Psychological Factors and Family Communication in Children and Adolescents with Elimination Disorders

Abstract

Background: Elimination disorders, such as urinary (enuresis) and fecal incontinence (encopresis), involve inappropriate voiding beyond the expected age due to developmental, psychological, or physiological factors. These conditions impact children's emotional well-being, self-esteem, social functioning, and family relationships. However, few studies have compared psychological functioning and family communication in affected children. This study examines general health, behavioral problems, and mother-child relationships in children with elimination disorders versus healthy peers. Methods: Seventy-two children participated: 25 with urinary incontinence, 24 with fecal incontinence, and 23 healthy controls. Participants were recruited from hospitals in Isfahan. Data were collected using standardized questionnaires: the General Health Questionnaire, Dyadic Adjustment Scale, Eyberg Child Behavior Inventory, and Mother-Child Relationship Evaluation. Statistical analyses included descriptive statistics, Shapiro-Wilk and Levene's tests for assumptions, and group comparisons using univariate and multivariate analysis of variance (ANOVA and MANOVA). Results: No significant differences were found between groups in maternal general health or marital satisfaction. However, children with elimination disorders displayed more severe behavioral problems and faced greater challenges in their mother-child relationships, including lower maternal acceptance and higher levels of overprotection and rejection. Conclusion and Recommendations: Elimination disorders are associated with behavioral difficulties and strained family interactions. Early psychological screening, family counseling, and public education are recommended to improve outcomes for affected children and their families.