State of the Science: The Hierarchical Taxonomy of Psychopathology (HiTOP).

The Hierarchical Taxonomy of Psychopathology (HiTOP) is a dimensional framework for psychopathology advanced by a consortium of nosologists. In the HiTOP system, psychopathology is grouped hierarchically from super-spectra, spectra, and subfactors at the upper levels to homogeneous symptom components and maladaptive traits and their constituent symptoms, and maladaptive behaviors at the lower levels. HiTOP has the potential to improve clinical outcomes by planning treatment based on symptom severity rather than heterogeneous diagnoses, targeting treatment across different levels of the hierarchy, and assessing distress and impairment separately from the observed symptom profile.

Where do neurodevelopmental conditions fit in transdiagnostic psychiatric frameworks? Incorporating a new neurodevelopmental spectrum.

Features of autism spectrum disorder, attention-deficit/hyperactivity disorder, learning disorders, intellectual disabilities, and communication and motor disorders usually emerge early in life and are associated with atypical neurodevelopment. These "neurodevelopmental conditions" are grouped together in the DSM-5 and ICD-11 to reflect their shared characteristics. Yet, reliance on categorical diagnoses poses significant challenges in both research and clinical settings (e.

A framework for assessment of adverse events occurring in psychedelic-assisted therapies.

Objective: Despite considerable research examining the efficacy of psychedelic-assisted therapies (PATs) for treating psychiatric disorders, assessment of adverse events (AEs) in PAT research has lagged. Current AE reporting standards in PAT trials are poorly calibrated to features of PAT that distinguish it from other treatments, leaving many potential AEs unassessed.

Methods: A multidisciplinary working group of experts involved in PAT pooled formally and informally documented AEs observed through research experience and published literature.

Rethinking trauma-related psychopathology in the Hierarchical Taxonomy of Psychopathology (HiTOP).

Research on trauma exposure and its consequences has made tremendous progress in elucidating the role of traumatic life events in the development and maintenance of psychopathology as well as in evaluating interventions aimed at addressing the personal and public burden of trauma-related psychopathology. However, there is growing concern that problems with predominant definitions of posttraumatic syndrome (e.g.

To fully leverage fine-grained clinical phenomena, we have to think beyond DSM-based concepts and the presumption of diagnostic kinds.

In light of the limitations of dominant psychiatric classification systems such as the (), this special section positions fine-grained clinical phenomena as key to the future of psychopathology research. This shift is necessary given the constraints DSM-based diagnoses place on (a) the specificity of theories and models of psychopathology and (b) efforts to develop alternative paradigms. Fine-grained clinical phenomena offer comparative advantages, but transitioning to their study involves significant challenges.

A Bridge Between Section II Personality Disorder Criteria and Personality Disorder Trait Domains.

The organization of personality pathology into trait domains (vs. specific disorders) in represents an important shift in personality disorder (PD) nosology. However, to facilitate clinical implementation, a bridge is needed between this system and the Section II system familiar to many researchers and clinicians.

Negative Mood Dysregulation Loads Strongly Onto Common Factors With Many Forms of Psychopathology: Considerations for Assessing Nonspecific Symptoms.

There have been proposals to expand definitions for categorical disorders and dimensionally conceptualized syndromes (e.g., psychopathy) to include negative mood lability and dysregulation (NMD).

Factor analysis in personality disorders research: Modern issues and illustrations of practical recommendations.

The development of factor analysis is uniquely situated within psychology, and the development of many psychological theories and measures are likewise tethered to the common use of factor analysis. In this article, we review modern methodological controversies and developments of factor analytic techniques through concrete demonstrations that span the exploratory-confirmatory continuum. Also, we provide recommendations for working through common challenges in personality disorders research.

Validation of hierarchical taxonomy in a clinical sample.

Background: Quantitatively derived dimensional models of psychopathology enjoy overwhelming empirical support, and a large and active community of psychopathology researchers has been establishing an empirically based dimensional hierarchical taxonomy of psychopathology (or HiTOP) as a strong candidate replacement for the current categorical classification system. The hierarchical nature of this taxonomy implies that different levels of resolution are likely to be optimal for different purposes. Our aim was to identify which level of detail is likely to provide optimal validity and explanatory power with regard to relevant clinical variables.

Levels of Anger Severity in Psychiatric Patients.

Given anger's clinical relevance and adverse impact on functioning, there is a need to examine diagnostically heterogeneous individuals at different levels of anger severity to provide a basis for considering anger severity in clinical research and practice. In the present report from the Rhode Island Methods to Improve Diagnostic Assessment and Services project, we examined the validity of severity classifications based on the Clinically Useful Anger Outcome Scale (CUANGOS) in 1738 clinically heterogeneous psychiatric outpatients. We compared patients reporting no, mild, moderate, or severe anger with regard to demographics, psychosocial morbidity, functioning, and life satisfaction.

Sudden gains and treatment outcomes among depressed individuals in a partial hospitalization programme.

Sudden gains commonly occur among patients receiving psychotherapy for depression and have been found to consistently predict better treatment outcomes. However, the majority of prior research has examined sudden gains primarily in weekly or biweekly treatment settings. Individuals were divided into two groups: those who experienced at least one sudden gain and those who did not.

Focusing Narrowly on Model Fit in Factor Analysis Can Mask Construct Heterogeneity and Model Misspecification: Applied Demonstrations across Sample and Assessment Types.

This study builds upon research indicating that focusing narrowly on model fit when evaluating factor analytic models can lead to problematic inferences regarding the nature of item sets, as well as how models should be applied to inform measure development and validation. To advance research in this area, we present concrete examples relevant to researchers in clinical, personality, and related subfields highlighting two specific scenarios when an overreliance on model fit may be problematic. Specifically, we present data analytic examples showing that focusing narrowly on model fit may lead to (a) incorrect conclusions that heterogeneous item sets reflect narrower homogeneous constructs and (b) the retention of potentially problematic items when developing assessment measures.

Validity and utility of Hierarchical Taxonomy of Psychopathology (HiTOP): III. Emotional dysfunction superspectrum.

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.

Preliminary Scales for Personality Disorder: Self and Interpersonal Dysfunction Plus Five Personality Disorder Trait Domains.

The personality disorder model is the first fully dimensional assessment of personality pathology. It consists of a personality disorder (PD) dysfunction-severity dimension, which encompasses both self- and interpersonal dysfunction, and six optional qualifiers for five prominent personality traits-Negative Affectivity (NA), Detachment (DET), Dissociality (DSL), Disinhibition (DSN), and Anankastia (ANK)-plus a borderline pattern that is defined by the criteria of borderline PD. This article reports on the development of a new self-report measure to assess self- and interpersonal dysfunction and the five trait qualifiers.

A Clinically Useful Anger Outcome Scale.

In the present report from the Rhode Island Methods to Improve Diagnostic Assessment and Services (MIDAS) project, we describe the development and validation of the Clinically Useful Anger Outcome Scale (CUANGOS). Current anger measures vary in their psychometric quality, clinical utility, and clinically relevant content coverage, and no one scale addresses all three of these key considerations. We aimed to develop a brief, clinically useful anger scale that (a) assesses clinically relevant aspects of anger, (b) performs well across different patient populations, and (c) is brief, accessible, and easy to use in routine clinical practice either as a stand-alone measure or as part of an assessment battery.

The Development of Preliminary HiTOP Internalizing Spectrum Scales.

As part of a broader project to create a comprehensive self-report measure for the Hierarchical Taxonomy of Psychopathology consortium, we developed preliminary scales to assess internalizing symptoms. The item pool was created in four steps: (a) clarifying the range of content to be assessed, (b) identifying target constructs to guide item writing, (c) developing formal definitions for each construct, and (d) writing multiple items for each construct. This yielded 430 items assessing 57 target constructs.

Beyond Distress and Fear: Differential Psychopathology Correlates of PTSD Symptom Clusters.

Background: Research suggests that re-experiencing and avoidance are "core" PTSD symptoms, but there has been little research explicating their unique connections to psychopathology other than internalizing conditions such as depression and anxiety. We aim to unpack symptom heterogeneity within PTSD by exploring associations between re-experiencing and avoidance clusters and major psychopathology domains in a dimensional metastructural framework (e.g.

Three recommendations based on a comparison of the reliability and validity of the predominant models used in research on the empirical structure of psychopathology.

The present study compared the primary models used in research on the structure of psychopathology (i.e., correlated factor, higher-order, and bifactor models) in terms of structural validity (model fit and factor reliability), longitudinal measurement invariance, concurrent and prospective predictive validity in relation to important outcomes, and longitudinal consistency in individuals' factor score profiles.

What Is the General Factor of Psychopathology? Consistency of the p Factor Across Samples.

Bifactor analyses have become a popular way to model a general psychopathology factor (or ) that accounts for correlations among higher order internalizing, externalizing, and thought-disorder dimensions. However, to advance dimensional nosology and construct validation of the p factor, this body of research needs to be synthesized. This study focuses on the p factor as a substantive construct by testing its consistency across samples and models.

Examining the Criterion Validity and Diagnostic Specificity of Self-Report Measures of Narcissism and Mania.

We examined the validity of self-report measures of narcissism and mania by relating them to interview-based ratings of psychopathology. Narcissism scales were taken from the Narcissistic Personality Inventory (NPI), the Personality Diagnostic Questionnaire-4+, and the Short Dark Triad. Mania measures included the Altman Self-Rated Mania Scale (ASRM) and scales taken from the Hypomanic Personality Scale (HPS) and Expanded Version of the Inventory of Depression and Anxiety Symptoms.

Aspects of extraversion and their associations with psychopathology.

Extraversion shows both negative and positive associations with psychopathology. Previous work in this area has focused largely on either a broad higher order extraversion domain score or on specific lower-order extraversion facets. The goal of this study was to explicate how two intermediate of the trait- and -relate to psychopathology.

Anxious, but not depressive, symptoms are associated with poorer prospective memory performance in healthy college students: Preliminary evidence using the tripartite model of anxiety and depression.

Prospective memory (PM) - or memory for tasks to be completed in the future - is essential for daily functioning. Although depression and anxiety have been shown to impair PM performance, few studies have explored the relative contributions of different symptom domains. Here, we examined the relation between anxiety, depression, negative mood, and PM performance using the tripartite model.