Desensitization of Triggers and Urge Reduction for Paruresis: A Case Report

Paruresis is a special type of non-generalized social phobia that involves fear and avoidance of urination in public restrooms. We administered eight 60-minute sessions of desensitization of triggers and urge reduction (DeTUR), an addiction protocol of eye movement desensitization and reprocessing (EMDR) therapy, to a 29-year old man with paruresis of 10 year duration. Because phobic avoidance is the hallmark of any anxiety disorder, we applied DeTUR targeting the urge to avoid each anxiety-provoking situation in succession. After treatment, the participant no longer met the requirements for a diagnosis of social anxiety disorder, and the self-reported symptoms of social anxiety had decreased to non-clinical levels; furthermore, these treatment gains were maintained at the one-year follow-up. Further clinical studies are needed to generalize this finding.

Paruresis / Paruresis

Paciente masculino de 36 años de edad, profesional universitario, casado en primeras nupcias, con dos hijos. Refiere dificultad para orinar en presencia de otras personas, “desde siempre”, pero actualmente le crea problemas, pues por el trabajo que ha desempeñado en los últimos 3 años tiene que viajar con relativa frecuencia. Plantea que es una persona sana, sin padecimientos psíquicos; maneja el estrés de forma satisfactoria y su situación económica la considera favorable. Previamente se estudió por urología. Se brinda información sobre la afección y se establece una estrategia de exposición in vivo, con la cooperación de la esposa y empleo de urinarios públicos para la práctica y exploración de avances. Luego de 6 meses de seguimiento y con discretos progresos, deja de asistir a consulta; regresa aproximadamente un año después, plantea que se siente mejor y la mayor parte de las veces logra efectuar la micción. Se espera a partir de la presentación de este caso, motivar a otros autores a estudiar y publicar sus hallazgos sobre esta afección en Cuba. Es la primera vez que en los años de práctica del autor como psiquiatra, un paciente le solicita ayuda por esta causa.

A 36 year-old male patient (college graduate, married his first wife, has two children) referred to always have difficulty at urinating in the presence of others, but currently this is a problem because he has to business travel quite often during in the last three years. He argues that he is healthy with no mental illnesses; he manages stress successfully and he considers having favorable economic situation. Previously he was studied at the urology service. Information about this condition is offered, and a strategy of in vivo exposure is established with the cooperation of his wife and using public urinals to practice and exploration progress. After 6 months follow-up and modest progress, he failed to attend consultation. He returned about a year later, he suggested that felt better and most of the time he achieved urination. It is expected, from the presentation of this case, to motivate others to study and publish their findings on this condition in Cuba. It is the first time a patient asks for support for this cause to this author in his years of practice as a psychiatrist.

The Reliability and Validity of Korean Version of Paruresis Check list (K-PCL) / 신경정신의학

OBJECTIVES : Paruresis (or Shy bladder syndrome) is characterized by the inability to urinate in the public lavatory. The Paruresis Checklist (PCL) is the only tool that screens for this disorder. The aim of this study was to assess the reliability and validity of the Korean Version of the Paruresis Checklist (K-PCL), and to examine characterstics of this disorder. METHODS : 530 males were enrolled in this study. We administered the K-PCL, the Social Avoidant and Distress scale (SAD), and the Beck Anxiety Inventory (BAI). The Case group included individuals whos PCL score was > or =5. Statistical analyses were performed to compare the BAI and Korea-Social Avoidance and Distress (K-SAD) scores of each group using 2-way ANOVA and Scheffe methods. RESULTS : The K-PCL score ranged from 0 to 6, with a mean 0.75. The Cronbach alpha coefficients of the K-PCL were .72, SAD .74 and BAI .73. A total of 8 males (1.51%) were included in the case group. Comparison of the case and control groups showed a significant difference in BAI scores, but no significant difference in K-SAD scores. CONCLUSION : The K-PCL showed a significant reliability and validity for paruresis. However, our results were not consistent with the notion that paruresis is a special form of social phobia.

The Reliability and Validity of Korean Version of Paruresis Check list (K-PCL) / 신경정신의학

OBJECTIVES : Paruresis (or Shy bladder syndrome) is characterized by the inability to urinate in the public lavatory. The Paruresis Checklist (PCL) is the only tool that screens for this disorder. The aim of this study was to assess the reliability and validity of the Korean Version of the Paruresis Checklist (K-PCL), and to examine characterstics of this disorder. METHODS : 530 males were enrolled in this study. We administered the K-PCL, the Social Avoidant and Distress scale (SAD), and the Beck Anxiety Inventory (BAI). The Case group included individuals whos PCL score was > or =5. Statistical analyses were performed to compare the BAI and Korea-Social Avoidance and Distress (K-SAD) scores of each group using 2-way ANOVA and Scheffe methods. RESULTS : The K-PCL score ranged from 0 to 6, with a mean 0.75. The Cronbach alpha coefficients of the K-PCL were .72, SAD .74 and BAI .73. A total of 8 males (1.51%) were included in the case group. Comparison of the case and control groups showed a significant difference in BAI scores, but no significant difference in K-SAD scores. CONCLUSION : The K-PCL showed a significant reliability and validity for paruresis. However, our results were not consistent with the notion that paruresis is a special form of social phobia.