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The Hierarchical Taxonomy of Psychopathology (HiTOP)

A New Model That Addresses Limitations of Traditional Taxonomies

An inaugural publication from an international consortium of psychologists and psychiatrists offers a new approach to diagnosing mental disorders.

The Hierarchical Taxonomy of Psychopathology (HiTOP) — introduced by Dr. Roman Kotov and colleagues (online first) in the Journal of Abnormal Psychology (PDF, 297KB) — is a new, dimensional classification system of a wide range of psychiatric problems that was developed to reflect the state-of-the art scientific evidence.

Diagnosis is important because it defines groups of patients who will receive treatment and public assistance. It is used by drug companies for development of new medications and guides research efforts overall.

Recent years have seen clashes over psychiatric diagnosis. The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, or DSM–5, was published in 2013 and immediately divided medical opinion.

DSM–5 is a guidebook by the American Psychiatric Association on how to diagnose mental disorders. It has many critics, including the National Institute of Mental Health (NIMH), which in response produced an alternative model to guide research efforts. However, this approach has also been controversial, as it focuses heavily on neurobiology and much less on investigating issues that are important for everyday psychiatric care, such as symptoms and illness course.

The HiTOP system has been articulated to address the limitations currently plaguing psychiatry.

Photo: Spectra of the Hierarchical Taxonomy of Psychopathology. Note: Dashed lines indicate elements of the model that were included on provisional basis and require more study. Disorders with most prominent cross-loadings are listed in multiple places. Minus sign indicates negative association between histrionic personality and detachment spectrum. [Hi-Res]

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