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.

Emptiness and negative affect changes related to binge eating and borderline personality traits.

Borderline personality disorder (BPD) is characterized by unstable self-image, conflictual interpersonal relationships, emotional dysregulation, and marked impulsivity. One form of impulsivity commonly seen in BPD is binge eating; however, little is known about this maladaptive behavior in the context of BPD. In the eating disorder (ED) literature, multiple theories suggest binge eating occurs as a result of heightened levels of negative affect.

Perception of stigma across diagnostic models of personality pathology.

Stigmatizing views surrounding mental illness are widespread. Personality disorders (PDs) are among the most stigmatized mental illnesses, as individuals with PDs are often described using pejorative terms, which might impact clinicians' a priori expectations and increase the likelihood of stigmatization, discrimination, or early termination from treatment. The degree to which the terms used in any diagnostic classification systems are stigmatizing has never been examined.

Development and Validation of the Five-Factor Borderline Inventory-Super Short Form and Screener.

The Five-Factor Borderline Inventory (FFBI) and FFBI-Short Form (FFBI-SF) are 120-item and 48-item measures that assess the underlying maladaptive personality traits of borderline personality disorder (BPD). The purpose of this study was to develop a super short form (FFBI-SSF) and an FFBI-Screener to facilitate the use of dimensional trait measures for BPD. Using item response theory analyses, the 48-item measure was reduced to 22 items using a large undergraduate sample ( = 1300) and then retested using a Mechanical Turk sample ( = 602), demonstrating strong replicability.

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Shortcomings of approaches to classifying psychopathology based on expert consensus have given rise to contemporary efforts to classify psychopathology quantitatively. In this paper, we review progress in achieving a quantitative and empirical classification of psychopathology. A substantial empirical literature indicates that psychopathology is generally more dimensional than categorical.

Development of Measures for the Hierarchical Taxonomy of Psychopathology (HiTOP): A Collaborative Scale Development Project.

In this article, we describe the collaborative process that is underway to develop measures for the Hierarchical Taxonomy of Psychopathology (HiTOP). The HiTOP model has generated much interest in the psychiatric literature in recent years, but research applications and clinical translation of the model require measures that are specifically keyed to the model. To that end, the Measures Development Workgroup of HiTOP has been engaged in a collaborative effort to develop both questionnaire and interview methods that (a) are specifically tied to the elements of the HiTOP structure, and (b) provide one means of testing that structure.

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

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 clinicalpractice are therefore limited. The Hierarchical Taxonomy of Psychopathology (HiTOP) consortium proposed a model based on structural evidence.

The distinction between symptoms and traits in the Hierarchical Taxonomy of Psychopathology (HiTOP).

The Hierarchical Taxonomy of Psychopathology (HiTOP) is an empirically and quantitatively derived dimensional classification system designed to describe the features of psychopathology and, ultimately, to replace categorical nosologies. Among the constructs that HiTOP organizes are "symptom components" and "maladaptive traits," but past HiTOP publications have not fully explicated the distinction between symptoms and traits. We propose working definitions of symptoms and traits and explore challenges, exceptions, and remaining questions.

Redefining phenotypes to advance psychiatric genetics: Implications from hierarchical taxonomy of psychopathology.

Genetic discovery in psychiatry and clinical psychology is hindered by suboptimal phenotypic definitions. We argue that the hierarchical, dimensional, and data-driven classification system proposed by the Hierarchical Taxonomy of Psychopathology (HiTOP) consortium provides a more effective approach to identifying genes that underlie mental disorders, and to studying psychiatric etiology, than current diagnostic categories. Specifically, genes are expected to operate at different levels of the HiTOP hierarchy, with some highly pleiotropic genes influencing higher order psychopathology (e.

Integrating the Hierarchical Taxonomy of Psychopathology (HiTOP) into clinical practice.

Objective: Diagnosis is a cornerstone of clinical practice for mental health care providers, yet traditional diagnostic systems have well-known shortcomings, including inadequate reliability, high comorbidity, and marked within-diagnosis heterogeneity. The Hierarchical Taxonomy of Psychopathology (HiTOP) is a data-driven, hierarchically based alternative to traditional classifications that conceptualizes psychopathology as a set of dimensions organized into increasingly broad, transdiagnostic spectra. Prior work has shown that using a dimensional approach improves reliability and validity, but translating a model like HiTOP into a workable system that is useful for health care providers remains a major challenge.

Disinhibition as a unifying construct in understanding how personality dispositions undergird psychopathology.

Disinhibition has been a construct of interest for decades, as evidenced by its inclusion in most prominent models of general personality functioning and its link to personality pathology, other psychopathology, health behaviors, and public health concerns. Disinhibition is manifest in behavioral, task based, and physiological measures, and common etiologies are a major reason for the coherence of the domain across a variety of assessment modalities. The current review will provide a summary of the conceptualization of the construct across prominent models, its link to psychopathology and maladaptive behaviors, and its etiology.

Treatment of personality pathology through the lens of the hierarchical taxonomy of psychopathology: Developing a research agenda.

Despite the emphasis on evidence-based treatment for psychological disorders, to date, there has been limited research examining treatment for nine of the 10 categorical personality disorders in DSM-5 Section 2. This is perhaps not surprising given the complex heterogeneity and co-morbidity within personality pathology. The hierarchical taxonomy of psychopathology (HiTOP) was proposed to address limitations within the traditional categorical model of the diagnostic system.

Precursors of the emotional cascade model of borderline personality disorder: The role of neuroticism, childhood emotional vulnerability, and parental invalidation.

The emotional cascade model proposes that the emotional instability and engagement in maladaptive behaviors within borderline personality disorder (BPD) may be linked to rumination. Previous research has established that BPD is highly related to neuroticism, childhood emotional vulnerability, and parental invalidation. Therefore, the purpose of the current study was to assess whether the constructs of the emotional cascade model relate to other constructs within the BPD nomological network.

A Hierarchical Taxonomy of Psychopathology Can Transform Mental Health Research.

For more than a century, research on psychopathology has focused on categorical diagnoses. Although this work has produced major discoveries, growing evidence points to the superiority of a dimensional approach to the science of mental illness. Here we outline one such dimensional system-the Hierarchical Taxonomy of Psychopathology (HiTOP)-that is based on empirical patterns of co-occurrence among psychological symptoms.

Criterion A of the AMPD in HiTOP.

The categorical model of personality disorder classification in the American Psychiatric Association's (5th ed. []; American Psychiatric Association, 2013 ) is highly and fundamentally problematic. Proposed for 5 and provided within Section III (for Emerging Measures and Models) was the Alternative Model of Personality Disorder (AMPD) classification, consisting of Criterion A (self-interpersonal deficits) and Criterion B (maladaptive personality traits).