the Discussion section below.

Employment status

Main effects for employment type emerged on all dependent variables (see Table 7 ), globally showing, in the paired comparisons, that being unemployed is associated with lower well-being compared to the 3 other employment status categories (all p s < 0.001 for these specific comparisons). These employment status main effects align with (yet could also be confounded with) the income main effects reported above. Two significant interactions also emerged. The significant interaction observed on life satisfaction shows that pet owners who are unemployed reported lower life satisfaction compared to non-pet owners who are unemployed ( F (1, 2412) = 10.65, p = 0.001, η 2 p = 0.004). Furthermore, pet owners who have other employment statuses (i.e., who are students, homemakers, retired) reported lower life satisfaction compared to non-pet owners who have these other employment statuses ( F (1, 2412) = 10.06, p = 0.002, η 2 p = 0.004). Pet and non-pet owners who work full time or part time did not differ in terms of their life satisfaction ( F (1, 2412) = 0.14, p = 0.711, η 2 p = 0.000; F (1, 2412) = 0.92, p = 0.338, η 2 p = 0.000, respectively). The significant interaction observed on presence of life meaning also reveals that pet owners who are unemployed reported lower meaning in life compared to non-pet owners who are unemployed ( F (1, 2413) = 9.41, p = 0.002, η 2 p = 0.004). As well, pet owners who have other employment statuses reported lower presence of life meaning compared to non-pet owners who have these other employment statuses ( F (1, 2413) = 14.34, p < 0.001, η 2 p = 0.006). Pet and non-pet owners who work full time or part time did not differ in terms of presence of life meaning ( F (1, 2413) = 0.01, p = 0.943, η 2 p = 0.000; F (1, 2413) = 2.28, p = 0.131, η 2 p = 0.001, respectively). These findings also point to a possible strain effect, and suggest that pet ownership could represent more of a burden among certain strata of the Canadian population (i.e., people who are unemployed and those in more instable situations). We come back to a discussion of these findings in the Discussion section.

Number of children living at home

Main effects of number of children living at home emerged on all of the dependent variables (see Table 8 ). Globally, the trend whereby having at least one child living at home is associated with higher well-being was observed specifically on the life satisfaction and presence of life meaning measures (all p s < 0.001 for these specific comparisons). Two significant interactions also emerged. The significant interaction observed on loneliness shows that pet owners who have 3 or more children living with them at home reported higher loneliness compared to non-pet owners who have 3 or more children living with them at home ( F (1, 2412) = 17.41, p < 0.001, η 2 p = 0.007); pet and non-pet owners who have either no children ( F (1, 2412) = 2.15, p = 0.143, η 2 p = 0.001), those who have 1 child living with them at home ( F (1, 2412) = 3.46, p = 0.063, η 2 p = 0.001), and those who have 2 children living with them at home ( F (1, 2412) = 0.00, p = 0.987, η 2 p = 0.000) did not differ in their levels of loneliness. Similarly, the significant interaction observed on stress reveals that pet owners who have 3 or more children living with them at home, as well as those with 2 children living at home reported higher stress compared to non-pet owners who have 3 or more children living with them at home ( F (1, 2410) = 6.02, p = 0.014, η 2 p = 0.002) and those who have 2 children living with them at home ( F (1, 2410) = 4.88, p = 0.027, η 2 p = 0.002). Pet and non-pet owners who have no children ( F (1, 2410) = 0.00, p = 0.947, η 2 p = 0.000), and those who have 1 child living with them at home ( F (1, 2410) = 1.10, p = 0.294, η 2 p = 0.000), did not differ in their levels of stress. The interaction effects uncovered here also align with a possible strain explanation, such that people who have 2 or more children at home may become burdened by the presence of a pet in the COVID context.

Whereas the popular media typically presents pets as beneficial to human health and mental health 6 , 7 , and as helping humans combat loneliness and stress during the COVID-19 pandemic 53 , 54 , previous research findings about the role played by pets in human health and well-being remain mixed 13 , 32 . To this aim, the current study explored for whom pet ownership can be more or less beneficial during a time of high stress. All statistical analyses included a poststratification weight to ensure the representativeness of the current sample relative to the general Canadian population, to account for potentially confounding sociodemographic factors, and to maximize the comparability of the pet and non-pet owner subgroups; applying the poststratification weight to the current data ensured that comparisons of pet vs. non-pet owners were not confounded by sociodemographic differences. A range of psychological well-being measures were taken: while some had been included in prior studies comparing pet and non-pet owners (e.g., stress, loneliness), additional measures capture more positive facets of well-being (e.g., vitality).

When comparing pet and non-pet owners in terms of their psychological well-being, we found that pet owners reported lower psychological well-being on four of the well-being measures (i.e., lower vitality, life satisfaction, presence of life meaning, but higher loneliness). Furthermore, pet owners reported experiencing more COVID-related impacts compared to non-pet owners. These findings suggest pet ownership during a stressful event like COVID may bring added stress to an already challenging context. Importantly, when accounting for the species of the pets participants owned (i.e., dog(s), cat(s), other pet species) and the number of pets, the majority of the effects uncovered for general pet ownership remained significant, and the same overall pattern of findings was observed. However, and in line with some prior research (e.g., 55 ), including recent research conducted during the COVID-19 pandemic 56 , dog ownership, compared to the ownership of other species of pets (i.e., including, but not restricted to, cats), was associated with higher well-being (i.e., higher vitality and life satisfaction; lower loneliness and COVID-related impacts) in this context (see also 57 , and 58 on the negative effects of pet ownership being driven by cat ownership compared to dog ownership). These effects could be due to dogs’ particularly clear capacity to elicit physical outdoor activity and social interactions with fellow humans 59 , 60 , within the limits imposed during the pandemic.

To explore for whom pet ownership may impact on well-being the most, we examined differences between pet and non-pet owners drawing on sociodemographic data. Our findings were generally consistent with the notion that pet ownership may represent an added burden when personal or financial resources are already thin. First, pet ownership was associated with lower well-being (i.e., lower vitality, life satisfaction, presence of life meaning, higher loneliness) among women but not among men. This corresponds to research showing that women were impacted to a greater extent by the pandemic with increased childcare and housework responsibilities 61 . Second, pet ownership was associated with lower well-being (i.e., higher loneliness and stress) among people who have 2 children, and those who have 3 and more children, currently living at home with them. Again, this is consistent with research showing increased mental distress among parents with children during the pandemic 41 , 62 . Third, pet owners reported lower psychological well-being (i.e., lower life satisfaction, presence of life meaning) if they were unemployed or had more unstable forms of employment (e.g., students, homemakers). For these participants, the experience of pet ownership may represent an additional financial burden or responsibility.

The experience of negative COVID-related impacts provides a converging picture, with pet owners (vs. a non-pet owner) reporting higher COVID-related impacts if they were women, unemployed, and those with lower incomes. Beneficial effects of pet ownership in attenuating the experience of COVID-related impacts was found only among young adults (18–24 years-old), suggesting that those who benefited from pet ownership during the pandemic had fewer family-related responsibilities (e.g., child rearing).

Taken together, these findings suggest that occupying typically caring roles during the pandemic (e.g., having at least 2 children living at home; spending time and energy caring for children) and experiencing situations of disadvantage (i.e., being unemployed) provided a source of strain on available resources; by adding to these existing levels of strain, pet ownership was associated with reduced well-being. Emerging findings observed during the COVID-19 pandemic have also uncovered null and negative associations between the presence of pets and human wellness. For example, in a longitudinal study conducted among adolescents, Mueller, Richer, Callina, and Charmaraman 63 found that pet ownership predicted higher levels of loneliness during COVID-19 as well as higher increases in loneliness from before to during the pandemic. Phillipou and colleagues 64 found that pet ownership was significantly associated with poorer quality of life during the COVID-19 pandemic, but was not significantly associated with resilience or loneliness. In a large cross-sectional study, Ratschen and colleagues 45 found that while pet ownership was associated with smaller decreases in mental health since lockdown, a majority of pet owners (67.6%) reported having been worried about their pet because of the pandemic (e.g., restricted access to veterinary care, restrictions to exercise/walks), suggesting this added responsibility in times of COVID can create an additional strain (see also 65 ). The current findings build on this prior work by bringing additional nuance to our understanding of the role of pets during the pandemic – providing insights across a range of well-being measures and showing differential effects across segments of the population. Our findings, together with this prior research, suggest that our intuition that pets are good for well-being at times of high stress may be largely inaccurate.

The current findings have implications for decisions to adopt a pet during times of high strain like the COVID-19 pandemic, revealing that such decisions should take into account existing strain on personal and financial resources. While the effect sizes for our statistically significant effects (which ranged from η 2 p = 0.002 to 0.005 in the analyses of variance) are considered of small magnitude 66 and account for, at the most, approximately 0.05% of the variance in the prediction of the well-being measures, they do point to what appears to be a robust and generalizable trend. Our findings also call for a deeper reflection about pet ownership in the context of social inequalities and disadvantage 67 , 68 ; our results indicate that in order to reap the benefits of pet ownership, people need sufficient personal and financial resources, and a lack of these resources may turn pet ownership into a burden for well-being at times of acute stress.

Given the methodological and statistical procedures employed, our findings can be generalized to the Canadian population and build on existing studies by surveying participants from diverse sociodemographic backgrounds (e.g., in terms of SES, gender; see 37 , 38 ). The comparison of pet and non-pet owners was also robust due to our approach of statistically adjusting each of the two subgroups (i.e., pet and non-pet owners) to the overall Canadian population, therefore increasing the robustness of this specific comparison. Nevertheless, and given the cross-sectional nature of the current study, future research could employ longitudinal and/or experimental designs (using ethically sound procedures) to further test the direction of causality between pet ownership and human wellness. While the current study was not specifically designed (i.e., based on the quotas and poststratification weight variable employed) to examine the effects of the species of participants’ pets, future research should be designed to systematically and robustly test the impact of owning different species of pets on human wellness. Furthermore, future work should directly measure the quality of people’s relationships with their pets when assessing the benefits (or lack thereof) of pet ownership.

In sum, this research provided a systematic and nuanced account for the role played by pets in human well-being during the current COVID-19 pandemic. In light of the current depictions of pets as being beneficial to human wellness during this historic period, the present findings provide a counterpoint to these commonly shared assumptions. We hope that the rigorous methodological and statistical approaches employed herein, combined with a data-driven approach, will continue raising research interest in a widespread social phenomenon: the experience of pet ownership.

Recruitment

Results were based on a nationally representative survey (based on age, gender, region, and language) of 2424 Canadian adults (18 and older), conducted by the survey firm Léger from September 24 to October 7, 2020. Based on Canada’s total population (38 million), this sample size involves a margin of error of 2% and a 95% confidence level. Quotas were also imposed to recruit an equal number of pet and non-pet owners; the sample finally included 1220 pet owners and 1204 non-pet owners. Participants were invited to participate in the study via an email sent by Léger. All invitations were bilingual and participants could complete the questionnaire in either French or English, which are the two official languages in Canada. Respondents were drawn from Léger’s LEO internet panel, a widely used national probability-based online panel that includes over 420,000 households across Canada; it is the largest Canadian-owned panel. Within this panel, 61% of participants have been recruited randomly over the phone, 65% of the profiles have been updated in the last six months, and 50% of the profiles are based on the 2016 Statistics Canada census. Léger panels have been used in other peer-reviewed academic research 69 , 70 , 71 , 72 .

Léger administered the Qualtrics-based online questionnaire. The following measures were taken to maximize participation and the representativity of the final sample: the survey was open for two weeks, so as to leave sufficient time for participants to open the invitation email and complete the questionnaire; the email invites were sent in waves over this 2-week data collection period; participants could stop and continue the questionnaire at a later point in time, without loosing their responses; the questionnaire was accessible 24/7, via computer or mobile devises, so as to maximise participation among all age groups; in case of technical problems, participants could directly reach Léger’s technical support team by email or phone; email reminders were sent to nonresponders.

A total of 20,320 email invitations were sent to panel members, of which 3770 opened the invitation email. Among those, 96 refused to take part in the study, and 192 participants were considered non eligible (i.e., 72 did not consent to taking part in the study, 4 were non-eligible on the basis of their age, 3 lived outside of Canada, 113 failed one of the two attention check questions), and 670 had incomplete data (i.e., they did not reach the end of the questionnaire). This resulted in 2424 qualified completes used for analysis. When considering the total number of email invitations sent to potential participants, the participation rate is 12%; when not considering the individuals who have not opened the invitation email in this calculation, the participation rate is 64%. Median response time among qualified completes was 32 min. Participants were paid the equivalent of CAN$3 directly by Léger for participating in this study. Participants’ compensation takes the form of points that can be redeemed from different merchants (e.g., Starbucks, Tim Hortons) and entry into a draw (full details available via: www.legeropinion.com/fr/recompenses/ ). Informed consent is obtained from all the participants. The study was approved by the Ethics Committee involving Human Participants of the University of Québec in Montréal and was conducted in line with the Canadian Tri-Council Policy for the Ethical Conduct of Research Involving Humans.

Poststratification weights

Poststratification statistical weights were prepared by Léger and provided to the research team, and then used in the main statistical analyses to account for differences between our sample and Canadian Census benchmarks. Based on the most recent data from Statistics Canada, the following benchmark distributions of Canadians who are 18 years and older from the general population were used to compute the poststratification weights: gender, age, Province of residence, native language, education, type of dwelling, marital status, area lived in (rural or urban), ethnicity, gross annual household income, employment status, presence of children in the household.

These sociodemographic variables were chosen on the basis of their utility for adjusting the current sample to the general Canadian population, and of recommendations for conducting research comparing pet and non-pet owners 19 , 32 . The poststratification weight variable used in the main analyses reported in the current study adjusts both the pet and non-pet owners subgroups to the general Canadian population on these sociodemographic variables. Doing so ensures that the poststratification weight variable is based on known data (Canadian Census), that both subgroups are each adjusted idiosyncratically to the Canadian population, and maximises these subgroups’ comparability.

Questionnaire and measuring instruments

The measuring instruments were translated from English to French using a back-to-back translation procedure. When conducting this translation, the research assistants were instructed by the lead researcher to give priority to loyalty of meaning and familiarity of the content instead of strict loyalty to the original language (i.e., a decentering approach 73 ). The individual measures included in the current study were taken from a larger representative survey pertaining to relationships with pets, close others, and well-being.

Sociodemographic and pet ownership information

The sociodemographic data included the following categories: gender (male, female, other), age (18–21, 22–24, 25–29, 30–34, 35–39, 40–44, 45–49, 50–54, 55–59, 60–64, 65–69, 70–74, > 75 years), education level (Primary school diploma, High school diploma, Diploma of Collegial studies (CEGEP), Professional studies diploma, Bachelor's degree, Master's degree, Doctoral degree, Other), dwelling type (apartment/condo, house, other), area lived in (city, suburb, countryside), annual household gross income (less than $20,000, $40,000–$59,999, $60,000–$79,999, $80,000–$99,999, $100,000–$119,999, $120,000–$139,999, $140,000–$159,999, $160,000–$179,999, $180,000–$199,999, over $200,000), employment (full-time, part-time, temporary, self-employed, unemployed, student, homemaker, retired), ethnicity (Caucasian or White, Native Canadian or Inuit, Metis, Black or African Canadian, East Asian or South-East Asian, South Asian, Middle Eastern or North African or Central Asian, Hispanic or Latino, other), marital status (common-law union, married, separated, divorced, single, widowed, single parent, other), number of children currently living at home. Participants were asked if they have lost their job during COVID (yes, no). To measure pet ownership, participants were asked: “Do you have one or more pet(s) currently?” (yes, no). To assess the number of pets currently owned, pet owners were asked: ‘‘How many pets do you currently have?’’ (non-pet owners were attributed a score of zero on this variable). To measure the species of their pet(s), pet owners were asked: “Please specify the species of this/these pet(s) you currently have” (bird, cat, dog, fish, reptile, rodent, other, please specify), for up to five pets.

COVID-related impacts

This measure is composed of three items: ‘To what extent are you experiencing stress as a result of the current COVID-19 epidemic?’; ‘To what extent are you experiencing uncertainty as a result of the current COVID-19 epidemic?’; ‘To what extent are you experiencing family-related issues as a result of the current COVID-19 epidemic?’ (see 74 ). Participants provided their responses on a 1 ( no stress/uncertainty/family-related issues at all ) to 7 scale ( extreme stress/extreme uncertainty/a very large number of family-related issues ). This measure showed adequate reliability, as indicated by its satisfactory Cronbach's alpha (α) = 0.82. For this measure and each of the psychological well-being measures presented below, composite scores were created by calculating the mean of the measure’s items.

Psychological well-being measures

A broad range of well-being measures were included, in line with a holistic conception of human health and wellness 75 . These measures had been selected on the basis of their validity and established psychometric properties. In addition to providing the standard instructions for completing each scale, each measure asked participants to respond by referring specifically to how they feel during the COVID-19 pandemic.

Vitality was evaluated with seven items 76 . This scale measures the energizing aspect of psychological well-being (e.g., ‘I feel alive and vital’; α = 0.92). Responses were made on a 1 ( does not correspond at all ) to 7 ( corresponds exactly ) scale. Loneliness was assessed using the UCLA Loneliness Scale (Version 3) 77 . This 20-item scale is designed to measure one’s subjective feelings of loneliness as well as feelings of social isolation (e.g., ‘How often do you feel that you are “in tune” with the people around you?’; α = 0.93). Participants rated each item on a scale from 1 ( never ) to 4 ( always ). Life satisfaction was measured with the 5-item Satisfaction With Life Scale 78 (e.g., ‘In most ways my life is close to my ideal’; α = 0.91). Participants indicated their agreement with each item using a 1 ( strongly disagree ) to 7 ( Strongly agree ) scale. To assess presence of life meaning ( α = 0.90) 79 , participants were asked to think about what makes their life feel important to them and respond to 5 items as truthfully and accurately as they could on a scale from 1 ( absolutely untrue ) to 7 ( absolutely true ); higher scores are indicative of higher psychological well-being 80 (e.g., ‘My life has a clear sense of purpose’). The 14-item Perceived Stress Scale 81 assesses the degree to which people perceive their lives as stressful (e.g., ‘How often have you been upset because of something that happened unexpectedly?’; α = 0.87). Participants rated each item on a scale from 1 ( never ) to 5 ( very often ).

Statistical analyses

Statistical analyses were performed using SPSS (IBM SPSS Statistics for Windows, Version 27.0. Armonk, NY: IBM Corp.). Table 1 presents the results of the analyses of variance (ANOVAs) conducted to compare pet and non-pet owners on the psychological well-being measures; the data used for these analyses are weighted. The hierarchical regression analyses reported in the text also included weighted data. Tables 2 , 3 , 4 , 5 , 6 , 7 and 8 present the results of the ANOVAs conducted to compare pet and non-pet owners’ well-being at the different levels of the sociodemographic variables; the data used for these analyses are also weighted.

Data availability

The data and codes that support the findings presented in this manuscript can be accessed, for verification purposes only, via the following link: https://osf.io/56sbh/?view_only=bbca7561fdff46618666454a0d66c892 .

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Acknowledgements

This research was funded by a grant from the Social Sciences and Humanities Research Council of Canada (SSHRC) and a Senior Fellowship from the Fund for Research on Health – Québec (FRQS) to Catherine E. Amiot. We thank Hugues Leduc for his statistical advice as well as the Léger research firm for managing the online questionnaire and the data collection, conducting the data cleaning and the preliminary analyses, and creating the poststratification weights variables.

This article was funded by Social Sciences and Humanities Research Council of Canada (Grant no. 430-2018-00961), Fonds de Recherche du Québec-Santé (Grant no. 268393).

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C.E.A. and B.B. contributed to design of the study, and elaboration of the research questions and hypotheses. C.E.A. and C.G. conducted the statistical analyses. C.E.A and B.B. wrote the first draft of the manuscript. All authors (C.E.A., B.B., and C.G.) contributed to interpretation of the findings and to writing the manuscript; all authors (C.E.A., B.B., and C.G.) read and approved the submitted version.

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February 2018

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The Power of Pets

Health Benefits of Human-Animal Interactions

Illustration of people with different types of pets

Nothing compares to the joy of coming home to a loyal companion. The unconditional love of a pet can do more than keep you company. Pets may also decrease stress, improve heart health, and even help children with their emotional and social skills.

An estimated 68% of U.S. households have a pet. But who benefits from an animal? And which type of pet brings health benefits?

Over the past 10 years, NIH has partnered with the Mars Corporation’s WALTHAM Centre for Pet Nutrition to answer questions like these by funding research studies.

Scientists are looking at what the potential physical and mental health benefits are for different animals—from fish to guinea pigs to dogs and cats.

Possible Health Effects

Research on human-animal interactions is still relatively new. Some studies have shown positive health effects, but the results have been mixed.

Interacting with animals has been shown to decrease levels of cortisol (a stress-related hormone) and lower blood pressure. Other studies have found that animals can reduce loneliness, increase feelings of social support, and boost your mood.

The NIH/Mars Partnership is funding a range of studies focused on the relationships we have with animals. For example, researchers are looking into how animals might influence child development. They’re studying animal interactions with kids who have autism , attention deficit hyperactivity disorder (ADHD) , and other conditions.

“There’s not one answer about how a pet can help somebody with a specific condition,” explains Dr. Layla Esposito, who oversees NIH’s Human-Animal Interaction Research Program. “Is your goal to increase physical activity? Then you might benefit from owning a dog. You have to walk a dog several times a day and you’re going to increase physical activity. If your goal is reducing stress, sometimes watching fish swim can result in a feeling of calmness. So there’s no one type fits all.”

NIH is funding large-scale surveys to find out the range of pets people live with and how their relationships with their pets relate to health.

“We’re trying to tap into the subjective quality of the relationship with the animal—that part of the bond that people feel with animals—and how that translates into some of the health benefits,” explains Dr. James Griffin, a child development expert at NIH.

Animals Helping People

Animals can serve as a source of comfort and support. Therapy dogs are especially good at this. They’re sometimes brought into hospitals or nursing homes to help reduce patients’ stress and anxiety.

“Dogs are very present. If someone is struggling with something, they know how to sit there and be loving,” says Dr. Ann Berger, a physician and researcher at the NIH Clinical Center in Bethesda, Maryland. “Their attention is focused on the person all the time.”

Berger works with people who have cancer and terminal illnesses. She teaches them about mindfulness to help decrease stress and manage pain.

“The foundations of mindfulness include attention, intention, compassion, and awareness,” Berger says. “All of those things are things that animals bring to the table. People kind of have to learn it. Animals do this innately.”

Researchers are studying the safety of bringing animals into hospital settings because animals may expose people to more germs. A current study is looking at the safety of bringing dogs to visit children with cancer, Esposito says. Scientists will be testing the children’s hands to see if there are dangerous levels of germs transferred from the dog after the visit.

Dogs may also aid in the classroom. One study found that dogs can help children with ADHD focus their attention. Researchers enrolled two groups of children diagnosed with ADHD into 12-week group therapy sessions. The first group of kids read to a therapy dog once a week for 30 minutes. The second group read to puppets that looked like dogs.

Kids who read to the real animals showed better social skills and more sharing, cooperation, and volunteering. They also had fewer behavioral problems.

Another study found that children with autism spectrum disorder were calmer while playing with guinea pigs in the classroom. When the children spent 10 minutes in a supervised group playtime with guinea pigs, their anxiety levels dropped. The children also had better social interactions and were more engaged with their peers. The researchers suggest that the animals offered unconditional acceptance, making them a calm comfort to the children.

“Animals can become a way of building a bridge for those social interactions,” Griffin says. He adds that researchers are trying to better understand these effects and who they might help.

Animals may help you in other unexpected ways. A recent study showed that caring for fish helped teens with diabetes better manage their disease. Researchers had a group of teens with type 1 diabetes care for a pet fish twice a day by feeding and checking water levels. The caretaking routine also included changing the tank water each week. This was paired with the children reviewing their blood glucose (blood sugar) logs with parents.

Researchers tracked how consistently these teens checked their blood glucose. Compared with teens who weren’t given a fish to care for, fish-keeping teens were more disciplined about checking their own blood glucose levels, which is essential for maintaining their health.

While pets may bring a wide range of health benefits, an animal may not work for everyone. Recent studies suggest that early exposure to pets may help protect young children from developing allergies and asthma. But for people who are allergic to certain animals, having pets in the home can do more harm than good.

Helping Each Other

Pets also bring new responsibilities. Knowing how to care for and feed an animal is part of owning a pet. NIH/Mars funds studies looking into the effects of human-animal interactions for both the pet and the person.

Remember that animals can feel stressed and fatigued, too. It’s important for kids to be able to recognize signs of stress in their pet and know when not to approach. Animal bites can cause serious harm.

“Dog bite prevention is certainly an issue parents need to consider, especially for young children who don’t always know the boundaries of what’s appropriate to do with a dog,” Esposito explains.

Researchers will continue to explore the many health effects of having a pet. “We’re trying to find out what’s working, what’s not working, and what’s safe—for both the humans and the animals,” Esposito says.

ORIGINAL RESEARCH article

Dogs and the good life: a cross-sectional study of the association between the dog–owner relationship and owner mental wellbeing.

1 School of Veterinary Science, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Neston, United Kingdom
2 Department of Livestock and One Health, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Neston, United Kingdom
3 Department of Comparative Pathobiology, College of Veterinary Medicine, Purdue University, West Lafayette, IN, United States

Dog ownership is believed to benefit owner wellbeing but, contrary to popular belief, there is limited evidence to suggest that simply owning a dog is associated with improved mental health. This mixed-methods study investigates whether dog owners with stronger relationships with their dogs experience better mental health. Participants ( n = 1,693, adult United Kingdom dog owners) completed an online survey. Owners’ health was measured using the validated PROMIS questions regarding depression, anxiety, emotional support, and companionship. The dog–owner relationship was measured using the validated MDORS scale, which has three subscales: interaction, emotional closeness, and perceived costs. Univariable and multivariable linear regression analyses were conducted, adjusting for confounding factors. Additionally, positive and negative impacts of dog ownership on mental wellbeing were coded from open questions using thematic analysis. A stronger dog–owner relationship was associated with greater feelings of emotional support and companionship but poorer mental health in terms of anxiety or depression. However, the perceived costs (burden) subscale was consistently associated with better mental health outcomes. Direction of causality cannot be inferred as people with poor mental health may acquire dogs to help relieve symptoms, which qualitative analysis supported. Key themes included positive impacts on owner wellbeing and happiness through providing purpose, companionship and self-acceptance, pleasure and distraction, as well as lessening emotional pain and suffering and reducing risk behaviors. However, negative impacts of a strong relationship include anticipatory grief over loss of the dog, and concerns regarding the burden of responsibility and ability to meet dog’s needs. Perceived ability to adequately meet dog’s needs promoted personal growth and positive relationships with others, whereas perceived inability led to feelings of guilt, or anger/frustration, and reduced autonomy and sense of environmental mastery. Dog ownership contributes to both hedonic and eudaimonic wellbeing in multiple ways, including supporting owners through periods of poor mental health and providing purpose. However, the burden of responsibility and owner and dog characteristics can create challenges, and owners may benefit from support in caring for their dogs and reducing problematic behaviors.

Introduction

Mental health is “a state of wellbeing in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community, “according to the World Health Organization ( WHO, 2018b ). At any time, 1 in 10 people worldwide are affected by a mental health disorder, bringing the absolute number to 792 million ( Ritchie and Roser, 2018 ). Mental health conditions include depression, anxiety, obsessive–compulsive disorder and schizophrenia. Globally, in 2016, depressive symptoms are in the 16th place for Disability-Adjusted Life Year(s) (DALYs), and are in the top 20 DALYs for all regions and continents other than Africa ( WHO, 2018a ). Self-harm is included in the top 20 DALYs for all regions other than Africa and Eastern Mediterranean. Moreover, anxiety disorders are included in the top 20 DALYs list for the American continent ( WHO, 2018a ). In England, 1 in 4 adults encounters a mental health condition in any given year ( Nice, 2019 ). From a financial point of view, the consequences of poor mental health were responsible for the decrease of the United Kingdom GDP by £25 billion in 2015 ( Oxford Economics, 2016 ).

Many studies have suggested a positive association between interacting with an animal and psychological wellbeing ( Barker and Wolen, 2008 ; Gilbey and Tani, 2015 ; Rodriguez et al., 2021 ). Studies of the impact of actual pet ownership, in contrast to interacting with a trained therapy or assistance animal, are less clear. Contrary to popular belief, most studies conducted comparing dog owners and non-dog owners found no association between dog ownership and improved mental wellbeing, as a result of inconsistent methodology, complexity of the human–animal interaction (HAI) relationship ( Rodriguez et al., 2021 ), and demographical heterogeneity of pet owners ( Fraser et al., 2020 ). In some cases, pet owners have reported more depressive symptoms than non-pet owners ( Parslow et al., 2005 ; Enmarker et al., 2015 ; Fraser et al., 2020 ; Sharpley et al., 2020 ), and in particular owners with less friendly and less obedient pets experience higher depressive and anxiety symptoms, respectively, ( Bradley and Bennett, 2015 ). Similarly, no evidence of change in depressive symptoms or positive/negative affect has been seen in longitudinal analyses of pet acquisition ( Powell et al., 2019 ; Sharpley et al., 2020 ). Contrarily, in a study of treatment-resistant depression, it was found that an intervention group who adopted a pet improved compared to a control ( Mota Pereira and Fonte, 2018 ), and in a study conducted on US veterans suffering from PTSD, it was reported that adopting a companion dog increased their wellbeing while decreasing their mental health symptoms ( Stern et al., 2013 ). Further, among people with PTSD, owning a pet at the time of the traumatic event was associated with higher levels of happiness ( González-Ramírez et al., 2019 ). There is also some evidence that dog owners may be less lonely ( Gilbey and Tani, 2015 ; Powell et al., 2019 ) and less likely to report a long-standing mental health illness ( Liu et al., 2019 ).

Studies of how the quality of the pet-owner relationship may moderate impacts on the owner’s wellbeing are even less clear. Some research suggests that a stronger attachment to a pet is associated with poorer mental health of the owner ( Peacock et al., 2012 ). On the other hand, in pet owners with long-term mental health conditions, pets are considered to support their owner through encouraging social contact ( Zimolag and Krupa, 2009 ), and distraction from the owner’s problems, thus pets are considered a main source of support ( Brooks et al., 2016 ). Consequently, even though pets do not cure mental health conditions, they may help prevent or reduce symptoms ( Hawkins et al., 2021 ). Most activities with a dog are perceived to have a positive effect on the owner psychological wellbeing, e.g., meeting with other people while outside with the dog increases owner’s positive relations with others, even if negative impacts also exist, for example, dog’s aging/death, dog’s unwanted behaviors or a perceived failure to meet dog’s needs ( Barcelos et al., 2020 ).

Overall, findings are contradictory and complex, which may be because pet owners and non-pet owners also differ in many socio-demographic variables, which may influence the psychological profile of the individual, regardless of pet ownership ( Saunders et al., 2017 ; Wong et al., 2019 ). The impact of dog ownership may also be influenced by the activities performed with the dog, for instance variable participation in dog walking ( Westgarth et al., 2017 ), which is itself influenced by socio-demographic factors ( Westgarth et al., 2014 , 2017 ). In addition, direction of causality is difficult to infer from cross-sectional studies—for example, do dogs make people more depressed, or are depressed people more likely to seek comfort in dog ownership?

Furthermore, the study of human mental wellbeing is itself difficult to measure. What does it mean to “live well” or to have a “good life”? A key interest in psychology is answering these very questions through the lens of happiness, which can be split into two broad concepts: hedonism and eudaimonism ( Ryan and Deci, 2001 ). Hedonism is based on the presence of positive affect and the absence of negative affect. Eudaimonism is focused on living life with meaning and purpose and can be categorized further into 6 elements: (1) autonomy (self-determining and independent), (2) personal growth (feeling of continued development), (3) self-acceptance (positive attitude toward self), (4) life purpose (goals and sense of direction), (5) environmental mastery (competence in managing the environment), and (6) positive relations with others (satisfying and trusting relationships; Ryff, 1989 ). The theoretical construct of hedonic and eudaimonic happiness has been used in qualitative research to explore how activities of dog ownership may impact on owner wellbeing, claiming both types of happiness are at play ( Barcelos et al., 2020 ). However, the deductive approach used, by asking owners to view their interactions with their dogs through this explanatory framework and to suggest which activities fit into which concept, may not be an ideal method in comparison to an inductive approach where themes and theory are developed from the owner’s suggestions without supplying them with preconceived ideas ( Pope et al., 2000 ).

In summary, the association between dog ownership and owners’ mental wellbeing requires further investigation. Little emphasis has been placed on the strength of the relationship between dogs and their owners and the impact this may have on potential wellbeing effects; the strength of the pet-owner relationship is not just about the amount of time spent together, but what is done during that time and the feelings that are developed toward the animal. Therefore, the first aim of this study was to investigate the association between the strength and dimensions of the dog–owner relationship and the owner’s psychological health outcomes. The second aim of the study was to inductively explore how aspects of the dog–owner relationship impact positively and negatively on the owner’s mental wellbeing, to complement the quantitative approach and so that the meanings and experiences behind directions of causality can be better understood ( Pope and Mays, 1995 ).

Materials and Methods

Data collection.

An anonymous convenience sampling survey was conducted using Qualtrics online survey software from December 21, 2017 to February 9, 2018. Participants (United Kingdom resident dog owners aged 18 years or over) were recruited via social media advertising on Facebook and Twitter. The study was ethically approved by the University of Liverpool Veterinary Research Ethics Committee (Study VREC605) and participants provided informed consent by completing the survey after reading an information sheet.

Questionnaire

The questionnaire consisted of five blocks of questions which included both closed and open-ended questions (see Supplementary Materials —Questionnaire). The first block comprised the eligibility questions (i.e., United Kingdom citizens, aged 18 or over, who consider themselves dog owners). The second block went by the name of “Dog-related questions,” including the dog’s demographics (see Table 1 ) and reasons for acquiring the dog. Participants who owned more than one dog were asked to complete the survey for the dog to which they were emotionally closest to, given that we specifically wished to study the effects of the dog who was most likely to be impacting the mental wellbeing of the owner through their relationship.

Table 1 . The demographic characteristics of the dogs whose owners filled out the questionnaire.

The third block was named “Dog-owner relationship questions” and consisted of the Monash Dog-Owner Relationship Scale (MDORS; Howell et al., 2017 ), comprising three subsections: pet-owner interaction, perceived emotional closeness, and perceived costs. The fourth block, titled “Owner health-related questions,” had five parts. First, the participants were asked questions about their general health, including self-rating of their physical health, using the Patient-Reported Outcomes Measurement Information System (PROMIS) Global Items Scale ( Ron et al., 2009 ). Second, they were asked the PROMIS item bank short forms: 8a for anxiety, 8b for depression, 4a for emotional support and 4a for companionship ( Cella et al., 2007 , 2010 ). Participants were then asked to answer 3 open-ended questions about how dog ownership improves their mental health, may make their mental health worse, and any challenges they may face in caring for their dog. Participants were also asked if they had ever been diagnosed with a mental health problem or if they had a physical disability. Finally, participants were asked about their physical activity levels using questions modified from the Dogs and Physical Activity Tool ( Cutt et al., 2008 ), including time spent walking, cycling or jogging with their dog. The fifth and final block of the survey covered “Questions about yourself,” asking for demographic information ( Table 1 ).

Quantitative Analysis

The data were analyzed using the IBM SPSS Statistics software, version 24.0. Missing responses were not included.

Dependent Variables

The MDORS questions (score 1–5 for each item) were used to create scores for the three subscales: pet-owner interaction, perceived emotional closeness and perceived costs (reverse scored); and a total score (see Supplementary Table 1 ). A higher score indicated a stronger relationship between the owner and their pet, i.e., high pet-owner interaction, high emotional closeness, or low perceived burden of owning the dog.

Four PROMIS mental profile sum scores were calculated for each individual, which measured anxiety, depression, emotional support and companionship (see Supplementary Table 2 ). Scores were calculated so that higher score in anxiety, depression, emotional support and companionship scales indicated a poorer mental health status.

Data Analysis

The outcomes were highly positively skewed and non-normal distributed. Linear regression was used to model the log10 of each psychological outcome against each dog–owner relationship subscale and relationship total score. Multivariable linear regression was performed in order to adjust for confounding variables of: age, gender, marital, work and educational statuses (Model 1); plus the minutes per week spent walking the dog (Model 2); plus the dog’s age and location in the house (Model 3); plus owner self-rated physical health status and mental health diagnosis (Model 4).

Qualitative Analysis

The data submitted in response to the open questions was used to conduct thematic analysis ( Braun and Clarke, 2006 ) using NVivo software, version 12. The responses to “describe any way you personally think owning a dog improves your mental health” was used to inform positive aspects of dog ownership; “Describe any way you personally think owning a dog makes your mental health worse” and “what are the biggest challenges you face in caring for your dog?” were used to generate themes on negative aspects of dog ownership. Line-by-line open coding was conducted by the first author (AM) in order to identify and categorize key themes; coding involved reading the participants’ answers and organizing similar responses into themes, then comparing and contrasting new responses into the same or further themes, or modifying previous themes as generated theory evolved. Coding was regularly discussed with author CW and emerging themes and their relationships to each other’s discussed also with TMG. Coding and categorization of the key themes was continued until theoretical saturation was reached and no new themes were emerging ( Saunders et al., 2018 ).

Sample Description

The survey had initially 2,437 responses: 41 were removed because they did not meet all the eligibility criteria; 701 responses were removed as mostly incomplete (especially regarding demographic information). Therefore, the total number of the final sample analyzed was 1,693 respondents (69.5%). Tables 1 and 2 summarize the socio-demographics of the sample. The typical profile of the individual that completed the questionnaire was a 25 to 45-year old female, overweight, married and living with one other person, childless, holding an undergraduate degree, employed, and living without any mental health diagnosis or any physical disability or chronic disease ( Table 1 ). The typical profile of the dog had the participant as its primary caretaker, was neutered, medium size, 1–4 years old, normal weight and allowed access to all rooms of the house ( Table 2 ).

Table 2 . The demographic characteristics of the dog owner survey participants.

Quantitative Findings

Participant responses are summarized in the Supplementary Materials : anxiety ( Supplementary Table 3 ); depression ( Supplementary Table 4 ); emotional support ( Supplementary Table 5 ); companionship ( Supplementary Table 6 ); pet-owner interaction ( Supplementary Table 7 ); emotional closeness ( Supplementary Table 8 ); perceived costs ( Supplementary Table 9 ).

Table 3 presents the results of the adjusted and unadjusted analyses for anxiety, depression, companionship and emotional support outcomes. Green and red colors indicate an association which results in better or worse mental health of the owner, respectively. Model 1 results, adjusted for age, gender, marital, work and educational level are used to present the main findings.

Table 3 . Linear regression examining whether pet-owner interaction, perceived emotional closeness, perceived costs and their sum are predictors of poorer mental health outcomes (logged).

There was evidence of an association between high emotional closeness with their dog and higher (worse) anxiety score (Model 1 B = 0.004, 95%CI = 0.003–0.006, p < 0.001), and this association remained through all models. In contrast, there was also an association between high scores in the perceived costs of dog owning, i.e., perceived lower burden involved in dog ownership, and lower anxiety (Model 1 B = –0.005, 95%CI = –0.007 to −0.003, p < 0.001) and again this association remained through all models.

A higher total relationship score in the unadjusted analysis was associated with a higher (worse) depression score ( B = 0.001, 95%CI = 0.001–0.002, p = 0.002), however after adjustment the association remained in Model 2 but not in Model 1 or any other model. Higher pet-owner interaction was associated with higher depression (Model 1 B = 0.002, 95%CI = 0.000–0.004, p = 0.038), and also remained in Model 2. Higher perceived emotional closeness was also associated with higher depression (Model 1 B = 0.006, 95%CI = 0.004–0.008, p < 0.001) and in further adjustments. However, a higher score in the perception of the costs of dog ownership, i.e., perceived lower burden involved in dog ownership, was associated with a lower (better) depression score (Model 1 B = –0.005, 95%CI = –0.006 to −0.003, p < 0.001), and remained with all adjustment.

Emotional Support

Even though there was no evidence of an association between the total relationship score and emotional support in the unadjusted analysis, for adjusted Model 1 a higher total relationship score was associated with lower (better) emotional support ( B = –0.001, 95%CI = –0.002–0.000, p = 0.020), and this continued for Models 2–4. Higher perception of costs (i.e., lower burden of dog ownership) was associated with a lower (better) score in emotional support (Model 1 B = –0.005, 95%CI = –0.007 to −0.003, p < 0.001) and remained after further adjustment.

Companionship

The total relationship score was associated with a lower (better) companionship score in Model 1 ( B = –0.001, 95%CI = –0.002 to 0.000, p = 0.001), and remained in Models 2–4. In the unadjusted analysis, a higher pet-owner interaction score was associated with a low companionship score, i.e., a healthier individual ( B = –0.002, 95%CI = –0.004 to 0.000, p = –0.035), however this disappeared after adjustment in Model 1, but returned in Models 2, 3 and 4. Finally, higher perceived costs of dog ownership score (i.e., lower burden) was associated with a lower (better) companionship score, (Model 1 B = –0.005, 95%CI = –0.007 to −0.003, p < 0.001) and also remained with further adjustment.

Summary of Quantitative Findings

In summary, based upon Model 1 adjustments for age, gender, marital status, work status and educational level, higher (greater) pet-owner interaction was associated with a higher (worse) depression score ( B = 0.002, 95%CI = 0.000 to 0.004, p = 0.038). Higher (greater) perceived emotional closeness was associated with higher (worse) anxiety ( B = 0.004, 95%CI = 0.003 to 0.006, p < 0.001) and higher (worse) depression ( B = 0.006, 95%CI = 0.004 to 0.008, p < 0.001). Higher score on perceived costs of dog ownership (lower burden) was associated with lower (better) scores for anxiety ( B = –0.005, 95%CI = –0.007 to −0.003, p < 0.001), depression ( B = –0.005, 95%CI = –0.006 to −0.003, p < 0.001), emotional support ( B = –0.005, 95%CI = –0.007 to −0.003, p < 0.001), and companionship ( B = –0.005, 95%CI = –0.007 to −0.003, p < 0.001). When the total MDORS scores were calculated, a closer dog–owner relationship was associated with lower (better) emotional support ( B = –0.001, 95%CI = –0.002 to 0.000, p = 0.020) and companionship ( B = –0.001, 95%CI = –0.002 to 0.000, p = 0.001).

Qualitative Findings

We found specific positive and negative aspect of owning pets which theoretically align with both hedonic and eudaimonic states ( Figure 1 ).

Figure 1 . Thematic model of positive and negative impacts of dog ownership on owner wellbeing from qualitative analysis of open-text responses.

How Dog Ownership Increases Owner Perceived Happiness

Dog attributes promote pleasure and enjoyment (↑ hedonia).

Owners reported that their dogs made them laugh which provided simple pleasure and daily fun and entertainment:

“Keeps me entertained” (P45).

“My dog has taught me how to have fun again, something I did not think would happen again. She has taught me to live in the moment, and makes me laugh, truly laugh with joy” (P515).

“Always funny things happening when you own dogs, always! What’s not to like?” (P1484).

Dog Attributes Promote Feelings of Self-Acceptance (↑ Eudaimonia)

Dogs were described as devoted, loyal, and non-judgmental. Their companionship and presence made owners feel safe and valued:

“They are devoted, loyal” (P301).

“No matter what happens, they are the only thing that never judges you” (P720).

“Always here with unconditional love” (P198).

“Feeling like you matter is linked to your self-esteem and therefore mental health” (P1301).

Dogs and Their Activities Provide Purpose (↑ Eudaimonia)

Feeling a need to care for the dog motivated owners to get out of bed in the morning and to take better care of themselves:

“(My dog) gives me a reason to get up in the morning” (P1319).

“Doing things for him gives me a purpose and makes my life more fulfilled […] he means everything to me, and I am a better person for it” (P75).

“It’s a good feeling, to be needed. That this small life depends on me for most things. Looking after my dog means I take better care of me” (P681).

One owner stated that this purpose gave them more confidence and thus more autonomy too:

“He makes me feel less helpless, less annoying, more independent, more capable, more able to achieve” (P55).

Owning a dog was felt to be a privilege which they were grateful for, helped them to fulfill their potential and live more meaningfully and mindfully in the moment:

“Enables you to realise your potential for happiness and to live life to the fullest. Seeing how a dog can enjoy something seemingly mundane allows me to believe that happiness can be found anywhere” (P59).

In particular dogs provided owners with a purpose to get outdoors, where fresh air provided a new perspective:

“Fresh air and to walk, which I personally find really helps with stress and anxiety and getting a fresh perspective” (P5).

“Walking and fresh air leave me feeling mentally healthier, as does feeling like I’m making something else’s life enjoyable” (P1236).

“365 days of daily walks. Being outside on days you would not have bothered if there wasn’t a dog. Being part of the changing seasons” (P403).

Dog Activities Provide Mastery, Positive Relations and Personal Growth (↑ Eudaimonia)

The purpose and activities created by caring for a dog led to routines that were deemed helpful for structuring the day of the owner:

“Gives a routine to my day without which I would be faced with too many decisions about what to do and when” (P325).

Even when the weather was not conducive, owners reported mostly mastering this challenge and making the most of the opportunity:

“Sometimes it’s a groan in bad weather to go out but once out you meet people and smile and chat with other dog walkers, and when you get back you feel good” (P243).

Many owners described the roles that dogs played in promoting positive connections to others, mainly through dog walking:

“Having to go out to walk the dog twice a day makes you feel better, and you meet people and chat. Dog owners are almost always lovely” (P366).

Dogs also promoted owners to participate in activities that can contribute to the development of new skills and personal growth:

“My dog promotes a healthy lifestyle and encourages me to take part in hobbies and activities I would not take part without them” (P22).

Dog Attributes Lessen Owner Emotional Pain or Suffering (↑ Hedonia and Eudaimonia)

As a result of the innate nature of dogs, owners reported that they provided a positive distraction:

“[My dog] provides a model of positivity” (P205).

“[My dog] has helped me not to focus on my own problems” (P441).

Many owners described their dogs as intuitive and aware, providing comfort when they were unhappy:

“She instinctively knows when I’m unhappy and will come and sit alongside me” (P73).

“Cheers you up especially when you had a bad day” (P345).

This comfort appeared to help reduce mental health symptoms, with owners emphasizing the impacts on stress relief and depression:

“I have anxiety attacks nearly every day, sometimes more than once a day. Stroking my dog calms me down and stops my heart [from] racing. I’d be lost without [the dog]” (P117).

“I have depression and it was a lot worse before I had my dog. He cheers me up and gives me a reason to get up and out of the house” (P992).

“Someone to cuddle when I’m down” (P311).

“I can talk to them and share my thoughts with them, and this helps my mental health” (P390).

Dogs also helped ease the pain of loneliness:

“I never feel alone or lonely because I’m a dog owner” (P270).

Dogs also helped owners to deal with loss:

“I got my dog shortly after my husband was killed on his motorbike. She’s saved my life” (P324).

Finally, some owners reported that dogs helped them manage risk behavior, for example dealing with suicidal thoughts or self-harming, or relief from other symptoms:

“Honestly my dog was the main reason I stopped trying to kill myself and self-harming” (P281).

“Having my dog cured my lifelong fear of dogs and agoraphobia. She set me free” (P62).

“[My dog] saved my life, I was ready to end it a few years ago, but my family made me take her out for a walk and I came back in tears, I could not end my life because she would be out in the woods on her own […] I had to take her home and had to admit to my mental health issues” (P151).

How Dog Ownership May Decrease Owner Perceived Happiness

All participants had positive aspects of dog ownership to share; however, not all participants experienced negative aspects, with some reporting “nothing” at all.

Response-Ability Decreases Self-Acceptance, Environmental Mastery, Autonomy and Positive Relations (↓Eudaimonia)

Meeting dog needs. The main challenge related to the burden of responsibility of ownership was to do well by their dog by adequately meeting their needs, which involved negotiations and sacrifice on the owner’s part:

“Making sure [my dog] is fulfilled physically and mentally” (P264).

“Have to be committed and care for them always, they have to come first, and you sometimes have to miss things to ensure they are cared for” (P253).

A particular dog activity reported to pose challenges was walking:

“Walking every day (even when I feel exhausted or miserable)” (P103).

“The biggest and only challenge I have caring for my dog is walking her with other dogs. She’s nervous around other dogs. Bless her” (P340).

Guilt. Inability to meet dog’s needs in the way owners wanted (in a sense, response-inability) led to feelings of inadequacy and guilt, which in turn could worsen owner’s confidence and mental health:

“Feeling like a failure when struggling to give the pet the attention it needs all the time” (P67).

“It can increase worry, anxiety, feelings of guilt. Am I training him properly? Is he OK when he’s left alone? Am I feeding him the best food? Feeling guilty when he’s not been walked enough because of [my] low mood” (P196).

“When I am too anxious to go out on a dog walk, I feel guilty and useless that I cannot do the right thing for my dogs” (P411).

Worry. Participants expressed worries about their dogs getting sick, of themselves dying first, and/or of their dog getting stolen:

“Biggest worry is worrying about them getting ill or injured” (P112).

“Worry about what would happen to the dog if we were not here for her” (P201).

“Making sure she’s safe. So many issues these days with dogs being stolen” (P424).

The burden of responsibility felt and perceived ability to adequately meet dog’s needs (thus response-ability) appeared to be dependent on both owner characteristics and dog characteristics.

Owner Characteristics

Confidence. Some owners felt overwhelmed by the responsibility of deciding how to best provide for their dogs, given all the conflicting information out there, and considering issues regarding agency and that pets are unable to speak or decide for themselves:

“Knowing how best to train them for their happiness and health” (P214).

“Having to make decisions on their behalf when it comes to their healthcare” (P203).

Time. Balancing pet care with work or other family responsibilities could also be challenging:

“I wish I had more time to train him properly, but I have to juggle work and childcare, I sometimes feel guilty about this” (P827).

Money. Costs of pet care were frequently mentioned as a challenging factor that could influence ability to adequately meet dog’s needs:

“Financial issues such as medications or unexpected circumstances” (P70).

“Affording to give her the life she deserves” (P1679).

Health. Also shaping ability to adequately meet dog’s needs was owner’s physical and mental health:

“Physically being capable to meet his demands, though my carers help in that aspect” (P55).

“Sometimes when I am more unwell than usual, when my chronic pain and fatigue flare up or if I get a virus, then I can feel mentally worse as I know she needs to go out for walks or that she wants to play but I struggle to do it. I can then feel very low and helpless because I am upset or annoyed at my ability to provide stimulation and fun for her” (P300).

“Owning a dog comes with difficulties, e.g., dealing with illness, which due to the nature of my mental health difficulties can be very difficult for me, but I accept this is the case” (P74).

Support. Owners relied on support from others to help care for their dog and without access shared challenges. Owners worried about leaving the dog, and who they could trust their dog with, which limited ability to travel or socialize (autonomy and positive relations):

“Sometimes when I am depressed, I struggle to deal with him. He is incredibly energetic, and I do not have the energy for it but feel guilty for not interacting with him as much, so it makes me anxious and overwhelmed. Luckily, I live with my mum and she helps me take care of him when I cannot” (P1404).

“Getting reliable cover when I am unable to walk my dogs can be an issue” (P1025).

“Holidays as we will not leave him in kennels as he finds it too stressful and so do we, so we do not go away unless family can care for him” (P782).

Dog Characteristics

Health. Sometimes the health of the dog presented challenges in terms of the burden of responsibility to meet the dog’s needs:

“The dog I chose for the survey has IBD and a spinal injury. Because of this, she needs careful exercise, special feeding and protection from stress. This is hard work on a daily basis” (P400).

“If my dog is unwell or if I am worried about her health then it negatively affects my mental health” (P1444).

Behavior. Aggression, barking, separation anxiety, phobias (mainly noise-related), hyperactivity and other challenging behaviors were also highlighted as problematic:

“Coping with her aggression and anxiety issues” (P54).

“Makes me scared or worried when she barks in the middle of the night” (P1403).

“With her being a puppy it is the constant cleaning up and disobedience at times which makes me feel worn out and worthless when she does not listen” (P138).

As well as creating feelings of guilt, inadequacy and worry, dog behaviors also led to feelings of anger, frustration and exhaustion:

“Frustrating if they make a mess” (P470).

“Sometimes they can drive you a little crazy or do something to annoy you” (P1338).

“I become agitated, angry and very overwhelmed with my small dog initiating barking at things, when my big dog will sometimes join in. I feel stressed then and often wonder whether my small dog is good for my mental health. Although I could never part with her, I love her too much” (P1364).

“The breed requires a lot of attention and he does not really care if I am unwell, he still wants to use up his energy. It can be exhausting at times!” (P1098).

In particular, behavior characteristics of the dog could impact the ability to leave them alone at home, contributing to a loss of spontaneity for the owner:

“She shreds paper and plastic so makes enormous mess and cannot be left with anything important alone. If she would grow out of this she would have more access to the house and I would enjoy her more. A bit exhausting!” (P273).

“My dog has severe separation anxiety and cannot be left at home unattended” (P139).

“I worry a lot about [my dog] …My time outside the home can be limited because I will not leave her alone for long periods. Can affect my social life at times” (P283).

Anticipatory Grief (↓ Hedonia)

Finally, owners worried in advance about how they would cope in future when their dog died, impacting their pleasurable emotions in the current moment:

“The only thing is that I will be devastated when I lose him and might get very depressed” (P33).

Tolerated Inconvenience

There were some aspects of dog ownership that were recognized as negative, but owners reflected that they tolerated them more as an inconvenience that was worth it, typically cleanliness issues such as mud and hair, or the time commitment involved: “I suffer from allergies and asthma so obviously the battle to keep the house clean and allergen free can be tough at times as a dog owner especially as my dog sheds quite heavily. […] wet, muddy paws all over the floor can also make me feel a bit stressed so I find myself constantly trying to keep on top of that. I think the benefits of dog ownership far outweigh the negatives though” (P1424).

“My dog does not like to be left alone so I have to take her pretty much everywhere with me! It can be a little tricky but me and my partner manage and she’s worth it!” (P899).

Summary of Qualitative Findings

Dogs appeared to contribute to hedonic wellbeing in two important ways: by promoting pleasure and enjoyment and by lessening pain and suffering (e.g., providing comfort and distraction, helping to ease the pain of loneliness and loss, and reducing engagement in risky behavior). Dogs also contributed to aspects of eudemonic wellbeing, specifically through providing meaning and purpose, and encouraging positive relations with others and activities that can lead to personal growth and feelings of mastery. Their characteristics as non-judgmental and loving contributed to feelings of positive self-worth. However, the responsibility of caring for a dog and the perception of whether their needs were being met (response-ability) carried a large burden, in particular, where dog behavioral and physical health characteristics were problematic or the owner’s physical or mental health needs prevented them from caring for their dog in their perceived ideal way. The burden of these responsibilities may contribute to owners being unable to control their environment, accept themselves fully, be as autonomous as they would like, or establish good relations with others. Due to their shorter lifespans, owners also anticipated the eventual loss of their dog as being difficult to deal with.

Summary of Findings

The aim of this paper was to investigate the association between owners’ relationship with their dogs and impacts on owner mental wellbeing, using both quantitative and qualitative approaches. Our findings appear at first somewhat in conflict, in that owners who have close relationships with their dogs feel more emotionally supported and have a stronger sense of companionship, but this does not appear to result in lower scores in anxiety and depression. The qualitative findings elucidate why this may be the case. Dogs increase their owners’ hedonic and eudaimonic wellbeing by helping owners enjoy themselves, and feel accepted, purposeful and more able to achieve. The activities done with dogs in particular act as motivators for more positive interpersonal relationships, give purpose and structure in their lives, and help their owners to “grow.” Dogs show support and love to their owners, and they make them feel valued through the responsibilities of caregiving; particularly appreciated by participants who mentioned that they have a mental health diagnosis. However, managing dogs’ physical health, behavioral issues and performing some dog-related activities can be a burden at times, negatively affecting sense of autonomy and opportunities to meet others. Further, worrying about their future can create anxiety. This caregiver burden can lead to negative feelings such as frustration, exhaustion, and in particular if owners perceive they are not fulfilling the dog’s needs, inadequacy and guilt. Therefore, depending on the owner, the dog, and their unique relationship, pet ownership can either positively or negatively affect owner mental wellbeing. However, crucially, dogs also help owners manage other aspects of their negative emotions and/or mental health difficulties like anxiety, depression and suicidal thoughts. This suggests that owners may seek out emotional support from their dogs in order to assist with managing their mental wellbeing, but this does not come without some burden of its own that warrants further investigation.

Comparison With Previous Literature

Our contradictory findings regarding anxiety and depression and different scales of the dog–owner relationship corroborate the existing literature, as some studies find a positive relationship between pet ownership/dog–owner relationships and mental wellbeing ( Zimolag and Krupa, 2009 ; González RamÍrez and Landero Hernández, 2011 ; Bakerjian, 2014 ; Wheeler and Faulkner, 2015 ; Brooks et al., 2016 ; Mota Pereira and Fonte, 2018 ; González-Ramírez et al., 2019 ; Liu et al., 2019 ; Powell et al., 2019 ; Hawkins et al., 2021 ), others a negative relationship ( Parslow et al., 2005 ; Peacock et al., 2012 ; Bradley and Bennett, 2015 ; Enmarker et al., 2015 ; Mueller et al., 2018 ; Sharpley et al., 2020 ) and others none ( Fraser et al., 2020 ; Le Roux and Wright, 2020 ). In our research, the perceived costs subscale consistently showed a lower perceived burden was positively associated with all mental health outcomes, including anxiety and depression. This is supported by our qualitative analysis, where our findings are in accordance with the paper of Barcelos et al. (2020) , suggesting a mostly positive relationship which, however, comes with costs to owner mental wellbeing, particularly regarding the burden of responsibility and caregiving.

Our findings also support others who found that dogs can help in managing and alleviating mental health conditions, especially during times of crisis ( Brooks et al., 2018 ). Even though our quantitative data showed that stronger emotional closeness with the dog was associated with poorer anxiety and depression, this is likely to be in part due to reverse causality and seeking out support from dogs (a form of co-dependency), as our qualitative research showed that the presence of the dog sometimes lessened mental health symptoms, such as suicidal thoughts or self-harming. Dog ownership may be valued for its protective effects, especially in at risk populations, such as LGBTQ+ emerging adults ( Mcdonald et al., 2021 ), adults with a diagnosis of autism ( Barcelos et al., 2021 ), or older adults who are at higher risk of fatal first suicidal attempts ( Figueiredo et al., 2015 ; Young et al., 2020 ), and this requires further investigation. There are perhaps parallels to consider regarding the caregiving responsibility of parenthood and suggested impacts on lower suicide rates in adults with children ( Dehara et al., 2021 ).

In some circumstances, owners wrote that their dogs supported them in extremely difficult situations, e.g., loss of a loved one. Previous research has found that dog ownership may promote resilience in the face of adversity ( Applebaum et al., 2021 ) and decreases loneliness ( Staats et al., 2008 ; Powell et al., 2019 ; Hui Gan et al., 2020 ), in particular in individuals with low human social support ( Antonacopoulos and Pychyl, 2010 ). The emotional support provided by dogs appears to be of particular importance, and echoes other findings that a closer pet-owner relationship is associated with a more socially supported individual ( Joseph et al., 2019 ). The provision of direct and indirect emotional support could be particularly important for those with mental health difficulties ( Brooks et al., 2018 ), or marginalized populations, such as racialized minority populations, sexual and gender minority populations ( Applebaum et al., 2021 ).

In addition to providing support in managing negative emotions, dogs also promoted positive emotions, and thus improved the owners’ hedonic and eudaimonic wellbeing in this manner. Owners reported increased happiness, mindful presence, gratefulness, and confidence from their interaction with their dogs, and enjoyed themselves around them, especially when dogs do something the owners perceive as amusing, similar to reported previously ( Westgarth et al., 2017 ; Owczarczak-Garstecka et al., 2021 ). Attributes of dogs that led to positive mental wellbeing effects included the concept of the dog being loyal, non-judgmental and showing empathy and unconditional love. Communication between the dog and the owner using non-verbal language “two-way” and contributes to the owner feeling valued, heard and understood ( Maharaj and Haney, 2015 ) and engenders the sense of responsibility for the pet as “kin” ( Westgarth et al., 2019 ). This leads to caregiving behavior which further improved eudaimonic wellbeing through providing motivation, purpose and a routine. Owners reported that through dog-related activities, mainly dog walking, dogs were a motivator for them to get of the house, meet new people and even uptake new dog-related hobbies. Even though some owners struggled to find the motivation to walk with their dogs, especially when experiencing depressive symptoms, most of them commented that once they did go outside, it had many positive impacts that they were thankful for. Dog walking has previously been shown to generate feelings of happiness, through sharing of vicarious pleasure, stress relief, and promoting social connection ( Westgarth et al., 2017b ) and dogs are known to increase social connections within communities ( Wood et al., 2007 ; Graham and Glover, 2014 ). However, unlike suggested by Barcelos et al. (2020) our owners tended to not volunteer information that suggested that greater autonomy was created as a result of owning a dog, rather than a particular downside of caregiving responsibilities is reduced autonomy by preventing owners from being able to pursue other interests or relationships, similar to that found by others ( Graham et al., 2019 ).

Indeed, positive effects of dog ownership appeared to be conditional to particular contexts, in particular their experience of behavioral problems which were frustrating and exhausting. Other research concurs that owner and animal welfare are strongly linked. Owners that have well behaved pets when left alone were happier whereas owners who witnessed separation-related anxiety problems in their dogs were stressed ( González-Ramírez et al., 2018 ). Unpicking directions of causality is difficult; however some researchers suggests that although human and dog long-term anxiety are strongly correlated, it is dogs mirroring their owners’ stress levels ( Sundman et al., 2019 ). Dogs’ physical illnesses and behavioral problems, such as aggression, barking, anxiety, phobias and training problems, can affect the owners’ psychological wellbeing as they feel less autonomous, and have a lower regard for self and it further restricts their management of everyday affairs and social life.

Responsibility for caring for a dog also comes with wider burdens. Our findings agree with the results of other studies, that dog walking is overall pleasurable but also able to generate negative feelings when perceived as a chore and that guilt and the dog’s needs are the primary motivator for the walk ( Westgarth et al., 2014 , 2019 , 2021 ). While perceived ability to meet dog’s needs has been identified previously to negatively impact owner wellbeing ( Barcelos et al., 2020 ), our study more deeply elucidates how this is underpinned and influenced by characteristics of the dog and the owner. For example, owners’ physical or mental limitations, restrictions such as finance, caregiving knowledge, time, work and social support available were identified as impacting perceived ability to caregive. Most owners consider these stressful challenges to negotiate, as identified in older adults where responsibilities such as costs and cleaning can compromise their wellbeing ( While, 2017 ). It is also interesting to point out that some owners thought that the lack of agency of the dog to control its own life and responsibility of deciding on the dog’s behalf compounded this stress and feelings of inadequacy. When individuals worry about something negative that might happen in future, it can further increase their anxiety in the present ( Schubert et al., 2020 ), and we found that owners often worried about what might happen to their dog or what would happen to the dog if they die first. They also suffered anticipatory grief ( Spitznagel et al., 2021 ) about how they would cope with the loss of their dog. Even though the caregiving responsibilities are stressful, it is interesting to note that caregiving for a severely ill animal has been suggested to create less burden and more positive attitude compared to caregiving for a human family member ( Karysa et al., 2018 ).

These burdens added to the other noted instances of feeling exhausted, annoyed, challenged, frustrated, and overwhelmed, may suggest that the added responsibility of caring for a dog can be challenging for owner mental wellbeing and acquiring a dog may not always be a suitable choice. Further, our multivariable regression analyses showed that owner characteristics, such as age, marital and work statuses and whether there was a mental health problem diagnosis, were independently associated with anxiety, depression, emotional support and companionship. This confirms that that a close relationship with a dog is not the only factor affecting the mental health of the owner, and these also need to be taken into account when considering whether dog ownership is a suitable course of action.

In our study, some owners explicitly stated that there was “nothing” negative in owning a dog. and many highlighted that dog ownership “is worth it,” i.e., the positives outweigh any negatives, as observed in previous research ( Westgarth et al., 2019 ). Therefore, although there may be difficulties that dog ownership can bring, which may be particularly challenging to someone already living with a mental health diagnosis, overall, owning a dog appears to provide invaluable benefits to the owner. Our findings suggest that the key to a healthy dog–owner relationship that supports owner mental wellbeing is ensuring the right supports are in place, including but not limited to: affordable veterinary care and dog training, walking, and boarding services, access to pet-friendly housing and dog-supportive environments, and mental health support for people who may be struggling with anticipatory grief or who may have recently lost a pet, particularly for those with limited social support.

Strengths and Limitations

A strength of this study is its large sample, especially for the qualitative aspects, but a limitation is that it is a cross-sectional study with self-reported replies rather than objective measures of mental wellbeing. The qualitative responses are inductive rather than deductive, but were limited by being relatively short replies rather than in-depth conversation. It is also a convenience sample as people completed the questionnaire at their discretion in response to a social media advert. Moreover, it is an almost female-only sample, as is the majority of human-animal interaction research ( Rodriguez et al., 2021 ). Tower and Nokota suggested that women benefit more from a pet compared to men ( Tower and Nokota, 2006 ), suggesting that our findings may not necessarily fully apply in the male owner context, and further research into this is required. Further, a relatively high proportion (40%) felt that they had a mental health diagnosis, which may reflect some recruitment bias but is a useful sample for our research questions. Looking into disadvantaged populations also needs further investigation, as mental health difficulties may be even more prominent and the human-animal bond more complex ( Applebaum et al., 2021 ). Additionally, it should be pointed out that the scales taken from the PROMIS for emotional support and companionship did not state clearly if they concerned humans only and thus participants may have varied in their interpretations of these questions.

Finally, reverse causation in a cross-sectional study should be taken into consideration as the directionality of the relationship is difficult to infer. However, the novel mixed-method nature of this particular study is a strength that helps elucidate how causality may be occurring. It may be that people who are closer to their dogs are more inclined to develop mental health difficulties, or those who already have depression or anxiety are more likely to get a dog in order to manage its symptoms and/or are more inclined toward becoming more strongly emotionally attached to their dogs. Our qualitative findings suggest that the latter explanations are certainly playing a part. Further, even though some participants mentioned that caring for a dog is sometimes stressful and overwhelming, especially on their “bad days,” no participant explicitly said that they were mentally healthy previously and getting a dog created a mental health problem; in fact, the opposite was often stated.

It is often believed that dogs can bring many mental health benefits to their owners, and hypothesized that the closer the relationship, the greater those benefits, but our findings somewhat contradict these assumptions. It was found that a closer relationship is associated with higher feelings of emotional support and companionship, but poorer levels of anxiety and depression. Yet many mental health benefits, and mechanisms of increasing experiences of hedonia and eudaimonia, were described due to interactions with dogs. Dogs were also mentioned as a useful aid for dealing with mental health symptoms, such as suicidal thoughts. Hence, we suggest that a close dog–owner relationship may be a feasible strategy to help people cope during mentally challenging times, but they are not a panacea in terms of prevention or treatment for depression or anxiety. It must be noted that every person is different, every dog is different, and the dog–owner relationship comes with many responsibilities and challenges. Longitudinal research is needed to further investigate for whom, and in what context, dog ownership is a feasible strategy to contribute to positive wellbeing, and how to ensure the dog’s health and behavioral welfare is also high, not least because without this, our findings show that dog ownership can become a challenging burden. The perceived costs subscale demonstrated the most consistent associations with wellbeing outcomes and thus it may the most useful representation of the dog–owner relationship in regards to impact on owner wellbeing. A lower perceived burden was beneficially associated with all mental health outcomes, including lower anxiety and depression, and also was found to be important in our qualitative explorations, and so it is important for future research and practical interventions to address issues that lead to a sense of burden created by owning and caring for a dog.

Data Availability Statement

The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation.

Ethics Statement

The studies involving human participants were reviewed and approved by University of Liverpool Veterinary Ethics Committee. The patients/participants provided their written informed consent to participate in this study. The animal study was reviewed and approved by University of Liverpool Veterinary Ethics Committee. Written informed consent was obtained from the owners for the participation of their animals in this study.

Author Contributions

CW devised and designed the study, assisted qualitative and quantitative data analysis, and drafted the manuscript. AM designed the data collection, collected the data, performed all analysis, and drafted the manuscript. TG assisted with qualitative data analysis and supported drafting of the manuscript. MO’H and RP assisted with study design, advised on quantitative data analysis, and commented on the manuscript. All authors contributed to the article and approved the submitted version.

AM summer studentship funded by Wellcome Trust Institutional Strategic Support Fund awarded to University of Liverpool.

Conflict of Interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Publisher’s Note

All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.

Acknowledgments

AM would like to thank Loukia Pantzechroula Merkouri for her continuous support.

Supplementary Material

The Supplementary Material for this article can be found online at: https://www.frontiersin.org/articles/10.3389/fpsyg.2022.903647/full#supplementary-material

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Keywords: dogs, ownership, pets, human–animal bond, depression, mental health, anxiety, qualitative

Citation: Merkouri A, Graham TM, O’Haire ME, Purewal R and Westgarth C (2022) Dogs and the Good Life: A Cross-Sectional Study of the Association Between the Dog–Owner Relationship and Owner Mental Wellbeing. Front. Psychol . 13:903647. doi: 10.3389/fpsyg.2022.903647

Received: 24 March 2022; Accepted: 17 June 2022; Published: 18 July 2022.

Reviewed by:

Copyright © 2022 Merkouri, Graham, O’Haire, Purewal and Westgarth. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

*Correspondence: Carri Westgarth, [email protected]

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

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Pet ownership and...

Pet ownership and human health: a brief review of evidence and issues

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Peer review
June McNicholas , psychologist ( june{at}cullach.fsnet.co.uk ) 1 ,
Andrew Gilbey , lecturer 2 ,
Ann Rennie , general practitioner 3 ,
Sam Ahmedzai , professor of palliative medicine 4 ,
Jo-Ann Dono , director 3 ,
Elizabeth Ormerod , veterinary surgeon 3
1 Croit Cullach, Durnamuck, Dundonnell, Ross-shire
2 Massey University, New Zealand
3 Society for Companion Animal Studies, Blue Cross, Burford, Oxon
4 Royal Hallamshire Hospital, University of Sheffield
Correspondence to: J McNicholas
Accepted 4 November 2005

Research into the association between pet ownership and human health has produced intriguing, although frequently contradictory, results often raising uncertainty as to whether pet ownership is advisable on health grounds

Introduction

The question of whether someone should own a pet is never as simple as whether that pet has a measurably beneficial or detrimental effect on the owner's physical health. The emotional bond between owner and pet can be as intense as that in many human relationships and may confer similar psychological benefits. Death of a pet can cause grief similar to that in human bereavement, whereas threat of loss of a pet may be met with blunt refusal and non-compliance with advice on health.

We examine the current evidence for a link between pet ownership and human health and discuss the importance of understanding the role of pets in people's lives.

Is pet ownership associated with human health?

Research dating from the 1980s popularised the view that pet ownership could have positive benefits on human health. Benefits ranged from higher survival rates from myocardial infarction 1 ; a significantly lower use of general practitioner services (prompting some researchers to speculate on considerable potential savings to health expenditure) 2 ; a reduced risk of asthma and allergic rhinitis in children exposed to pet allergens during the first year of life 3 4 ; a reduced risk of cardiovascular disease 5 ; and better physical and psychological wellbeing in community dwelling older people. 6 No studies have found significant social or economic differences between people who do or do not have pets that would adequately explain differences in health outcome, leading to the belief that pet ownership itself is the primary cause of the reported benefits.

Although the research did much to raise awareness of the importance that people attach to their pets, recent studies have failed to replicate the benefits. A review of the association between pets and allergic sensitisation found inconsistent results for cat ownership between studies of similar design, whereas dog ownership seemed to have no effect or even protected against specific sensitisation to dog allergens and allergic sensitisation in general. 7 Other studies on the subject suggest that exposure to pets may be beneficial provided that exposure is sufficient, as lower levels may enhance sensitisation whereas higher levels may protect against sensitisation. 8 Yet others suggest that the effects may heavily depend on age at exposure and type of pet. 9

Similarly, recent research has failed to support earlier findings that pet ownership is associated with a reduced risk of cardiovascular disease, 10 a reduced use of general practitioner services, 11 or any psychological or physical benefits on health for community dwelling older people. 12 Research has, however, pointed to significantly less absenteeism from school through sickness among children who live with pets. w1

Do we need a broader definition of health?

The main issue may not be whether pet ownership per se confers measurable physical benefits but the role that pets have in individual people's lives—namely, the contributions of the pet to quality of life or the costs to wellbeing through a pet's death. This issue embraces a broader definition of health that encompasses the dimensions of wellbeing (physical and mental) and a sense of social integration.

Three potential mechanisms have been proposed to explain the association between pet ownership and benefits to human health ( fig 1 ). 13 The first is that there is no real association between the two, rather that cofactors such as personality traits, age, and economic or health status impact on the decision to own a pet and thus produce an apparent link between pets and health. So far, however, evidence is lacking that any of these cofactors account for both health promoting attributes and propensity to own pets, suggesting that health benefits, when reported, may be attributable to some aspect of pet ownership.

Three proposed mechanisms for association between pet ownership and health benefits for humans

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A Munduruku boy carries his pet, a domesticated wild boar, for a daily cleansing swim in the Rio Canuma

Credit: GERD LUDWIG/PANOS

The second proposal is that pets may enhance social interactions with other people, thus providing an indirect effect on wellbeing. Social contact has been long recognised as beneficial in that it alleviates feelings of loneliness and social isolation. Pets undoubtedly act as “social catalysts,” leading to greater social contact between people. 14 These factors may be particularly important for those at risk of social isolation, such as elderly people or people with physical disabilities, who lack many of the opportunities for social interactions of their more able bodied peers. 15

The third proposal focuses on ways in which pet ownership may exert a direct effect on human health and wellbeing through the nature of the relationship. Close human relationships have a powerful influence on wellbeing by providing emotional support. They may reduce perceptions of stressful events thus protecting against anxiety related illness, may give confidence that successful coping strategies can be found to deal with stress, and may enhance recovery from serious illness such as stroke, myocardial infarction, and cancer. These aspects of a relationship are collectively referred to as social support. Social relationships, or the lack of, seem to constitute a major risk factor for health, rivalling the effects of well established risk factors such as cigarette smoking, blood pressure, blood lipid concentrations, obesity, and lack of physical activity. 16

The value of companionship

Companionship—a commonly stated reason for pet ownership—is regarded as theoretically distinct from social support in that it does not offer extrinsic support but provides intrinsic satisfactions, such as shared pleasure in recreation, relaxation, and uncensored spontaneity, all of which add to quality of life. Thus companionship may be important in fostering positive mental health on a day to day basis, whereas social support may be of particular value in buffering threats to mental health and wellbeing from real or perceived stressors. Figure 2 illustrates the inter-relationship between functions served by pet ownership and human health outcomes. 15

Correlations between questionnaire items measuring social facilitation, affectionate relationship, social support, and recipients' self perceived health in study on non-task related benefits of a trained assistance dog to people with physical disabilities. Correlations, derived from carrying out Pearson's correlation, are significant at P<0.05

Although research has primarily focused on human relationships as providing support and companionship, it is a short step to extrapolating these to pets. Studies have shown that the support from pets may mirror some of the elements of human relationships known to contribute to health. 17 Although support from pets should not be regarded as a replacement for help from people, the fact that pets are not human confers certain advantages; the relationships are less subject to provider burnout or to fluctuations, and they do not impose a strain or cause concern about continuing stability. Relationships with pets seem to be of value in the early stages of bereavement w2 and after treatment for breast cancer. w3

Most pets are valued family members

Credit: BARRY LEWIS/NETWORK PHOTOGRAPHERS

Why pet ownership should be taken seriously

The question of whether a person should acquire a pet or continue to own a pet requires careful consideration of the balance between benefits and potential problems. About half of households in the United Kingdom own pets. w4 Most are valued as family members. Conflict between health interests and pet ownership can cause non-compliance with advice on health. Some sources estimate that up to 70% of pet owners would disregard advice to get rid of a pet owing to allergies, w5 whereas reports abound of older people avoiding medical care through fear of being admitted to hospital or residential care as this often means giving up a pet. w6

Summary points

Over 90% of pet owners regard their pet as a valued family member

Reluctance to part with a pet may lead to non-compliance with health advice

Pets may be of particular value to older people and patients recovering from major illness

The death of a pet may cause great distress to owners, especially when the pet has associations with a deceased spouse or former lifestyle

Many people would welcome advice and support to enable them to reconcile or manage pet ownership and health problems whenever possible

The loss of a pet may be particularly distressing for owners if it was linked with a deceased spouse or if it offered companionship or social contact with people. 18 For these reasons many people may appreciate help and advice on how to manage a pet in the event of a health problem in the family.

Animal welfare organisations cite allergies and the fear of zoonoses as common reasons for people giving up their pets. Yet in some cases this may not be necessary. Research from the University of West Virginia shows that simple, day to day hygiene and pet care can reduce allergic reactions by up to 95%. 3 A recent review of pets in nursing homes provides a comprehensive list of potential health problems and steps that can be taken to avoid these. 19

People do not own pets specifically to enhance their health, rather they value the relationship and the contribution their pet makes to their quality of life. 20 Greater understanding among health professionals is needed to assure people that they do not need to choose between pet ownership and compliance with health advice.

Contributors and sources JMcN has special research interests in the influence of pet ownership on health and lifestyle. She was formerly based at the University of Warwick. Her current work is with Dogs for the Disabled, the Society for the Protection of Animals Abroad, and Cats Protection, UK. She is a member of the Society of Companion Animal Studies. AG gained his doctorate from the University of Warwick, researching the role of pets in the alleviation of loneliness. AR and SA are members of the Society of Companion Animal Studies. J-AD has a degree in psychology and is director of the Society of Companion Animal Studies. EO is chairwoman of the Society of Companion Animal Studies. References refer to primary sources located through MIMAS web of knowledge service/web of science records. JMcN wrote the article, with contributions from the other authors, and is guarantor.

Competing interests JMcN received a research award, 2000-2, from Masterfoods UK to investigate the role of pets in children's health. AG was employed as a research assistant at University of Warwick, 1999-2003, funded by Waltham Centre for Animal Nutrition.

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Policy Forum Highlights Data on the Vital Role of Pets for Better Mental Health

The pet effect.

Did you know pets can improve your cardiovascular health?

Learn more about The Pet Effect here.

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Human Animal Bond Research Institute (HABRI) Works with Partners to Increase Access to Pets for Mental Health

Washington, D.C. (May 23, 2024) — The Human Animal Bond Research Institute (HABRI) hosted its first-ever Spring Policy Forum focused on Mental Health and Companion Animals, convening leaders in the pet care community and partners in the mental health space to move society toward more widespread awareness of the important role of companion animals for improved mental health.

The Policy Forum program featured presentations addressing research, practice, and policies associated with this important topic and delivered by expert speakers from a wide array of disciplines. Speakers included Susan Trachman, MD, a Board-Certified Psychiatrist who talked about the role of pet ownership in supporting mental health and Mental Health America (MHA) and HABRI unveiled results of a survey of 4,000 MHA constituents on the care and resource-related needs of those impacted by mental health related to companion animals.

The MHA-HABRI survey found that pet owners overwhelmingly report positive health benefits resulting from their pet, that there is great interest and need for resources related to pets and mental health, and that this is particularly true among those living with a mental or physical disability:

98% of pet owners report at least one health benefit resulting from their pet, including reduced feelings of loneliness (73%), providing comfort (73%) and a source of happiness (79%)
71% of respondents (76% of those with a disability) are interested in working with a mental health professional who incorporates pets or animal-assisted interventions (AAI) into their practice
Those with a disability are more likely to say they are interested in pets to support their mental health (79%) compared to those without a disability (50%)
93% of respondents agree there should be more support for pet ownership and AAIs in society

“Mental Health America is proud to partner with HABRI to bring forward new data from our constituency on the experiences, benefits and challenges related to pets and mental health,” said America Paredes, PhD. “We found that not only is pet ownership incredibly important for so many people, but also that more than three quarters of those living with a disability want to work with a mental health professional who incorporates pets in their practice. Our survey showed that it is hard to find reliable information about pets and mental health, revealing a great need for resources and information related to pets and animal-assisted interventions.”

“HABRI is proud to bring together a diverse group of leaders in mental health, veterinary medicine, research, animal-assisted interventions, pet care, and public policy to elevate the conversation about pets and mental health,” said Steven Feldman, President of HABRI. “Armed with research, new insights, model practices and policy considerations, HABRI’s goal is to drive the conversation on how best to support pet ownership and the human-animal bond for a healthier society.”

HABRI’s Spring Policy Forum is sponsored by leading pet care and animal health companies and organizations; American Pet Products Association (APPA), Petco Love, Mars Petcare, American Veterinary Medical Association (AVMA) and whiskerDocs.

“Policy Forum sponsors and all of HABRI’s partners are committed to supporting better mental health for pet owners, veterinarians and everyone who can benefit from the research-backed benefits of the human-animal bond,” Feldman added.

For more information, please visit www.habri.org/policy-forum . Images available upon request.

About About HABRI

HABRI is a not-for-profit organization that funds innovative scientific research to document the health benefits of companion animals; educates the public about human-animal bond research; and advocates for the beneficial role of companion animals in society. For more information, please visit http://www.habri.org .

Logan Trautman

[email protected], (412)-915-4038, more press releases, press releases.

Federal Grant Applications Now Open: $3MM Now Available to Support Pet-Friendly Domestic Violence Shelters

The PAWS Act Coalition, a group of nonprofit and for-profit organizations committed to protecting survivors of domestic violence and their pets, is thrilled to share the recent announcement of the Fiscal Year (FY) 2022 U.S. Department of Justice (DOJ) Office of Victims of Crime (OVC) Emergency and Transitional Pet Shelter and Housing Assistance Grant Program. The $3 million appropriated for 2022 represents the fully-authorized amount under the Pet and Women Safety (PAWS) Act, a $500,000 increase in funding from 2021. “The increase in funding for this grant program is a direct reflection of the need for more pet-friendly options for domestic violence survivors,” said Nina Leigh Krueger, CEO and President of Nestlé Purina PetCare. “Purina is proud to see and support continued momentum to ensure more survivors and their pets enter safe shelter and begin the healing process together.” “The PAWS Act Coalition looks forward to working with the Department of Justice to raise awareness of the $3 million available to aid survivors of domestic violence and their pets,” said Steven Feldman, President of the Human Animal Bond Research Institute (HABRI). “We are proud to help spread to word about the opening of the 2022 grant applications, and to encourage eligible organizations across the country to apply.” FY 2022 grants will provide funding for shelter and transitional housing and other assistance for survivors of domestic violence with pets, service animals, emotional support animals, or horses. Grants awarded may also be used for programs that provide support services designed to enable someone fleeing an abuser to locate and secure housing with their pet, safe accommodations for their pet, or related services such as transportation and other assistance. The OVC can fund five grants of up to a maximum of $400,000 each and 15 grants of up to $100,000 each. The grants will be for a 36-month period of performance, to begin on October 1, 2022. Smaller awards are...

Therapy Dogs Improve Social Behaviors in Psychiatrically Hospitalized Youth with Autism

March 14, 2019– The Human Animal Bond Research Institute (HABRI), the Children’s Hospital Colorado and the University of Colorado Anschutz Medical Campus today announced the publication of a pilot study exploring the benefits of animal-assisted activities (AAA) for psychiatrically hospitalized youth with autism spectrum disorder (ASD). “Individuals with autism spectrum disorder have difficulties with communication and socialization skills, and often experience difficulties with emotion dysregulation, which can lead to more intensive intervention services such as psychiatric hospitalization,” said researcher and lead author, Monique Germone, PhD, BCBA, University of Colorado, Children’s Hospital Colorado. “Psychiatric hospital environments can be particularly overwhelming and stressful environments for individuals with ASD, and animal-assisted activity is one of the most widely used complementary forms of treatment in hospital settings. We chose to build on existing science that shows children with ASD demonstrate significantly more positive social-communication behaviors when an animal is present.” Dr. Germone, along with study’s principal investigator Robin Gabriels, PsyD, professor of psychiatry at the University of Colorado School of Medicine recruited participants ages 4-17 years old from the inpatient and partial hospitalization unit of a specialized psychiatric unit for pediatric patients with ASD. A crossover study design, participants attended both the experimental (AAA) and control (novel toy) conditions. Both group sessions occurred in a classroom setting and began with quiet play, followed by social skills group and then participants engaging in either the experimental or control condition. The 10-minute experimental sessions included therapy dog-handler teams. The researchers captured behavioral data via video and used the OHAIRE coding system designed to quantify social communication, and interactions with animals and control objects. Categories...

Human Animal Bond Research Institute (HABRI) Shareable Infographic: The Top Benefits of Pet Ownership for Healthy Hearts

In recognition of Heart Health Month, the Human Animal Bond Research Institute (HABRI) has created a new shareable infographic, “The Top Benefits of Pet Ownership for Healthy Hearts”. The infographic highlights research supporting the positive role of pets in improving cardiovascular health. “Scientific research shows a link between pet ownership and improved heart health, including a lower risk of heart diseases and heart-related health issues,” said HABRI President Steven Feldman. “HABRI’s goal is to raise awareness of the important role of human-animal bond for healthier hearts during Heart Health Month, a time to focus on cardiovascular health.” This infographic is part of an ongoing series to share human-animal bond research. In June, HABRI shared “Can Pets Help You Live Longer?“. In November, HABRI issued “5 ways the Human-Animal Bond is Improving Lives During the Pandemic”.

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A young woman laughs while holding her dog near to her face.

Pets give companionship, cuddles and joy – and also unavoidable stresses

Assistant Professor of Psychiatry, University of Colorado Anschutz Medical Campus

Disclosure statement

Emily Hemendinger does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

University of Colorado Anschutz Medical Campus provides funding as a member of The Conversation US.

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Owning a pet can be a roller coaster. There are the highs, like when your dog greets you with a full-body wiggle when you return home, or when your cat purrs loudly as you cuddle next to one another. Then there are the lows, like stressful trips to urgent care, waking up to that unpleasant vomiting noise, or making the difficult choice to say goodbye because of medical problems or even intractable behavioral issues.

For those pet-owners who are struggling, it’s beneficial to their mental health to acknowledge that pets can create stress and that some animals are more work than others.

Research has shown that both cats and dogs can have equally positive impacts on mental health .

Pets may be helpful at reducing stress, anxiety and feelings of being overwhelmed, including in children. Pet ownership has also been shown to improve well-being by instilling people with a sense of purpose and responsibility .

As a licensed clinical social worker , animal lover and proud dog mom , I have both professionally and personally seen the mental health impacts of having animal companions.

Media stories commonly cover the positives of pet ownership . But the hardships and downsides of owning a pet are not discussed as often. For instance, while there are many positive aspects to pet ownership, some research is showing that pets may lead to exacerbated mental health concerns or even sleep issues .

Whether you’re adopting or shopping, pets can bring a full range of emotions into our lives. Research has even shown that pets may benefit non-pet owners around them as well.

How pets can enrich our lives

A pet owner may easily be able to tick off an infinite number of positive effects their fuzzy companion has had on their life. Research backs them up.

Pets can provide constant companionship for individuals and families. This is particularly true for older adults . There was an uptick in adoptions of pets during the early days of the COVID-19 pandemic . Many people benefited from pets during periods of stay-at-home mandates and quarantines.

Research shows that dogs can reduce loneliness in their owners. In fact, being accompanied by a dog may even make you seem more approachable .

Pets, especially dogs, may help improve one’s ability to socialize and feel connected with others , as well as increasing the prospects for social interactions. People may bond over the experience of having pets, socialize at the dog park, or even meet up at the local cat café.

Animals and pets have also been used to assist in detecting the onset symptoms of medical episodes, including seizures . Animal-assisted therapy and pet therapy have shown promise in improving symptom management and overall quality of life in a number of conditions, including trauma and stressor-related disorders , anxiety disorders , eating disorders , autism , traumatic brain injuries , neurological disorders and more.

The inherent stressors

Despite the many positive impacts of pet ownership, it also can have negative impacts. For example, one survey found that 47% of Americans felt separation anxiety when leaving their dogs at home.

The survey also found that 41% of pet owners declined social invitations because they did not want to leave their dog at home, and that 70% of pet owners would prefer to work remotely so they could stay at home with their pet. Pet owners have also identified feeling anxious about their pet getting sick or running away, or the risk that they might harm the animal unintentionally.

Stress from pet ownership is common. There’s the stress of house-training and making sure the pet is getting enough enrichment – both physically and mentally. Then there are the challenges associated with vet appointments and navigating illness, as well as financial stressors and finding pet sitters.

Another element of pet ownership that people often don’t talk about is the stress, and often shame , that owners with reactive dogs experience from walking their dog, having people over to the house or having their dog around children.

Finally, there’s the reality that our pet companions live shorter lives than we do, leading to end-of-life planning, expensive treatments for older-age ailments, and, of course, the grief that will be felt from the loss of a pet. For some people, the loss of a pet may feel worse than human loss .

People may judge or criticize pet owners for an “overblown” grief reaction. The common experience of invalidation and lack of acknowledgment related to grief around pet loss – similar to the grief felt from divorce and miscarriage – is categorized as disenfranchised grief . This term refers to grief that is not acknowledged, validated or accepted socially.

Young man sits in front of his laptop and puts his nose up to the nose of his cat.

Strings attached

Pet owners, especially post-pandemic, have reported high levels of guilt related to leaving their pets at home while at work or social events. Some of this guilt may be related to concerns about providing insufficient attention to the pet or about the pet’s health. This guilt has even been shown to be similar to the feeling human parents have concerning their human children.

As someone who adores their dog, I can relate to the guilt of leaving him alone. To complicate things, my dog has joint issues, anxiety and discoid lupus , a type of lupus that affects the skin on his nose. He can also be reactive. All of these aspects require me to provide extra care. When friends invalidate my worries and guilt, it can feel isolating and shaming.

And I’m not alone in these feelings. Overall, when there is a lack of consideration for the complex feelings pet owners experience, the invalidation and disenfranchised feelings can lead to depression, anxiety , feelings of being isolated and worsened quality of life .

Woman sits on a dock with her arm around her dog, which looks backward over her shoulder into the camera.

Finding support

The human-animal bond is unique, with humans receiving unconditional love and full acceptance from their animal companion. When society can honor and respect this bond through validation, patience and compassion, it not only helps pet owners but also the clinicians who treat the animals .

Employers can be supportive by continuing to provide remote and hybrid work options, flexibility in scheduling and opportunities for employees to feel validated and receive support. If a loved one is experiencing guilt around leaving their dog at home or a friend is having anxiety about their cat’s health, instead of minimizing their experience, try talking to them and asking how best to support them through their distress.

Another support tool is encouraging pet owners to practice self-compassion and mindfulness, being present and focusing on the time they do have with their pet.

Pets can bring infinite joy and companionship to our lives, whether that’s through pet ownership, fostering, volunteering or engaging in animal-assisted therapy.

It remains important, however, to acknowledge the stressors and difficulties pet owners face. After all, the ups and downs of pet ownership, just like the ups and downs of the human experience, are what make life and relationships that much more meaningful.

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Companion animals and mental health, pet ownership can improve mental health and avert loneliness..

Posted May 27, 2024 | Reviewed by Davia Sills

Pets can have a positive impact on physical and mental health.
Young adults with psychiatric diagnoses report a decrease in symptoms because of their companion animals.
Pets can provide the tactile aspect of life missing for older adults whose spouses have died.

Yesterday, I was the keynote speaker at the HABRI conference. HABRI is an organization that promotes research on the human-animal bond as it impacts physical and emotional health. I was amazed at the wealth of research available on this subject and the participants’ passion.

When I was 10 days old, my father brought home my first best friend. No, it wasn’t a stuffed bear or a doll. It was Bruno, one of several puppies born “out of wedlock” to a neighbor’s dog who had gone into heat and escaped from her backyard. Bruno became my friend, protector, and constant companion. He was the beginning of my lifetime love of animals.

Mental Health Benefits of Pet Ownership

Jonathan Haidt, the author of The Anxious Generation, has a theory about why there has been a dramatic rise in mental health disorders among young adults since 2015 when smartphones became available. He suggests people become more depressed and anxious when they feel socially disconnected and lose the face-to-face contact that leads to meaningful connections. In 2017, Surgeon General Vivek Murthy released a report indicating that almost half of the U.S. population experiences loneliness daily, which can increase the risk of premature death by 26 percent. Both authors share the same premise—the lack of connection to something or someone contributes to a decline in physical and mental health.

A study undertaken in Perth, Australia, and four American cities investigated the effects of pet ownership on the likelihood that individuals in a community would meet their neighbors and develop some relationships. They specifically asked participants:

How or if they had gotten to know neighbors.
Whether they owned a pet. If they had a dog, did they walk it?
If they met neighbors, did any friendships ensue, and if so, were pets involved?
If they made friendships through their pets, did they receive social support from the friendships?

The results indicated that pet ownership was the second most common way for participants to meet their neighbors—dog walking was the most common variable. In each of the four cities, almost a quarter of pet owners met people in the neighborhood through their pets and considered one or more of those they met to be friends.

Early adulthood is a peak time for the emergence of mental health disorders. A study at the University of Edinburgh researched young adults’ experiences of how their companion dogs and cats impacted their mental health symptoms. The participants were between the ages of 18 and 26, and all had a prior psychiatric diagnosis. The results fell into several categories:

Social Anxiety and Loneliness: The young adults who had generalized anxiety disorder spoke of how their pets helped reduce anxiety symptoms by promoting a sense of mindfulness , allowing them to focus on the present, and distracting them from their worries. For participants who had specific anxiety problems, pets helped reduce their symptoms by providing a sense of safety. For example, one of the female participants described how her dog helped her to feel safe when she was home alone.
Impact on Mood and Stress : One way that pets improved the participants’ moods was through laughter and comic relief. Some described their pets as “cute” and said they “did silly things” to make them laugh. Pets helped these young adults feel better and have a more positive outlook.

For those who reported a history of low mood, a critical benefit of pet ownership was an increased sense of purpose. Some reported that their pets helped them get up and out of bed to engage in healthy activities, such as walking outdoors.

Impact on Severe Mental Health and Suicide Prevention: Pets were a deterrent against self-harm and thoughts of suicide.

There is a worldwide increase in the aging population. The aging process is associated with a growing risk of stressors common in later life, which can lead to loneliness and greater dependency on others for social and emotional needs. Pets can play a pivotal role in providing various mental health benefits by protecting against loneliness and depression . Researchers in the United Kingdom studied community-dwelling adults over 65 who were pet owners. The study aimed to determine the effect of pet ownership on the mental health of these older adults. Their findings fell into several categories:

Feelings of Comfort and Safety: Pet owners reported their animals could lift their moods by being a “constant” in their lives. All participants discussed positive experiences and memories of how their pets influenced their current situations. One man who suffered from depression said he was improved and happier because of the bond he shared with his pet. Several others mentioned that having a pet satisfied the tactile aspects of life that they found essential and missed after the death of a spouse.
Increased Social Engagement: All participants stated that pet ownership meant they engaged in pet-related activities, resulting in increased socialization with friends and family. Their pet acted as a “connector” between themselves and others. The increased socialization led to a sense of belonging in their communities and positively impacted their mental health.
Meaningful Life Role: Owning a pet was compared to parenting . Research on older adults shows that parenting and caring for a pet are socially valuable and meaningful. The responsibilities of pet ownership motivate older adults to “get up and do things every day,” which assists in developing a routine. These factors help avoid feeling “useless” and increase self-esteem by creating a sense of purpose.

I am an empty nester, so my animal friends are my in-home children. When I come home from work or vacation and am greeted by four pairs of eyes, wagging tails, and meows, I swear I can feel my blood pressure drop and experience a sense of calm. I am not alone. The National Institutes of Health (NIH) is participating in large studies promoting the positive health effects of owning a pet. They can improve cardiovascular health, decrease your body’s production of stress hormones , lower your blood pressure, and provide a lifeline to prevent loneliness.

Haidt, Jonathan. The Anxious Generation . Penguin, 2024.

Hawkins, Roxanne D., et al. “Young Adults’ Views on the Mechanisms Underpinning the Impact of Pets on Symptoms of Anxiety and Depression.” Frontiers in Psychiatry , Frontiers Media SA, Feb. 2024

Hui Gan, Genieve Zhe, et al. “Pet Ownership and Its Influence on Mental Health in Older Adults.” Aging & Mental Health , no. 10, Informa UK Limited, June 2019, pp. 1605–12.

Vivek, Murthy. “New Surgeon General Advisory Raises Alarm about the Devastating Impact of the Epidemic of Loneliness and Isolation in the United States | HHS.Gov.” HHS.Gov , U.S. Department of Health and Human Services, 3 May 2023.

Susan Trachman, M.D., is an associate professor at George Washington University and assistant professor at Virginia Commonwealth. She is a board-certified psychiatrist in adult and forensic psychiatry.

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Research Article

A prospective study of mental wellbeing, quality of life, human-animal attachment, and grief among foster caregivers at animal shelters

Roles Conceptualization, Data curation, Formal analysis, Funding acquisition, Methodology, Project administration, Resources, Supervision, Visualization, Writing – original draft, Writing – review & editing

* E-mail: [email protected]

Affiliation School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, United States of America

Roles Data curation, Project administration, Writing – review & editing

Roles Conceptualization, Funding acquisition, Writing – review & editing

Roles Conceptualization, Funding acquisition, Software, Writing – review & editing

Lauren Powell,
Roxy Ackerman,
Chelsea L. Reinhard,
James Serpell,
Brittany Watson

Published: May 22, 2024
https://doi.org/10.1371/journal.pone.0301661
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Foster care programs at animal shelters have emerged as an important tool for promoting animal welfare and supporting shelter life-saving efforts. Preliminary evidence suggests that foster caregiving may also be health-promoting for humans. The goals of this study were to investigate the experiences of foster caregivers at animal shelters based on measures of positive and negative affect, quality of life, and grief, and to describe human-animal attachment among foster populations. Between March 2022 and 2023, 131 foster caregivers from five shelters in the United States completed three online surveys before, during and after providing foster care to a shelter animal. Positive affect decreased significantly from baseline to post-foster (F = 5.71, p<0.01), particularly among dog caregivers (F = 6.17, p<0.01). Negative affect remained unchanged (F = 0.47, p = 0.63). Foster caregivers perceived their foster animal provided companionship, affection and emotional support, although dog foster caregivers reported significantly higher emotional (U = 313.50, p<0.01) and social/physical quality of life (t = 4.42, p<0.01) than cat foster caregivers. Caregivers reported low mean avoidant and anxious attachment, suggesting they were able to develop secure bonds with their foster animals. Retention of fosters was also strong, with 86% of caregivers reporting they were likely to provide foster care in the future. Our findings suggest that fostering at animal shelters may serve as a One Health intervention to offer companionship, affection and emotional support to human caregivers while promoting animal welfare. However, these benefits did not translate to improvements in caregiver mental wellbeing, so caution should be applied when considering foster caregiving as a potential mental health promotion tool.

Citation: Powell L, Ackerman R, Reinhard CL, Serpell J, Watson B (2024) A prospective study of mental wellbeing, quality of life, human-animal attachment, and grief among foster caregivers at animal shelters. PLoS ONE 19(5): e0301661. https://doi.org/10.1371/journal.pone.0301661

Editor: I Anna S. Olsson, Universidade do Porto Instituto de Biologia Molecular e Celular, PORTUGAL

Received: October 20, 2023; Accepted: March 20, 2024; Published: May 22, 2024

Copyright: © 2024 Powell et al. This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Data Availability: The dataset supporting this paper is available at Dryad: https://doi.org/10.5061/dryad.5mkkwh7d6 .

Funding: The study was funded by Nestlé Purina PetCare Global Resources, Inc. The Arnall Family Foundation provided salary support for L.P. and the Bernice Barbour Foundation provided salary support for C.L.R. The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Competing interests: The authors have declared that no competing interests exist.

Introduction

Millions of animals enter animal shelters around the world each year where they face a host of stressors and, in some cases, a heightened risk of euthanasia [ 1 – 5 ]. Shelters often have limited space and resources, so animals may have a reduced ability to exercise, exhibit normal behaviors and interact with conspecifics or humans. The loss of social attachments, excess noise, and lack of control or predictability in the shelter can also exaggerate stress levels and reduce quality of life (QoL) (see Taylor and Mills [ 6 ] for full review). Foster care has emerged as a promising tool to improve animal welfare for shelter animals. Short-term stays in a foster home can decrease stress, reduce cortisol and promote rest among shelter dogs [ 7 ]. Placement in a foster home can also boost animals’ visibility in the community, resulting in greater opportunities for adoption [ 8 ] and an increased likelihood of leaving the shelter alive [ 9 ].

Companion animal foster caregiving may also be health-promoting for humans [ 10 ]. A recent, cross-sectional survey of about 600 shelter foster caregivers found almost all caregivers agreed with the statement ‘fostering dogs adds to my happiness’ and 88% agreed that ‘interacting with my fosters helps me stay healthy’ [ 11 ]. In a pilot study of 11 foster caregivers, after six weeks of caring for a shelter dog, foster caregivers performed more physical activity and spent less time sitting based on accelerometer data. Caregivers also reported fewer depressive symptoms, and half the sample had met new people in their neighborhood because of their foster dog [ 12 ]. A second pilot study of four war veterans reported similarly promising results. Dog foster caregivers performed more steps per day, reported better QoL, increased positive affect, lower stress and decreased depression after three months of fostering [ 13 ].

However, foster caregivers are likely to also encounter challenges while providing care and/or feelings of loss when the animal departs the home. Fostering animals with behavioral problems appears to be particularly challenging [ 11 , 14 ], with previous data indicating that 23% of foster caregivers found caring for behavioral cases very emotionally challenging compared with only 7% of medical cases [ 11 ]. Caregivers who frequently foster puppies or ‘special needs’ cases have also reported more thoughts of quitting due to burnout [ 11 ]. Research focused on the experiences of human foster parents shows grief around the departure of a child leads many caregivers to consider quitting, although agency support and caregiver training can mitigate the risk of caregiver turnover [ 15 ]. Grief among companion animal foster caregivers has received little scientific attention, although initial data suggests that organizational support from shelters may be similarly important in reducing the emotional impacts of fostering and increasing the retention of caregivers [ 11 ].

Human-animal bonds could also influence caregivers’ perceptions of the benefits and challenges of shelter foster caregiving. Thielke and Udell [ 16 ] hypothesized that foster-animal attachment could be a source of stress for foster caregivers who feel conflicted about bonding with their foster animals due to concerns about how they will adjust when separated. The researchers used the LAPS questionnaire [ 17 ] to measure the strength of attachment among foster caregivers, finding comparable levels of attachment between animal shelter volunteers and foster caregivers [ 16 ]. Using a truncated version of the same questionnaire, Reese, Jacobs [ 11 ] also reported foster caregivers had similar levels of attachment to pet owners from previously published studies [ 17 ]. In their sample, increased attachment was correlated with a lower risk of quitting fostering due to bad experiences, suggesting that human-animal attachment may alleviate some of the stressors associated with foster caregiving [ 11 ].

No studies to date have considered foster caregiver-animal attachment based on style rather than strength, which limits our understanding of the human-animal bond in shelter populations [ 18 , 19 ]. Anxious and avoidant attachment dimensions have been used to characterize attachment in other populations. Individuals who score low on both components are said to have secure attachments where they feel comfortable bonding with and relying on their animal [ 20 ]. Anxious attachment describes intrusive thoughts, worrying, and seeking proximity or reassurance from the animal, and has been correlated with increased animal-directed caregiving behaviors [ 21 ] but poorer mental wellbeing, and increased anxiety and distress [ 20 ]. Avoidant attachment, which describes individuals who maintain emotional distance and avoid intimacy with their pet, has been associated with less attentiveness towards animals [ 21 ] but does not impact mental wellbeing or distress [ 20 ]. Service dog foster carers have been shown to exhibit increased avoidant attachment compared with companion animal owners [ 22 , 23 ]. The researchers hypothesized that avoidant attachment may help to prepare caregivers for the eventual departure of the animal [ 22 ]. Human attachment styles also impact animal behavior [ 24 – 26 ]. Increasing avoidant attachment, for example, has been associated with a greater prevalence of separation-related distress among dogs [ 25 ] which may be particularly relevant for shelter dogs as some evidence suggests they may be at greater risk of exhibiting separation anxiety [ 27 , 28 ].

Public interest in foster caregiving spiked during the COVID-19 pandemic, with reports of increased applications during the lock-down period [ 29 , 30 ]. Many shelters attempted to recruit new foster caregivers during this time and some initiated foster care programs for the first time [ 31 ]. However, the increased interest has since subsided [ 29 ] so retention of existing caregivers has become even more crucial for shelters. The goal of this study was to characterize the experiences of foster caregivers before, during, and after providing foster care for a shelter animal, using measures of positive and negative affect, QoL, and grief, and to describe retention among shelter foster populations. A secondary aim was to measure human-animal attachment among foster caregivers based on anxious and avoidant attachment dimensions.

Materials and methods

Study population.

Foster caregivers were recruited from five shelters in the United States between 8th March 2022 and 20th March 2023, including Providence Animal Center in PA, Humane Animal Partners in DE, Dakin Humane Society and Massachusetts Society for the Prevention of Cruelty to Animals in MA, and San Diego Humane Society in CA. The first four shelters were small to medium in size, taking in between 2655 and 5906 animals in 2019, while San Diego Humane Society was much larger, taking in approximately 29,000 animals in 2019 [described further in 32 ]. To be eligible to participate, foster caregivers had to be over the age of 18 years, agree to provide temporary care to a shelter animal in their home, not have fostered an animal in the previous seven days, not planning to use the foster period as a trial adoption and not have participated in the study previously. The inclusion and exclusion of participants is described further in Fig 1 . The study was reviewed and approved by the University of Pennsylvania Institutional Review Board (protocol number 850635) and all participants provided written informed consent.

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https://doi.org/10.1371/journal.pone.0301661.g001

The study used a prospective, observational design where foster caregivers were invited to participate in the study by shelter staff when they booked an appointment or attended the shelter to pick-up a foster animal ( Fig 2 ). The baseline survey was completed online using Qualtrics up to seven days before the foster animal was taken home or on an iPad at the shelter, depending on the shelter’s processes. Researchers then recorded the date on which the animal entered foster care based on the shelter records, which was accessed directly using PetPoint (PetPoint Data Management System, Version 6, Pethealth Software Solutions Inc., USA), Shelterluv (Shelterluv, Inc., USA) or through exported reports provided by the shelters. We contacted the participants via email or phone (depending on the participant’s preference) 10 days after the foster animal entered their home to complete the second survey. Researchers tracked when foster animals had an outcome in the shelter records or exported reports and contacted caregivers to complete the third survey once the foster animal had left the caregiver’s home. Foster caregivers were sent up to two reminders on subsequent days if they had not completed the follow-up surveys.

PANAS: Positive and Negative Affect Schedule. PAQ: Pet Attachment Questionnaire. DOQOL: Dog Owner-specific Quality of Life questionnaire.

https://doi.org/10.1371/journal.pone.0301661.g002

Questionnaires

The results from the baseline survey describing foster caregivers’ motivations for care based on their demographic characteristics and personality traits have been described in detail previously [ 32 ]. The data from the questionnaires below are presented here for the first time.

Animal demographics.

Foster caregivers were asked to report their foster animal’s shelter ID number, foster species, and primary and secondary reasons for foster at time point 2 (during care). We also asked participants whether their foster animal was experiencing any health conditions on a four-point scale (no condition, minor, moderate or serious health conditions) and whether they were experiencing any problems with their foster animal’s behavior (no problems, minor, moderate or serious problems).

Positive and Negative Affect Schedule (PANAS).

Participants completed the short form of the Positive and Negative Affect Schedule (PANAS) at each time point to provide measures of affect across the foster experience. The PANAS is a 10-item questionnaire that assesses an individual’s recent feelings and mood on a five-point scale from “never” (1) to “always” (5). It produces two subscales based on positive and negative affect, by averaging the respondents’ scores for the descriptors ‘alert’, ‘inspired’, ‘determined’, ‘attentive’, ‘active’ and ‘upset’, ‘hostile’, ‘ashamed’, ‘nervous’ and ‘afraid’, respectively. The short form of the PANAS exhibits strong psychometric properties, including internal reliability, convergent and criterion validity and has been shown to reflect measures of subjective well-being and happiness [ 33 ]. The PANAS has also been shown to reflect other measures of mental health. Scores in the positive affect scale are typically negatively correlated while negative affect scores are positively correlated with measures of psychological distress, stress, anxiety, depression, and fatigue [ 34 – 36 ].

Dog Owner-specific Quality of Life questionnaire (DOQOL).

The Dog Owner-specific Quality of Life questionnaire (DOQOL) was used to characterize the role of the foster animal in foster caregivers’ QoL during foster care (time point 2). The survey includes 10 questions presented on a seven-point scale, with answers ranging from “disagree strongly” (1) to “agree strongly” (7). The scores were then averaged to produce three subscale scores for emotional QoL, social/physical QoL, and stress/interference QoL. The DOQOL has established reliability and validity among dog owners but has not yet been applied among cat caregivers [ 37 ].

Pet Attachment Questionnaire (PAQ).

The Pet Attachment Questionnaire (PAQ) is a validated 26-item questionnaire that was used to measure attachment orientations of foster caregivers towards their foster animals during care (time point 2). Individuals were asked to indicate how much they agreed with each prompt on a 7-point Likert scale. Subscale scores for anxious and avoidant attachment were then calculated by reverse scoring the relevant prompts and averaging the scores. A higher score in both subscales was indicative of a higher avoidant or anxious attachment [ 20 ].

Foster parent grief scale.

At time point 3, after the foster animal had an outcome (e.g., adoption, returned to shelter, euthanized), caregivers completed a shortened version of the Foster Parent Grief Scale, adjusted to reflect shelter animals rather than human children. The original scale included a series of 16 statements about anticipatory and experienced grief where foster parents were instructed to indicate how much they agreed with each statement on a 5-point scale from strongly agree (1) to strongly disagree (5) [ 38 ]. Here, the foster caregivers were asked 7 adapted questions from the scale and several additional questions about how challenging they found foster care and how likely they were to provide foster care to future shelter animals.

Statistical analysis

As the DOQOL had not previously been used among cat caregivers, we first ran a confirmatory factor analysis in IBM SPSS AMOS 28 Graphics. Univariate normality was assessed using visual investigation of histograms, skew and kurtosis values and the Shapiro-Wilk test, and multivariate normality was assessed using Mardia’s normalized estimate of multivariate kurtosis. The data showed some non-normality, although skew and kurtosis values fell within normal ranges (-2 to +2, and <7 respectively). To account for this, we ran a maximum likelihood (ML) model with bootstrapping including 500 samples [ 39 ]. All other statistical analyses were conducted in IBM SPSS Statistics, version 29. We first compared demographic characteristics between participants with valid data across all time points relative to those with missing data using Pearson Chi Square or Fisher-Freeman tests where >20% of cells had an expected frequency less than 5. Linear mixed-effects models were then used to examine changes in positive and negative affect with time point (baseline, 10-day, and post-foster), foster species, an interaction term between time point*foster species, age, gender and previous foster experience included as fixed effects and participant included as a random effect. These models are commonly used for repeated measures as they can accommodate non-independence of measurements between time points and missing data points, so participants with missing data do not need to be excluded on a pairwise basis, thus maximizing sample size and reducing possible bias [ 40 ]. The positive affect residuals were normally distributed based on visual inspection of histograms and Q-Q plots. The negative affect residuals showed moderate deviation from normality, although previous research shows linear mixed-effects models are remarkably robust to violations of model assumptions [ 41 ]. We then compared QoL and pet attachment relative to foster species, perceived behavioral problems as a binary variable (no problems/minor, moderate or serious problems), the presence of medical conditions (no condition/minor, moderate or serious condition), and previous foster experience using Mann Whitney U tests for non-parametric data and independent samples t-tests for parametric data. Pearson’s r and Hedges’ g were calculated as measures of effect size, respectively, and are reported alongside p values we previously suggested [ 42 ]. P<0.05 was considered statistically significant, unless otherwise indicated.

Descriptive characteristics

The final sample included 131 respondents with valid baseline data, 74 with valid data at time point two (during foster care) and 63 with valid data at time point three (post-foster care, Fig 1 ). Almost two-thirds of the sample were under 39 years of age (42.0% were 18–29 years and 21.4% were 30–39 years). Most foster caregivers were female (n = 117, 89.3%), white (n = 108, 82.4%), previous (n = 120, 91.6%) or current pet owners (n = 77, 58.8%), and just over half had previous foster experience (n = 70, 53.4%). About half the sample fostered dogs (n = 65, 49.6%), while 46.6% fostered cats (n = 61), and 3.8% fostered other species (n = 5). Caregivers with missing data for at least one time point did not differ in gender (X2(3, n = 131) = 2.60, p = 0.53) or race (X2(6, n = 131) = 5.95, p = 0.40) from those with complete data, but were significantly more likely to be 18–29 years old (X2(6, n = 131) = 18.97, p<0.01) and to have no previous experience fostering (X2(1, n = 131) = 5.55, p = 0.02).

Most foster caregivers reported they were not experiencing any problems with their foster animal’s behavior (n = 51, 68.9%), although 28.4% experienced minor problems (n = 21), and 2.7% experienced moderate problems (n = 2). No foster caregivers said they were experiencing severe problems with their foster animal’s behavior. Health conditions were more common. About half of the fosters reported their animal/s had no health conditions (52.7%, n = 39), but 37.8% reported minor conditions (n = 28), 6.8% had moderate conditions (n = 5) and 2.7% had serious health conditions (n = 2).

Foster caregiver affect

Linear mixed models revealed a statistically significant main effect of time on positive affect (F2,140.99 = 5.71, p<0.01, Table 1 ) and an interaction effect between time and foster species (F2,140.99 = 6.17, p<0.01), suggesting the changes in positive affect differed significantly between dog and cat foster caregivers ( Fig 3 ). Negative affect was comparable at each time point (F2,169.33 = 0.47, p = 0.63, Table 1 ). Age (p≥0.10), gender (p≥0.69) and previous foster experience (p≥0.43) were not significantly associated with positive or negative affect and were subsequently removed from the models. Foster species was also non-significant and thus removed from the negative affect model (p = 0.69).

https://doi.org/10.1371/journal.pone.0301661.g003

https://doi.org/10.1371/journal.pone.0301661.t001

Foster caregiver quality of life

The median item scores for the DOQOL are provided in Table 2 . Confirmatory factor analysis supported a three-factor model in our sample of dog and cat foster caregivers. The model (X2 = 52.31, df = 32, p = 0.01) showed acceptable fit based on the comparative fit index (CFI = 0.95), the Tucker-Lewis Index (TIL = 0.92) and the root mean square error of approximation (RMSEA = 0.09), with all factor loadings in excess of 0.60 ( S1 Table ). The subscales also retained strong internal reliability based on Cronbach’s Alpha (emotional QoL = 0.91, social/physical QoL = 0.83, and stress/interference QoL = 0.81).

https://doi.org/10.1371/journal.pone.0301661.t002

A Mann-Whitney U test revealed a small (r = 0.40), statistically significant difference in emotional QoL between dog and cat foster caregivers (U = 313.50, z = -3.39, p<0.01), with dog foster caregivers reporting higher emotional QoL (median = 6.67, IQR = 5.50–7.00) compared with cat foster caregivers (median = 5.33, IQR = 4.33–6.00). We also found a large difference (g = 1.10) in social/physical QoL relative to foster species, with dog foster caregivers reporting a mean score of 4.90 (SD = 1.47) compared with cat caregivers (mean = 3.41, SD = 1.26) based on an independent samples t-test (t = 4.42, p<0.01). Stress/interference QoL did not vary between foster species (t = 0.25, p = 0.80, g = 0.06). Foster caregivers who reported experiencing problems with their foster animal’s behavior showed small but non-significant increases in social/physical (t = -0.86, p = 0.39, g = 0.22) and stress/interference QoL (t = -0.83, p = 0.41, g = 0.21) compared with foster caregivers who did not, although emotional QoL was comparable (U = 668.00 z = 0.96, p = 0.34, r = 0.11). Emotional (U = 696.00 z = 0.15, p = 0.88, r = 0.02) and social/physical QoL (t = 0.81, p = 0.42, g = 0.19) were also similar between caregivers who cared for animals with health conditions and those who did not. Stress QoL showed a small, but non-significant (t = 1.78, p = 0.08, g = 0.41), difference between those facing animal health conditions (mean = 3.51, SD = 1.29) compared with those who were not (mean = 2.93, SD = 1.52). First-time and repeat foster caregivers also reported comparable QoL (p≥0.19).

Foster caregiver attachment to pets

Foster caregivers reported low mean avoidant attachment (mean = 1.90, SD = 0.43, range = 1.08–3.15) and anxious attachment scores (mean = 1.64, SD = 0.48, range = 1.00–3.92) from a possible range of 0 to 7. There were no significant differences based on previous foster experience (p≥0.74), foster species (p≥0.07), caregivers’ perceptions of behavioral problems (p≥0.56) or the presence of health conditions (p≥0.07). Although the scores were not statistically different (t = -1.82, p = 0.07), cat foster caregivers reported higher mean avoidant attachment (mean = 1.98, SD = 0.42) than dog foster caregivers (mean = 1.79, SD = 0.43), equivalent to a medium effect size (g = 0.44). Caring for animal/s with a health condition was also associated with a small (r = 0.21), but non-significant, increase in anxious attachment (U = 849.00, Z = 1.81, p = 0.07).

Grief after foster animal left home

Excluding caregivers who adopted at least one of their foster animals (n = 13), the majority of the sample agreed that they missed their foster animal (42.0% somewhat agreed, 36.0% strongly agreed) and often wondered if the animal was doing well (40.0% somewhat agreed, 52.0% strongly agreed). However, most caregivers also reported that they had adjusted well since their foster animal left (68.0% strongly agree, 22.0% somewhat agree), and a minority felt lonely (18.0% somewhat agree, 0.0% strongly agree) or had periods of tearfulness since their foster animal left (20.0% somewhat agree, 10.0% strongly agree). The experiences of foster caregivers are described further in Fig 4 .

https://doi.org/10.1371/journal.pone.0301661.g004

Likelihood of providing future care

Among caregivers with post-foster responses (n = 63), 13 caregivers adopted at least one of their foster animals, 26 had an animal with an adoption outcome, 3 reported at least one animal was transferred to another caregiver, 36 returned at least one animal to the shelter, and 2 caregivers reported at least one of their foster animals was euthanized. The majority of foster caregivers were very likely to provide foster care again in the future (68.3%, n = 43), 17.5% were somewhat likely (n = 11), 4.8% were neither likely nor unlikely (n = 3), 6.3% were somewhat unlikely (n = 4) and 3.2% were very unlikely (n = 2). Of the 6 caregivers who were somewhat or very unlikely to provide future care, 50% had adopted their foster animal. Given the small number of participants who were unlikely to provide foster care in the future, we were unable to investigate possible differences in willingness based on previous foster experience, foster species, caregiver perceived behavioral problems, the presence of medical conditions or how challenging the experience was.

Several pilot studies [ 12 , 13 , 43 ] and a recent narrative review [ 10 ] have highlighted foster caregiving at animal shelters as a potential One Health intervention to promote both human and companion animal health and welfare. However, to our knowledge, this is the largest, longitudinal study of foster caregivers’ experiences at animal shelters to date.

We found foster caregiving did not promote mental wellbeing, based on repeated measures of positive and negative affect. Negative affect was unchanged throughout the foster period, although caregivers consistently reported fewer negative moods compared with previous studies of shelter staff [ 44 ], pet owners [ 45 ] and non-clinical populations [ 33 ]. Positive affect, on the other hand, decreased significantly after the foster animal left the home relative to baseline levels, particularly among dog foster caregivers. Cat caregivers reported stable levels of positive affect across all time points. The absence of the pet and associated feelings of grief, reported by many participants, likely contribute to the reduction in positive moods following the animal’s departure. The varying impacts on positive mood between species may be due to differences in both the degree and nature of human-animal interactions. For example, dog owners typically exhibit more animal-directed communication behaviors, such as petting, hugging, kissing and talking to, and perceive greater social support from their pets than cat owners [ 46 ]. These behavioral differences may facilitate the development of human-dog attachments among foster populations and contribute to the decline in positive affect after the dog leaves the foster home.

The lack of significant difference from baseline to during foster could be due to the timing of data collection. The baseline PANAS survey was completed after the foster caregivers had scheduled a foster appointment but before the animal entered their home, so the upcoming foster experience may have already boosted participants’ positive moods at the time of the baseline survey. Future studies may consider including an additional baseline data collection before caregivers book a foster appointment to test this hypothesis. Although caring for a foster animal did not have any additional mental health benefits, positive affect levels were comparable to previously reported mean values at all time points throughout the study [ 33 , 44 , 45 ]. Our findings differ from an existing pilot study that suggested foster caregiving increased positive affect among four veterans [ 13 ] which may be attributable to population differences between veterans and shelter foster populations, or differences between individuals who foster to adopt (as seen in the prior study) relative to those fostering without the intention to adopt.

Although we did not find longitudinal evidence of mental health benefits associated with caregiving, fosters reported self-perceived benefits in QoL. Caregivers perceived their foster animal had a positive impact on their emotional QoL during foster by providing love and affection, companionship, and, to a slightly lesser extent, emotional support. Social and physical QoL was mostly unaffected, while caregivers disagreed that fostering increased their stress-related QoL on average, which mirrors previous research [ 13 , 43 ]. Like some previous studies of pet owners [ 47 – 49 ], we found dog fosters perceived greater emotional, social and physical QoL benefits while caring for the dog than cat foster caregivers which may also contribute to the species-specific decline in positive affect described above. The differences between dog and cat caregivers are again likely due to variations in the nature of human-animal attachment between species. For example, dogs can motivate their caregivers to walk which can boost emotional and physical QoL, and promote social connections within neighborhoods. These species differences may also reflect an artifact of the scale which was originally designed for use among dog owners [ 37 ]. QoL did not differ statistically based on caregiver perceptions of behavioral problems or the presence of medical conditions, despite previous evidence to the contrary [ 50 – 52 ]. Separation-related behaviors, for example, have been associated with increased stress QoL among dog owners, while fearfulness has been linked with decreased physical QoL [ 50 ]. The temporary nature of foster caregiving and the training and support provided by shelters may have reduced the impacts of behavioral problems on caregiver QoL compared with typical pet ownership. Further research including larger, more diverse human and animal samples is needed to support this hypothesis.

We were also interested in the attachment styles of foster caregivers as increased anxious and avoidant attachment can negatively impact both human mental wellbeing and animal behavior [ 20 , 25 , 53 ]. Foster caregivers reported low levels of anxious and avoidant attachment compared with previous samples of pet owners [ 20 ] and assistance dog puppy raisers [ 22 ] which suggests caregivers were able to develop secure attachment bonds with their foster animals. By providing a secure base, the foster caregivers may also help their foster animals, who are known to exhibit more insecure attachment styles than pet dogs [ 16 ], to also develop secure bonds. The benefits of this could transcend the foster home to the future adoptive home by increasing the likelihood and speed of bond formation, as described previously among human foster children [ 54 ]. Previous studies have also found cat owners exhibited higher levels of avoidant attachment than dog owners, which Zilcha-Mano, Mikulincer and Shaver [ 20 ] hypothesized may be attributed to their species-specific behaviors, since cats are often perceived as independent while dogs are believed to be more attentive to their owners. We did not find statistically significant species differences here but this hypothesis warrants further investigation in foster care populations considering the observed difference in mental health and QoL between dog and cat caregivers.

Grief following the departure of the foster child has been associated with thoughts of discontinuing fostering among human foster caregivers [ 15 ]. Here, we found half of our sample reported some signs of anticipatory grief, meaning they anticipated experiencing difficulties when the foster animal left the home [ 38 ]. Most of the sample also showed ambiguous grief, which describes grief in situations with ambiguity surrounding the loss, such as when an individual is alive but not physically present [ 55 ]. For foster carers, this typically manifests in a desire to know how the animal or child is doing [ 56 , 57 ], as we also saw here. However, the majority of caregivers in our study also reported they had adjusted well since their foster animal left the home, which was considerably higher than previous studies of human foster children [ 38 ]. Although not a primary aim of the current study, future research could investigate the impact of grief on measures of positive and negative affect relative to foster caregiving using a validated, composite measure of pet grief.

Retention of foster caregivers in this sample appeared promising, with 86% indicating they were likely to provide foster care in the future. In fact, ‘foster failing’ where caregivers adopted their foster animal appeared to be a common reason why caregivers were unlikely to foster in the future. Foster failing has also been described as a common reason for quitting foster care in previous studies of shelter dogs, typically because participants felt they no longer had room to care for an additional animal [ 14 ]. Although we measured future intention to foster rather than actual behavior, and research shows that people do not always do what they intend to do [ 58 ], the findings suggest that most caregivers at least plan to foster shelter animals in the future.

The findings should be considered in light of several limitations. First, we were unable to calculate a response rate as shelter staff informed foster caregivers about the study, so the findings may be subject to selection bias. It is also possible that the results are impacted by nonresponse bias as a considerable proportion of caregivers dropped out of the study. For example, caregivers may have been more motivated to complete the study if they had strong opinions about their foster care experience, including both positive and negative perspectives. The generalizability of the findings is limited as most foster programs were located in the Northeastern United States and the study population was mostly white and female. However, it is also possible that the homogeneity of the study sample is indicative of a broader lack of diversity within shelter foster populations, as has also been described among shelter volunteers [ 59 ]. We were also limited by the length of the survey, and thus included positive and negative affect as sole measures of participants’ moods. Although affect is correlated with other measures of mental health and wellbeing [ 34 – 36 ], future research may consider using surveys specifically designed to measure stress, anxiety, depression or loneliness to further elucidate the impacts of foster caregiving on human mental health. The inclusion of physiological measures of stress and mental wellbeing, such as cortisol, oxytocin or heart rate variability, could also bolster our study findings.

We did not find longitudinal evidence to support the notion that foster caregiving can promote mental wellbeing, although both dog and cat foster caregivers reported that their foster animal provided love, affection, companionship and emotional support. Dog caregivers also indicated that their physical and social QoL benefited from foster caregiving. Caregivers appeared to form secure bonds with their foster pets, which could benefit both human mental wellbeing and animal behavior and welfare. While caregivers showed some signs of anticipatory and ambiguous grief at the end of the foster period, most believed they had adjusted well since their animal left and the vast majority were likely to provide foster care to future shelter animals. Our results provide support for the continued expansion of foster care programs for the mutual benefits of caregivers and shelter animals. However, additional studies including more comprehensive measures of mental wellbeing are needed to determine whether companion animal foster caregiving may serve as a mental health promotion tool.

Supporting information

S1 table. standardized factor loadings of doqol from confirmatory factor analysis using a maximum likelihood model with bootstrapping including 500 samples..

https://doi.org/10.1371/journal.pone.0301661.s001

Acknowledgments

We thank Dakin Humane Society, Providence Animal Center, Humane Animal Partners, Massachusetts Society for the Prevention of Cruelty to Animals, and San Diego Humane Society for their support of the study and their help recruiting foster caregivers.

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Published: 05 February 2018

The power of support from companion animals for people living with mental health problems: a systematic review and narrative synthesis of the evidence

Helen Louise Brooks ORCID: orcid.org/0000-0002-2157-0200 1 ,
Kelly Rushton 2 ,
Karina Lovell 2 ,
Penny Bee 2 ,
Lauren Walker 2 ,
Laura Grant 3 &
Anne Rogers 4

BMC Psychiatry volume 18 , Article number: 31 ( 2018 ) Cite this article

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There is increasing recognition of the therapeutic function pets can play in relation to mental health. However, there has been no systematic review of the evidence related to the comprehensive role of companion animals and how pets might contribute to the work associated with managing a long-term mental health condition. The aim of this study was to explore the extent, nature and quality of the evidence implicating the role and utility of pet ownership for people living with a mental health condition.

A systematic search for studies exploring the role of companion animals in the management of mental health conditions was undertaken by searching 9 databases and undertaking a scoping review of grey literature from the earliest record until March 2017. To be eligible for inclusion, studies had to be published in English and report on primary data related to the relationship between domestic animal ownership and the management of diagnosable mental health conditions. Synthesis of qualitative and quantitative data was undertaken in parallel using a narrative synthesis informed by an illness work theoretical framework.

A total of 17 studies were included in the review. Quantitative evidence relating to the benefits of pet ownership was mixed with included studies demonstrating positive, negative and neutral impacts of pet ownership. Qualitative studies illuminated the intensiveness of connectivity people with companion animals reported, and the multi-faceted ways in which pets contributed to the work associated with managing a mental health condition, particularly in times of crisis. The negative aspects of pet ownership were also highlighted, including the practical and emotional burden of pet ownership and the psychological impact that losing a pet has.

This review suggests that pets provide benefits to those with mental health conditions. Further research is required to test the nature and extent of this relationship, incorporating outcomes that cover the range of roles and types of support pets confer in relation to mental health and the means by which these can be incorporated into the mainstay of support for people experiencing a mental health problem.

Peer Review reports

The rise in people experiencing a mental health problem [ 1 ] and the identification of mental illness as the leading cause of disability adjusted life years globally (DALYs) [ 2 , 3 ] requires concerted effort in identifying and mobilising resources to support people living with a mental health problem. Traditional approaches to the self-management of long-term conditions focus on psychological mechanisms of behaviour change, which have been shown to have some utility for managing symptoms. However, these approaches often fail to take into account the wider resources including material and social relationships in people’s domestic and local environments which form the latent and constituent part of systems of lay and community support [ 4 ]. These are increasingly being recognised as holding significant relevance for the management of long-term health conditions [ 5 ]. Indication of the potential benefit that pets convey to the experience of mental health comes from evidence detailing the benefits of pet ownership in relation to stress reduction, improved quality of life, and pets as promoters of social and community interaction [ 6 , 7 , 8 ]. Recent work has shed light on the relevance of pets in the social networks of people who have received a diagnosis of a severe and enduring mental health illness (e.g. Schizophrenia and Bipolar disorder) [ 9 ] suggesting that pets can be considered alongside other human relationships. However, the evidence base for the benefit of pet ownership for those with diagnosable mental health conditions is fragmented and unclear.

The enduring relationship between humans and domestic animals is well documented and there are an estimated 10 million cats (23% of households with one or more cat) and 11.5 million dogs (30% of households with one or more dog) kept as pets in the UK [ 10 ], with similar rates of ownership found across Europe, Australia, China and Japan [ 11 ]. Despite this phenomenon, the potential benefits that owning a pet might confer specifically to mental health has received relatively little attention. Research has focused on formalised animal contact in closed settings such as Animal Assisted Therapy (AAT). Multiple reviews have considered AAT in a variety of fields including intellectual disability [ 12 ], autism [ 13 ], general healthcare [ 14 , 15 ] and neuro-rehabilitation [ 16 , 17 ], but there are no systematic syntheses of the role and effects of the less structured animal contact provided by pet ownership in open settings for people with mental health conditions. The provision of ongoing support in normalised everyday settings remains an aspiration of mental health policy but the mapping of the nature of resources available and how they are, and can be, deployed remains underexplored.

Underlying theoretical framework

This review draws on a framework of long-term condition ‘work’ informed by Corbin and Strauss [ 18 ] which was developed in the context of exploring the contribution and division of labour provided by intimate and weak ties in personal communities in relation to living with a long term condition [ 4 , 5 , 19 , 20 ]. This approach allows for an in-depth analysis of the role of pets in relation to the tasks that need to be done to manage mental health in the context of people’s everyday lives to consolidate the evidence base in this regard. Practical work consists of tasks undertaken by network members which are practical in orientation and includes general practical activities such as housekeeping, personal care and diet and exercise activities but also illness specific practical tasks such as taking medication, understanding symptoms, making appointments and preventative work to avoid crises. Emotional work relates to wellbeing, providing companionship and being a source of comfort when worried about everyday matters or specific illness matters. Biographical work relates to the tasks and generation of ontological security, required to retain a positive sense of identity and give life meaning again post diagnosis. This involves assessments of personal expectations, capabilities, relationships and biographical events. These types of work are distributed amongst weak as well as close ties [ 21 ]. This framework has been used in preference to more traditional notions of social support as it allows for the inclusion of an in-depth understanding of the open system resources, networks and relationships that people draw on when managing a long-term condition in their everyday lives [ 4 ]. The framework was used to guide the narrative synthesis of the studies included in the review.

This review aimed to explore the nature, extent and quality of the evidence demonstrating the role of pet ownership for people with mental health conditions.

Review questions

What is the nature, extent and quality of the evidence demonstrating the role of pet ownership for those with mental health conditions, with or without comorbid physical health conditions?

What is currently known about the mechanisms underlying any impact?

A comprehensive search of 9 electronic databases was undertaken in March 2017. The methods and reporting of the results of this systematic review are described according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines [ 22 ].

Eligibility criteria

The review sought to identify studies that reported primary data, which investigated the relationship between pet ownership and diagnosable mental health conditions. Inclusion/exclusion criteria can be found in Table 1 . All participants in the sample had a diagnosable mental health condition or mental health problems associated with a diagnosed physical health condition. Papers were excluded if it was unclear who the sample were and could only be included if specific reference to diagnosable conditions was made.

Studies were not excluded by date of publication or sample size. However, those that were not published in the English language, were only published in abstract form, or were not accessible via inter-library loan were not included in this review.

Search strategy and data sources

Electronic database searches were undertaken in March 2017 from the earliest record to March 2017 using ASSIA, CINAHL Plus, Embase, International Bibliography of the Social Sciences, Medline, PsychInfo, Social Science Full Text, Sociological Abstracts, and Web of Science. Grey literature sites were also searched including OpenGrey, Index to Theses, Electronic Theses Online Services, The Health and Social Care Information Centre Website and the Association of Health Observatories Website.

The search strategy was organised around four key areas: 1) Participants’ perspectives, 2) Pet ownership, 3) Diagnosed mental health conditions or co-morbid mental health related to long-term physical conditions and 4) impact of pets on mental health management. The search strategy was informed by published reviews, discussion within the wider project team, consideration of MeSH terms and the wider literature in the area of pet ownership. HB piloted search terms in a number of databases with input from an information technology specialist. Papers identified through piloting were assessed for additional terms, subject headings and key words with the aim of further refining the search strategy. A copy of the final search strategy is available from the author. Within each PICO component agreed search terms were combined using the Boolean operator ‘OR’ and across components using ‘AND’. The search was adapted for the individual databases and websites as required.

Review strategy

Search results were uploaded to Endnote before removing duplicates and exporting into the data management software Covidence ( https://www.Covidence.org ). The first stage of the review process involved single screening at the level of title and abstract (see Table 1 for a list of inclusion and exclusion criteria). An additional reviewer independently reviewed all excluded references for validity purposes. Full texts of included articles were obtained for the purposes of full text screening. Full texts were screened for inclusion independently by two reviewers and inclusion/exclusion conflicts were resolved by a third reviewer. Acceptable concordance was predefined at 90% [ 23 ]. A concordance rate of 93% was achieved at first rating (29 exclusion/inclusion conflicts).

The reference lists of included papers were also manually searched for relevant papers. A Google Scholar alert was created in February 2017 and stopped in August 2017, which did not identify any additional articles for inclusion.

Data extraction

Electronic forms were created in Microsoft Excel for the purpose of data extraction. Data was double extracted independently by two authors who each extracted all studies. Disagreement between extractors, which consisted of mostly minor additional detail, was resolved by consensus between authors.

The aim of the review was to explore the impact of pet ownership on diagnosed mental health conditions (or co-morbid mental health symptoms associated with other long-term conditions). Where data was available from quantitative and qualitative outcomes of mental health, these were extracted along with data relating to study design, included participants and other contextual factors.

Quality assessment

Included articles were assessed for relevance by HB, KR and AR and for quality by HB and KR using criteria adapted from the Qualitative Research Review Guidelines - RATS and the Quantitative Assessment tool for Quantitative Studies [ 24 ]. Any disagreements were resolved by discussion between authors. The quality assessment included assessment of potential bias in terms of selection and response and the reliability and validity of the methodology utilised. No study was excluded on quality alone [ 25 ]. Studies were given one point for each quality criteria the study met (see Additional files 1 and 2 ) and this was used to guide the narrative synthesis of the studies included in the review.

The quality assessment process generated an average quality rating of 5.5 out of 10 for qualitative studies and 8.75 out of 10 for quantitative work (refer to Additional files 1 and 2 ). There were no RCTs evaluating the impact of pet ownership on diagnosed mental health conditions.

Data synthesis

A deductive, thematic synthesis approach was constructed collaboratively between two authors (HB, KR) and the resultant analytical framework was elaborated and checked by a third (AR). Quantitative and qualitative data were synthesised and combined in parallel. Primary findings in each study were coded in line with the concepts of the networked work of illness management identified above which identified a set of three core types of work deployed by social network members of an individual’s personal community of support ( practical, emotional and biographical work ). We utilised a constant comparative approach to analysis to enhance the likelihood that concepts were translated successfully from one study to another [ 26 ]. Descriptive themes emerged which were used to describe groups of codes within each category of work. Using the framework we were able to draw comparisons between these themes and move beyond the primary findings presented within each individual paper. Individual benefits and disadvantages of pet ownership were considered in terms of the conditions and contexts they emerged from.

The search resulted in 17 studies for synthesis; the flow of studies is outlined in Fig. 1 . All study characteristics and quality indicators are detailed in Additional files 1 , 2 , 3 and 4 . Of the 17 studies, 8 were conducted in the USA [ 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 ], 4 in the UK [ 9 , 35 , 36 , 37 ], 2 in Canada [ 38 , 39 ] and 1 each in the Netherlands [ 40 ], Australia [ 41 ], and Sweden [ 42 ]. Twelve of the studies were reported in journal articles [ 9 , 27 , 30 , 32 , 33 , 34 , 35 , 38 , 39 , 40 , 41 , 42 ] and 5 were part of doctoral research [ 28 , 29 , 31 , 36 , 37 ]. Eight of the studies used qualitative methodology [ 9 , 27 , 28 , 31 , 34 , 36 , 37 , 42 ], 6 were quantitative [ 29 , 30 , 33 , 38 , 39 , 40 ] and 3 used mixed methods [ 32 , 35 , 41 ]. Methods used in the qualitative work included grounded theory [ 32 , 36 ] thematic analysis [ 41 , 42 ] phenomenology [ 28 , 31 ] and framework analysis [ 9 ]. Quantitative studies employed cross-sectional survey design and used a variety of descriptive statistics [ 29 , 30 , 32 , 33 , 35 , 39 , 40 , 41 ] correlational analysis [ 41 ] and regression analysis [ 29 , 33 , 35 , 40 ].

PRISMA flowchart. *Two articles identified through searching of reference lists of included articles so not included in earlier stages of the review

All participants in the studies resided within the community and had either a diagnosed serious mental health condition [ 9 , 30 , 31 , 32 , 38 , 39 ], mental health problems associated with a physical health condition [ 29 , 33 , 34 , 35 , 40 , 41 ], mental health problems associated with a developmental disorder [ 37 , 42 ] or self-reported mental health conditions [ 27 , 28 ]. Two of the studies involved interviews with parents of children who had a family pet [ 37 , 42 ], the remaining studies collected data directly from participants with a companion animal. Twelve of the studies included all types of companion animals [ 9 , 27 , 31 , 32 , 33 , 34 , 35 , 36 , 39 , 40 , 41 , 42 ] and four specifically focused on either dogs and/or cats [ 28 , 29 , 30 , 38 ]. A total of 1727 pet owners were involved in the included studies.

Of the 17 included studies, 15 reported positive aspects of pet ownership for people experiencing mental health problems [ 9 , 27 , 28 , 29 , 30 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 42 ] and 9 reported negative elements [ 9 , 27 , 32 , 35 , 36 , 38 , 39 , 41 , 42 ]. Neutral effects of pet ownership were reported in some of the included quantitative studies, where no difference in mental health outcomes, social contacts or loneliness were reported for pet owners compared to non-pet owners [ 29 , 32 , 35 , 40 ]. Benefits were mostly demonstrated through qualitative data, and negative elements, which were highlighted, were largely over-shadowed by co-occurring positive impact of pets in these studies [ 9 , 27 , 32 , 35 , 36 , 38 , 42 ].

Emotional work - alleviating worry, providing comfort and mitigating against feelings of isolation and loneliness

Evidence from quantitative studies relating to contribution of pets to emotional work was mixed. There were significant findings for the benefits of canine companionship for military veterans with post-traumatic stress disorder (PTSD), including effects on reducing feelings of loneliness, depression, worry and irritability, and increased feelings of calmness [ 30 ] and there was some evidence for the direct effect of pets on depression and mood [ 30 , 35 ] through close proximate contact and stroking [ 35 ]. However, this finding was not wholly supported by other quantitative studies, which reported neutral or small negative effects of pet ownership [ 29 , 35 , 40 , 41 ]. A study investigating the effect of pet ownership and strength of attachment on depression found that pet owners were just as likely as non-pet owners to be depressed [ 33 ]. However this focussed on the sequela of depression not its alleviation or contribution of pets to managing post diagnosis. Interestingly, a study by Siegel found that pets had an effect in mediating the relationship between AIDS diagnosis and depression and that there was a weak trend towards dogs being more successful in this role than cats [ 33 ].

The importance of pets in relation to the provision of emotional work was a recurrent theme in the numerous qualitative studies included in the review where people reported a profound connection with their pet [ 9 , 27 , 30 , 31 , 32 , 38 , 39 ] sometimes preferring relationships with pets over relationships with other humans [ 37 ] and viewing pets as replacement family members [ 32 ]. The mechanisms through which pets made the perceived contribution to emotional work seemed to be the provision of a consistent source of comfort and affection [ 9 , 34 , 36 , 41 , 42 ]. This constant presence meant that this provision was available instantaneously without request [ 9 , 27 , 36 , 42 ]. Pets provided calming support and were perceived to have a ‘sense’ of when it was needed.

“The dog approaches Karin when she’s crying and comforts her by lying next to her and licking away her tears. The dog hears her, and wherever he is in the house, he comes to her. We can’t always comfort her. Sometimes Karin has said, ‘It’s a good thing we have the dog, otherwise no one would be able to comfort me” [ 42 ].

Pets were able to provide unique emotional support as a result of their ability to respond to their owners in an intuitive way, especially in times of crisis and periods of active symptoms [ 9 , 30 , 31 , 35 , 36 ]. A related impact on loneliness was achieved through physical contact which reduced feelings of isolation [ 28 , 36 ], providing a source of physical warmth and companionship [ 35 ], and by providing opportunities for communication [ 34 , 36 ].

“It is very important of people not to feel alone and isolated, and pets help you feel like you’re like everyone else. Not less than other people. My birds are very important to me and I think other people with other pets feel that way, too” [ 27 ].

The study by Ford found that people were able to confide in their pets when they were unable to open up to other people.

“Sometimes if I talk to the cat, perhaps it's like being in a confessional, I find I can address things that perhaps I wouldn't have done normally if I hadn't have had the cat to talk to” [ 36 ].

In this respect, pets provided a safe environment where people can talk without fear of being judged or being a burden to others [ 9 ]. This was echoed in work where people reported that their dogs allowed them to express their feelings and clarify their thoughts without the concern that they will interrupt, offer criticism or advice, or betray confidence [ 30 , 31 ].

“They don’t have input, “this is what you should do, or maybe you should try this” or all the other commentary I get from people, who are trying to be helpful in their own right…their dying devotion and love, it’s true friendship” [ 31 ].

The sentiment of pets being non-judgemental underpins the absence of conditionality, which was a recurring finding in included studies. Pets provided unconditional love and affection [ 9 , 30 , 31 , 34 , 42 ] which fostered self-acceptance and congruence [ 28 ]. Pets constituted a source of support which people could trust and rely on compared with other social network members [ 9 ]; they provided simple relationships free from conflict [ 28 ] and they did not overstep boundaries [ 31 ]. The latter seems to be particularly beneficial for people with Autism [ 37 ] and PTSD [ 30 ].

“The dog offers comfort in a different way to how I do, more unconditional. Åsa can hold the dog when she is feeling miserable. The dog doesn’t ask why or what’s happened” [ 42 ].

By providing unconditional positive regard, pets promoted emotional stability through the regulation of feelings, management of stress and helping people to cope with difficult life events [ 27 , 42 ]. For people living alone, pets provided a source of ‘connectedness’ [ 27 ], reassurance, and normalcy [ 31 ].

She’s always there for me in a regular way of managing my stress. I tell her about my days, she snuggles, cuddles and sleeps with me [ 34 ].

Practical work - physical activity and symptom distraction

Quantitative data implicating pets in the practical work associated with mental health management pointed to the impact of dog ownership on physical activity [ 40 ] and self-reported quality of life related to physical health [ 29 ]. One study found that those with pets were more significantly likely to use ambulatory mental health care than those without [ 40 ].

Qualitative results from the studies expanded on illness specific practical work including in times of crisis [ 9 , 28 , 30 , 31 , 32 , 35 , 36 , 37 , 38 , 41 , 42 ]. The main mechanism through which pets appeared to contribute to practical work was through the ability of pets to distract and disrupt attention from symptoms or upsetting experiences such as hearing voices, panic attacks or suicidal ideation [ 9 , 27 , 28 , 30 , 31 , 32 , 34 , 36 ]. Pets contributed to practical work directly and indirectly by acting as a form of bridging tie to additional resources.

But if I’m here and I’m having…having problems with voices and that, erm, it does help me in the sense, you know, I’m not thinking about the voices, I’m just thinking of when I hear the birds singing [ 9 ].

One quantitative study by Stern and colleagues [ 30 ] demonstrated that whilst participants with PTSD did not report feeling less affected by painful memories or flashbacks they indicated that their pet tried to cheer them up when experiencing symptoms, indicating that the presence of their pet may have lessened a modicum of the negative impact of trauma [ 30 ].

Qualitative data pointed to the way in which pets were able to undertake the activities of practical work because of their consistent and proximate presence and through providing the opportunity for reciprocity [ 9 , 27 , 31 , 34 , 36 ]. Pets’ contribution to practical work is seemingly made possible through the provision of opportunities for routine tasks required to care for an animal, providing a positive focus for activity [ 9 , 27 , 30 , 31 , 32 , 34 , 36 , 42 ], providing a needed challenge [ 36 ], by introducing humour into situations [ 9 ], providing a direct grounding role [ 30 , 31 , 38 ], lessening the negative impact of symptoms [ 9 , 30 ] and reducing the stress associated with the vagaries of living with their condition [ 34 ]. One study found that participants felt that they required less medication because of this pet contribution [ 31 ].

So the physical thing of having to brush her and take her out and feed her, check that her toenails don't need cutting, you know perhaps pick up after her if she's had an accident, things like that. Cos she can be quite demanding as you've seen, she's up and she wants attention all the time, so it… interrupts your thought process a lot of the time [ 36 ].

They are something that is very important in my recovery and helping me not get too depressed. Even when I was so depressed, I was kind of suicidal. I never got really bad, but I was suicidal at one time. The thing that made me stop was wondering what the rabbits would do. That was the first thing I thought of and I thought, oh yeah, I can’t leave because the rabbits need me. So they were playing a really big role in that [ 32 ].

Pets could contribute to a sense of preparedness to take self-management action through increasing people’s positivity and self-efficacy [ 32 , 34 , 41 , 42 ]. They encouraged their owners to stay in the present avoiding worry and ruminations about past behaviours [ 28 , 30 ] or concerns about the future [ 34 ]. Pets were also considered important in terms of providing protection for their owners [ 28 , 31 ]. This was particularly of value for those participants experiencing the constant vigilance associated with Post Traumatic Stress Disorder [ 31 ].

He’ll start nudging me or hopping on me to get me into a petting session or he’ll grab my pants leg and start pulling on me or like my shirt or my arm and start pulling on me to kind of like bring me out of a flashback or anything else like that [ 31 ].

Owners felt that their pets could sense when practical support for mental health was required and acted accordingly [ 9 , 28 , 31 , 42 ]. However, this was not universal to all studies indicating the impact of pets cannot be fully explained by this behavioural initiation [ 37 ].

The puppy followed Bengt’s mood from the very first day. The dog reads him inside and out, she knows exactly when to go to him and when to keep back. If Bengt is unsettled and moving around, he may stop occasionally and sit down … and then along she comes. Then she kneels down and starts to nudge and lick him, and he starts to stroke her. She also knows if he’s in conflict with us. Then she follows him … and if he hasn’t closed his door, she goes in and sits with him [ 42 ].

Pam named the contact itself as playing a significant role in helping her to manage anxiety attacks. She specifically described an example of when her companion dog came to her during an anxiety attack in the middle of the night: Brutus licked her face and laid next to her for the rest of the night, and contact with him immediately improved her acute symptoms [ 28 ].

Indirectly, pets encouraged a form of behavioural activation. Pets were seen to enhance mobility [ 41 ], increase exercise [ 30 , 35 , 36 , 40 ] and promote contact with nature [ 30 , 36 ] all of which were considered beneficial to mental health.

Pets as conduits to social interaction and emotional nourishment

A feature of the role attributed to pets in terms of mental health management in the qualitative data was the various ways in which they facilitated the quality and quantity of social interactions. Pets reportedly increased social interaction with others including friends and family [ 34 ] and with more peripheral social interactions [ 9 , 38 ]. They also fostered a sense of social and community integration [ 9 , 32 , 35 , 36 , 38 , 42 ]. Interestingly, one study found that dogs increased social interactions that would not have been possible without their pet (e.g. other dog walkers [ 36 ]). This was supported by some [ 39 ] but not all of the included quantitative studies [ 29 , 32 , 39 , 40 ] indicating a complicated relationship between pets and social interaction which may be mediated by type of pet and/or number of pets [ 22 ].

Get out of the scope of a physical disability. I mean a physical disability yeah. I can’t get through that door. I can’t get up those steps. For a mental health patient it is not the physical barrier it’s an invisible [barrier] … Yes, these guys help me interact. Butch, when we go out … when Butch and I go out, we interact because he gets so much attention and with the attention focused on him, I can get engaged in all sorts of conversations with people who like dogs, so with these guys we develop friends who are into the same thing [ 38 ].

That surprised me, you know, the amount of people that stop and talk to him, and that, yeah, it cheers me up with him. I haven’t got much in my life, but he’s quite good, yeah [ 9 ].

The reasons identified in the included studies as to why pets were considered useful in terms of enhancing the amount and quality of social interactions included having the confidence to venture into new social situations with their pet, owners finding it easier to be in the presence of other people when their pet was present [ 30 ], being more open during social interactions [ 28 ] and being able to have difficult conversations with existing friends and family through their pet [ 34 , 36 ].

Biographical work - identity, a sense of self-worth and existential meaning

The data implicating pets in biographical work was mostly derived from the qualitative data. Two quantitative studies addressed this type of work; one found that despite a low effect score, pet owners performed significantly higher than non-pet owners on meaningful activity scales [ 39 ] and another found that since getting their pets individuals felt better about themselves as people [ 30 ].

Qualitative data suggested that pets provided their owners with a sense of purpose and gave meaning to their lives [ 41 ]. Often participants described how this had been diminished since diagnosis with a mental health condition but that pets helped them to overcome this and provided them with a platform for going forward with their lives [ 9 , 38 ]. This sense of meaning and purpose included pets giving their owners a reason to live [ 9 , 32 ], to contributing to a sense of control and empowerment [ 9 , 31 , 32 , 35 ] and giving individuals hope for the future [ 9 , 31 ]. This was considered particularly important when people were feeling consumed by illness or when self-management felt out of control [ 32 ].

It gives me something to do, to take care of them, the cleaning of the cage, feeding them [ 34 ].

Owners’ felt that their pets contributed directly to maintaining a consistent sense of identity and self [ 9 , 27 , 32 , 36 , 39 , 41 ]. They felt pets provided a form of validation through the pride associated with successfully caring for a pet [ 9 , 28 ] but also as sustaining elements of pre-illness identities including roles of mother, pet owner or animal lover [ 9 , 36 ] and as being a protector of animals [ 28 , 31 ].

My best quality is that I love animals and I take care of animals… Other than that, I can’t think of anything real outstanding [ 32 ].

Pets were also considered relevant in terms of mediating how other people viewed them [ 9 , 42 ]. Pet ownership connected their owners to valued activities such as hobbies [ 35 ] and were considered a culturally sanctioned meaningful occupational and social role [ 38 , 39 ]. One study also indicated that the mastery achieved through the training of animals also contributed to a positive sense of self [ 9 ].

Participants described elements of relationships with pets that were important to their mental health including the nature of relationships as simple and reciprocal, pets as understanding and honouring personal boundaries and pets not holding past behaviours against them [ 9 , 27 , 32 , 36 , 39 , 41 ]. These components were often missing from other human relationship and were considered important aspects of the human/pet dyad [ 9 ].

For Irene, taking care of her companion dog facilitated a change in her sense of self, from seeing herself as someone who “destroyed anything [she] loved” to seeing herself as a loving, nurturing protector [ 28 ].

There’s a lot less things to worry about. I mean you can’t…you can’t like be like if he was naughty or anything like that you’d tell him off and that was it and there’d be no hard feelings. That there’s not, you don’t get the nastiness [ 9 ].

Pets impacted directly on the management of negative perceptions and experiences related to a diagnosis of mental illness which arose either from themselves or from others within and outside of their existing social networks [ 9 , 28 , 31 , 34 , 35 , 39 ]. The mechanisms through which this appeared to operate included counterbalancing a loss of social status as a result of being diagnosed with a mental illness, providing non-judgemental acceptance often not available elsewhere [ 9 ], making owners feel wanted and valued [ 34 , 39 ] and encouraging owners to feel good about themselves [ 28 , 30 ]. One study proposed that companion animals symbolised abused childhood selves and that by caring for a pet they may have symbolically been caring for this part of themselves [ 28 ].

When he comes and sits up beside you on a night, it’s different, you know, it’s just, like, he needs me as much as I need him, sort of thing [ 9 ].

Negative aspects of pet ownership

Despite an overall sense of the positive impact of pet ownership on the management of diagnosed mental health disorders, some negative aspects surfaced within individual quantitative and qualitative studies. This included aspects such as financial costs and housing situations, the burden of pet ownership especially if pets were unruly which could be detrimental to mental health and the guilt that owners experienced if this was not managed successfully [ 9 , 35 , 36 , 38 , 39 ]. Horses and dogs were considered the most burdensome in this regard and research highlighted the importance of matching pets to individual circumstances [ 36 ]. The early stages of pet ownership were often the most difficult for people but were concomitantly considered as an important investment in terms of future support and companionship [ 35 ]. Pets could also be seen as a barrier to aspirational goals associated with recovery such as travel [ 9 , 35 ].

When I was working it wasn't a problem, but obviously when you're on a low budget income, it does become a financial hazard, because they're just unexpected you know. That's where the issues become, do you keep them or do you…and you don't want to let them go so you're sitting there, having to cut back and scrape the bottom of the barrel to make sure they're looked after sort of thing [ 36 ].

I was trying to care for 3 cats of my own that I loved, stray cats in the neighbourhood I was feeding. I tried to spay the ones that appeared to be pregnant, and I was putting food out twice a day, and I was just feeling overwhelmed, just overwhelmed and more and more depressed, more a sense of failure, and finally it just got worse and worse and worse [ 32 ].

The potential or actual loss of beloved companion animals was a major source of distress for owners [ 9 , 32 , 38 , 42 ] but it was acknowledged that joy could still be taken in their memories once death had been come to terms with [ 32 ] and that such experiences could facilitate understanding of other difficult life events [ 42 ].

I was very depressed by [pet’s] death. While she was getting worse, we had her home for a while and I had to make myself be strong […] It was more after her death that I kind of broke down, and just thinking about her would make me cry for a couple of weeks or more. Gradually I got to the point where I knew that it was her time. The life that she had and what she had given to me, I could always think of that. It always makes me happy [ 32 ].

Participants described how other people including health professionals were often concerned about the safety of their pets and their ability to care for them [ 27 , 33 ]. Siegel et al. demonstrated that those with HIV felt there was a perception that they should not have pets as a result of their condition [ 30 ]. This may also apply to those with mental health conditions but this was not covered in any of the included papers.

This review represents the first attempt to systematically identify and synthesise evidence related to the benefits of pet ownership for those with diagnosed mental health conditions. The majority of relevant data extracted for purposes of this review were qualitative and high quality prospective experimental studies were distinctly lacking. This indicates that the evidence in relation to the role of pets for the management of diagnosed mental health conditions is at an early stage and currently disparate and exploratory in nature. The use of thematic analysis informed by an existing framework led to the identification of a number of mechanisms through which companion animals were seen to support their owners to manage their mental health conditions. Very little data fell outside of the framework and what did related mostly to the demographics of pet owners. The results support the wider health benefits of companion animals for the general population [ 6 , 7 , 8 ]. However, the discrepancy often identified between quantitative and qualitative findings within the review and the range of factors mediating the relationship between pets and their owners identified within existing literature speaks to the complexity of this relationship. Mediating factors included the type of pet [ 33 ], the number of pets [ 30 ], perceived friendliness of pet [ 41 ] and attachment to pet [ 33 ].

Pets were implicated in emotional work because they provided a consistent and proximate source of calming support and companionship [ 9 , 27 , 30 , 31 , 32 , 38 , 39 ]. This was enhanced through a perception that animals could intuit when such support was needed and act accordingly providing a depth of connection that was considered particularly useful in time of crisis [ 9 , 30 , 31 , 35 , 36 ]. Companion animals contributed to practical work through their role in the distraction and disruption from upsetting symptoms and experiences [ 9 , 27 , 28 , 30 , 31 , 32 , 34 , 36 ] through the provision of routine and a role in behavioural activation [ 32 , 34 , 41 , 42 ]. Pets were considered important in the maintenance of a positive identity and sense of self because of the reciprocity associated with human-pet dyads [ 9 , 27 , 32 , 36 , 39 , 41 ], a perception that pets accepted their owners without judgement, the sense of pride associated with successfully caring for an animal [ 9 , 28 ] and supporting the management of felt and enacted stigma [ 9 , 28 , 31 , 34 , 35 , 39 ]. Qualitative data demonstrated the relative strength of the role of pets in relation to all three types of work but quantitative data was unavailable to unanimously support this impact particularly in relation to practical and biographical work where quantitative evidence was distinctly lacking. Existing quantitative studies failed to include measures which adequately addressed the potential roles of companion animals as identified within the qualitative data such as self-efficacy and preparedness to take action.

Despite the mixed evidence from the quantitative data, the participants included in the review enjoyed keeping their animals and believed that they gained psychological benefit from these relationships as demonstrated by the thick descriptions derived from the qualitative data. The review demonstrated that those with diagnosable mental health problems can infer the same benefits from pet ownership as the general population and pets may have a particular role in terms of enhancing quality of life given that levels of social exclusion and stigma are likely to be greater for this population [ 9 , 32 , 35 , 36 , 38 , 42 ].

Participants felt that their pets faciltiated the quality and quantity of existing social interactions and forged new relationships acting as a bridging tie to emotional nourishment [ 9 , 32 , 34 , 35 , 36 , 38 , 42 ]. This is likely to be of increasing importance given that social isolation is both a cause and effect of mental illness and that those with mental illness are considered one of the most socially isolated social groups [ 43 ].

Despite these identified benefits, it appeared that relationships with companion animals are not considered or incorporated into health care planning or wider health related discussions of consultations [ 9 ]. The contrary appears to occur where individuals are advised against pet ownership or experience negative attitudes from health professional in relation to their pet [ 33 , 34 ]. This indicates pet ownership can create additional work for professionals in terms of managing and advising people and highlights the need for a focus on professional attitudes, which is currently lacking from the evidence base.

The findings call for cultural changes in policy towards the way in which pets can be incorporated with other support in open systems which is often left untouched or unconsidered by formal service provision. A different logic of care is required; one which values the harnessing of available and valued support identified by people, which supports individuals’ capacity to undertake valued activities (such as dog walking) and looks for support which does not engage them in unequal power relationships which can sometimes be anti-therapeutic. With increasing emphasis being placed on evidence based health care, such macro-level policy changes are likely to necessitate strengthening the underpinning evidence base given the low quality of evidence identified within the review. Further exploration of the implementation feasibility and optimal implementation models may also be required, including the potentially important role of inter-agency and third sector working.

Negative aspects of pet ownership identified in the review included concerns about potential, and the significant distress associated with the actual loss of a pet supporting previous research [ 44 ]. Evidence from those involved in natural disasters such as hurricanes suggest that pet loss can add considerably to acute trauma and increase the risk of long-term impacts [ 45 , 46 ]. This highlights the potential for the loss of an animal to be of greater impact for those with diagnosable mental health conditions given the intense and positive identification reported with their pet and suggests the need to consider pets in planning and delivery of mental health care.

Strengths and limitations

This review gains its strengths from the combination of rigorous search and extraction methods and the underlying theoretical framework which guided the analysis. To guard against bias in the undertaking of the review, two reviewers independently extracted all data and where disagreement occurred, these were discussed between authors until agreement was reached.

The level of quality across included studies was a limiting factor in this review with an average quality rating of 5.5 out of 10 for qualitative studies and 8.75 out of 10 for quantitative work (refer to Additional files 1 and 2 ). There was also a lack of randomised trials evaluating the impact of pet ownership on diagnosed mental health problems. This is perhaps unsurprising given the pragmatic difficulties associated with randomising individuals or families to be pet or non-pet owners within RCTs. Prospective experimental or quasi-experimental designed studies should be used to compare outcomes for pet owners and non-pet owners using measures that adequately incorporate the range of tasks in relation to each type of work as identified within this review. Given the potential benefits which might be conveyed by pets for people with mental health conditions, there is a clear need for further rigorous, high quality research, in order to consolidate these existing findings and build an evidence base on which commissioners and policy makers can base decisions.

As part of our inclusion criteria, we included only those with a diagnosable mental health problem or mental health components of a diagnosable physical health condition which may have impacted on the studies included in our review.

Despite some inadequacies in the data, this review suggests that pets provide benefits to those with mental health conditions through the intensity of connectivity with their owners and the contribution they make to emotional support in times of crises together with their ability to help manage symptoms when they arise. Further rigorous research is required to test this relationship, incorporating outcomes that cover the range of roles pets may have in relation to mental health identified within this review. The research studies included in this review provide a point of debate that services and policy makers may wish to consider in the future.

Abbreviations

Animal assisted therapy

Acquired immunodeficiency syndrome

Disability adjusted life years

Human immunodeficiency virus

Preferred Reporting Items for Systematic Reviews and Meta-Analyses

Posttraumatic stress disorder

United Kingdom

United States of America

World Health Organisation

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Acknowledgements

The authors would like to thank Rebecca Pedley for her advice and support during the review process and Shu Eu and Katie Robinson for their contributions to the early stages of the review process.

This is a summary of independent research funded by the National Institute for Health Research (NIHR)‘s Programme Grants for Applied Research Programme (Grant Reference Number RP-PG-1210-12007). The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health.

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Kelly Rushton, Karina Lovell, Penny Bee & Lauren Walker

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HB, KR, PB and AR were involved in the design of the review. HB, KL, KR, LG, LW were involved in screening the identified papers. KR screened all included and excluded studies for validity purposes. AR scrutinized all included studies. HB and KR read all included papers and independently extracted data. HB, KR developed the initial analytical framework which was elaborated on and checked by AR. PB and KL were regularly consulted in the conceptualisation of the paper. All authors read and approved the final manuscript.

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Qualitative Quality Table. Quality scores related to the included qualitative studies. (DOCX 18 kb)

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Quantitative Quality Table. Quality scores related to the included quantitative studies. (DOCX 18 kb)

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Context Table. Extracted context data from each included study. (DOCX 19 kb)

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Participants Table. Extracted data related to study participants from each included study. (DOCX 18 kb)

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Brooks, H.L., Rushton, K., Lovell, K. et al. The power of support from companion animals for people living with mental health problems: a systematic review and narrative synthesis of the evidence. BMC Psychiatry 18 , 31 (2018). https://doi.org/10.1186/s12888-018-1613-2

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Header menu - Mobile | United Kingdom

Header menu - drawer | united kingdom, pets and mental health, how can a pet help my mental health, is having a pet right for me, what if i can’t have a pet.

A pet can be a great source of comfort and motivation. In many ways, pets can help us to live mentally healthier lives.

Caring for a pet can help our mental health in many ways, including:

increasing your physical activity . Dog owners are likely to take their pets for a walk or run every day. This can be a fun way to fit exercise into your routine
providing companionship . Pets can give you a sense of security and someone to share the day with. Caring for them can help you feel wanted and needed. This can be especially valuable for older people or those who live alone
reducing anxiety . The companionship of a pet can help to ease your anxiety
boosting self-confidence. Pets can be great listeners, offer unconditional love and won’t criticise you. This can help your self-confidence, especially if you feel isolated or misunderstood
helping you meet new people. Dog owners often stop and chat with each other on walks. But other pets can be a way to meet people too: in pet shops, training classes or online groups, for example
adding structure to your day. Feeding, exercising and caring for a pet can help you keep to a daily routine, which can help you feel more grounded and focused. It can give your day purpose and a sense of achievement.

Pets may also help with specific conditions. For example, people with ADHD may benefit from the structure and routine that a pet needs. Managing their pet’s responsibilities and keeping track of time – to feed or walk them on time, for example – may help them in other areas of their lives. Some people with ADHD are hyperactive – especially children – and playing with a pet can be a great way to release excess energy, whether that’s walking a dog or running around with a kitten.

Autistic people can benefit from having a pet. Pets provide the kind of unconditional relationship that can help someone build social skills and confidence. They can provide a sense of calm and reassurance if their owner feels overwhelmed. Autistic children with sensory issues can involve their pets in sensory integration activities to help them get used to how something feels against their skin or how it smells or sounds.

Having a pet is a serious commitment and not something to do on a whim. You'll need to have the time, money and energy for a pet, as well as a calm home environment with routine and consistency. Fostering a pet or helping a friend with theirs can help you see whether having your own is right for you.

When you’re ready to think about getting a pet, consider:

how much outdoor space do you have
how active you are
how much time do you have to spend with your pet
how much money do you have for vet’s bills, insurance, food, toys, etc.? Some charities offer low-cost vet care, but they are limited to certain areas and have financial criteria

Animal charity PDSA has other key things to think about before you get a pet.

If you can’t afford a pet, live somewhere you’re not allowed one, or you’re worried about having times where you’re too unwell to care for a pet, there are other options.

The simplest option may be spending time with friends’ pets, whether that’s walking their dogs, stroking their cats or cuddling their guinea pigs. They might be glad to have someone to pet sit for them while they’re on holiday. You can also consider signing up as a house-sitter: you look after someone's home, garden and pets in return for free accommodation.

If you miss having a dog in your life, you could sign up with BorrowMyDoggy . They connect dog owners to local people who would love to walk or play with a dog. The Cinnamon Trust also needs volunteer dog walkers to help out older people or those with a health condition or disability that means they can’t walk their dog as easily anymore. They also need people to foster pets while their owners are in hospital.

Contact a rescue centre near you to see what volunteering opportunities they may have. They may need volunteers to exercise, care for and socialise their pets. You could consider fostering an animal if you can have a pet on a short-term basis but can’t commit to one long-term. Some shy or scared animals need the peace and quiet of a home while waiting to be adopted.

Cats Protection and Dogs Trust both need people to provide temporary foster care for pets belonging to people fleeing domestic violence who may not be able to take their pets into a refuge with them.

Choosing the Best Dog for a Child With Autism (verywellhealth.com)

‘Dogs have a magic effect’: how pets can improve our mental health | Dogs - The Guardian

The Health and Mood-Boosting Benefits of Pets - HelpGuide.org

Pets & Kids With ADD - Psychology Today United Kingdom

Veterinary Financial Assistance In Your Local Area - RSPCA

* Last updated: 15 February 2022

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Policy Forum Highlights Data on the Vital Role of Pets for Better Mental Health

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May 23, 2024, 10:32 ET

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Human Animal Bond Research Institute (HABRI) Works with Partners to Increase Access to Pets for Mental Health

WASHINGTON , May 23, 2024 /PRNewswire-PRWeb/ -- The Human Animal Bond Research Institute (HABRI) hosted its first-ever Spring Policy Forum focused on Mental Health and Companion Animals, convening leaders in the pet care community and partners in the mental health space to move society toward more widespread awareness of the important role of companion animals for improved mental health.

The Policy Forum program featured presentations addressing research, practice, and policies associated with this important topic and delivered by expert speakers from a wide array of disciplines. Speakers included Susan Trachman , MD, a Board-Certified Psychiatrist who talked about the role of pet ownership in supporting mental health and Mental Health America (MHA) and HABRI unveiled results of a survey of 4,000 MHA constituents on the care and resource-related needs of those impacted by mental health related to companion animals.

98% of pet owners report at least one health benefit resulting from their pet, including reduced feelings of loneliness (73%), providing comfort (73%) and a source of happiness (79%)
71% of respondents (76% of those with a disability) are interested in working with a mental health professional who incorporates pets or animal-assisted interventions (AAI) into their practice
Those with a disability are more likely to say they are interested in pets to support their mental health (79%) compared to those without a disability (50%)
93% of respondents agree there should be more support for pet ownership and AAIs in society

"Mental Health America is proud to partner with HABRI to bring forward new data from our constituency on the experiences, benefits and challenges related to pets and mental health," said America Paredes , PhD. "We found that not only is pet ownership incredibly important for so many people, but also that more than three quarters of those living with a disability want to work with a mental health professional who incorporates pets in their practice. Our survey showed that it is hard to find reliable information about pets and mental health, revealing a great need for resources and information related to pets and animal-assisted interventions."

"HABRI is proud to bring together a diverse group of leaders in mental health, veterinary medicine, research, animal-assisted interventions, pet care, and public policy to elevate the conversation about pets and mental health," said Steven Feldman , President of HABRI. "Armed with research, new insights, model practices and policy considerations, HABRI's goal is to drive the conversation on how best to support pet ownership and the human-animal bond for a healthier society."

HABRI's Spring Policy Forum is sponsored by leading pet care and animal health companies and organizations; American Pet Products Association (APPA), Petco Love, Mars Petcare, American Veterinary Medical Association (AVMA) and whiskerDocs.

"Policy Forum sponsors and all of HABRI's partners are committed to supporting better mental health for pet owners, veterinarians and everyone who can benefit from the research-backed benefits of the human-animal bond," Feldman added.

For more information, please visit http://www.habri.org/policy-forum . Images available upon request.

About HABRI HABRI is a not-for-profit organization that funds innovative scientific research to document the health benefits of companion animals; educates the public about human-animal bond research; and advocates for the beneficial role of companion animals in society. For more information, please visit http://www.habri.org .

Media Contact

Hayley Maynard , Human Animal Bond Research Institute, (614) 532-5279, [email protected] , www.HABRI.org

SOURCE Human Animal Bond Research Institute

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Policy forum highlights data on the vital role of pets for better mental health.

Human Animal Bond Research Institute (HABRI) Works with Partners to Increase Access to Pets for Mental Health

The Policy Forum program featured presentations addressing research, practice, and policies associated with this important topic and delivered by expert speakers from a wide array of disciplines. Speakers included Susan Trachman , MD, a Board-Certified Psychiatrist who talked about the role of pet ownership in supporting mental health and Mental Health America (MHA) and HABRI unveiled results of a survey of 4,000 MHA constituents on the care and resource-related needs of those impacted by mental health related to companion animals.

98% of pet owners report at least one health benefit resulting from their pet, including reduced feelings of loneliness (73%), providing comfort (73%) and a source of happiness (79%)

71% of respondents (76% of those with a disability) are interested in working with a mental health professional who incorporates pets or animal-assisted interventions (AAI) into their practice

Those with a disability are more likely to say they are interested in pets to support their mental health (79%) compared to those without a disability (50%)

93% of respondents agree there should be more support for pet ownership and AAIs in society

For more information, please visit http://www.habri.org/policy-forum . Images available upon request.

Media Contact

Hayley Maynard , Human Animal Bond Research Institute, (614) 532-5279, [email protected] , www.HABRI.org

View original content to download multimedia: https://www.prweb.com/releases/policy-forum-highlights-data-on-the-vital-role-of-pets-for-better-mental-health-302154183.html

SOURCE Human Animal Bond Research Institute

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Dogs Supporting Human Health and Well-Being: A Biopsychosocial Approach

Nancy r. gee.

1 Department of Psychiatry, Center for Human Animal Interaction, School of Medicine, Virginia Commonwealth University, Richmond, VA, United States

Kerri E. Rodriguez

2 Human-Animal Bond in Colorado, School of Social Work, Colorado State University, Fort Collins, CO, United States

Aubrey H. Fine

3 Department of Education, California State Polytechnic University, Pomona, CA, United States

Janet P. Trammell

4 Division of Social Sciences and Natural Sciences, Seaver College, Pepperdine University, Malibu, CA, United States

Humans have long realized that dogs can be helpful, in a number of ways, to achieving important goals. This is evident from our earliest interactions involving the shared goal of avoiding predators and acquiring food, to our more recent inclusion of dogs in a variety of contexts including therapeutic and educational settings. This paper utilizes a longstanding theoretical framework- the biopsychosocial model- to contextualize the existing research on a broad spectrum of settings and populations in which dogs have been included as an adjunct or complementary therapy to improve some aspect of human health and well-being. A wide variety of evidence is considered within key topical areas including cognition, learning disorders, neurotypical and neurodiverse populations, mental and physical health, and disabilities. A dynamic version of the biopsychosocial model is used to organize and discuss the findings, to consider how possible mechanisms of action may impact overall human health and well-being, and to frame and guide future research questions and investigations.

Introduction – A Historical Perspective on Dog-Human Relationships

The modern relationship between humans and dogs is undoubtedly unique. With a shared evolutionary history spanning tens of thousands of years ( 1 ), dogs have filled a unique niche in our lives as man's best friend. Through the processes of domestication and natural selection, dogs have become adept at socializing with humans. For example, research suggests dogs are sensitive to our emotional states ( 2 ) as well as our social gestures ( 3 ), and they also can communicate with us using complex cues such as gaze alternation ( 4 ). In addition, dogs can form complex attachment relationships with humans that mirror that of infant-caregiver relationships ( 5 ).

In today's society, dog companionship is widely prevalent worldwide. In the United States, 63 million households have a pet dog, a majority of which consider their dog a member of their family ( 6 ). In addition to living in our homes, dogs have also become increasingly widespread in applications to assist individuals with disabilities as assistance dogs. During and following World War I, formal training of dogs as assistance animals began particularly for individuals with visual impairments in Germany and the United States ( 7 ). Following World War II, formal training for other roles, such as mobility and hearing assistance, started to increase in prevalence. Over the decades, the roles of assistance dogs have expanded to assist numerous disabilities and conditions including medical conditions such as epilepsy and diabetes and mental health disorders such as posttraumatic stress disorder (PTSD). At the same time, society has also seen increasing applications of dogs incorporated into working roles including detection, hunting, herding, and protection ( 8 , 9 ).

In addition to these working roles, dogs have also been instrumental in supporting humans in other therapeutic ways. In the early 1960s, animal-assisted interventions (AAI) began to evolve with the pioneering work of Boris Levinson, Elizabeth O'Leary Corson, and Samuel Corson. Levinson, a child psychologist practicing since the 1950s, noticed a child who was nonverbal and withdrawn during therapy began interacting with his dog, Jingles, in an unplanned interaction. This experience caused Levinson to begin his pioneering work in creating the foundations for AAI as an adjunct to treatment ( 10 ). In the 1970s, Samuel Corson and Elizabeth O'Leary Corson were some of the first researchers to empirically study canine-assisted interventions. Like Levinson, they inadvertently discovered that some of their patients with psychiatric disorders were interested in the dogs and that their patients with psychiatric disorders communicated more easily with each other and the staff when in the company of the dogs ( 11 , 12 ). Over the following decades, therapy dogs have been increasingly found to provide support for individuals with diverse needs in a wide array of settings ( 13 ).

Theoretical Framework for Dog Interaction Benefits

For over 40 years, the biopsychosocial model ( 14 ) has been widely used to conceptualize how biological, psychological, and social influences combine to determine human health and well-being. Biological influences refer to physiological changes such as blood pressure, cortisol, and heart rate, among others; psychological influences include personality, mood, and emotions, among others; and social influences refer to cultural, socio-economic, social relationships with others, family dynamics, and related matters. Figure 1 presents a graphical illustration of the relationship among these three influences in determining overall health and well-being. Although the model has dominated research and theory in health psychology for decades, more recently, it was re-envisioned as a more dynamic system ( 15 ) that construes human health as the result of the reciprocal influences of biological, psychological and social factors that unfold over personal and historical time. For example, if a person breaks his/her arm, there will be a biological impact in that immune and muscle systems respond and compensate. Social, or interpersonal, changes may occur when support or assistance is offered by others. Psychological changes will occur as a result of adjusting to and coping with the injury. Thus, the injury represents a dynamic influence initiated at one point in time and extending forward in time with diminishing impact as healing occurs.

An external file that holds a picture, illustration, etc.
Object name is fvets-08-630465-g0001.jpg

A biopsychosocial perspective of how biological, psychological, and social influences may impact one another (solid lined arrows) and influence human health and well-being (represented here by the large thick circular shape).

This dynamic biopsychosocial approach to understanding health and well-being is appealing to the field of human-animal interaction (HAI) because of the dynamic nature of the relationship between humans and animals. For example, a person may acquire many dogs over his/her lifetime, perhaps from childhood to old age, and each of those dogs may sequentially develop from puppyhood to old age in that time. Behaviorally, the way the human and the dog interact is likely to be different across the lifespans of both species. From a biopsychosocial model perspective, the dynamic nature of the human-canine relationship may differentially interact with each of the three influencers (biological, psychological, and social) of human health and well-being over the trajectories of both beings. Notably, these influencers are not fixed, but rather have an interactional effect with each other over time.

While a person's biological, psychological, and social health may affect the relationship between that person and dogs with whom interactions occur, the focus of this manuscript is on the reverse: how owning or interacting with a dog may impact each of the psychological, biological, and social influencers of human health. We will also present relevant research and discuss potential mechanisms by which dogs may, or may not, contribute to human health and well-being according to the biopsychosocial model. Finally, we will emphasize how the biopsychosocial theory can be easily utilized to provide firmer theoretical foundations for future HAI research and applications to therapeutic practice and daily life.

Psychological Influences

Much research has been conducted on the impact of dog ownership and dog interactions on human psychological health and functioning. Frequent interactions with a dog, either through ownership or through long-term interventions, have been associated with positive psychological outcomes across the lifespan [for a systematic review of this evidence see ( 16 )]. One psychological aspect of interest to many HAI researchers is depression, especially among older adults. However, the relationship of pet dog ownership and depression over the lifespan continues to have inconsistent and inconclusive findings ( 16 ). Nevertheless, there are examples in the literature highlighting the beneficial role of dog ownership in reducing depression. As is frequently the case in HAI, the evidence from intervention studies is stronger than that of pet ownership studies ( 16 ), with the preponderance of this evidence linking animal-assisted interventions to a decrease in depression, as measured by self-report indices. Among the mechanisms for this reduction in depression are biological and social influences. For example, one such study found that an attachment relationship with a pet dog may serve as a coping resource for older women by buffering the relationship between loneliness (also measured by self-report indices) and depression, such that the presence of the pet dog appears to ameliorate the potential for loneliness to exacerbate depression ( 17 ). A causal relationship between dog ownership and mental health is difficult to determine. Not only may owning a pet dog increase stress, but those who are already suffering from loneliness or depression may be more inclined to have a pet dog than those who do not.

Another psychological outcome related to dog interaction that receives considerable research attention is anxiety. Studies have found that short-term, unstructured interactions with a therapy dog can significantly reduce self-reported anxiety and distress levels [e.g., ( 18 )]. For example, children with their pet dog or a therapy dog present during a stressful task exhibit lower perceived stress and more positive affect compared to when alone ( 19 ), when a parent was present ( 20 ), or when a stuffed dog was present ( 21 ). In addition to psychological mechanisms, there are social and biological mechanisms at play as well. In these short-term stressful contexts, a dog may serve as both a comforting, nonjudgmental presence as well as a positive tactile and sensory distraction. Dog interaction might also reduce anxiety and distress by influencing emotion regulation while coping with a stressor ( 22 ). During animal-assisted therapy, having a dog present during psychotherapy such as cognitive behavioral therapy can aid in decreasing self-reported anxious arousal and distress for patients who have experienced trauma, making the therapeutic treatment process more effective ( 23 ).

In addition to the negative aspects of psychological functioning, HAI research has also aimed to quantify the effects of dog interaction and ownership on positive psychological experiences such as happiness and well-being. Some studies have found that dog ownership is associated with higher life satisfaction and greater well-being ( 24 ), while other studies show that this is the case only when the dog provided social support ( 25 ) or satisfied the owner's needs ( 26 ). However, other large-scale surveys have found no significant differences in self-reported happiness between dog owners, cat owners, and non-pet owners ( 27 ), contributing to mixed findings. Recent discussions argue that too much focus has been placed on the relationship between mental health and the simple variable of dog ownership, when the specific activities that owners engage in with their dogs (e.g., walking, tactile interaction, and shared activities,) may be more important in explaining positive well-being ( 28 ). Further, many other factors may be driving these inconsistent findings in depression, anxiety, and well-being, including the owner's personality ( 24 ), gender and marital status ( 29 ), and attachment to the dog ( 30 ).

Dogs may also provide a source of motivation; for example, people with dogs are more likely to comply with the rigors of their daily life ( 31 ). The relationship with a pet dog may provide motivation to do things that may be less desirable. For example, for older adults who own pets, it is not uncommon for them to be more involved in daily life activities because of the need to take care of their animals ( 32 ). Likewise, children also complete less desired activities due to their relationship with the dog [for a discussion of this topic see ( 33 )].

An accumulation of research also suggests that dog interaction may have specific psychological benefits for individuals with physical disabilities and chronic conditions. Cohabitating with a specially trained assistance dog, including guide, hearing, and service dogs, can be associated with increased psychological and emotional functioning among individuals with disabilities ( 34 ). For individuals with mental disorders such as posttraumatic stress disorder (PTSD), recent research has also found that having a psychiatric service dog is associated with fewer PTSD symptoms, less depression and anxiety, and better quality of life [For a review see ( 35 )]. These benefits appear to be due to a combination of the service dog's specific trained tasks and aspects inherent to cohabitating with a pet dog, including having a source of love, nonjudgmental social support, and companionship ( 36 ).

Similar research has also highlighted the value of dogs for children with disorders of executive functioning and self-regulation, especially autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD). For some children with ASD, dogs may provide a calming and positive presence ( 37 ) and may both reduce anxiety ( 38 ) and improve problematic behaviors ( 39 ). Parents report that both pet dogs and service dogs can provide certain benefits for children with ASD, including benefits to children's moods, sleep, and behavior ( 40 , 41 ). Therapy dogs have also been found to be impactful in supporting children with ADHD in their emotional regulation ( 42 ) and aspects of character development ( 43 ). Nevertheless, the outcome of dog interactions may not be positive for all individuals with ASD and ADHD; despite evidence of psychological benefits of dog interaction for some children, others may be fearful or become over-stimulated by dogs ( 44 ).

In addition to impacts on psychological health, dog interaction can also impact psychological functioning, cognition, and learning. Among children, emerging research suggests short-term interactions with a therapy dog may lead to improvements in specific aspects of learning and cognition. A recent systematic review of research on therapy dog reading programs indicated that reading to a dog has a number of beneficial effects including improved reading performance ( 45 ). Studies suggest that interacting with a therapy dog may also improve speed and accuracy on cognitive (e.g., memory, categorization, adherence to instructions) and motor skills tasks among preschool-aged children compared to interacting with a stuffed dog or human ( 46 ). Similarly, a recent study showed that 10–14-year-old children had greater frontal lobe activity in the presence of a real dog as compared to a robotic dog, indicating a higher level of neuropsychological attention ( 47 ).

Among young adults, similar effects on cognition and learning have been found. Numerous colleges and universities now offer interactions with therapy dogs, typically during high stress times (such as before exams). In this sense, a biological mechanism through which dog interaction may positively impact cognition and learning is via stress reduction and improvement in positive affect. Even such short and infrequent interactions with therapy dogs may decrease perceived stress and increase perceived happiness in college students [e.g., ( 48 , 49 )]. Further, some institutions have permanent resident therapy dogs and/or long-term intervention programs; one such program showed that students who interacted with therapy dogs for 8 weeks reported significantly less homesickness and greater satisfaction with life than wait-listed controls ( 50 ). These effects may translate to additional effects on students' academic success, learning, and cognition. For instance, a recent randomized controlled trial ( 51 ) paired a standard academic stress management program with therapy dog interaction; the pairing produced significantly higher levels of self-reported enjoyment, usefulness, self-regulation, and behavior change than the stress management program or dog interaction alone. However, when therapy dog interaction is closely paired with more specific learning experiences, beneficial effects on stress remain, but benefits to academic performance may not manifest. For example, a recent study showed that interacting with a therapy dog resulted in significant improvements in students' perceived stress and mood, but not in actual exam scores ( 52 ). Similarly, interacting with a therapy dog during the learning and recall phase of a memory test did not improve memory compared to a control group ( 53 ). Taken together, dog interaction may improve stress and affect among college-aged adults as well as dimensions important for academic success and learning, but these results may or may not translate to cognitive performance benefits.

Biological Influences

The psychological and biological effects of HAI are often closely interwoven, as seen in the Psychological Influences section above and as demonstrated by the frequency with which psychological effects are evaluated using biological assessments of stress, anxiety, and arousal ( 54 ). For example, a plethora of studies have examined how short-term interactions with dogs can influence stress by measuring physiological biomarkers. Studies have found that dog interaction can influence parameters such as blood pressure, heart rate, and electrodermal activity ( 55 ) as well as neurochemical indicators of affiliative behavior [e.g., beta-endorphins, prolactin, and dopamine; ( 56 )].

However, one of the most popular physiological measures in HAI research is the stress hormone cortisol ( 57 ). Studies have found that short-term interactions with a dog can decrease both subjective stress and circulating cortisol concentrations [e.g., ( 58 )]. Cohabitating with a dog has also been found to impact circulating cortisol after waking among children with ASD ( 39 ) and military veterans with PTSD ( 59 ). Experimental studies have also examined how having a dog present may modulate the stress response and cortisol secretion among individuals undergoing a stressful situation. Among adults, studies have found that having a dog present during a socially stressful paradigm can attenuate cortisol compared to when alone or with a human friend ( 60 ). A recent randomized controlled trial similarly found that interacting with a therapy dog, for 20 min, two times per week, over a 4-week period resulted in reduced cortisol (basal and diurnal measurement) among typically developing and special needs school children compared to the same duration and length of delivery for a yoga relaxation or a classroom as usual control group ( 61 ). However, it is of note that many methodologically rigorous studies have not found significant effects of interacting with a dog on physiological parameters, including salivary cortisol ( 21 , 62 , 63 ). A recent review of salivary bioscience research in human-animal interaction concluded that significant variation exists with regards to sampling paradigms, storage and assaying methods, and analytic strategies, contributing to variation in findings across the field ( 57 ).

As research quantifying the physiological outcomes from dog interaction continues to increase, so does research attempting to understand the underlying mechanisms of action leading to stress reduction. One theoretical rationale for dogs' stress-reducing benefits consists of the dog's ability to provide non-judgmental social support ( 60 ), improve positive affect ( 64 ), and provide a calming presence ( 22 ). Dogs may also contribute to a feeling of perceived safety and provide a tactile and grounding comfort ( 65 ). For these reasons, dogs are often incorporated into treatment and recovery for individuals who have experienced a traumatic event ( 66 ). Another mechanism contributing to these stress reducing benefits may be tactile stimulation and distraction derived from petting or stroking a dog. For example, Beetz et al. ( 67 ) found that the more time a child spent stroking the dog before a stressful task, the larger the magnitude of cortisol decrease. In fact, calming tactile interactions such as stroking, touching, and petting may be a key mechanism explaining animal-specific benefits to stress physiology, as touch is more socially appropriate in interactions with animals than as with other people ( 22 ). While there are many hypothesized mechanisms underlying positive psychophysiological change following human-dog interaction, more research is needed to determine how individual differences in humans, animals, and the human-animal relationship affects outcomes ( 21 , 57 , 62 , 63 ).

Another mechanism in which positive dog interaction may result in psychophysiological benefits is via the secretion of oxytocin. Oxytocin not only buffers the stress response and cortisol secretion ( 68 ) but is also involved emotion, trust, and bonding ( 69 ). The oxytocin system has been hypothesized to be a primary mechanistic pathway involved in human-dog interactions ( 70 ). Positive dog-owner interactions including stroking, petting, and talking have been shown to result in increased oxytocin levels in both dog owners and dogs, which has been related to the strength of the owner-dog relationship ( 71 ) and dog-human affiliative behaviors ( 72 , 73 ). Some studies have also found differential effects in oxytocin reactivity after dog interaction between human males and females ( 74 ), giving context to potential gender and/or hormonal differences in dog-human interactions. However, even though the oxytocin system exhibits potential as a pathway by which dogs provide psychophysiological benefits, it should be noted that mixed findings and methodological and measurement differences limit strong conclusions ( 75 ).

In regards to pet dog ownership, many studies have also sought to understand the biological effects of long-term interactions with a pet dog. Some research suggests that sharing animal-associated microbes with a pet dog can have long-term impacts on human health ( 76 ) while others have found that cohabitating with a pet dog can be beneficial for child allergies ( 77 ) and immune system development ( 78 ). However, most research on the long-term health impacts of pet dog ownership has focused on cardiovascular functioning. Epidemiological research suggests that dog ownership is linked to greater physical activity levels (presumably linked to dog-walking), and reduced risk for cardiovascular disease, stroke, and all-cause mortality [for a summary see ( 79 )]. A recent meta-analysis of ten studies amassing data from over three million participants found that pet dog ownership was associated with a 31% risk reduction for mortality due to cardiovascular disease ( 80 ). However, dog ownership research of this nature will always suffer from an important chicken and egg type question: do dogs make us healthier, or do healthy people opt to own dogs?

Social Influences

A final way in which dog companionship and interaction may contribute to human health and well-being is through the social realm. Dogs may impact social functioning by providing direct social support ( 81 ) and a source of an attachment bond ( 82 ) which in turn may contribute to better social and mental health by providing companionship. Acquiring a pet dog has been reported to reduce both short-term and long-term self-reported loneliness ( 83 ). Particularly for those who live alone, dog ownership may serve as a protective factor against loneliness in times of social isolation, such as during the COVID-19 pandemic ( 84 ). Among older adults living in long-term care facilities or who live alone, dog visitation may also decrease loneliness by providing a source of meaningful companionship and social connectedness ( 85 , 86 ). However, the literature on pet dogs and loneliness is also characterized by mixed findings, raising the possibility that dog ownership may be a response to loneliness rather than protection from loneliness. Further, there remains a lack of high quality research in this area which limits any causal conclusions ( 87 ).

Another way in which the social support from a pet dog may benefit social functioning is by facilitating social interactions with others. For example, observational studies have found that being accompanied by a dog in public increases the frequency of received social interactions ( 88 ) and social acknowledgments [e.g., friendly glances, smiles; ( 89 )]. For those who engage in dog walking, social interactions are perceived as a rewarding side effect ( 90 ). Dogs can also provide a source of social capital, defined as the glue that holds society together ( 91 ). The research of Wood and colleagues ( 92 ) suggests that dogs can function as facilitators for social contact and interaction, with pet owners reporting higher perceptions of suburb friendliness and more social interactions with neighbors compared to non-pet owners.

For children and adolescents, pet dog ownership may contribute to healthy social development. Positive child–pet dog interactions have been shown to have benefits to children's social competence, interactions, and play behavior [for a review see ( 93 )]. Not only can children form attachment relationships with dogs ( 94 ), but pet dogs may promote feelings of safety and security ( 95 ) that can facilitate childhood social development. Pet ownership may also help children develop skills to form and maintain social relationships with their peers ( 96 ). For example, cross-sectional studies found that children with a pet dog in the home have fewer peer problems and have more prosocial behavior with children without a dog [e.g., ( 97 , 98 )].

Among children with developmental disorders, dog interaction has also been similarly shown to impact social functioning. For children with ADHD, two randomized controlled trials have found that 12 weeks of visits with a therapy dog, incorporated into curricula designed to improve skills and reduce behavioral problems, can result in improved social skills, prosocial behaviors, and perceptions of social competence ( 42 , 43 ). One potential explanation for these benefits is that children may interpret the dogs' nonverbal communication as less threatening and easier to interpret than human interaction ( 99 , 100 ). A recent eye-tracking study found that children with ASD exhibit a bias in social attention to animal faces, including dogs, compared to human faces ( 101 ). The presence of a dog in clinical applications may also promote more social engagement with a therapist while reducing negative behaviors ( 102 , 103 ). Further, there is some evidence that having a pet dog in the home can have a positive impact on social interactions of children with ASD, especially among verbal children, while teaching children responsibility and empathetic behavior ( 104 , 105 ).

Potential Mechanisms of Action

We have discussed how, in the psychological realm, interacting with a dog can positively relate to depression, anxiety, and well-being as well as psychological functioning in the areas of cognition, learning, and attention. It is interesting to note that most psychological constructs are measured using self-report indices, such as the Beck Depression Inventory ( 106 ) or the UCLA Loneliness Scale ( 107 ), while a smaller group of constructs are measured using speed and accuracy to detect targets (attention) or to remember information (learning and memory). In the biological realm, we discussed how interacting with dogs can influence stress-related physiological parameters and long-term biological and cardiovascular health. Biological measures are often recorded in real-time, such as heart rate or blood pressure, or are collected at critical time points during the study (e.g., saliva, urine, or blood samples for such measures as cortisol or oxytocin). Finally, we discussed the social realm, in which interacting with a dog can provide social support, facilitate social interactions, and improve social development and social skills. Measures used to assess variables in the social realm include self-report indices (e.g., demographics such as marital status, numbers of family members and friends), real time observations of social interactions (e.g., video analyses of interactions using ethograms), and parent/teacher reports of social functioning [e.g., Social Skills Rating System; ( 108 )]. To better understand and organize these various findings, we now consider potential mechanisms of action in the context of the biopsychosocial model, and as part of this discussion we will consider the potential for different types of measurement to have their own influence.

The mechanisms that underly positive human-dog interactions are likely to be interrelated and broadly, yet differentially, impactful across the three influencers of health (biological, psychological and social). According to the biopsychosocial model, impacts on one of the influencers of health is likely to impact the others ( 14 ). Further, an underlying mechanism of change may have a larger immediate impact on one realm than on the other two ( 15 ). Although this applies to the many influences we have discussed above, we will describe a reduction in stress as a more detailed example of how the biopsychosocial model can be considered. Stress is likely to have an immediate and measurable impact on the biological system through endocrinological (e.g., changes in cortisol) and psychophysiological (e.g., changes in blood pressure) processes. This same reduction in stress is likely to impact the psychological system through changes in mood or affect, concentration, and motivation, but that impact may not be immediately measurable or may be smaller in magnitude. This conjectured delay or reduction in effect size stems at least in part, from the way these changes are typically measured and the time course for potential effects to become measurable. For example, some biological changes indicative of increased stress (e.g., heart rate) can be measured in direct correspondence with the experimental manipulations (e.g., interacting with the dog vs. experiencing a control condition), and provide real time biological indications of changes in stress levels. Psychological indications of stress may be measured by a self-report survey instrument assessing state or trait anxiety. This type of measure cannot be completed in real time during the various experimental conditions (e.g., interacting with the dog vs. experiencing a control condition), but must be completed at some point following the experimental manipulation. It is possible that psychological measures are not as immediately sensitive to changes in the constructs they measure because of the required delay between manipulation and measurement. Such a delay may underestimate the real time effect as it may fade over time. Finally, reductions in stress have the potential to impact social systems by increasing social approaches and acceptance of approaches by others, but that impact may be of a small size or require even more time to be measurable. For example, exposure to stress may have immediate physiological effects, but it could take more time (prolonged exposure to stress) for those effects to impact some measures of social influence such as number of friends.

In Figure 2 , the mechanism of stress reduction is used as one example for the purposes of this discussion to exemplify how human-dog interactions may influence human health and well-being, as explained by the biopsychosocial model. Stress reduction may have a more immediate or larger impact on the biological realm as demonstrated by the larger arrow, while having a smaller (or perhaps delayed) impact on the psychological realm and an even smaller (or potentially more delayed) impact on the social realm.

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An example of the potential for differential impact (represented by the different arrow thickness) of one mechanism of action (stress reduction) on the three realms of influence of overall health and well-being (depicted by the larger encompassing circle).

Based on the research described earlier, we have seen that interacting with a dog can have stress reducing impacts in the biological realm such as decreased cortisol, heart rate, and blood pressure, and increases in oxytocin. In the psychological realm, stress reduction can be a driver of immediate improvements in self-report measures of stress, mood, and anxiety and more delayed improvements in overall mental health and quality of life. The social realm is also likely to be directly and indirectly impacted by this stress reduction from both immediate and delayed psychophysiological changes as well as more long-term improvements in social support, social networks, social development, and overall social health. Therefore, it is important to consider the dynamic nature of these three realms in that there may be a strong immediate effect of dog interaction on one realm, but a lesser, delayed impact in the other two realms. Similar to our more detailed example of stress above, other influences we have discussed (e.g., social support, positive affect, etc.) are likewise mechanisms that operate in a similar reciprocal biopsychosocial framework. Further, although it likely that the three influences are interrelated, it is not known from the current evidence the degree to which they may be interrelated and thus have shared and overlapping effects on one another and on overall health and well-being. Therefore, a consideration of mechanisms that influence human-dog interactions from a dynamic and flexible biopsychosocial perspective, instead of from a single realm, is an important addition to the study of human-animal interaction.

Conclusion and Future Directions

In conclusion, the biopsychosocial model is a promising theoretical model to be applied to human-animal interaction research for several reasons. First, the field of HAI has been plagued by mixed findings in which some research suggests that dogs have beneficial effects on human health and well-being and others suggest no effect or even a negative effect [for a discussion see ( 109 )]. This variability in HAI research outcomes caused by differing methodologies, measurement, populations, and interventions is described in detail by Rodriguez et al. ( 110 ). However, we also argue that some of the variability seen in HAI research may be explained by the potential for differential immediate and delayed impacts within each of the three biopsychosocial model realms. For example, if dog interaction shows immediate reduction in physiological measures of stress, how long does that reduction last, and do we see corresponding immediate and/or delayed responses in the psychological and social realms? Therefore, more information about differential impacts of dog interactions on each of the three influencers at various points in time is needed. In addition, it may be necessary to apply a variety of measures (at least one measure per influencer realm) over time to fully disentangle the existing mixed results in the field of HAI.

Secondly, due to the flexibility that this dynamic biopsychosocial model offers in explaining HAI research outcomes, we propose this model as an effective avenue to promote future theoretically grounded research in our field. Saleh ( 111 ) stresses that practice, research, and theory are the corner stones of any field, HAI is not exempt from this consideration. The field of HAI will benefit from applying an accepted model, like the biopsychosocial model, because it provides a useful framework for understanding and predicting how interactions between humans and animals impacts human health and well-being. As Saleh ( 111 ) explains, “it is the result of the relationship between the process of inquiry (research) and the product of knowledge (theory)” that our understanding of a process may become clearer. Therefore, current research should continue to modify and impact a present theory, which should act as a guide for researchers to constantly generate and test the basis of a theory ( 111 ). The findings from such theory-driven research could then help practitioners, as well as health care policy makers, in how to effectively incorporate dogs in therapeutic settings and in homes.

Lastly, the reciprocal relationship of the psychological, biological, and social domains can be used to elucidate the mechanisms that both impact and are impacted by interactions between humans and animals. Theory-driven science (for which we have proposed the biopsychosocial model as a useful framework) should be used to influence and inform research, practice, and policy. Thus, researchers and practitioners applying the biopsychosocial model will be instrumental not only in guiding future research in the field, but also in clarifying existing research as well people's perceptions of benefits derived from canine-human interactions.

Author Contributions

NG provided the initial organization and theoretical framework. All authors wrote and edited the document in shared collaboration and discussed and conceived the idea for the paper.

Conflict of Interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Acknowledgments

The authors wish to express their appreciation to the Wallis Annenberg Petspace for supporting this theoretical framework and exploration of the Human-Canine bond.

Funding. As part of the conferment of Fellowship status to all authors, the Wallis Annenberg Petspace provided the funding for publication fees of this document.

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ORIGINAL RESEARCH article

Introduction

Materials and Methods

Questionnaire

Quantitative Analysis

Dependent Variables

Data Analysis

Qualitative Analysis

Sample Description

Quantitative Findings

Emotional Support

Companionship

Summary of Quantitative Findings

Qualitative Findings

How Dog Ownership Increases Owner Perceived Happiness

Dog Attributes Promote Feelings of Self-Acceptance (↑ Eudaimonia)

Dogs and Their Activities Provide Purpose (↑ Eudaimonia)

Dog Activities Provide Mastery, Positive Relations and Personal Growth (↑ Eudaimonia)

Dog Attributes Lessen Owner Emotional Pain or Suffering (↑ Hedonia and Eudaimonia)

How Dog Ownership May Decrease Owner Perceived Happiness

Response-Ability Decreases Self-Acceptance, Environmental Mastery, Autonomy and Positive Relations (↓Eudaimonia)

Owner Characteristics

Dog Characteristics

Anticipatory Grief (↓ Hedonia)

Tolerated Inconvenience

Summary of Qualitative Findings

Summary of Findings

Comparison With Previous Literature

Strengths and Limitations

Data Availability Statement

Ethics Statement

Author Contributions

Conflict of Interest

Publisher’s Note

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Supplementary Material

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Pet ownership and human health: a brief review of evidence and issues

Introduction