Based on longitudinal ethnographic fieldwork in Bosnia and Herzegovina I trace ontologies of posttraumatic stress disorder (PTSD) and their enactments among veterans of the 1992-1995 war. My aim is to problematize and rethink social constructionists' approaches in medical anthropology that discuss war trauma and PTSD in relation to naturalistic models and treat them as constructed realities not determined by the nature of things. I argue that such a standpoint produces a particular epistemological/ontological side-effect: it allows medical anthropologists to craft a purely social ontology of trauma and PTSD by claiming that the realness of these "constructs" is a result of psychiatric discourse, moral economy of contemporary societies or Western (intellectual, political, and medical) hegemony. Considering the ontology of PTSD as an empirical question I analyze the enactments of PTSD in four settings: the ethnographic genre itself, the organization of war veterans with PTSD in the city of Tuzla, the veterans' welfare system in the Federation of Bosnia and Herzegovina, and Bosnian public arena. I argue that PTSD is practiced as a heterogeneous and multiple reality that cannot be situated solely either in the realm of human organism (and explained by naturalistic models) or society and culture (and...

Based on longitudinal ethnographic fieldwork in Bosnia and Herzegovina I trace ontologies of posttraumatic stress disorder (PTSD) and their enactments among veterans of the 1992-1995 war. My aim is to problematize and rethink social constructionists' approaches in medical anthropology that discuss war trauma and PTSD in relation to naturalistic models and treat them as constructed realities not determined by the nature of things. I argue that such a standpoint produces a particular epistemological/ontological side-effect: it allows medical anthropologists to craft a purely social ontology of trauma and PTSD by claiming that the realness of these "constructs" is a result of psychiatric discourse, moral economy of contemporary societies or Western (intellectual, political, and medical) hegemony. Considering the ontology of PTSD as an empirical question I analyze the enactments of PTSD in four settings: the ethnographic genre itself, the organization of war veterans with PTSD in the city of Tuzla, the veterans' welfare system in the Federation of Bosnia and Herzegovina, and Bosnian public arena. I argue that PTSD is practiced as a heterogeneous and multiple reality that cannot be situated solely either in the realm of human organism (and explained by naturalistic models) or society and culture (and...

<p>Psychiatric assistance dogs for military veterans with posttraumatic stress disorder (PTSD) currently make up over 19% of assistance dog partnerships globally. We conducted a systematic review of the literature relating to these partnerships, with specific aims to (1) summarize their characteristics, (2) evaluate the quality of existing evidence, and (3) summarize outcomes. A total of 432 records were independently screened (Cohen’s kappa=0.90). Of these, 41 articles (29 peer-reviewed publications and 12 unpublished dissertations) met inclusion criteria. Data extraction was conducted to address the research aims, including a meta-analysis (quantitative outcomes) and meta-synthesis (qualitative outcomes). All peer-reviewed publications on the topic of psychiatric assistance dogs for veterans with PTSD were published within the last five years. The majority of included articles were quantitative (53%), 41% were qualitative, and 6% employed mixed methods. Mean methodological rigor scores were 80% for peer reviewed articles and 71% for dissertations, where higher scores represent more rigorous methodology. Quantitative articles reported significant improvements in the domains of PTSD severity, mental health, and social health. Impacts on physical health and global quality of life appear inconclusive. Meta-analysis (9 articles) revealed that partnership with an assistance dog had a clinically meaningful, significant, and large effect on PTSD severity scores (<em>g</em>=−1.129; <em>p</em><0.0001). Qualitative meta-synthesis identified two third order constructs: (1) Impact on the individual: mental & physical health and (2) Impact beyond the individual: building relationships & connection. This synthesis of increasingly prevalent research on assistance dogs for veterans with PTSD provides support for the impact of this complementary and integrative health intervention on PTSD symptom severity, and signs of meaningful improvements in adjacent domains including mental and social health. Gaps between quantitative and qualitative findings, along with the need to report greater demographic detail, highlight key opportunities for future research.</p>