Assessment of behavioral mechanisms maintaining encopresis: Virginia Encopresis-Constipation Apperception Test.
OBJECTIVE
To develop and test a scale for parent and child, evaluating theoretical and clinical parameters relevant to children with encopresis. Encopretic children were hypothesized to have more bowel-specific, but not more generic, psychological problems, as compared with nonsymptomatic control children. In addition, mothers were also believed to be more discerning than children.


METHODS
The Virginia Encopresis-Constipation Apperception Test (VECAT) consists of 9 pairs of bowel-specific and 9 parallel generic drawings. Respondents selected the picture in each pair that best described them/their child. It was administered to encopretic children (N = 87), nonsymptomatic siblings (N = 27), and nonsymptomatic nonsiblings (N = 35). The mothers of all the participants also completed the VECAT. Encopretic children were retested 6 and 12 months posttreatment with Enhanced Toilet Training.


RESULTS
The VECAT demonstrated good test-retest reliability and internal consistency. Encopretic children and their mothers reported more bowel-specific, but not more generic, problems. Bowel-specific scores improved significantly posttreatment only for those patients who demonstrated significant symptom improvement. Mothers were significantly more discerning than children.


CONCLUSIONS
The VECAT is a reliable, valid, discriminating, and sensitive test. Bowel-specific problems appear to best differentiate children with and without encopresis.
Cox
Daniel J
DJ
Behavioral Medicine Center, University of Virginia Health System, Charlottesville 22908, USA..
Ritterband
Lee M
LM
Quillian
Warren
W
Kovatchev
Boris
B
Morris
James
J
Sutphen
James
J
Borowitz
Stephen
S
D002648:Child; D002652:Child Behavior; D004688:Encopresis / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008960:Models, Psychological; D015203:Reproducibility of Results; D014039:Toilet Training