Enuresis While the requirements for

Enuresis
While the requirements for self control affect many aspects of the todler’s life, they are keenly felt when they intrude upon bodily function. Yhe young child lives close to his or her body, and eating and elimination hold special pleasure and special fascinations. The socializing parent’s demands can, therefore, trigger some of the most intense conflicts of early chilhold. We will be exploring a major disturbance in regulating elimination namely, unuresis.
Defenition and characteristics
Defenition
Enuresis has along history. It was mentioned in egyptian medical texts as early as 1950. In current usage enuresis is defined as repeated involuntary or intentional discharge of urine into bed or clothes beyond the expected age for controlling urination. According to DSM IV TR, this age is a 5 years or a comparable developmental level. The behavior is clinically significant if it occurs twice a week for at least three consecutive months. However, it may also be regarded as significant if there is considerable distress or impairment in important areas of funtioning. Another qualification is that enurasis is not due to a general medical condition or to drugs that affect urination.
There are three different types of enuresis. In nocturnal enuresis passing urine occurs only during nighttime sleep. In diurnal enuresis urine is passed during waking hours. In mixed, or nocturnal and diurnal enuresis, urine passed both waking and sleep ing hours. There three distinctions are not always made in the research literature, however, resulting in certain ambiguity in the findings.
There is another important clasification. Primary enuresis, refers to shildren who have never been successfully trained to control their urination. Secondary enuresis, refers to shildren who have never been successfully trained but revert back wetting for example, in response to a stressful situation in the family. In our developmental terminology, primary enuresis represents a fixation, whereas secondary enuresis represents a regression.
Prevalence and characteristics
In the United States, approximately 15 to 20 percent of 5 years old children will develop symptoms of enuresis. Fischel and Liebert (2000) summarize prevalence rates across several studies and find that the prevalence of enuresis change significantly with age. It is found in 33 percent of 5 year olds, 25 percent of 7 year olds, 15 percent of 9 year olds, 8 percent of 11 year olds, 4 percent of 13 year olds, and 3 percent of 15 to 17 year olds. Of these children, 75 percent showed only nocturnal enuresis; diurnal enuresis is much less common. There is a gender difference: Overall, 60 percent of enuretic children niale. However, this too changes with age. Between ages 4 and 6 years the number of boys and girl with enuresis is about equal. However, the ratio changes so that by 11 years of age there are twice as many boys as girls. There is evidence that the incidence of enuresis varies with social class; in the United States it is more prevalent among those who are socioeconomically disadvantages (Walker, 1995).
There is no evidence at present for ethnic differences. Comorbidity attention problems and hyperactivity co-occur frequently with enuresis. Children with enuresis also are more likely to display behavior problems such as misconduct, anxiety, immaturity, and under-achiement in school. Enuresis also has been implicated in studies of encopresis (fecal soiling), learning disabilities, and developmental delays in intelegence.
Developmental course
Both nocturnal and diurnal enuresis appear to be self limiting; this is children tend to outgrow them even without treatment. There is some evidence that remission rates for girls may be higher than those for boys: 71 percent of girls and 44 percent of boys between the ages of 4 and 6 spontaneously stop wetting themselves (Harbeck-Weber & Paterson, 1996). Since there are also effective treatment, as we shall see, the prognosis is quite favorable for enuresis.
Etiology
The Biological Context
Enuresis can be caused by a number of purely medical problems such as anormalies of innervation of the bladder that result in an inability to empty it completely, illnesses such as diabetes insipidus or urinity tract infections, and drugs such as diuretics. The clinical child psycologist should make sure that these factors have been ruled out by a medical axamination.
There are two leading contenders in biologically focused theories of etiology. The first involves deficiencies in the nighttime secretion of antidiruetic hormone, which normally reduces the amount of urine produced at night. However, evidence in support of this hypothesis is questionable, since not all children who produce excessive urine are enuretic (Ondersma & Walker, 1998). The other leading theory involves the absence of learned muscle responses that inhibi urine flow during sleep (Mellon & stern, 1998).
There are two be a strong genetic component to enuresis. For example, when both parents have a chilhoold history of enuresis, the risk of the child’s developing the disorder is estimated to be 80 percent. In contrast, if one parent had the disorder, the risk for the child is 45 percent, whereas if neither parent were enuretic, the child’s risk is only 15 percent (Fischel & liebert, 2000). Furthemore, there is a 68 percent concordance rate for monozygotic twins and only a 36 percent concordance rate for dizygotic twins (Harbeck-Weber & Paterson, 1996).

Hasil (Bahasa Indonesia) 1:

Enuresis Sementara persyaratan untuk kontrol diri mempengaruhi banyak aspek kehidupan todler, mereka sangat merasa ketika mereka mengganggu berdasarkan fungsi tubuh. Anak muda YHE hidup dekat tubuh Nya, dan makan dan penghapusan tahan kesenangan khusus dan khusus fascinations. Orangtua bersosialisasi tuntutan dapat, oleh karena itu, memicu beberapa konflik paling intens dari awal chilhold. Kita akan menjelajahi gangguan besar dalam mengatur penghapusan yaitu unuresis.Defenition dan karakteristikDefenition Enuresis memiliki sepanjang sejarah. Disebutkan dalam teks-teks medis Mesir awal sebagai 1950. Dalam penggunaan saat ini enuresis didefinisikan sebagai berulang disengaja atau tidak disengaja keluarnya urin ke tempat tidur atau pakaian melampaui usia diharapkan untuk mengendalikan buang air kecil. Menurut DSM IV TR, usia ini adalah 5 tahun atau tingkat perkembangan yang sebanding. Perilaku klinis yang signifikan jika terjadi dua kali seminggu selama setidaknya tiga bulan berturut-turut. Namun, hal itu mungkin juga dianggap sebagai signifikan jika ada cukup tertekan atau gangguan dalam bidang-bidang penting funtioning. Kualifikasi lain adalah enurasis yang tidak karena kondisi medis umum atau obat yang mempengaruhi buang air kecil.Ada tiga jenis enuresis. Dalam Ngompol melewati urin terjadi hanya selama tidur malam. Diurnal enuresis urin adalah lulus selama jam bangun. Campuran, atau nokturnal dan diurnal enuresis, urin lulus bangun dan tidur jam ing. Ada tiga pembedaan tidak selalu dibuat dalam literatur penelitian, namun, mengakibatkan tertentu ambiguitas dalam temuan.Ada enis penting lain. Utama enuresis, merujuk kepada shildren yang telah pernah berhasil dilatih untuk mengontrol buang air kecil mereka. Enuresis sekunder, merujuk kepada shildren yang pernah telah berhasil dilatih tetapi kembali kembali membasahi misalnya, dalam menanggapi situasi stres dalam keluarga. Dalam terminologi kami perkembangan, utama enuresis mewakili fiksasi, sedangkan sekunder enuresis mewakili regresi.Prevalensi dan karakteristik In the United States, approximately 15 to 20 percent of 5 years old children will develop symptoms of enuresis. Fischel and Liebert (2000) summarize prevalence rates across several studies and find that the prevalence of enuresis change significantly with age. It is found in 33 percent of 5 year olds, 25 percent of 7 year olds, 15 percent of 9 year olds, 8 percent of 11 year olds, 4 percent of 13 year olds, and 3 percent of 15 to 17 year olds. Of these children, 75 percent showed only nocturnal enuresis; diurnal enuresis is much less common. There is a gender difference: Overall, 60 percent of enuretic children niale. However, this too changes with age. Between ages 4 and 6 years the number of boys and girl with enuresis is about equal. However, the ratio changes so that by 11 years of age there are twice as many boys as girls. There is evidence that the incidence of enuresis varies with social class; in the United States it is more prevalent among those who are socioeconomically disadvantages (Walker, 1995).There is no evidence at present for ethnic differences. Comorbidity attention problems and hyperactivity co-occur frequently with enuresis. Children with enuresis also are more likely to display behavior problems such as misconduct, anxiety, immaturity, and under-achiement in school. Enuresis also has been implicated in studies of encopresis (fecal soiling), learning disabilities, and developmental delays in intelegence.Developmental courseBoth nocturnal and diurnal enuresis appear to be self limiting; this is children tend to outgrow them even without treatment. There is some evidence that remission rates for girls may be higher than those for boys: 71 percent of girls and 44 percent of boys between the ages of 4 and 6 spontaneously stop wetting themselves (Harbeck-Weber & Paterson, 1996). Since there are also effective treatment, as we shall see, the prognosis is quite favorable for enuresis.Etiology The Biological ContextEnuresis can be caused by a number of purely medical problems such as anormalies of innervation of the bladder that result in an inability to empty it completely, illnesses such as diabetes insipidus or urinity tract infections, and drugs such as diuretics. The clinical child psycologist should make sure that these factors have been ruled out by a medical axamination.There are two leading contenders in biologically focused theories of etiology. The first involves deficiencies in the nighttime secretion of antidiruetic hormone, which normally reduces the amount of urine produced at night. However, evidence in support of this hypothesis is questionable, since not all children who produce excessive urine are enuretic (Ondersma & Walker, 1998). The other leading theory involves the absence of learned muscle responses that inhibi urine flow during sleep (Mellon & stern, 1998).There are two be a strong genetic component to enuresis. For example, when both parents have a chilhoold history of enuresis, the risk of the child’s developing the disorder is estimated to be 80 percent. In contrast, if one parent had the disorder, the risk for the child is 45 percent, whereas if neither parent were enuretic, the child’s risk is only 15 percent (Fischel & liebert, 2000). Furthemore, there is a 68 percent concordance rate for monozygotic twins and only a 36 percent concordance rate for dizygotic twins (Harbeck-Weber & Paterson, 1996).