A Novel Application of Inhibitory Learning Theory: Pediatric Retentive Encopresis.

Encopresis is a common disorder of childhood that accounts for about one in four referrals to pediatric gastroenterology clinics (Culbert & Banez, 2007). Encopresis involves the repeated passage of feces into inappropriate places. Encopresis with constipation and overflow incontinence (retentive encopresis) accounts for more than 80% of pediatric encopresis cases. Despite its prevalence, the literature on the etiology and treatment of retentive encopresis is underdeveloped and has seen little innovation over the past half-century. While classical and operant conditioning mechanisms have long been implicated in the onset and maintenance of retentive encopresis, a comprehensive, transdiagnostic conceptualization has been lacking. This paper reviews the predominant model of retentive encopresis and proposes a novel framework grounded in inhibitory learning theory. Given the mechanistic similarities between anxiety disorders and retentive encopresis, this paper will propose that inhibitory learning theory should be utilized to optimize and innovate behavioral interventions for retentive encopresis, leading to more effective treatments.