Assessment of behavioral mechanisms maintaining encopresis: Virginia Encopresis-Constipation Apperception Test

Area of Science:

• Pediatric Gastroenterology
• Child Psychology
• Clinical Assessment

Background:

• Encopresis in children presents unique challenges for accurate assessment.
• Differentiating between bowel-specific and general psychological issues is crucial for effective treatment.
• Parental perception can significantly influence the understanding of a child's condition.

Purpose of the Study:

• To develop and validate the Virginia Encopresis-Constipation Apperception Test (VECAT) for assessing encopresis in children.
• To evaluate if encopretic children exhibit more bowel-specific, rather than generic, psychological problems.
• To compare the discernment levels between children and their mothers in identifying encopresis-related issues.

Main Methods:

• The VECAT, comprising 18 paired drawings (9 bowel-specific, 9 generic), was administered to encopretic children, their siblings, and unrelated controls.
• Mothers of all participants also completed the VECAT.
• Encopretic children were reassessed 6 and 12 months post-treatment using Enhanced Toilet Training.

Main Results:

• The VECAT demonstrated strong test-retest reliability and internal consistency.
• Encopretic children and their mothers reported significantly more bowel-specific problems compared to controls.
• Mothers showed a significantly higher level of discernment than their children in identifying symptoms.

Conclusions:

• The VECAT is a reliable, valid, discriminating, and sensitive tool for assessing encopresis.
• Bowel-specific problems are key indicators differentiating children with and without encopresis.
• The VECAT can aid in targeted interventions for childhood encopresis.