Primary nocturnal enuresis: A psychodynamic clinical perspective

Do Children With Primary Nocturnal Enuresis Have Clinically Significant Behavior Problems?

“…One body of literature suggests PNE is a symptom of a refractory mental health condition that requires specialized mental health treatment. [4][5][6][7] Another body of literature suggests PNE is a biobehavioral problem typically requiring only direct medical and/or behavioral treatment for the wetting itself. 2,[8][9][10][11] One empirical method to validate these perspectives is to examine the comorbidity of PNE and clinically significant behavior problems.…”

“…The results thus extend the validity of previous, less well-controlled research on enuresis and comorbid behavior problems. [4][5][6][7] This study has limitations of its own, however. It uses only 1 measure of psychopathological abnormalities and did not establish and analyze the role of wetting frequency.…”

Current concepts in pediatric primary nocturnal enuresis

“…Alternative views that enuresis was an expression of character disorder (Michaels, 1955), was symptomatic of a deficient mother/child relationship (Mishne, 1993;Sperling, 1965) or was related to masturbatory conflict (Sperling, 19651 have not been well supported by the empirical literature. Although children who have been referred for treatment of PNE exhibit more behavioral problems than enuretic children who have not been referred (Moffatt, 1989), it is likely that these behaviors are the result rather than the cause of enuresis (Moffatt, et.…”

“…This should come as no surprise considering that self-esteem can be a multiply determined construct. Investigations of symptom substitution following successful treatment of PNE have documented a notable lack of this phenomenon (Baker, 1969;Moffatt, 1989), although there remain contemporary psychodynamic explanations of enuresis that adhere to this theory (Mishne, 1993).…”

“…A variety of behavioral interventions have been proposed for enuresis, ranging from hypnosis tAmbrose, 1983) and elimination diets (Esperanca & Gerrard, 1968) to short-term psychotherapy (Sperling, 1965) and psychoanalysis (Mishne, 1993). In comparative studies of the psychological therapies, short-term psychotherapy has yielded results comparable to control groups and greatly inferior to conditioning therapies (De Leon & Mandell, 1966;Werry & Cohrssen, 1965).…”