Development of the Thought Disorder Measure for the Hierarchical Taxonomy of Psychopathology

Abstract

The Hierarchical Taxonomy of Psychopathology consortium aims to develop a comprehensive self-report measure to assess psychopathology dimensionally. The current research describes the initial conceptualization, development, and item selection for the thought disorder spectrum and related constructs from other spectra. The thought disorder spectrum is defined primarily by the positive and disorganized traits and symptoms of schizophrenia-spectrum disorders. The Thought Disorder Sub-Workgroup identified and defined 16 relevant constructs and wrote 10 to 15 items per each construct. These items were administered, along with detachment and mania items, to undergraduates and people with serious mental illness. Three hundred and sixty-five items across 25 scales were administered. An exploratory factor analysis of the scale scores suggested a two-factor structure corresponding to positive and negative symptoms for two samples. The mania scales loaded with the positive factor, while the detachment scales loaded with the negative factor. Item-level analyses resulted in 19 preliminary scales, including 215 items that cover the range of thought disorder pathology, and will be carried forward for the next phase of data collection/analysis.

Mapping established psychopathology scales onto the Hierarchical Taxonomy of Psychopathology (HiTOP)

“…These results are consistent with views that consider mentalizing impairments and epistemic mistrust as defining features of the p factor and that place self-and interpersonal functioning at the core of psychopathology (Widiger et al, 2019;Wright et al, in press). In fact, whereas we found evidence for suspiciousness to be a pure marker of the p factor, it has previously been placed in the spectra of detachment , antagonism (Krueger et al, 2021;Mullins-Sweatt et al, 2022), or thought disorder (Cicero et al, 2022). Yet consistent with our results, studies using the Personality Inventory for DSM-5 (APA, 2013) have indicated that suspiciousness exhibits strong associations with a general PD factor but low domain-specificity (e.g., Somma et al, 2019;Williams et al, 2018).…”

“…Using this approach, the meaning and validity of constructs can be better established, specific associations can be studied (i.e., beyond higher‐level psychopathology dimensions), jingle‐jangle fallacies can be better identified (Lawson & Robins, 2021), and, finally, the treatment utility of clinical assessments may be enhanced (Kamphuis et al, 2021). Currently, an omnibus measure of the HiTOP model is under development (Simms et al, 2022) with initial results being published for preliminary scales of HiTOP spectra (Cicero et al, 2022; Mullins‐Sweatt et al, 2022; Sellbom et al, 2022; Watson, Forbes, et al, 2022; Zimmermann et al, 2022). Until the instrument becomes available (and most likely beyond), researchers will need to rely on existing measures that capture psychopathology broadly and are compatible with HiTOP.…”

“…Beneath these, the current working model of HiTOP specifies six dimensions on an intermediate level of the hierarchy—the spectra of internalizing, antagonistic externalizing (hereinafter simply referred to as antagonism), disinhibited externalizing (disinhibition), thought disorder, detachment, and somatoform (Kotov et al, 2017). Lower levels of the hierarchy may consist of finer grained symptom clusters, but fewer studies have investigated their number, nature, or structure (e.g., Cicero et al, 2022; Forbes et al, 2021; Mullins‐Sweatt et al, 2022; Sellbom et al, 2022; Watson, Forbes, et al, 2022; Zimmermann et al, 2022).…”

Measurement to Improve Treatment Delivery: A Commentary on the HiTOP Measure Development Project

“…As has historically been the case, new nosological proposals are often followed by an attempt to assess psychopathology in a manner that conforms to the new perspective. Thus, it no surprise that members of the HiTOP consortium has formed working groups aimed at measuring psychopathology that is in line with their dimensional model (Cicero et al, 2021;Sellbom et al, in press;Simms et al, in press;Watson et al, 2021;Zimmerman et al, in press).…”

Mental Health of Incarcerated Veterans and Civilians: Latent Class Analysis of the 2016 Survey of Prison Inmates

“…This accords with a long line of research demonstrating that manic symptoms can be conceptualized as belonging to both internalizing and thought disorder spectra (keyes et al, 2013; kotov et al, 2020). Correspondingly, across samples, an extremely strong relationship is routinely observed between bipolar disorder and psychotic disorders due to overlapping features, such as positive symptoms, hyperactive cognition, and disrupted sleep patterns (Cicero et al, 2022;Goldberg et al, 2009). By contrast, members of the pure Internalizing class were somewhat less likely to have a psychotic or personality disorder comorbidity, but more likely to have co-occurring anxiety or PTSDs.…”