Translating the hierarchical taxonomy of psychopathology (HiTOP) from potential to practice: Ten research questions

Abstract

The Hierarchical Taxonomy of Psychopathology (HiTOP) is a novel diagnostic system grounded in empirical research into the architecture of mental illness. Its basic units are continuous dimensions-as opposed to categories-that are organized into a hierarchy according to patterns of symptom co-occurrence observed in quantitative studies. Previous HiTOP discussions have focused on existing evidence regarding the model's structure and ability to account for neurobiological, social, cultural, and clinical variation. The present article looks ahead to the next decade of applied research and clinical practice using the HiTOP rubric. We highlight 10 topics where HiTOP has the potential to make significant breakthroughs. Research areas include genetic influences, environmental contributions, neural mechanisms, real-time dynamics, and lifespan development of psychopathology. We also discuss development of novel assessments, forecasting methods, and treatments. Finally, we consider implications for clinicians and educators. For each of these domains, we propose directions for future research and venture hypotheses as to what HiTOP will reveal about psychopathology. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Figure 1:. HiTOP Working Model

Note. HiTOP working model. Thin vertical lines represent the nested relationship between broader and narrower concepts. DSM diagnoses are not part of the HiTOP model, as reflected in the solid line separating HiTOP from DSM concepts. Still, HiTOP is based on the same signs and symptoms that compose DSM diagnoses, and the color scheme symbolizes where the primary features of DSM disorders are likely to fall in the HiTOP structure. OCD = obsessive-compulsive disorder; ADHD = attention-deficit/hyperactivity disorder.