Rebuilding HiTOP from the ground up: Symptom-level analyses and a revised mapping to the DSM

Area of Science:

• Psychology
• Psychopathology Research
• Taxonomic Systems

Background:

• The Hierarchical Taxonomy of Psychopathology (HiTOP) model's evidence base is limited by reliance on diagnostic correlations.
• Previous models did not fully deconstruct disorders into constituent symptoms or personality facets.

Purpose of the Study:

• To empirically derive and validate a hierarchical model of psychopathology from symptom-level data.
• To compare the derived model with the existing HiTOP structure and identify areas for refinement.

Main Methods:

• Deconstruction of Diagnostic and Statistical Manual of Mental Disorders (DSM) diagnoses into individual symptoms.
• Item-level assessment of Alternative Model for Personality Disorders facets.
• Application of hierarchical clustering and principal components analyses on large online study samples (n=11,762 primary, n=3,000 holdout).
• Cross-sample and cross-method validation of the derived hierarchical structure.

Main Results:

• The empirically derived model closely resembled the HiTOP model, validating its overall structure.
• Nearly all HiTOP subfactors, spectra, and superspectra were identified, with some structural reorganization.
• Key differences included prominent broad disinhibition/hypomania and pathological introversion dimensions.
• Lower-order constructs largely mirrored HiTOP components, suggesting potential revisions.

Conclusions:

• The structural foundations of the HiTOP model are largely sound and empirically supported.
• The study provides a symptom-level validated framework for psychopathology.
• Findings indicate specific areas for potential revision and refinement of the HiTOP model.