Behavioral treatment of sensory urgency in female urethral syndrome.
Item
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Title
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Behavioral treatment of sensory urgency in female urethral syndrome.
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Identifier
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AAI8820844
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identifier
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8820844
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Creator
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Blendinger, Doris E.
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Contributor
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Adviser: W. Crawford Clark
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Date
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1988
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Language
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English
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Publisher
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City University of New York.
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Subject
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Psychology, Physiological
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Abstract
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Frewen's theoretical model has suggested an association between learned response of frequent urination and symptomatology of the urethral syndrome. Treatment of choice for reducing urologic symptoms is behavior modification, also called bladder drill, which teaches patients to successfully increase their inter-voiding intervals (IVI). Decreasing the high rate of micturition increases the functional capacity of the bladder and tends to diminish the neural activity of the autonomically mediated smooth muscles of the bladder.;Twelve female out-patients (mean age 42.0 years), diagnosed as having sensory urgency, were evaluated at pre-, post-treatment (mean treatment time of 0.9 years) and at follow-up (mean of 2.1 years past treatment) on five components: urologic measures, effects of medication intake, discriminability and criterion measures of bladder pressure to volume voided, and verbal pain reports. Psychological symptomatology was assessed at follow-up. Bladder drill resulted in a significant reduction of day-time frequency and nocturia associated with larger mean volumes voided. Negative factors with respect to treatment success included symptom severity and medication intake.;The patient's ability to discriminate bladder pressure sensations relating to volumes voided was assessed by use of Sensory Decision Theory (SDT). Discriminability, P(A), remained relatively unchanged across treatment status, with non-medicated patients being significantly better discriminators than medicated patients. The frequency of high bladder pressure reports was reduced (higher criterion, B) following treatment, patients indicating less bladder discomfort.;Verbal pain reports, assessed by the McGill Pain Questionnaire (MPQ), showed a significant decrease in number of words chosen (NWC) and scaled scores (SS) across treatment status and reflected an improvement in the patient's emotional state and decreased perceptions of pain. Higher scores were associated with increased bladder symptomatology following treatment and medication intake. The MPQ best described the urethral symptomatology by a cluster of 23 descriptors chosen by at least 30% of patients at pre-treatment. The most frequent pain descriptors were pain evaluative words and the largest reduction following treatment occurred in the affective category.;The Brief Symptom Inventory (BSI) assessed the psychologic symptomatology at follow-up and represents limited information. Non-medicated patients indicated "super-normal" scores, while medicated patients (who obtained poorer treatment results) exhibited moderate psychologic distress.
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Type
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dissertation
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Source
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PQT Legacy CUNY.xlsx
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degree
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Ph.D.
