Linking RDoC and HiTOP: A new interface for advancing psychiatric nosology and neuroscience

Abstract

The Research Domain Criteria (RDoC) and the Hierarchical Taxonomy of Psychopathology (HiTOP) represent major dimensional frameworks proposing two alternative approaches to accelerate progress in the way psychopathology is studied, classified, and treated. RDoC is a research framework rooted in neuroscience aiming to further the understanding of transdiagnostic biobehavioral systems underlying psychopathology and ultimately inform future classifications. HiTOP is a dimensional classification system, derived from the observed covariation among symptoms of psychopathology and maladaptive traits, which seeks to provide more informative research and treatment targets (i.e., dimensional constructs and clinical assessments) than traditional diagnostic categories. This article argues that the complementary strengths of RDoC and HiTOP can be leveraged in order to achieve their respective goals. RDoC's biobehavioral framework may help elucidate the underpinnings of the clinical dimensions included in HiTOP, whereas HiTOP may provide psychometrically robust clinical targets for RDoC-informed research. We present a comprehensive mapping between dimensions included in RDoC (constructs and subconstructs) and HiTOP (spectra and subfactors) based on narrative review of the empirical literature. The resulting RDoC-HiTOP interface sheds light on the biobehavioral correlates of clinical dimensions and provides a broad set of dimensional clinical targets for etiological and neuroscientific research. We conclude with future directions and practical recommendations for using this interface to advance clinical neuroscience and psychiatric nosology. Ultimately, we envision that this RDoC-HiTOP interface has the potential to inform the development of a unified, dimensional, and biobehaviorally-grounded psychiatric nosology.

Figure 1.

Research Domain Criteria (RDoC) and Hierarchical Taxonomy of Psychopathology (HiTOP). Notes: A. The RDoC matrix includes six domains (rows) and their respective constructs (some of which also include subconstructs, not shown here), which can be characterized on the basis of eight units of analysis (columns). B. HiTOP dimensions span from super-spectra (broader and more general) to symptoms components and maladaptive traits (narrower and more specific). Dashed lines indicate provisional elements requiring more study. DSM diagnoses are not part of the HiTOP model and are only included here to allow mapping of their symptoms and signs onto HiTOP. DSM diagnoses mapping onto more than one HiTOP spectrum or subfactor are listed in multiple places. (−) indicates negative association between histrionic personality and the Detachment spectrum. Abbreviations: ADHD, attention-deficit/hyperactivity disorder; DSM, Diagnostic and Statistical Manual of Mental Disorders; GAD, generalized anxiety disorder; IED, intermittent explosive disorder; MDD, major depressive disorder; OCD, obsessive–compulsive disorder; ODD, oppositional defiant disorder; PD, personality disorder; PTSD, posttraumatic stress disorder.

Figure 2.

Overview of top associations between the Research Domain Criteria (RDoC) and the Hierarchical Taxonomy of Psychopathology (HiTOP). Notes: Arrows show the most consistent associations between RDoC domains and HiTOP spectra (i.e., those depicting robust associations between more than one third of RDoC constructs within a domain with a HiTOP spectrum or its subfactors). Full details of associations between RDoC constructs/subconstructs and HiTOP spectra/subfactors are given in text and Supplementary Figures. Red = positive association; Blue = negative association. Associations that differed in sign across RDoC constructs within the domain are depicted with double arrows.