Problem: For the treatment of nocturnal enuresis, the method of regular awakening was applied as a conditioning procedure.
After the repeated trials of regular awakening, is the nocturnal enuresis improved? What are the characteristics of remediable and irremediable cases? The effect of the treatment was evaluated by the decrease of the number of bed wetting.
Procedure: After excluding the cases who showed organic defects in the light of physical examination and urinalysis, the enuretic child was prognosticated by the materials of individual records, case histories, relationship with parents, and clinical symptoms. Twenty-nine subjects of both sexes, with IQ 83 or above, ranged in age from 3 years 3 months to 11 years 5 months. The nocturnal enuresis grade (N. E. G.) was calculated for each child on the bases of the bed wetting times per week and the awakened times at night. The treatment was completed when the child did not wet the bed during 2 weeks without awakening.
Results: 1) The N. E. G. decreased for the whole group consisting of both remaining and terminating cases. The cases who showed no reduction in N. E. G., called the long-term irremediable group, could not be conditioned by reinforcement.
2) Conditioning was progressing because there was a significant difference in N. E. G. between the early stage (10.8 times per week) and the later stage (7.0 times per week).
3) The long-term irremediable cases showed 3 symptoms; they were unable to acquire the nocturnal bladder control, had much difficulty in waking, and belonged to the multifarious family having conflicts among family members. Each one of these 3 symptoms by itself did not distinguish the long-term irremediable group from the remediable group. When 3 symptoms were combined, however, we can distinguish between two groups. These 3 symptorns were incompatible with the conditioning principles.
4) These 3 symptoms may represent essential symptoms of nocturnal enuresis, and they may cover all cases of nocturnal enuresis.
