Meta-analysis of structural evidence for the Hierarchical Taxonomy of Psychopathology (HiTOP) model

Abstract

Background The Hierarchical Taxonomy of Psychopathology (HiTOP) is a classification system that seeks to organize psychopathology using quantitative evidence – yet the current model was established by narrative review. This meta-analysis provides a quantitative synthesis of literature on transdiagnostic dimensions of psychopathology to evaluate the validity of the HiTOP framework. Methods Published studies estimating factor-analytic models from diagnostic and statistical manual of mental disorders (DSM) diagnoses were screened. A total of 120,596 participants from 35 studies assessing 23 DSM diagnoses were included in the meta-analytic models. Data were pooled into a meta-analytic correlation matrix using a random effects model. Exploratory factor analyses were conducted using the pooled correlation matrix. A hierarchical structure was estimated by extracting one to five factors representing levels of the HiTOP framework, then calculating congruence coefficients between factors at sequential levels. Results Five transdiagnostic dimensions fit the DSM diagnoses well (comparative fit index = 0.92, root mean square error of approximation = 0.07, and standardized root-mean-square residual = 0.03). Most diagnoses had factor loadings >|0.30| on the expected factors, and congruence coefficients between factors indicated a hierarchical structure consistent with the HiTOP framework. Conclusions A model closely resembling the HiTOP framework fit the data well and placement of DSM diagnoses within transdiagnostic dimensions were largely confirmed, supporting it as valid structure for conceptualizing and organizing psychopathology. Results also suggest transdiagnostic research should (1) use traits, narrow symptoms, and dimensional measures of psychopathology instead of DSM diagnoses, (2) assess a broader array of constructs, and (3) increase focus on understudied pathologies.

Risk perception, treatment adherence, and personality during COVID‐19 pandemic: An international study on cancer patients

“…Finally, we tested the 3 HiTOP superspectra 14,31,32 (internalizing, externalizing, psychosis) that are supposed to be hierarchically higher dimensions in respect to PID‐5‐BF traits, and examined each as a moderator of the relationship between risk perception and non‐adherence and risk perception and distress (using safeguards perception as a covariate). The three superspectra were computed by adding the scores of relative lower‐level traits (internalizing: negative affect; externalizing: antagonism, disinhibition; psychosis: detachment, psychoticism), and confirming the reliability through McDonald's Omega (internalizing = 0.84; externalizing = 0.77; internalizing = 0.79).…”

Momentary dynamics of emotion-based impulsivity: Exploring associations with dispositional measures of externalizing and internalizing psychopathology.

“…In order to comprehensively assess externalizing and internalizing psychopathology, we organized assessments based on the Hierarchical Taxonomy of Psychopathology (HiTOP; Kotov et al, 2017, 2021; Ringwald et al, in press). HiTOP is a classification system of quantitative empirically derived structures of personality pathology and clinical mental disorders.…”

Dysphoria and well-being in daily life: Development and validation of ecological momentary assessment scales.

“…One goal of HiTOP is to specify the symptom contents of psychopathology and their empirical associations, ranging from very broad to highly specific symptoms. HiTOP is organized by five higher-order latent factors (spectra) capturing the broad shared variance across various types of related disorders with overlapping symptomatology (i.e., internalizing, thought disorder, detachment, disinhibited externalizing, antagonistic externalizing), followed by increasingly specific symptom clusters defined by subfactors (e.g., eating problems, substance abuse) and then syndromes (i.e., groups of specific, highly related symptoms; Kotov et al, 2017; Ringwald et al, 2021). The internalizing spectrum in HiTOP can be broken down into distinguishable subfactors that organize related clusters of symptoms with greater specificity (which can themselves be broken down further).…”