<prompt> Encopresis is associated withLow socioeconomic classLess than 4 year old childFemale sexSevere emotional disturbances  <response>: D Severe emotional disturbances Severe emotional disturbances Encopresis also known as paradoxical diarrhea is involuntary fecal soiling in adults and children who have usually already been toilet trained. Persons with encopresis often leak stool into their undergarments. Strong emotional reactions typically result from failed and repeated attempts to control this highly aversive bodily product. These reactions then in turn may complicate conventional treatments using stool softeners, sitting demands, and behavioral strategies. The estimated prevalence of encopresis in four-year-olds is between one and three percent. The disorder is thought to be more common in males than females, by a factor of 6 to 1. 