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 effects of extending the CS-UCS interval on the effectiveness of the conditioning treatment for nocturnal enuresis

Previous studies of the “conditioning method” of enuresis treatment have confounded the effects of conditioning with those of nonspecific psychotherapeutic aspects of the procedure. The present study compared three groups of enuretic children: (1) under the conventional bell-light conditioning procedure; (2) under a similar procedure, but which involved a three-minute delay between wetting and alarm, and (3) under no-treatment conditions. Double-blind precautions were used. Results suggested that conditioning effects improvement over and above that effected by nonspecific influences. The findings are qualified by large variances in improvement, and by premature termination of the experiment.     

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The traditional pad and bell apparatus is not superseded but commonly exhibits defects and hazards for which the recessed electrode principle is introduced as a solution.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.     

Treatment of nocturnal headbanging by behavior modification techniques: a case report

The application of behavior modification techniques to the alleviation of maladaptive behavior occurring during the waking state is well documented (Bandura, 1969; Franks, 1969). Recently, several case studies have been reported which demonstrate the successful extension of behavior modification techniques such as the desensitization procedure to the modification of sleep state maladaptive behavior, e.g. recurrent nightmares (Cautela, 1968; Geer and Silverman 1966; Silverman and Geer, 1968) and sleep walking (Clement, 1969). The present case study illustrates that other sleep state maladaptive behavior, in this case nocturnal headbanging, is amenable to the same behavior modification techniques which are used to modify maladaptive behavior during the waking state. Case background     

Conditioning treatment of nocturnal enuresis in adults: preliminary findings

Four male and six female adults (aged between 16 and 23) were treated for nocturnal enuresis with bell and pad apparatus. Although the trial was based upon an atypical sample (most patients were referred by psychiatrists), the results do suggest that bell and pad treatment may often markedly reduce or entirely eliminate nocturnal wetting even when the problem has persisted into adulthood.The special problems which may occur when treating enuresis in adults are discussed.     

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.     

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.     

Critique of Turner, Young and Rachman's conditioning treatment of enuresis

The abstract of the paper begins by asserting that “one hundred and fifteen children were assigned to five treatment groups (including two control treatments)”. The abstract continues “over a one month period there was no difference between conditioning and control procedures”. A further sentence to the effect that conditioning treatment brought about an initial arrest of bedwetting in 81.4 per cent of cases, does nothing to dispel the implication of the earlier sentences that a large scale study has failed to produce evidence that conditioning treatment is superior to “placebo” or “arousal” treatments.