Elimination Disorders

Question 0

Theoretical Perspectives on Enuresis

Answer 0

Psychodynamic: expression of hostility toward parents b/c of harsh potty training

Regression in response to stressors such as new sibling

Learning theorists: most common when potty trained to early, early failures connected anxiety to bladder control

Primary Enuresis: primary form, nighttime bed wetting which control never established for, genetic ties

Secondary: no genetic ties, comes after child already learned urinary control

Question 1

Enuresis

Answer 1

Failure to control urination after reaching the “normal” age for attaining control

DSM: must be at least 5, or equivalent developmental level, must meet following:

1. Repeatedly wetting bedding/clothes (intentional or involuntary)
2. Wetting occurs 2x a week for 3 months, or causes significant distress
3. No medical or organic reason for disorder

More common in boys, affects 7 million kids over age 6

Nighttime-only is most common, usually occurs a during deepest sleep may reflect immaturity of nervous symptom.

Question 2

Treatment Enuresis

Answer 2

Usually resolves itself as kid matures

Urine alarm: uses classical conditioning. moisture activated alarm placed beneath kid, sensor goes off when wet wakes kid up, eventually get learns to wake up before bed wetting

Question 3

Encopresis

Answer 3

Lack of bowel movement not caused by organic problem

Must be at least 4, affects boys more

More likely to happen in day

Causes high levels of anxiety, activating ANS causing more anxiety and less control of bowel

Behavior therapy helpful, involves parents rewarding child for successful attempts At self control, and mild punishment for accidents