The Hierarchical Taxonomy of Psychopathology (HiTOP): A dimensional alternative to traditional nosologies.
The reliability and validity of traditional taxonomies are limited by arbitrary boundaries between psychopathology and normality, often unclear boundaries between disorders, frequent disorder co-occurrence, heterogeneity within disorders, and diagnostic instability. These taxonomies went beyond evidence available on the structure of psychopathology and were shaped by a variety of other considerations, which may explain the aforementioned shortcomings. The Hierarchical Taxonomy Of Psychopathology (HiTOP) model has emerged as a research effort to address these problems. It constructs psychopathological syndromes and their components/subtypes based on the observed covariation of symptoms, grouping related symptoms together and thus reducing heterogeneity. It also combines co-occurring syndromes into spectra, thereby mapping out comorbidity. Moreover, it characterizes these phenomena dimensionally, which addresses boundary problems and diagnostic instability. Here, we review the development of the HiTOP and the relevant evidence. The new classification already covers most forms of psychopathology. Dimensional measures have been developed to assess many of the identified components, syndromes, and spectra. Several domains of this model are ready for clinical and research applications. The HiTOP promises to improve research and clinical practice by addressing the aforementioned shortcomings of traditional nosologies. It also provides an effective way to summarize and convey information on risk factors, etiology, pathophysiology, phenomenology, illness course, and treatment response. This can greatly improve the utility of the diagnosis of mental disorders. The new classification remains a work in progress. However, it is developing rapidly and is poised to advance mental health research and care significantly as the relevant science matures. (PsycINFO Database Record
Department of Psychiatry.
Roman
R
Kotov
Department of Psychology, University of Minnesota.
Robert F
RF
Krueger
Department of Psychology, University of Notre Dame.
David
D
Watson
Department of Psychiatry, University of Vermont.
Thomas M
TM
Achenbach
Department of Psychiatry, University of Vermont.
Robert R
RR
Althoff
Department of Psychology, University of Toronto.
R Michael
RM
Bagby
Department of Psychology, Boston University.
Timothy A
TA
Brown
Department of Psychiatry, University of Maryland School of Medicine.
William T
WT
Carpenter
Department of Psychology and Neuroscience, Duke University.
Avshalom
A
Caspi
Department of Psychology, University of Notre Dame.
Lee Anna
LA
Clark
Department of Psychology, Stony Brook University.
Nicholas R
NR
Eaton
Department of Psychology, University of Minnesota.
Miriam K
0000-0002-6954-3818
MK
Forbes
Department of Psychology, University of Kansas.
Kelsie T
0000-0002-5900-4204
KT
Forbush
Institute of Psychiatry, Psychology & Neuroscience, King's College London.
David
D
Goldberg
Department of Psychiatry, College of Physicians and Surgeons, Columbia University.
Deborah
D
Hasin
Stanley Center for Psychiatric Research, Broad Institute of MIT.
Steven E
SE
Hyman
Department of Psychiatry, University of Vermont.
Masha Y
MY
Ivanova
Department of Psychological Sciences, Purdue University.
Donald R
DR
Lynam
Department of Psychological and Brain Sciences, University of Iowa.
Kristian
K
Markon
Department of Psychology, University of Georgia.
Joshua D
JD
Miller
Department of Psychology and Neuroscience, Duke University.
Terrie E
0000-0002-8589-6760
TE
Moffitt
Department of Psychology, Texas A&M University.
Leslie C
0000-0001-7711-5568
LC
Morey
Department of Psychology, Oklahoma State University.
Stephanie N
SN
Mullins-Sweatt
Department of Psychiatry, University of Groningen.
Johan
J
Ormel
Department of Psychology, Florida State University.
Christopher J
CJ
Patrick
Department of Psychiatry, Uniformed Services University.
Darrel A
DA
Regier
Department of Psychology, Bryn Mawr College.
Leslie
L
Rescorla
Department of Psychology, University of North Texas.
Camilo J
CJ
Ruggero
Department of Psychological Sciences, Purdue University.
Douglas B
DB
Samuel
Department of Psychology, University of Otago.
Martin
M
Sellbom
Department of Psychology, University at Buffalo.
Leonard J
LJ
Simms
Department of Psychiatry, University of Arizona.
Andrew E
AE
Skodol
Nation Drug and Alcohol Research Centre, University of New South Wales.
Tim
T
Slade
Department of Psychological Sciences, Purdue University.
Susan C
SC
South
Department of Psychology, Northwestern University.
Jennifer L
JL
Tackett
Department of Psychology, Emory University.
Irwin D
ID
Waldman
Department of Psychiatry, Stony Brook University.
Monika A
MA
Waszczuk
Department of Psychology, University of Kentucky.
Thomas A
TA
Widiger
Department of Psychology, University of Pittsburgh.
Aidan G C
AGC
Wright
Department of Psychiatry and Human Behavior, Brown Alpert Medical School.
Mark
M
Zimmerman
D015897:Comorbidity; D006801:Humans; D001523:Mental Disorders / Q000145:classification* / Q000175:diagnosis* / Q000523:psychology; D010551:Personality; D011599:Psychopathology / Q000379:methods*