1/4. encopresis and anal masturbation.Current pediatric and psychiatric studies on encopresis and its treatment are heavily influenced by mechanical, physiological, and behavioral considerations. Although psychodynamic treatment has generally been considered to be of little benefit, and its findings suspect, the authors suggest that a psychodynamic approach adds substantially to the understanding of some cases of encopresis; that the anal sensations and anal erotic feelings reported by a number of encopretic children are intense, and that the encopretic symptom, soiling, in these children is the result of a conscious form of anal masturbation in which the fecal mass is used for stimulation; and that any study of encopresis is incomplete that does not include what encopretic children, engaged in a sound therapeutic relationship, know and say about their soiling. The authors further suggest that physical treatments of those children whose encopresis is psychologically driven may be contraindicated. The presence of a large stool does not in itself substantiate a physical illness. Further research is needed to elucidate the prevalence of anal masturbation in encopretic children.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
2/4. Development of a young man with prader-willi syndrome and secondary functional encopresis.A case review of a twenty-two year old man suffering from prader-willi syndrome, Secondary Functional encopresis, mental retardation and aggressive behaviour is presented. Emphasis is made in assessing this man from various developmental perspectives. This includes: personality development, cognitive development, physical abilities, sexual development and family life stage. The role of a psychiatrist in treating this complex problem is established. An eclectic approach to treatment is reviewed using many therapeutic modalities found effective with the mentally handicapped. These modalities include: group therapy, play therapy, individual psychotherapy, behavioural therapy, family therapy, and use of medication. A literature review of prader-willi syndrome is included.- - - - - - - - - - ranking = 0.5keywords = physical (Clic here for more details about this article) |
3/4. A behavioral approach to the treatment of nonretentive nocturnal encopresis in an adult with severe learning disabilities.encopresis is widely assumed to be "normal" among individuals who are learning disabled. Yet, reports on its prevalence, etiology and treatment are rare and mainly confined to secondary encopresis or to populations with milder learning disabilities. The behavioral treatment of a life-long nonretentive, nocturnal encopresis is described for a young adult with severe learning and physical disabilities living at home. Treatment involved waking prior to soiling, time-limited use of suppositories and rewards for appropriate evacuation. Soiling decreased to zero over 20 weeks. time of waking was then gradually "shaped" back to normal.- - - - - - - - - - ranking = 0.5keywords = physical (Clic here for more details about this article) |
4/4. A behavioural programme for the modification of encopresis.This paper describes a behaviour modification programme for the treatment of encopresis. The programme, which is carried out by the parents over a relatively short period of time in the home setting, aims to make the child aware of internal cues prior to elimination and to rearrange the contingencies for appropriate use of the toilet. To date, seven of eleven children, both continuous and discontinuous encopretics, have been treated successfully and have remained clean for up to 7 months regardless of other problems in the child and his family. From a relatively detailed analysis of those treated it can be concluded that a behavioural approach is effective with chronic encopretic children, many of whom had been previously treated unsuccessfully by both physical and psychotherapeutic procedures. The failures suggest, firstly that careful assessment of each child and the motivation of the parents is required, so that the standard programme can be modified to suit each individual case. Secondly a maintenance programme must follow the intensive treatment procedure to ensure that parents continue to handle the child consistently.- - - - - - - - - - ranking = 0.5keywords = physical (Clic here for more details about this article) |