Journal article
Validity and utility of Hierarchical Taxonomy of Psychopathology (HiTOP): II. Externalizing superspectrum
World psychiatry, Vol.20(2), pp.171-193
06/2021
DOI: 10.1002/wps.20844
PMCID: PMC8129870
PMID: 34002506
Abstract
The Hierarchical Taxonomy of Psychopathology (HiTOP) is an empirical effort to address limitations of traditional mental disorder diagnoses. These include arbitrary boundaries between disorder and normality, disorder co-occurrence in the modal case, heterogeneity of presentation within dis-orders, and instability of diagnosis within patients. This paper reviews the evidence on the validity and utility of the disinhibited externalizing and antagonistic externalizing spectra of HiTOP, which together constitute a broad externalizing superspectrum. These spectra are composed of elements subsumed within a variety of mental disorders described in recent DSM nosologies, including most notably substance use disorders and "Cluster B" personality disorders. The externalizing superspectrum ranges from normative levels of impulse control and self-assertion, to maladaptive disinhibition and antagonism, to extensive polysubstance involvement and personality psychopathology. A rich literature supports the validity of the externalizing superspectrum, and the disinhibited and antagonistic spectra. This evidence encompasses common genetic influences, environmental risk factors, childhood antecedents, cognitive abnormalities, neural alterations, and treatment response. The structure of these validators mirrors the structure of the phenotypic externalizing superspectrum, with some correlates more specific to disinhibited or antagonistic spectra, and others relevant to the entire externalizing superspectrum, underlining the hierarchical structure of the domain. Compared with traditional diagnostic categories, the externalizing superspectrum conceptualization shows improved utility, reliability, explanatory capacity, and clinical applicability. The externalizing superspectrum is one aspect of the general approach to psychopathology offered by HiTOP and can make diagnostic classification more useful in both research and the clinic.
Details
- Title: Subtitle
- Validity and utility of Hierarchical Taxonomy of Psychopathology (HiTOP): II. Externalizing superspectrum
- Creators
- Robert F. Krueger - University of MinnesotaKelsey A. Hobbs - University of MinnesotaChristopher C. Conway - Fordham UniversityDanielle M. Dick - Virginia Commonwealth UniversityMichael N. Dretsch - Walter Reed Army Institute of ResearchNicholas R. Eaton - Stony Brook UniversityMiriam K. Forbes - Macquarie UniversityKelsie T. Forbush - University of KansasKatherine M. Keyes - Columbia UniversityRobert D. Latzman - Georgia State UniversityGiorgia Michelini - University of California, Los AngelesChristopher J. Patrick - Florida State UniversityMartin Sellbom - University of OtagoTim Slade - University of SydneySusan C. South - Purdue University West LafayetteMatthew Sunderland - University of SydneyJennifer Tackett - Northwestern UniversityIrwin Waldman - Emory UniversityMonika A. Waszczuk - Stony Brook UniversityAidan G. C. Wright - University of PittsburghDavid H. Zald - Vanderbilt UniversityDavid Watson - University of Notre DameRoman Kotov - Stony Brook UniversityHierarchical Taxonomy of Psychopathology (HiTOP) Utility WorkgroupKristian E Markon (Contributor) - Psychological and Brain Sciences
- Resource Type
- Journal article
- Publication Details
- World psychiatry, Vol.20(2), pp.171-193
- Publisher
- Wiley
- DOI
- 10.1002/wps.20844
- PMID
- 34002506
- PMCID
- PMC8129870
- ISSN
- 1723-8617
- eISSN
- 2051-5545
- Number of pages
- 23
- Grant note
- University of Kansas, Research Excellence Initiative 00074041 / National Science Foundation Graduate Research Fellowship Program; National Science Foundation (NSF) R01AG053217; U19AG051426; K02AA018755; P50AA022537; R01DA050721 / US National Institutes of Health; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA US Department of Defense; United States Department of Defense
- Language
- English
- Date published
- 06/2021
- Academic Unit
- Psychological and Brain Sciences
- Record Identifier
- 9984627251902771
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