Page 1 of 2 12 LastLast
Results 1 to 10 of 19

Thread: DSM-5 says Enuresis may still be intentional? Does that include some of us?

  1. #1

    Question DSM-5 says Enuresis may still be intentional? Does that include some of us?

    It seems when I get particularly stressed out, or have particularly bad anxiety, I get into a wave of "baby mode" and sometimes end up doing research... One of the things that I thought was interesting was that in the Diagnostic and Statistical Manual of Mental Disorders (the book that determines everything psychologists would consider a disorder) says that the criteria for Enuresis is the following:


    A. Repeated voiding of urine into bed or clothes, whether involuntary or intentional.
    B. The behavior is clinically significant as manifested by either a frequency of at least twice a
    week for at least 3 consecutive months
    or the presence of clinically significant distress or
    impairment in social, academic (occupational), or other important areas of functioning.
    C. Chronological age is at least 5 years (or equivalent developmental level).
    D. The behavior is not attributable to the physiological effects of a substance (e.g., a di*
    uretic, an antipsychotic medication) or another medical condition (e.g., diabetes, spina
    bifida, a seizure disorder).
    Specify
    whether:
    Nocturnal only:
    Passage of urine only during nighttime sleep.
    Diurnal only:
    Passage of urine during waking hours.
    Nocturnal and diurnal:
    A combination of the two subtypes above.
    ........
    The prevalence of enuresis is 5%-10% among 5-year-olds, 3%-5% among 10-year-olds,
    and around 1% among individuals 15 years or older
    So for me, I've had periods of my life where I've intentionally wet the bed (diapers) a couple times a week, mostly intentionally for an extended period of time (I say mostly because after a while of getting used to it I tend to "forget" sometimes lol).

    So do you think that can mean for those of us that do/did it on purpose, we are/were clinically "enuretic" (a bedwetter/daywetter)? Just something that ponders my mind...There doesn't seem to be an ending for age either, just a minimum age. And what about the day wetting/incontinence? Although that one I believe already defined us as "functionally" incontinent somewhere before... Things that cross my mind. lol
    Last edited by Plushie; 18-Sep-2015 at 12:11.

  2. #2

  3. #3

    Default

    Yeah. Enuresis itself is not a diagnosis but a symptom of something else. I would assume that this definition is in there to standardize the definition throughout the rest of the DSM when looking for mental disorders associated with it.

  4. #4

    Default

    I'm pretty sure that the information at the bottom of that article is way off.

  5. #5

    Default

    So I have probably wet my diaper or clothes 2+ times a week for the past 18 months so I probably have the combination kind day and night.

  6. #6

    Default



    Quote Originally Posted by Merp View Post
    I'm pretty sure that the information at the bottom of that article is way off.
    definitely agree with you on that Merp. If that was the case, then why so many adult diapers/ nappies even now on supermarket shelves? Sure they might be pull-up's or shaped pads but I don't remember seeing them until recent years.

    To the OP - clinical classification here is an interesting one... I do get the feeling that it could be referring to children who wet intentionally for various reasons such as feeling a lack of attention when a new sibling arrives etc. I believe that is very common. At the same time, I guess it could be argued that if you do wet yourself regularly, deliberately or not, then you are a bed/ day wetter by definition, although if discussed with a medical professional who can give that diagnosis, then it would be assumed that it was involuntary or the discussion should not be happening in the first place

  7. #7

    Default



    Quote Originally Posted by arcituthis View Post
    Yeah. Enuresis itself is not a diagnosis but a symptom of something else. I would assume that this definition is in there to standardize the definition throughout the rest of the DSM when looking for mental disorders associated with it.
    I don't know... I found the book here: http://www.terapiacognitiva.eu/dwl/dsm5/DSM-5.pdf
    and on page 355 (390 if you load the PDF) it falls under "Elimination Disorders" as the first entry... So I believe it considers it a "disorder" on it's own.

    - - - Updated - - -



    Quote Originally Posted by Merp View Post
    I'm pretty sure that the information at the bottom of that article is way off.
    That part was on pg 391... but I agree, that's quite different than expected. But again, since it's including those of us that intentionally do it - can it be encapsulating ABDL reasons as well? Or making assumptions based on statistical data that may be skewed if it weren't examining the greater populace and only the limited groups of people that had some other disorder they were being treated for. (perhaps these rates of enuresis are in people who have other problems they see more often at a facility?) Or maybe it's from different countries altogether? I don't know. Who knows where they got that data... However, if we fall under that banner, that should alter the numbers a bit.

    - - - Updated - - -



    Quote Originally Posted by Fascinating View Post
    So I have probably wet my diaper or clothes 2+ times a week for the past 18 months so I probably have the combination kind day and night.
    So you are apparently qualifying as legitimately enuretic according to that. Unless I'm missing something and I very well may be, but since this is like the Bible of mental health, there's not much room to argue. xD

    - - - Updated - - -



    Quote Originally Posted by bohemian85 View Post
    To the OP - clinical classification here is an interesting one... I do get the feeling that it could be referring to children who wet intentionally for various reasons such as feeling a lack of attention when a new sibling arrives etc. I believe that is very common. At the same time, I guess it could be argued that if you do wet yourself regularly, deliberately or not, then you are a bed/ day wetter by definition, although if discussed with a medical professional who can give that diagnosis, then it would be assumed that it was involuntary or the discussion should not be happening in the first place
    Well, to the fact that it's referring to children, I think you are right, but this line is interesting:


    Elimination Disorders all
    involve the inappropriate elimination of urine or feces
    and are usually first diagnosed in childhood or adolescence
    So that begs the question - does that leave it open for diagnosis after adolescence? Especially since we already know Secondary Enuresis is when wetting occurs after a period without wetting... Could there only be adult onset Enuresis? I imagine there can - all I have to say is - alcoholics, lol.


    Also, why would you be going to the doctor for that diagnosis if it was deliberate anyway? Like what would the purpose be? If you enjoy wetting, even if it's accidental, would you really try and "fix" that? Like even if you're staying the night in the hospital or something, would that be something you were looking to diagnose or inform - if you were still capable of not wetting?

  8. #8

    Default

    Ok, after looking through it, and looking at this website: http://www.webmd.com/mental-health/enuresis, it looks like a catch-all diagnosis when urinary incontinence from all other means are ruled out. I'm looking at this:

    How Is Enuresis Diagnosed?

    First, the doctor will take a medical history and perform a physical exam to rule out any medical disorder that may be causing the release of urine, which is called incontinence. Lab tests may also be performed, such as a urinalysis and blood work to measure blood sugar, hormones, and kidney function. Physical conditions that could result in incontinence include diabetes, an infection, or a functional or structural defect causing a blockage in the urinary tract.
    You really wouldn't go to the doctor for the voluntary half and would likely go to the doctor after incontinence began affecting your life in a negative way (as it usually does).

    It also makes the percentages seem more reasonable. As people age, they tend to grow out of wetting unintentionally and people that still do tend to have an underlying medical reason and no longer qualify for the diagnosis.

  9. #9

  10. #10

    Default

    This discussion is exactly where the problem in the DSM-V exists and is something that is controversial within the mental health profession (not specifically enuresis but I'm talking about mental health problems in general).

    You have to remember that the definitions in here do clarify everything "disorders" but in actuality they aren't at all. For example, (and i can't remember the exact phrasing or details off the top of my head) there is a section in the DSM-V that lists depression that lasts more then a month and due to the loss of a close relative/pet as a "disorder". This is clearly not the case as something like that is known to be part of a normal grieving process and not a disorder at all.

    So DSM-V, whilst is the go to guide for mental health practitioners, is exactly only that, a guide. It is more a way for people within the health profession to be able to talk between each other and know what they are talking about. So if someone says that a patient has Major depression they would know what that means as opposed to an emotional disturbance after losing a relative. But that brings around the question is that are these things disorders or not even if they are listed under the category of disorders. And this is the problem that the DSM has in the health profession, that it labels people who don't actually need to be labelled as they are perfectly normal.

    Also, you mentioned the part about adult onset enuresis/secondary enuresis, but your definitions are slightly incorrect. Secondary enuresis is where someone begins wetting after being toilet trained and after being able to stay dry for a period of at least a year. In the extract you put in about the different criteria, it shows one of the important ones is that the age is at least older then 5 years. This is kind of the magic number when it comes to elimination disorders as most children would be toilet trained successfully by this age and aft er this age things begin to become a problem for their social/emotional/attachment wellbeing.

    As far as i am aware the definition they stated that it is usually diagnosed in childhood/adolescence is pretty accurate. This is because as an adult these sorts of things don't actually happen. This diagnosis of enuresis (as someone previously mentioned) is more used for the psychological issues that arise in children. A new sibling comes along and the older child starts to wet themselves for attention. Or another thing that happens is that the younger child is "babied' by their parents (as in treated in a way that someone that age isn't usually treated and ends up causing development issues) longer then they should be and emotionally develop an abnormal attachment with their parents. In this circumstance, the child will think that when their parents want them to "grow up" that means losing the attachment they have and they end up going through a period of regression. This can include things like wetting themselves intentionally.

    That is why this definition exists. It is more for the children who are doing it intentionally as part of an attention seeking behaviour. That is why there is no mention of adult-onset type behaviour. This is because as adults we try to get attention in different ways and wetting ones-self is more of an embarrassment type behaviour (which would probably be classified under the more sexual paraphilias that relate to the enjoyment of intense embarrassment.

Similar Threads

  1. Replies: 4
    Last Post: 22-May-2014, 19:44
  2. Non-Intentional Bullying
    By Shadowhawk in forum Mature Topics
    Replies: 30
    Last Post: 19-Nov-2012, 15:00
  3. Replies: 2
    Last Post: 01-Mar-2012, 04:31
  4. Replies: 11
    Last Post: 19-Jun-2011, 22:03
  5. My art *soon to include AB art
    By glassyeyedbb in forum Off-topic
    Replies: 10
    Last Post: 22-Dec-2009, 17:26

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •  
ADISC.org - the Adult Baby / Diaper Lover / Incontinence Support Community.
ADISC.org is designed to be viewed in Firefox, with a resolution of at least 1280 x 1024.