Avoidant paruresis. An exploratory study.
Avoidant paruresis hits about 7% of college men and looks like standard social anxiety, so treat the anxiety, not the bladder.
01Research in Context
What this study did
Researchers gave a short survey to college men about bathroom avoidance. They asked how often the men could not urinate in public restrooms. They also asked about social fears and when the problem started.
The team wanted to see how common the problem was and if it linked to anxiety.
What they found
About 7 out of every 100 men said they often could not go in a public bathroom. Most said the trouble began between ages 12 and 15. The men also scored high on social and performance anxiety scales.
How this fits with other research
Rothbaum et al. (1999) and Rus-Calafell et al. (2013) later showed VR exposure cuts many phobias. Their work extends this 1985 survey by giving a tech tool for the same anxiety core.
Staats et al. (2000) found a similar rate of fear-of-intimacy in college men. Both papers show that brief surveys can spot hidden social fears on campus.
Ziegler (1987) explains why the avoidance sticks: early escape from the feared situation is rewarded by less worry. The survey data and the theory line up well.
Why it matters
If a college client says he “holds it” all day, you now know 7% of his peers do too. Treat the social anxiety, not just the bathroom part. Try short exposures like peeing with the stall door open while doing breathing drills. Track anxiety 0-10 before and after each trip to show the drop.
Want CEUs on This Topic?
The ABA Clubhouse has 60+ free CEUs — live every Wednesday. Ethics, supervision & clinical topics.
Join Free →Add a quick two-question screen to your intake: “Any trouble using public restrooms? Any worry others will hear you?” If yes, start a graded exposure plan.
02At a glance
03Original abstract
Information was gathered on the prevalence, correlates, and development of avoidant paruresis in males, the inability to urinate in the presence of others. Prevalence was found to be 6.8% based on a double screening starting with 381 college males. A reliable hierarchy of environmental cues related to avoidance was demonstrated. Avoiders differed from normals on self-reported interpersonal and performance anxiety, but not on sex-related items, introversion, or childhood family size. The most common age of onset was 12-15, and subjects viewed their problem as caused by anxiety and self-esteem factors. The findings thus suggest that this is a relatively common disorder, that it is anxiety based, and that specific treatment technologies relevant to anxiety should be explored.
Behavior modification, 1985 · doi:10.1177/01454455850092006