A longitudinal bifactor approach to modelling somatic symptom development in psychosomatic treatment
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Date
2026
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Citation
Petzke, Tara M. - Köteles, Ferenc - Kessler, Henrik et al: A longitudinal bifactor approach to modelling somatic symptom development in psychosomatic treatment. Journal of Psychosomatic Research 204. évfolyam, 112577. szám, 2026. 1-8 p.
MTMT:
36965076
Abstract
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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All authors:
Tara M. Petzke, Ferenc Köteles, Henrik Kessler, Stephan Doering, Aram Kehyayan, Magdalena Pape, Tobias Hofmann, Matthias Rose, Katrin Imbierowicz, Franziska Geiser, Ilona Croy, Kerstin Weidnerl, Jörg Rademacher, Silke Michalek, Eva Morawa, Yesim Erim, Julia Barbara Krakowczyk, Martin Teufel, Stanislav Heinzmann, Claas Lahmann, Eva Milena Johanne Peterss, Johannes Kruse, Dirk von Boetticher, Christoph Herrmann-Lingen, Mariel Nohre, Martina de Zwaan, Ulrike Dinger, Hans-Christoph Friederich, Alexander Niecke, Christian Albus, Rüdiger Zwerenz, Manfred Beutel, Casper Roenneberg, Heribert Sattel, Peter Henningsen, Barbara Stein, Christiane Waller, Karsten Hake, Carsten Spitzer, Andreas Stengel, Stephan Zipfel, Katja Weimer, Harald Gündel, Stephan Herpertz, Michael Witthoft, Nadine Lehnen
Keywords
tünetek ; pszichoszomatika, psychosomatic medicine ; bifactor models ; persistent somatic symptoms ; functional disorders ; predictive processing