Integrating the Hierarchical Taxonomy of Psychopathology (HiTOP) into clinical practice.
Open accessAbstract
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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The HiTOP model emphasizes dimensional assessment of psychopathology, focusing on the level of severity rather than categorical diagnosis.
“the HiTOP model emphasizes dimensional assessment of psychopathology, focusing on the level of severity rather than categorical diagnosis [23, 27].”
From Trajectories of Maternal and Paternal Internalizing Symptoms from Pregnancy to 2 Years Postpartum: Identifying Modifiable Risk and Protective Factors (2024) · cites this paper as [27]
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- Authors
- Ruggero, C. J., Kotov, R., Hopwood, C. J., First, M., Clark, L. A., Skodol, A. E., Mullins-Sweatt, S. N., Patrick, C. J., Bach, B., Cicero, D. C., Docherty, A., Simms, L. J., Bagby, R. M., Krueger, R. F., Callahan, J. L., Chmielewski, M., Conway, C. C., De Clercq, B., Dornbach-Bender, A., Eaton, N. R., Forbes, M. K., Forbush, K. T., Haltigan, J. D., Miller, J. D., Morey, L. C., Patalay, P., Regier, D. A., Reininghaus, U., Shackman, A. J., Waszczuk, M. A., Watson, D., Wright, A. G. C., & Zimmermann, J.
- Affiliations
- University of North Texas (US)
- Stony Brook University (US)
- University of California, Davis (US)
- New York State Psychiatric Institute (US)
- University of Notre Dame (US)
- University of Arizona (US)
- Florida State University (US)
- University of Copenhagen (DK)
- University of Utah (US)
- University at Buffalo, State University of New York (US)
- University of Toronto (CA)
- University of Minnesota (US)
- Southern Methodist University (US)
- William & Mary (US)
- Macquarie University (AU)
- University of Kansas (US)
- University of Georgia (US)
- Texas A&M University (US)
- MRC Unit for Lifelong Health and Ageing (GB)
- Uniformed Services University of the Health Sciences (US)
- Maastricht University (NL)
- University of Maryland, College Park (US)
- University of Pittsburgh (US)
- University of Kassel (DE)
- ORCID
- Ruggero, Camilo J.
- Kotov, Roman
- Hopwood, Christopher J.
- First, Michael
- Clark, Lee Anna
- Patrick, Christopher J.
- Bach, Bo
- Cicero, David C.
- Docherty, Anna
- Simms, Leonard J.
- Bagby, R. Michael
- Krueger, Robert F.
- Callahan, Jennifer L.
- Chmielewski, Michael
- Conway, Christopher C.
- Eaton, Nicholas R.
- Forbes, Miriam K.
- Forbush, Kelsie T.
- Haltigan, John D.
- Miller, Joshua D.
- Morey, Leslie C.
- Patalay, Praveetha
- Regier, Darrel A.
- Reininghaus, Ulrich
- Shackman, Alexander J.
- Waszczuk, Monika A.
- Watson, David
- Wright, Aidan G. C.
- Zimmermann, Johannes
- Venue
- Journal of Consulting and Clinical Psychology
- Published
- 2019-12
- Volume
- 87
- Issue
- 12
- Pages
- 1069-1084
- ISSN
- 0022-006X (ISSN-L)
- 1939-2117
- PMC
- PMC6859953
- OpenAlex
- W2986368852
- Cited by
- 333
- References
- 121
- Citations by year
- 2026: 42 · 2025: 43 · 2024: 58 · 2023: 57 · 2022: 47 · 2021: 56 · 2020: 27 · 2019: 2 · 2018: 1
- FWCI
- 38.91
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Journal of Consulting and Clinical Psychology (publishedVersion, other-oa)
- PubMed (publishedVersion)
- Research Publications (Maastricht University) (publishedVersion, other-oa)
- Research at the University of Copenhagen (University of Copenhagen) (publishedVersion)
- Zurich Open Repository and Archive (University of Zurich) (acceptedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- UCL Discovery (University College London) (submittedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Research Portal (King's College London) (submittedVersion)
- Zurich Open Repository and Archive (University of Zurich) (submittedVersion)
- Research Publications (Maastricht University) (submittedVersion, other-oa)
- Zurich Open Repository and Archive (University of Zurich)
- Funders
- National Institutes of Health (DA040717, MH107444)
- University of Maryland
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Mental Health Research Topics
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
- Keywords
- Hierarchical Taxonomy of Psychopathology, transdiagnostic dimensions, mental illness diagnosis, clinical utility, case formulation, treatment planning, disease classification, implementation barriers, comorbidities
- MeSH terms
- Adolescent, Adult, Mental Disorders, Humans, Models, Theoretical, Psychopathology
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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