Incontinence: A Biobehavioral Perspective

Incontinence in childhood in either of its forms, enuresis and encopresis, is one of the most prevalent and distressing of all childhood problems. Due to widespread misunderstanding, incontinence is a significant precipitating factor in the mistreatment of afflicted children. Interpretations of and treatments for enuresis and encopresis have shifted in the past few decades from a mostly psychopathological perspective to a biobehavioral perspective. Although the primary clinical features of incontinence are medical/organic, environmental and psychosocial elements are factors, and the most empirically supported treatments have a significant behavioral dimension. This chapter reviews the literatures on enuresis and encopresis with attention focused on clinical description, causes and correlates, assessment, treatment, challenges, and implications for practice. Case examples are included to illustrate these features.