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Journal of Pediatric Psychology, Vol. 27, No. 7, 2002, pp. 585-591
© 2002 Society of Pediatric Psychology

Psychological Differences Between Children With and Without Chronic Encopresis

Daniel J. Cox, PhD, James B. Morris, Jr., PhD, Stephen M. Borowitz, MD and James L. Sutphen, MD, PhD

University of Virginia, Health Sciences Center

All correspondence should be sent to Daniel J. Cox, Box 800-223, University of Virginia Health Systems, Charlottesville, Virginia 22908. E-mail: djc4f{at}virginia.edu.

Objective: To validate a theoretical model of encopresis in terms of psychological factors that differentiates children with and without chronic encopresis and to identify scales that demonstrate these differences.

Methods: Eighty-six children with encopresis were compared to 62 nonsymptomatic children on five psychometric instruments. Differences in the mean scores and the percentages of children falling beyond preselected clinical thresholds were compared across the patient-control groups.

Results: Children with encopresis were found to have more anxiety/depression symptoms, family environments with less expressiveness and poorer organization, more attention difficulties, greater social problems, more disruptive behavior, and poorer school performance (ps = .01 <= .001 on 15/20 subscales). There were no differences in self-esteem. On those subscales where proportionately more encopretic children exceeded clinical thresholds, approximately 20% more of the encopretic children exceeded thresholds than control children.

Conclusions: As a group, children with encopresis differ from children without encopresis on a variety of psychological parameters. However, only a minority of children with encopresis demonstrated clinically significant elevations in these parameters. Identification and treatment of such clinical issues may enhance treatment efficacy.

Key words: encopresis; behavioral problems; family environment; children; biopsychosocial.


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