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Hierarchical Taxonomy of Psychopathology (HiTOP) consortium working model. Constructs higher in the figure are broader and more general, whereas constructs lower in the figure are narrower and more specific. Dashed lines denote provisional elements requiring further study. At the lowest level of the hierarchy (i.e. traits and symptom components), for heuristic purposes, conceptually related signs and symptoms (e.g. phobia) are indicated in bold, with specific manifestations indicated in parentheses. Abbreviations: ADHD, attention-deficit/hyperactivity disorder; GAD, generalized anxiety disorder; IED, intermittent explosive disorder; MDD, major depressive disorder; OCD, obsessive-compulsive disorder; ODD, oppositional defiant disorder; SAD, separation anxiety disorder; PD, personality disorder; PTSD, post-traumatic stress disorder [Colour figure can be viewed at wileyonlinelibrary.com]
Source publication
Structural models of mental illness delineate the major phenotypic dimensions of psychopathology. These evidence‐based models, such as the Hierarchical Taxonomy of Psychopathology, are poised to supplement—and even supplant—categorical diagnostic systems in research, assessment and treatment arenas. This special issue of Personality and Mental Heal...
Contexts in source publication
Context 1
... structure reflects the perspective that psychopathology can be understood at various levels of breadth. Heterogeneous constructs, such as internalizing and externalizing dimensions, are located near the top of the HiTOP model (Figure 1). Closer to the bottom are more homogeneous dimensions, such as symptom components (e.g. ...
Context 2
... are the number and nature of dimensions needed to parsimoniously explain (co)variation in common forms of mental illness? Figure 1 presents the current HiTOP conceptualization, which is based on decades of factor analytic work across a wide range of populations and assessment routines. Despite a strong data base for this model, quantitative nosology remains a work in progress. ...
Context 3
... structure reflects the perspective that psychopathology can be understood at various levels of breadth. Heterogeneous constructs, such as internalizing and externalizing dimensions, are located near the top of the HiTOP model (Figure 1). Closer to the bottom are more homogeneous dimensions, such as symptom components (e.g. ...
Context 4
... are the number and nature of dimensions needed to parsimoniously explain (co)variation in common forms of mental illness? Figure 1 presents the current HiTOP conceptualization, which is based on decades of factor analytic work across a wide range of populations and assessment routines. Despite a strong data base for this model, quantitative nosology remains a work in progress. ...
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Citations
... This model organizes psychopathology into six hierarchical levels: superspectra, spectra, subfactors, syndromes/disorders, components and maladaptive traits, and signs and symptoms. Several studies have shown the validity and utility of the HiTOP model (Conway et al., 2019;Conway & Simms, 2020), based, for instance, on genetic, cognitive, and affective evidence (Kotov et al., 2017(Kotov et al., , 2021. For a visual representation of the HiTOP model, see Kotov et al. (2017) or Kotov et al. (2021) for an updated representation. ...
The Inventory of Depression and Anxiety Symptoms–Expanded version (IDAS-II) is one of the few tools designed to assess internalizing symptoms based on dimensional models. We conducted two studies, the first testing internal validity aspects of the IDAS-II and the second testing the external validity of the scales. In the first study we adapted the IDAS-II to Brazilian Portuguese and tested its internal structure, including a higher order factorial solution coherent with the internalizing spectrum, the stability of the factor structure, and its measurement invariance for sex and racial groups. Participants were 2,379 Brazilian adults. In the second study, we investigated the IDAS-II scales’ associations with broad pathological personality traits in Brazilian (N = 245) and North American (N = 402) samples. The results of the first study indicated that the IDAS-II scales are grouped into three first-order factors (Distress, Obsessions/Fear, and Positive Mood), replicating Wester et al. (2022) and Petre et al. (2023). Our results also suggested the plausibility of an internalizing second-order factor for the IDAS-II Brazilian version. The multigroup confirmatory factor analysis shows that this scale is invariant for males and females and for White and Black/Brown people. In the second study, the IDAS-II scales demonstrated mostly coherent associations with broad domains of pathological personality traits. Besides the internal validity of the Brazilian IDAS-II, our results also provide information about its external validity and expand its nomological network, as it is the first study reporting its associations with broad domains of pathological personality traits.
... Recent studies have suggested the suitability of IDCP-2 to the HiTOP model, 21 as well as its usefulness in assessing specific disorders based on this model, such as the Avoidant PD 22 and the schizotypal PD. 23 Previous empirical evidence suggests the Attention Seeking, Seduction and manipulation, Need for recognition, Superiority, Dominance, and Indifference IDCP-2 factors as relevant for NPD traits assessment. 24,25 In light of the emergence of the HiTOP model as a viable base for developing screening and diagnostic tools, there is a pressing need for scales that align with the HiTOP's underlying assumptions. 11,25 These scales must effectively capture NPD traits' clinical significance and associated impairments. ...
... 24,25 In light of the emergence of the HiTOP model as a viable base for developing screening and diagnostic tools, there is a pressing need for scales that align with the HiTOP's underlying assumptions. 11,25 These scales must effectively capture NPD traits' clinical significance and associated impairments. 6,7 To this end, our study aimed to construct and validate a dedicated version of the IDCP-2 that focuses specifically on NPD traits, thereby adhering to the HiTOP model. ...
... Studies show that the PDS-ICD-11 score substantially accounts for the variance of a Borderline PD composite score Gutiérrez et al., 2022b;Sellbom et al., 2023). These findings are consistent with established research showing that a general factor, essentially composed of Borderline PD features, accounts for the global severity of personality pathology (Conway and Simms, 2020;Sharp et al., 2015;Williams et al., 2018). Thus, research suggests that the "borderline pattern" is a redundant specifier as it is sufficiently explained by severity and trait domain specifiers (Gutiérrez et al., 2022a;Mulder et al., 2020;Mulder and Tyrer, 2023). ...
... Given the emergence of the HiTOP model as a screening and diagnostic possibility, tools are needed that operationalize the assessment of disorders following the assumptions of the HiTOP (Conway et al., 2019;Conway & Simms, 2020). It includes scales focusing on DPD traits, considering the clinical relevance and associated losses (Furnham, 2018;McClintock & McCarrick, 2017). ...
... The HiTOP is a current dimensional model aggregating evidence from different sources (e.g., genetic, cognitive, and emotional evidence) about its validity and utility (Conway et al., 2019;Ringwald et al., 2021). However, few assessment scales are suitable for HiTOP, justifying the need to develop or adapt scales to assess the mental health indicators covered by the model (Conway et al., 2019;Conway & Simms, 2020). Our objective in this study was to create and validate a version of IDCP-2 to evaluate DPD traits based on HiTOP, the IDCP-DPD. ...
We developed and validated a self-report scale for screening pathological traits of dependent personality disorder (DPD) from the Hierarchical Taxonomy of psychopathology (HiTOP) perspective. The sample was 693 adults who answered the new scale, the Dimensional Clinical Personality Inventory DPD (IDCP-DPD), the PID-5, the FFDI, and the FFBI. The IDCP-DPD was composed of six factors grouped in one general score. The scores showed associations with external measures in the expected direction, and the means comparisons showed large differences. Our findings indicated the IDCP-DPD as a useful clinical measure, and the structure observed confirms the spectrum level of the HiTOP.
... From a dimensional perspective (DSM-5;American Psychiatric Association, 2013;Conway & Simms, 2020;Kotov et al., 2017), people can present elevation in traits and behaviors typically associated with ASPD without showing the complete diagnosis criteria. Correctly identifying an individual with ASPD tendencies is necessary to reduce the disorder's impact (Gibbon et al., 2010;Khalifa et al., 2020). ...
We aimed to refine the previously proposed antisocial subscale for the Dimensional Clinical Personality Inventory 2 (IDCP-ASPD). The sample involved 628 Brazilian adults between 18 and 81 years old. We administered the revised ASPD subscale (IDCP-ASPD-R), the Affective and Cognitive Measure of Empathy (ACME), the Crime and Analogous Behavior Scale (CAB), and the Levenson Self-Report Psychopathy (LSRP). We confirmed the 3-factors structure for the IDCP-ASPD-R. The IDCP-ASPD-R and its former version presented a good capacity to distinguish the groups, with the largest effect size for the Affective factor (IDCP-ASPD-R). Although the IDCP-ASPD-R has shown good performance, we have observed only a slight increase over the previous version of the scale. Therefore, we can only expect a small higher contribution of IDCP-ASPD-R in its practical application to group discrimination. However, from a theoretical perspective, the IDCP-ASPD-R overrides its former version.
... One particular shortcoming of the PD categories is that they do not in themselves give any indication of PD severity, which is unfortunate since PD severity has been deemed the most important clinical indicator of prognosis, expected treatment outcome, risk of harm to self or others, needed intensity of treatment, and clinical decision making Clark et al., 2018;Crawford et al., 2011;Gordon et al., 2019;Hansen et al., 2019;Koelen et al., 2012;Morey, Bender, et al., 2013). In general, there is promising empirical support for focusing on a global continuum of PD severity, which may be qualified by a separate description of stylistic trait expressions (Bender et al., 2011;Conway et al., 2016;Conway & Simms, 2020;Hopwood et al., 2011;Sharp et al., 2015). Consequently, the ICD-11 (WHO, 2021) and the DSM-5 Alternative Model of Personality Disorders (AMPD; APA, 2013) have adopted such an approach to PD classification. ...
Objective: The International Classification of Diseases, 11th edition (ICD-11) model of personality disorders (PD) allows clinicians to classify personality dysfunction according to four levels of severity. This approach is partially inspired by Kernberg's levels of personality organization, in which various PD types are organized according to their level of severity. This study sought to investigate whether the established ICD-10 PD categories can be organized according to the four levels of ICD-11 PD severity, and to what extent this organization aligns with Kernberg's four levels of personality organization.
Method: A sample of 247 patients were rated by their mental health professionals according to ICD-10 PD categories and ICD-11 PD severity levels.
Results: The frequencies of ICD-10 PDs on the different ICD-11 PD severity levels were generally found to be consistent with Kernberg's model. Accordingly, borderline and antisocial PDs predominantly occurred at the most severe levels, whereas anankastic, avoidant, and dependent PDs typically occurred at the milder levels. Only paranoid and histrionic PDs were less consistent with Kernberg's model.
Conclusions: The findings indicate that the new ICD-11 PD severity dimension largely aligns with Kernberg's model of personality functioning with respect to the organization of PD types. Clinicians may therefore conceptualize familiar PD types in terms of their ICD-11 PD severity and vice versa.
... The HiTOP was developed from empirical evidence on the classification of psychopathologies and is hierarchically organized into five levels, from the broadest to the most specific: super-spectra, spectra, subfactors, syndromes/disorders and, maladaptive traits. Although empirically based, the model lacks studies that expand its use in clinical practice [5,6]. Besides, the developers of the mod-el recommend as high priority the development or update of assessment scales based on the Hi-TOP [3]. ...
... Combining the clinical relevance of the PPD traits with the need for studies that seek to provide empirical bases for the implementation of HiTOP in professional practice [5,6], this study aimed to operationalize a version of IDCP-2 for the screening of typical traits of the PPD from the perspective of HiTOP. Therefore, we created the IDCP Paranoid Personality Disorder Scale (IDCP-PPD), as well as investigated its internal and external validity. ...
... HiTOP is a hierarchical dimensional taxonomic model that aims to change the current panorama of the classification of mental disorders based on empirical evidence [3,4]. Clinical scales should be based on this model, enabling the operationalization of HiTOP in professional practice [5,6]. We aimed to operationalize and validate a version of IDCP-2 for the evaluation of pathological traits of PPD based on HiTOP. ...
Aim of the study
This study aimed to operationalize a version of the Dimensional Clinical Personality Inventory 2 (IDCP-2) for the screening of typical traits of the Paranoid personality disorder (PPD) from the perspective of the HiTOP, as well as investigate its internal and external validity.
Subject or material and methods
We selected IDCP-2 factors that appropriately represented PPD traits according to the HiTOP. We created new items for a Rudeness factor. The participants were 454 Brazilian adults (aged 18-70 years). We administered the following scales: IDCP-PPD, PID-5, and CAT-PD-SV.
Results
We found a one higher-order factor structure for the IDCP-PPD The factors that composed this higher-order factor reflect traits from both HiTOP spectra witch PPD is represented, Thought disorder and Antagonistic externalizing. The expected correlations between IDCP-PPD factors and external measures were observed. Groups comparison indicated people with high levels of pathological traits in the external measures showing higher means in the IDCP-PPD scores in comparison to people with lower means in these measures.
Discussion
The factors of the IDCP-PPD demonstrated a good capacity for the assessment of PPD traits.
Conclusions
The findings of our study indicate the IDCP-PPD scale as a useful tool for operationalizing HiTOP for clinical practice. Future studies should test our findings in patients with a PPD diagnosis.
... Although dimensional models of psychopathology originated in the developmental literature [3,139], neurodevelopmental disorders are yet to be fully integrated into the HiTOP model [163]. The HiTOP framework conceptualises psychopathology as a multi-dimensional hierarchy, with an overarching factor for general psychopathology, or 'p' factor, represented at the top of the hierarchy and reflecting a common liability for mental disorder [48,66]. Below this 'p' factor are super spectra; internalising, externalising, and psychosis; representing shared vulnerabilities to more specific ranges of problems. ...
Background
ASD and ADHD are prevalent neurodevelopmental disorders that frequently co-occur and have strong evidence for a degree of shared genetic aetiology. Behavioural and neurocognitive heterogeneity in ASD and ADHD has hampered attempts to map the underlying genetics and neurobiology, predict intervention response, and improve diagnostic accuracy. Moving away from categorical conceptualisations of psychopathology to a dimensional approach is anticipated to facilitate discovery of data-driven clusters and enhance our understanding of the neurobiological and genetic aetiology of these conditions. The Monash Autism-ADHD genetics and neurodevelopment (MAGNET) project is one of the first large-scale, family-based studies to take a truly transdiagnostic approach to ASD and ADHD. Using a comprehensive phenotyping protocol capturing dimensional traits central to ASD and ADHD, the MAGNET project aims to identify data-driven clusters across ADHD-ASD spectra using deep phenotyping of symptoms and behaviours; investigate the degree of familiality for different dimensional ASD-ADHD phenotypes and clusters; and map the neurocognitive, brain imaging, and genetic correlates of these data-driven symptom-based clusters.
Methods
The MAGNET project will recruit 1,200 families with children who are either typically developing, or who display elevated ASD, ADHD, or ASD-ADHD traits, in addition to affected and unaffected biological siblings of probands, and parents. All children will be comprehensively phenotyped for behavioural symptoms, comorbidities, neurocognitive and neuroimaging traits and genetics.
Conclusion
The MAGNET project will be the first large-scale family study to take a transdiagnostic approach to ASD-ADHD, utilising deep phenotyping across behavioural, neurocognitive, brain imaging and genetic measures.
... Combining the clinical relevance of STPD with the need for studies that seek to implement HiTOP in professional practice (Conway & Simms, 2020), this study aimed to operationalize a version of IDCP-2 for screening typical pathological traits of STPD from the perspective of the HiTOP. Hence, we developed a specific version of IDCP-2 to assess STPD-related pathological traits according to HiTOP, the IDCP schizotypal personality disorder scale (IDCP-STPD), and investigating its internal and external validity. ...
... The restructuration of the taxonomy of mental disorders, including personality disorders, is a cardinal target of the HiTOP . However, the development of assessment tools based on the HiTOP is required, allowing researchers to test the model in clinical practice (Conway & Simms, 2020). This study aimed to develop the IDCP Schizotypal Personality Disorder Scale (IDCP-STPD), a specific version of IDCP-2, to measure typical pathological traits of the STPD according to HiTOP. ...
Schizotypal personality disorder (STPD) is characterized by difficulties in intimate relationships, social and interpersonal deficits, and perceptual distortions. Encompassing this personality disorder and other mental conditions, the Hierarchical taxonomy of psychopathology (HiTOP) is an evidence‐based, dimensional model covering pathological traits in its lower range. This study aimed to develop a self‐report scale for screening pathological traits of STPD from the perspective of the HiTOP. The sample consisted of 474 Brazilian adults aged 18–70 years who answered the developed scale, the IDCP‐STPD, facets of the Personality Inventory for DSM‐5 (PID‐5), and factors of the Computerized Adaptive Assessment of Personality Disorder Static Form (CAT‐PD‐SF). The scale was composed of 73 items distributed in two factors. Internal structure reliability was higher than 0.80 for all scores of the scale. The factors showed associations with the expected external measures, and the groups based on the STPD external measures (healthy and pathological) showed big to huge differences. Although initial, our findings suggested the IDCP‐STPD as a helpful measure to the clinical context to screen the STPD pathological traits. Moreover, the structure observed for the IDCP‐STPD confirms the spectrum level of the HiTOP.
... We include the data and 1 We intend for these tutorials to be self-contained, but researchers who want to learn more about HiTOP's origins and applications can refer to other materials published by the HiTOP consortium (e.g., Conway et al., 2019;Kotov et al., 2017;Krueger et al., 2018;Ruggero et al., 2019, Waszczuk et al., 2020. Several scientific journals have recently printed special issues dedicated to examining HiTOP's philosophy and research applications (Conway & Simms, 2020;Eaton, 2017;Krueger, Tackett, & MacDonald, 2016;Krueger, Watson, & Widiger, 2020). Support and information also are available from the consortium's website. ...
... Finally, the HiTOP consortium is now in the process of developing a measure of the higher-and lower-order dimensions in 6 HiTOP domains: internalizing, detachment, thought disorder, somatoform pathology, and both disinhibited and antagonistic forms of externalizing psychopathology (Simms et al., 2020). After an omnibus self-report questionnaire is finalized, there are plans also to create informant-report and interview measures. ...
Mental health research is at an important crossroads as the field seeks more reliable and valid phenotypes to study. Dimensional approaches to quantifying mental illness operate outside the confines of traditional categorical diagnoses, and they are gaining traction as a way to advance research on the causes and consequences of mental illness. The Hierarchical Taxonomy of Psychopathology (HiTOP) is a leading dimensional research paradigm that synthesizes decades of investigation into evidence-based dimensions of psychological disorders. This article aims to make the application of dimensional approaches in mental health research more accessible through tutorials that demonstrate how to use the HiTOP model to formulate and test research questions. Data and annotated code (written for R and Mplus software programs) for each example are included (https://osf.io/8myzw). We outline how investigators can use these ideas and tools to generate new insights in their own substantive research programs.
