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J Abnorm Psychol. 2017 May;126(4):454-477. doi: 10.1037/abn0000258. Epub 2017 Mar 23.

The Hierarchical Taxonomy of Psychopathology (HiTOP): A dimensional alternative to traditional nosologies.

Author information

1
Department of Psychiatry.
2
Department of Psychology, University of Minnesota.
3
Department of Psychology, University of Notre Dame.
4
Department of Psychiatry, University of Vermont.
5
Department of Psychology, University of Toronto.
6
Department of Psychology, Boston University.
7
Department of Psychiatry, University of Maryland School of Medicine.
8
Department of Psychology and Neuroscience, Duke University.
9
Department of Psychology, Stony Brook University.
10
Department of Psychology, University of Kansas.
11
Institute of Psychiatry, Psychology & Neuroscience, King's College London.
12
Department of Psychiatry, College of Physicians and Surgeons, Columbia University.
13
Stanley Center for Psychiatric Research, Broad Institute of MIT.
14
Department of Psychological Sciences, Purdue University.
15
Department of Psychological and Brain Sciences, University of Iowa.
16
Department of Psychology, University of Georgia.
17
Department of Psychology, Texas A&M University.
18
Department of Psychology, Oklahoma State University.
19
Department of Psychiatry, University of Groningen.
20
Department of Psychology, Florida State University.
21
Department of Psychiatry, Uniformed Services University.
22
Department of Psychology, Bryn Mawr College.
23
Department of Psychology, University of North Texas.
24
Department of Psychology, University of Otago.
25
Department of Psychology, University at Buffalo.
26
Department of Psychiatry, University of Arizona.
27
Nation Drug and Alcohol Research Centre, University of New South Wales.
28
Department of Psychology, Northwestern University.
29
Department of Psychology, Emory University.
30
Department of Psychiatry, Stony Brook University.
31
Department of Psychology, University of Kentucky.
32
Department of Psychology, University of Pittsburgh.
33
Department of Psychiatry and Human Behavior, Brown Alpert Medical School.

Abstract

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.

PMID:
28333488
DOI:
10.1037/abn0000258
[Indexed for MEDLINE]

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