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Ruggero, Camilo J; Kotov, Roman; Hopwood, Christopher J; First, Michael; Clark, Lee Anna; Skodol, Andrew E; Mullins-Sweatt, Stephanie N; Patrick, Christopher J; Bach, Bo; Cicero, David C; Docherty, Anna; Simms, Leonard J; Bagby, R. Michael; Krueger, Robert F; Callahan, Jennifer L; Chmielewski, Michael; Conway, Christopher C; De Clercq, Barbara; Dornbach-Bender, Allison; Eaton, Nicholas R; Forbes, Miriam K; Forbush, Kelsie T; Haltigan, John D; Miller, Joshua D; Morey, Leslie C; Patalay, Praveetha; Regier, Darrel A; Reininghaus, Ulrich; Shackman, Alexander J; Waszczuk, Monika A; Watson, David; Wright, Aidan G. C; Zimmermann, Johannes
Journal of consulting and clinical psychology, 12/2019, Letnik: 87, Številka: 12Journal Article
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. Method: The present work outlines the HiTOP model and describes the core principles to guide its integration into clinical practice. Results: Potential advantages and limitations of the HiTOP model for clinical utility are reviewed, including with respect to case conceptualization and treatment planning. A HiTOP approach to practice is illustrated and contrasted with an approach based on traditional nosology. Common barriers to using HiTOP in real-world health care settings and solutions to these barriers are discussed. Conclusions: HiTOP represents a viable alternative to classifying mental illness that can be integrated into practice today, although research is needed to further establish its utility. What is the public health significance of this article? Redefining a taxonomy of psychopathology according to data results in dimensions, not categories, that can be organized hierarchically-with at least six higher level spectra near the top of the model and more specific lower level components and traits at the bottom. This approach may improve case conceptualizations and align more closely with transdiagnostic treatments, while also specifying more narrow targets for intervention. A case illustration shows how the HiTOP model can be used in clinical practice today, although additional research is needed to fully assess the utility of this approach for providers and patients.
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JCR | SNIP | JCR | SNIP | JCR | SNIP | JCR | SNIP |
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in: SICRIS
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