Conditioning treatment of enuresis: Auditory intensity

The auditory stimulus characteristics of three commercially-produced enuresis alarms are described and the results of a clinical trial of the three alarm types are reported. No significant differences regarding outcome, either in terms of treatment efficiency or of subsequent relapse, were found.     

The effectiveness of Dry Bed Training for nocturnal enuresis in adults

Nine enuretic adults were successfully treated by the Dry Bed Training in a fairly short time (means = 15 weeks) including the retraining period for 3 Ss who relapsed after the therapy. There were no differences between primary and secondary (nocturnal) enuretics. The few relapses were neutralized by a short retraining. The study shows that this minimal intervention treatment is effective and efficient.     

Conditioning functional enuresis: follow-up after retraining

Of 52 enuretics treated with bell-and-pad, 44 (84.6%) were initial successes. One year after training, 16 (30.8%) remained continually dry. Positive outcomes increased to 24 (46.2%) with the addition of successful retrainees and to 29 (55.8%), including 5 unretrained relapses who subsequently were found dry. Most clients reach initial success, but less than one third remain continually dry.

In retraining, over 84.2% (16/19) of the clients were again successful, but training time was shorter, and half relapsed a second time. Retraining is an appropriate and relatively easy approach for modifying relapse, at least for many enuretics. More rigorous assessment of retraining requires a balanced follow-up design and comparison with other approaches.     

Conditioning treatment of enuresis using a 70% intermittent reinforcement schedule

A 70% intermittent variable ratio reinforcement schedule was administered by automated equipment to 80 enuretic children of both sexes. Dryness criterion (14 consecutive dry nights) was reached by 94% of the sample. Mean treatment duration was less than seven weeks. Approximately 80% of the sample recorded at least one multiple wetting night during the early stages of conditioning treatment. Relapse rates varied as a function of age ranging from 5.25% in 7–8 year olds to 50% in 9–10 year olds. For all ages combined, the observed relapse rate of 25% was found to be significantly lower than reported in the enuresis literature over the past 10 years.     

Treatment of nocturnal enuresis by conditioning techniques

One hundred and fifteen enuretic children were assigned to five treatment groups. Three groups received Mowrer-type continuous signal (C.S.), Twin-Signal (T.S.) or intermittent Twin Signal (T.S.-I.R.) conditioning treatment, and two groups were given “placebo” or “arousal” control treatments. Over a one-month period, there was no difference between conditioning and control procedures, and it was concluded that further research is needed to determine the basis of treatment response. There was no evidence in support of the escape training hypothesis, and the twin-signal modification to standard bell-and-pad treatment is not recommended. The investigation confirmed the success of conditioning treatment in bringing about the initial arrest of enuresis (i.e. in 81.4 per cent of the cases) but the relapse rate was high. The investigation provided tentative evidence that intermittent conditioning treatment offers one way of reducing the frequency of relapse. The problem of obtaining satisfactory parental co-operation in a badly housed working-class population was apparent, and ways of reducing the demands that treatment imposes on parents are indicated. The results are discussed with regard to theories of conditioning treatment of nocturnal enuresis, and possible improvements in this technique of treatment.     

A controlled trial of the treatment of nocturnal enuresis in residential homes for children

The present study was undertaken to evaluate the practicability and efficacy of treating enuretic children in residential Children's Homes by means of the enuresis alarm. A control group design was employed with 19 and 20 subjects in the treatment and control groups respectively. Eighteen of the nineteen treatment group children achieved initial arrest of enuresis in a mean of 11.9 weeks of treatment (range 5–28 weeks). Over the initial 12-week period, the treatment group showed a statistically significant reduction in mean wetting frequency, both over time and in comparison with the control group. After a follow-up period of at least 20 months. 17 of the 19 children were known to be dry. The results of an independent evaluation are reported, and it is concluded that alarm treatment is as effective and practicable in Children's Homes as it is in family situations.     

Childhood nocturnal enuresis: The prediction of premature withdrawal from behavioral conditioning

Predictors of premature withdrawal from a 12-week program of behavioral conditioning for childhood nocturnal enuresis were examined for 47 children treated at a university outpatient clinic. All children were administered the Piers-Harris Children's Self-Concept Scale; parents completed the 55-item Behavior Problem Checklist and the Tolerance Scale for Enuresis. Parents also reported the methods (i.e., random awakening, restriction of fluids, rewards,punishment, medication, other) previously used to control their child's wetting. A stepwise discriminant function analysis revealed that the function containing number of previous techniques used, presence of child behavior problems, and parent tolerance of enuresis was a significant predictor of early termination of treatment.     

The effect of parent-administered dry-bed training on nocturnal enuresis in children

In this study, two substantial modifications were made to the Dry-Bed training procedure described by Azrin, Sneed and Foxx (Behav. Res. and Therapy, 12, 147–156 (1974). The first modification was to have parents administer the intensive all-night training programme rather than an outside trainer. With fourteen children treated in this manner, nocturnal enuresis was eliminated in all cases. The median time taken to the last night of wetting was only 12 days. There were two relapses in a 6-month follow-up. The second modification involved administering the Dry-Bed procedure without the adjunct of an enuresis machine. This resulted in significantly reduced frequency of bedwetting, although nocturnal enuresis was not completely arrested in any of the ten children treated. The implications of these findings are discussed.     

Motor-motor adaptation: preliminary findings

This study investigated the relationship between speech perception and speech production. An experimental technique called motor-motor adaptation was devised. Subjects produced a speech token repeatedly (20 to 40 repetitions), then produced a second token one time. These tokens all contained stop consonants and were subsequently analyzed for voice onset time. The results paralleled previous findings using the experimental procedure, perceptuomotor adaptation. The present study supports the notion of a perception-production link.     

Relapse and therapeutic response in the conditioning treatment of enuresis: A review of recent findings on intermittent reinforcement,overlearning and

Recent research concerning relapse and response to auditory alarm stimuli in the conditioning treatment of enuresis is reviewed. Both intermittent reinforcement and overlearning procedures have been found to be associated with reduced relapse rates—of 25% and 12.8% respectively, a consensus of published results to date favouring overlearning as the more effective procedure in countering relapse. Auditory stimulus intensity is identified as a critical factor affecting rate of acquisition of continence, but not relapse, and appears implicated in the improved acquisition obtained in past studies of variations upon basic conditioning treatment.     

Apparatus for conditioning treatment of enuresis

Recent experimental work is cited which has implications for basic equipment design. Some unsatisfactory earlier innovations are also briefly discussed.

The traditional pad and bell apparatus is not superseded but commonly exhibits defects and hazards for which the recessed electrode principle is introduced as a solution. New high-sensitivity requirements in circuitry to match the recessed electrode pad are met in an unusual and inexpensive way.     

Five personality factors and sex: preliminary findings

This study assessed the relationships between the Big Five personality domains, attitudes to sex, and three specific sexual behaviours. Respondents were 123 undergraduate students (51 males; 72 females). Men were found to score significantly higher than women on measures of sexual curiosity and sexual excitement, while women were higher on sexual satisfaction. Neuroticism (N) and Extraversion (E) appeared to be the most important predictors of attitudes to sex, although Conscientiousness (C) and Openness to experience (O) were also implicated. N, C, and Agreeableness (A) were implicated in sexual behaviours. Some suggestions for future research are made.