The Hierarchical Taxonomy of Psychopathology (HiTOP) is a quantitative nosological system that addresses shortcomings of traditional mental disorder diagnoses, including arbitrary boundaries between psychopathology and normality, frequent disorder co‐occurrence, substantial heterogeneity within disorders, and diagnostic unreliability over time and across clinicians. This paper reviews evidence on the validity and utility of the internalizing and somatoform spectra of HiTOP, which together provide support for an emotional dysfunction superspectrum. These spectra are composed of homogeneous symptom and maladaptive trait dimensions currently subsumed within multiple diagnostic classes, including depressive, anxiety, trauma‐related, eating, bipolar, and somatic symptom disorders, as well as sexual dysfunction and aspects of personality disorders. Dimensions falling within the emotional dysfunction superspectrum are broadly linked to individual differences in negative affect/neuroticism. Extensive evidence establishes that dimensions falling within the superspectrum share genetic diatheses, environmental risk factors, cognitive and affective difficulties, neural substrates and biomarkers, childhood temperamental antecedents, and treatment response. The structure of these validators mirrors the quantitative structure of the superspectrum, with some correlates more specific to internalizing or somatoform conditions, and others common to both, thereby underlining the hierarchical structure of the domain. Compared to traditional diagnoses, the internalizing and somatoform spectra demonstrated substantially improved utility: greater reliability, larger explanatory and predictive power, and greater clinical applicability. Validated measures are currently available to implement the HiTOP system in practice, which can make diagnostic classification more useful, both in research and in the clinic.

The current study compared two competing theories of the stress generation model of depression (stress causation vs. stress continuation) using interview-based measures of episodic life stress, as well as interpersonal and noninterpersonal chronic life stress. We also expanded on past research by examining anxiety disorders as well as depressive disorders. In addition, we examined the role of neuroticism and extraversion in these relationships. Participants were 627 adolescents enrolled in a two-site, longitudinal study of risk factors for depressive and anxiety disorders. Baseline and follow-up assessments were approximately one year apart. Results supported the stress causation theory for episodic stress generation for anxiety disorders, with neuroticism partially accounting for this relationship. The stress causation theory was also supported for depression, but only for more moderate to severe stressors; neuroticism partially accounted for this relationship as well. Finally, we found evidence for interpersonal and noninterpersonal chronic life stress continuation in both depressive and anxiety disorders. The present findings have implications regarding the specificity of the stress generation model to depressive disorders, as well as variables involved in the stress generation process.

Though there is a considerable amount of research supporting the association between stressful life events and major depression, there is a paucity of research concerning a range of other life stress constructs, non-depressive disorders, the role of stable personality traits, and gender differences. This study addresses these deficits by: (a) focusing on the association between interpersonal and non-interpersonal chronic life stress (CLS) and both depressive and anxiety disorders, (b) examining the roles of neuroticism and low extraversion in these associations, and (c) assessing gender differences. Participants were 603 adolescents from a study examining risk factors for emotional disorders. Depression and social phobia were associated with interpersonal CLS, with neuroticism partially accounting for these associations. Low extraversion partially accounted for the association between social phobia and interpersonal CLS. Depression was also associated with non-interpersonal CLS, but only in females. This study provides preliminary evidence for the importance of personality variables in explaining shared associations between stress and depression. Additionally, the stress-social phobia relationship is highlighted, with no evidence supporting an association between other anxiety disorders and CLS.

This study examines whether content overlap artificially inflates estimates of the associations of emotional disorders with neuroticism and whether disorder-specificity of prediction exists. We demonstrated a statistical approach for testing the validity of hypothesized facets of neuroticism. In a sample of 627 adolescents, we indentified six facets of neuroticism, one intermediate facet, and a general neuroticism factor (GNF). Only the GNF and the depression facet were significantly associated with depressive symptomatology. The GNF and all facets significantly predicted anxiety symptomatology. This study offers a new statistical approach for addressing content overlap, testing for disorder specific prediction and identifying facets of a broad personality trait, while indicating that content overlap does not largely explain the associations of neuroticism with psychopathology.

A trait approach to personality has many implications for psychotherapy. Given that traits contribute to the expression of symptoms of common psychiatric disorders, are moderately heritable, and relatively stable (yet also dynamic to some extent), long-term change in symptoms is possible but is likely to be limited. Analogous to the manner in which genes set the reaction range for phenotype, standing on certain traits may set the patient's ''therapeutic range.'' On the other hand, some of the same traits that may limit the depth of therapeutic benefits might also increase their breadth. In addition, taking the patient's standing on different traits into account can inform the choice of therapeutic strategy and targets and can affect the formation of the therapeutic alliance and compliance with self-help exercises. Finally, other aspects of personality beyond traits, such as ego development and narrative identity, also appear to have important implications for psychotherapy.A great deal of theory and research has focused on the implications of personality traits for the development and course of psychopathology. Indeed, questions concerning the associations between personality traits and the development and course of psychopathology were a central focus of the research programs developed by H. J.

Nearly two decades ago, Harkness and Lilienfeld (1997) published a seminal article in which they articulated the potential roles that personality assessment might play in treatment planning. Four broad areas were outlined, including how personality assessment can (a) inform where to focus change efforts, (b) foster realistic expectations of therapeutic gains, (c) facilitate effective treatment matching, and (d) enhance self-development. We review the literature examining the role of personality assessment in treatment, using these four recommendations as a framework. We conclude that more research is needed to test (a) whether changes in characteristic adaptations mediate effects of basic personality dispositions on symptom improvement, (b) the effect of personality on treatment motivation and homework compliance, (c) the role of personality in the prediction of various aspects of psychotherapy, and (d) the efficacy of therapeutic assessment techniques using measures of universal personality traits. We also assert, more generally, that although the field has progressed to some extent in the past two decades, clinical psychologists should cultivate and advance a stronger recognition of how personality assessment can be used to enhance treatment interventions. We believe positive treatment is optimized if psychotherapists or other providers of intervention are equipped with information from personality assessment to select treatment modalities and construct treatment plans.Clinical psychologists possess highly specialized and unique skillsets in their capacity to deliver evidencebased therapies and discipline-specific training in psychological assessment (American Psychological Association, 2016). Yet despite this unique combination of skill and knowledge, it is uncommon for clinical psychologists to use evidence-based personality assessment to inform treatment decisions. One explanation for this is that research examining the role of personality assessment in treatment is not sufficiently developed to inform empirically supported guidelines for psychotherapeutic decision making. There is no shortage, however, of speculation for why and how personality assessments can be used to enhance treatment.Approximately two decades ago, Harkness and Lilienfeld (1997) published a seminal article identifying four ways in which personality assessment can inform treatment planning. These authors suggested that personality assessment could and should be used to (a) inform where to focus change efforts, (b) foster realistic expectations of therapeutic gains, (c) facilitate effective treatment matching, and (d) promote self-development. In the current article, we review the existing empirical research examining the role of personality assessment in treatment, as guided by the framework of these four recommendations. A focus is placed on personality as

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Individuals with borderline personality disorder (BPD) have biases in facial emotion recognition, which may underlie many of the core features of this disorder. Although they are known to misperceive specific prototypic expressions of emotion (i.e., those displayed at full emotional intensity), patients with this disorder may also show biases in their perceptions of emotions that are expressed at lower levels of emotional intensity. Females with BPD (n = 31) and IQ- and demographically matched nonpsychiatric controls (n = 28) completed a task assessing the recognition of neutral as well as happy and sad facial expressions at mild, moderate, and prototypic emotional intensities. Whereas patients with BPD were more likely than controls to ascribe an emotion to a neutral facial expression, they did not consistently attribute a more negative or positive valence to these faces as compared with controls. Patients were also more likely to perceive mildly sad facial expressions as more intensely sad, and this finding could not be attributed to depressed mood. The results of this study suggest that perceptions of even subtle expressions of negative affect in faces may be subjectively magnified by individuals with BPD, although there was no consistent evidence for a negative perceptual bias for faces displaying a neutral expression. These biases in facial emotion perception for patients with BPD may contribute to difficulties understanding others' emotional states and to problems engaging effectively in social interactions.