Enuresis in cross-cultural perspective: a comparison of training for elimination control in three Israeli ethnic groups.

Enuresis was investigated in the context of different styles of training for bladder control among three Israeli ethnic groups (Jews of Moroccan, Kurdish or Eastern European descent). Semistructured interviews were conducted in ethnically homogeneous agricultural villages with 46 mothers of 248 children between the ages of 3 and 18 years. In contrast to previous British and American studies, no sex differences were found, but there were higher rates of primary enuresis and lower rates of secondary (regressive) enuresis. Enuresis was correlated among siblings in the Kurdish group only and with disorderly sleeping arrangements in the Moroccan group. The Moroccan and Kurdish groups had higher rates of enuresis than the Ashkenazi group. The higher rates appear to be related to differences in the age of onset of training and a lack of age-appropriate changes in the parent-child interaction, which led to chronic enuresis and the inability to seek effective assistance. These results are discussed in terms of a proposed typology for training: an early symbiotic style, a strict toddler style, and a communicative partnership.