Browsing by Author "Köteles Ferenc Gábor"

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    A longitudinal bifactor approach to modelling somatic symptom development in psychosomatic treatment
    (2026) Köteles Ferenc Gábor; Petzke, Tara M.; Kessler, Henrik; Pszichológiai Intézet; Általános Lélektani és Módszertani Tanszék; KRE - Bölcsészet- és Társadalomtudományi Kar
    Background: Persistent somatic symptoms display a large public health problem and are often treated or addressed alongside other conditions in psychosomatic medicine units. With growing evidence pointing to unfavorable central nervous processing in persistent symptom perception, we aimed at modelling somatic symptom clusters together with an overarching general factor (g-factor) longitudinally during psychosomatic treatment. Methods: This study analyses data from the Multicenter Effectiveness Study of Inpatient PsychosomaticPsychotherapeutic Treatment in German University Hospitals (MEPP, 19 academic psychosomatic medicine departments with inpatient and day clinics, N = 2094 patients with ICD diagnoses between F30 and F69). The PHQ-15 was used to construct bifactor models of symptom perception. We used structural equation models to investigate how the g-factor and symptom-group clusters developed from treatment intake over discharge to a one year follow-up. Factor scores were used to evaluate treatment effects on the individual components. Results: As expected, the highest treatment effects, from a bifactor model perspective, were found for the overarching affective-motivational component (η2 part = 0.277) and for fatigue (η2 part = 0.250). All components predicted themselves at future timepoints: autoregressions were high, significant, and explained large proportions of the variance (all β > 0.69, p < .001). Conclusions: The bifactor model of symptom perception can be longitudinally applied in a large clinical sample with various diagnoses. Psychosomatic treatment showed effects on all components, both those similar to an overarching g-factor and those related to the perception of physiological signals, even when somatic symptoms were not the main target of the treatment.
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    Age, sex and mental distress as predictors of rate and deterioration of persistent physical symptoms over three and six years in a general population
    (2026) Fjellborg, Karl; Cervin, Clara; Witthöft, Michael; Köteles Ferenc Gábor; Nordin, Steven; Pszichológiai Intézet; Általános Lélektani és Módszertani Tanszék; KRE - Bölcsészet- és Társadalomtudományi Kar
    Background: Better understanding for persistent physical symptoms (PPS) may improve prevention of symptoms from becoming persistent and deteriorating over time. This study tested the hypotheses of age and level of mental distress symptoms of anxiety, depression, sleep disturbance and burnout statistically predicting rate of PPS and deterioration of PPS over three and six years in a general adult population. We also addressed whether sex is associated with these two aspects of PPS. Method: A population-based sample (n = 1837) aged 18–79 years from Vasterbotten ¨ in Sweden was used. Longitudinal data were collected based on the 15-item Patient Health Questionnaire for PPS assessment as well as other validated questionnaire instruments at baseline and 3- and 6-year follow-up. Deterioration was assessed with the reliable change index paradigm. Chi-square tests and analyses of covariance were applied. Results: Old age was found to statistically predict deterioration, but not long-term rate, of PPS over three and six years, and female sex to predict rate, but not deterioration. Symptom levels of all four types of mental distress predicted both PPS rate (η2 = 0.097–0.202) and deterioration (η2 = 0.007–0.023) over both three and six years. When controlling for the other three types of mental distress, sleep disturbance, and in particular burnout, explained most unique variance in predicting rate and deterioration. Conclusions: The findings encourage healthcare professionals to assess PPS at an early stage, especially in persons at old age, in women and in patients with mental distress.
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    Positive interventions cannot prevent the occurrence of symptoms triggered by negative pictures
    (2026) Köteles Ferenc Gábor; Tőkés Bernadett; Petzke Tara; Witthöft Michael; Pszichológiai Intézet; Általános Lélektani és Módszertani Tanszék; Általános Lélektani és Módszertani Tanszék; KRE - Bölcsészet- és Társadalomtudományi Kar
    Objective: The affect and symptom paradigm was developed to study the mechanisms behind somatic symptom perception. In this paradigm, the presentation of negative pictures, compared to neutral ones, typically increases symptom reporting, and this effect is stronger in participants with high levels of persistent somatic symptom distress. An open and clinically highly relevant question is, however, whether positive interventions can prevent this effect. Also, findings concerning the physiological changes accompanying somatic symptom reports are mixed. Methods: In a preregistered laboratory experiment, young adults (n = 118) in two groups were administered three times with blocks of neutral or negative pictures, respectively. Before the presentation of a picture block, they received positive interventions (positive pictures, slow stroking of the skin) or no intervention (control) in a randomized order. Heart rate, respiration rate, and skin conductance level were recorded simultaneously. Certain psychological characteristics (somatic symptom distress, negative affectivity, somatosensory amplification, health anxiety) were also assessed. Results: The negative picture group consistently showed more somatic symptoms than the neutral picture group. Positive pictures could not prevent the increase of symptoms. Following slow stroking, symptom reports increased but did not elevate further after the presentation of negative pictures. No differences in physiology were found between the two groups. Psychological characteristics were positively related to symptom reports. Conclusion: The appearance of physical symptoms could not be prevented by positive psychological and bodily interventions. Psychological characteristics related to symptom reporting might have contributed to the change; however, symptoms were not associated with physiological changes.