title: Assessment of behavioral mechanisms maintaining encopresis: Virginia Encopresis-Constipation Apperception Test.
abstract: 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.
authors.affiliation: Behavioral Medicine Center, University of Virginia Health System, Charlottesville 22908, USA..
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Cox
authors.forename: Lee M
authors.initials: LM
authors.lastname: Ritterband
authors.forename: Warren
authors.initials: W
authors.lastname: Quillian
authors.forename: Boris
authors.initials: B
authors.lastname: Kovatchev
authors.forename: James
authors.initials: J
authors.lastname: Morris
authors.forename: James
authors.initials: J
authors.lastname: Sutphen
authors.forename: Stephen
authors.initials: S
authors.lastname: Borowitz
mesh_terms: 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