The Hierarchical Taxonomy of Psychopathology (HiTOP): A Quantitative Nosology Based on Consensus of Evidence

Abstract

Traditional diagnostic systems went beyond empirical evidence on the structure of mental health. Consequently, these diagnoses do not depict psychopathology accurately, and their validity in research and utility in clinical practice are therefore limited. The Hierarchical Taxonomy of Psychopathology (HiTOP) consortium proposed a model based on structural evidence. It addresses problems of diagnostic heterogeneity, comorbidity, and unreliability. We review the HiTOP model, supporting evidence, and conceptualization of psychopathology in this hierarchical dimensional framework. The system is not yet comprehensive, and we describe the processes for improving and expanding it. We summarize data on the ability of HiTOP to predict and explain etiology (genetic, environmental, and neurobiological), risk factors, outcomes, and treatment response. We describe progress in the development of HiTOP-based measures and in clinical implementation of the system. Finally, we review outstanding challenges and the research agenda. HiTOP is of practical utility already, and its ongoing development will produce a transformative map of psychopathology. Expected final online publication date for the Annual Review of Clinical Psychology, Volume 17 is May 2021. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

Effects of Coronavirus Fears on Anxiety and Depressive Disorder Symptoms in Clinical and Subclinical Adolescents: The Role of Negative Affect, Intolerance of Uncertainty, and Emotion Regulation Strategies

“…According to this model, general distress (negative affect) is a common temperamental factor for anxiety and depression, while anhedonia (low positive affect) is specific for depression (e.g., see Watson et al, 2008). The temperamental concept of negative affect has been used as equivalent to the concept of neuroticism (Barlow et al, 2014) and is currently integrated as a temperamental dimension for internalizing disorders in the HiTOP hierarchical taxonomy of psychopathology (Kotov et al, 2021).…”

Which anxious adolescents were most impacted by the COVID-19 pandemic?

“…Some suggest that differences among anxiety symptoms during adolescence are not clinically meaningful (Rutter, 2011), whereas others suggest that these differences might predict differential outcomes (Pine, 2007(Pine, , 2011. Other positions fall somewhere in between, suggesting the existence of both shared and more specific features (Kotov et al, 2021). The most consistent evidence of specificity arises for a domain involving fears, including symptoms of social anxiety disorder, and a domain involving distress, including symptoms of generalized anxiety disorder.…”

Linking Individual Differences in Personalized Functional Network Topography to Psychopathology in Youth

“…However, it is increasingly recognized that these categories do not align with the underlying biology (Insel et al, 2010; Insel, 2014). Efforts including the RDoC initiative and HiTOP have been proposed given increasing empirical evidence that psychopathology is a dimensional phenomenon that is highly comorbid in nature, with the presence of one disorder increasing risk for the development of all others (Insel et al, 2010; Insel, 2014; Kotov et al, 2017; Kotov et al, 2021). In the current study, we used a dimensional approach that accounts for a continuous spectrum of psychopathology (Kaczkurkin et al, 2019).…”