A longitudinal bifactor approach to modelling somatic symptom development in psychosomatic treatment.
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Petzke Tara M, Köteles Ferenc, Kessler Henrik, Doering Stephan, Kehyayan Aram, Pape Magdalena, Hofmann Tobias, Rose Matthias, Imbierowicz Katrin, Geiser Franziska, Croy Ilona, Weidner Kerstin, Rademacher Jörg, Michalek Silke, Morawa Eva, Erim Yesim, Krakowczyk Julia Barbara, Teufel Martin, Heinzmann Stanislav, Lahmann Claas, Peters Eva Milena Johanne, Kruse Johannes, von Boetticher Dirk, Herrmann-Lingen Christoph, Nöhre Mariel, de Zwaan Martina, Dinger Ulrike, Friederich Hans-Christoph, Niecke Alexander, Albus Christian, Zwerenz Rüdiger, Beutel Manfred, Roenneberg Casper, Sattel Heribert, Henningsen Peter, Stein Barbara, Waller Christiane, Hake Karsten, Spitzer Carsten, Stengel Andreas, Zipfel Stephan, Weimer Katja, Gündel Harald, Herpertz Stephan, Witthöft Michael, Lehnen Nadine
Аннотация
METHODS: This study analyses data from the Multicenter Effectiveness Study of Inpatient Psychosomatic-Psychotherapeutic 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 (ηpart2=0.277) and for fatigue (ηpart2=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.