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J Consult Clin Psychol. 2019 Dec;87(12):1069-1084. doi: 10.1037/ccp0000452.

Integrating the Hierarchical Taxonomy of Psychopathology (HiTOP) into clinical practice.

Author information

1
Department of Psychology, University of North Texas.
2
Department of Psychiatry, Stony Brook University.
3
Department of Psychology, University of California, Davis.
4
Department of Psychiatry, New York State Psychiatric Institute, Columbia University.
5
Department of Psychology, University of Notre Dame.
6
Department of Psychiatry, University of Arizona.
7
Department of Psychology, Oklahoma State University.
8
Department of Psychology, Florida State University.
9
Psychiatric Research Unit, Slagelse Psychiatric Hospital.
10
Department of Psychiatry, University of Utah.
11
Department of Psychology, University at Buffalo, The State University of New York.
12
Departments of Psychology and Psychiatry, University of Toronto.
13
Department of Psychology, University of Minnesota.
14
Department of Psychology, Southern Methodist University.
15
Department of Psychological Sciences, College of William and Mary.
16
Department of Developmental, Personality, and Social Psychology, Ghent University.
17
Department of Psychology, Stony Brook University.
18
Centre for Emotional Health, Department of Psychology, Macquarie University.
19
Department of Psychology, University of Kansas.
20
Department of Psychiatry, University of Toronto.
21
Department of Psychology, University of Georgia.
22
Department of Psychology, Texas A&M University.
23
Centre for Longitudinal Studies and MRC Unit for Lifelong Health and Ageing, University College London.
24
Department of Psychiatry, Center for the Study of Traumatic Stress, Uniformed Services University.
25
Department of Psychiatry and Neuropsychology, Maastricht University.
26
Department of Psychology, University of Maryland.
27
Department of Psychology, University of Pittsburgh.
28
Department of Psychology, University of Kassel.

Abstract

OBJECTIVE:

Diagnosis is a cornerstone of clinical practice for mental health care providers, yet traditional diagnostic systems have well-known shortcomings, including inadequate reliability, high comorbidity, and marked within-diagnosis heterogeneity. The Hierarchical Taxonomy of Psychopathology (HiTOP) is a data-driven, hierarchically based alternative to traditional classifications that conceptualizes psychopathology as a set of dimensions organized into increasingly broad, transdiagnostic spectra. Prior work has shown that using a dimensional approach improves reliability and validity, but translating a model like HiTOP into a workable system that is useful for health care providers remains a major challenge.

METHOD:

The present work outlines the HiTOP model and describes the core principles to guide its integration into clinical practice.

RESULTS:

Potential advantages and limitations of the HiTOP model for clinical utility are reviewed, including with respect to case conceptualization and treatment planning. A HiTOP approach to practice is illustrated and contrasted with an approach based on traditional nosology. Common barriers to using HiTOP in real-world health care settings and solutions to these barriers are discussed.

CONCLUSIONS:

HiTOP represents a viable alternative to classifying mental illness that can be integrated into practice today, although research is needed to further establish its utility. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

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