Child and Adolescent Disorders
II. Specific Disorders
Published Online: 25 JUN 2012
Copyright © 2012 John Wiley & Sons, Inc. All rights reserved.
Handbook of Evidence-Based Practice in Clinical Psychology
How to Cite
Williams, W. L. and Jackson, M. 2012. Enuresis. Handbook of Evidence-Based Practice in Clinical Psychology. 1:II:16.
- Published Online: 25 JUN 2012
This chapter describes the epidemiology and conditions of enuresis, including diurnal, nocturnal, primary, secondary, and polysymptomatic enuresis. Pharmacological, behavioral, and other interventions for enuresis are described and the relevant literature reporting their effectiveness is reviewed in terms of standard criteria for evidence-based outcomes. Some pharmacological treatments were found to be effective only for the short term. Overall, the urine alarm is an evidence-based practice for the treatment of nocturnal enuresis; however, it is not successful for everyone, and relapse rates are high. In general, the use of retention control training as a stand-alone treatment has been inconsistent in its effectiveness, whereas reinforcement-based procedures alone can be effective in eliminating enuresis. Dry bed training (DBT) meets the requirements for evidence-based treatment with the alarm, and may be effective alone as long as the enuretic is awakened. The literature on DBT suggests that some components may be necessary while others may be less critical to the success of treatment. In general, meta-analyses are not available for complex treatments of enuresis, and conclusions that can only be drawn from small-N experiments indicate that alarm and other interventions such as DBT are more effective than alarm alone but that any treatment with alarms appears better than any treatment without alarms.
- urine alarm;
- retention control training;
- dry bed training;
- positive practice;
- positive reinforcement;
- waking schedule