Somatic symptom reporting has a dimensional latent structure: results from taxometric analyses

Abstract

Medically unexplained symptoms (MUS) are one of the key features of somatoform disorders. Although MUS are currently treated as both categorical (in terms of the diagnosis of somatoform disorders) and dimensional (in terms of quantitative measures of somatization/somatic symptom reporting), little is known about the empirical latent structure of MUS. Using taxometric analyses, the latent structure of somatic symptom reporting was analyzed with the Patient Health Questionnaire (PHQ)-15 in two student samples (N=782 and N=2,577) and a primary care sample (N=519). We applied three popular taxometric methods: Maximum Eigenvalue (MAXEIG), Mean Above Minus Below a Cut (MAMBAC) and Latent-Mode (L-Mode). Simulation data were created to evaluate the appropriateness of the data for our analyses and to create the comparison curve fit index (CCFI) as an objective outcome measure. The results of all taxometric methods in any of the three data sets were in favor of a dimensional solution (CCFI<.50). Simulated taxonic and dimensional datasets differed substantially and the samples were appropriate for taxometric analysis. Accordingly, the latent structure of somatization/somatic symptom reporting as assessed by the PHQ-15 is dimensional in both primary care and student samples. Implications regarding the practical application as well as models of etiology and pathogenesis of somatic symptom reporting are discussed.