A Hierarchical Taxonomy of Psychopathology Can Transform Mental Health Research
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For more than a century, research on psychopathology has focused on categorical diagnoses. Although this work has produced major discoveries, growing evidence points to the superiority of a dimensional approach to the science of mental illness. Here we outline one such dimensional system—the Hierarchical Taxonomy of Psychopathology (HiTOP)—that is based on empirical patterns of co-occurrence among psychological symptoms. We highlight key ways in which this framework can advance mental-health research, and we provide some heuristics for using HiTOP to test theories of psychopathology. We then review emerging evidence that supports the value of a hierarchical, dimensional model of mental illness across diverse research areas in psychological science. These new data suggest that the HiTOP system has the potential to accelerate and improve research on mental-health problems as well as efforts to more effectively assess, prevent, and treat mental illness.
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Imprecise assessment can interfere with predictor measurement, such as behavioural markers with high variability or neuroimaging markers with poor reproducibility.
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“…and externalizing PTH. Crucially, instead of investigating disconnected PTH indicators, this allows for the recognition of effect patterns between CMC and higher-level dimensions and manifestations of PTH (see Conway et al., 2019, for additional arguments supporting a dimensional approach to PTH).”
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Hierarchical models of psychopathology: empirical support, implications, and remaining issues
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Psychometric evaluation of the Swedish Multidimensional Psychological Flexibility Inventory (MPFI)
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“To synthesize and organize the findings, identified mental disorders were categorized within the conceptual framework of internalizing and externalizing spectra, a robust, validated model that continues to demonstrate utility in contemporary psychopathology (Kotov et al., 2017; Conway et al., 2019).”
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- Authors
- Conway, C. C., Forbes, M. K., Forbush, K. T., Fried, E. I., Hallquist, M. N., Kotov, R., Mullins-Sweatt, S. N., Shackman, A. J., Skodol, A. E., South, S. C., Sunderland, M., Waszczuk, M. A., Zald, D. H., Afzali, M. H., Bornovalova, M. A., Carragher, N., Docherty, A. R., Jonas, K. G., Krueger, R. F., Patalay, P., Pincus, A. L., Tackett, J. L., Reininghaus, U., Waldman, I. D., Wright, A. G. C., Zimmermann, J., Bach, B., Bagby, R. M., Chmielewski, M., Cicero, D. C., Clark, L. A., Dalgleish, T., DeYoung, C. G., Hopwood, C. J., Ivanova, M. Y., Latzman, R. D., Patrick, C. J., Ruggero, C. J., Samuel, D. B., Watson, D., & Eaton, N. R.
- Affiliations
- William & Mary (US)
- Macquarie University (AU)
- University of Kansas (US)
- University of Amsterdam (NL)
- Pennsylvania State University (US)
- State University of New York (US)
- Department of Psychology, Oklahoma State University
- University of Maryland, College Park (US)
- University of Arizona (US)
- Purdue University West Lafayette (US)
- UNSW Sydney (AU)
- Vanderbilt University (US)
- Université de Montréal (CA)
- University of South Florida (US)
- University of Utah (US)
- University of Minnesota (US)
- University of Liverpool (GB)
- Northwestern University (US)
- King's College London (GB)
- Emory University (US)
- University of Pittsburgh (US)
- University of Kassel (DE)
- Slagelse Hospital (DK)
- University of Toronto (CA)
- Southern Methodist University (US)
- University of Hawaiʻi at Mānoa (US)
- University of Notre Dame (US)
- MRC Cognition and Brain Sciences Unit (GB)
- University of California, Davis (US)
- University of Vermont (US)
- Georgia State University (US)
- Florida State University (US)
- University of North Texas (US)
- Stony Brook University (US)
- Corresponding author
- Conway, Christopher C.
- ORCID
- Conway, Christopher C.
- Forbes, Miriam K.
- Forbush, Kelsie T.
- Fried, Eiko I.
- Hallquist, Michael N.
- Kotov, Roman
- Shackman, Alexander J.
- South, Susan C.
- Sunderland, Matthew
- Waszczuk, Monika A.
- Zald, David H.
- Afzali, Mohammad H.
- Bornovalova, Marina A.
- Carragher, Natacha
- Docherty, Anna R.
- Jonas, Katherine G.
- Krueger, Robert F.
- Patalay, Praveetha
- Pincus, Aaron L.
- Tackett, Jennifer L.
- Reininghaus, Ulrich
- Waldman, Irwin D.
- Wright, Aidan G. C.
- Zimmermann, Johannes
- Bach, Bo
- Bagby, R. Michael
- Chmielewski, Michael
- Cicero, David C.
- Clark, Lee Anna
- Dalgleish, Tim
- DeYoung, Colin G.
- Hopwood, Christopher J.
- Ivanova, Masha Y.
- Latzman, Robert D.
- Patrick, Christopher J.
- Ruggero, Camilo J.
- Samuel, Douglas B.
- Watson, David
- Eaton, Nicholas R.
- Venue
- Perspectives on Psychological Science
- Publisher
- SAGE Publications
- Published
- 2019-03-07
- Volume
- 14
- Issue
- 3
- Pages
- 419-436
- ISSN
- 1745-6916 (ISSN-L)
- 1745-6924
- PMC
- PMC6497550
- OpenAlex
- W2922020216
- Cited by
- 426
- References
- 99
- Citations by year
- 2026: 27 · 2025: 29 · 2024: 105 · 2023: 49 · 2022: 61 · 2021: 75 · 2020: 54 · 2019: 25 · 2018: 1
- FWCI
- 63.19
- Type
- journal article
- Language
- en
- Open access
- green
- www.zora.uzh.ch
- Locations
- Perspectives on Psychological Science (publishedVersion)
- PubMed (publishedVersion)
- Zurich Open Repository and Archive (University of Zurich) (acceptedVersion, other-oa)
- PubMed Central (acceptedVersion)
- UA Campus Repository (The University of Arizona) (acceptedVersion)
- Leiden Repository (Leiden University) (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Digital Commons - University of South Florida (University of South Florida) (submittedVersion)
- Research Publications (Maastricht University) (submittedVersion, other-oa)
- UCL Discovery (University College London) (submittedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Research Portal (King's College London) (submittedVersion)
- OSF Preprints (OSF Preprints) (submittedVersion, cc-by)
- Zurich Open Repository and Archive (University of Zurich) (submittedVersion, other-oa)
- Research Publications (Maastricht University) (submittedVersion)
- Zurich Open Repository and Archive (University of Zurich)
- Funders
- National Institute for Health and Care Research (PB-PG-0214-33072)
- National Institutes of Health (5r01mh107444-05)
- National Institute of Mental Health (R01-MH107444, K01MH109765)
- National Institute on Drug Abuse (R21DA040717)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Mental Health Research Topics
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- Hierarchical Taxonomy of Psychopathology, dimensional models of psychopathology, symptom co-occurrence, hierarchical classification, mental illness, mental health assessment, mental health prevention, psychotherapy
- MeSH terms
- Heuristics, Mental Disorders, Humans, Models, Theoretical, Terminology as Topic, Research Design
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