49 research outputs found
Integrating the Hierarchical Taxonomy of Psychopathology (HiTOP) Into Clinical Practice
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
Criterion A of the AMPD in HiTOP
The categorical model of personality disorder classification in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (5th ed. [DSM-5]; American Psychiatric Association, 2013) is highly and fundamentally problematic. Proposed for DSM-5 and provided within Section III (for Emerging Measures and Models) was the Alternative Model of Personality Disorder (AMPD) classification, consisting of Criterion A (self-interpersonal deficits) and Criterion B (maladaptive personality traits). A proposed alternative to the DSM-5 more generally is an empirically based dimensional organization of psychopathology identified as the Hierarchical Taxonomy of Psychopathology (HiTOP; Kotov etal., 2017). HiTOP currently includes, at the highest level, a general factor of psychopathology. Further down are the five domains of detachment, antagonistic externalizing, disinhibited externalizing, thought disorder, and internalizing (along with a provisional sixth somatoform dimension) that align with Criterion B. The purpose of this article is to discuss the potential inclusion and placement of the self-interpersonal deficits of the DSM-5 Section III Criterion A within HiTOP
Les progrÚs dans la réalisation de la classification quantitative de la psychopathologie
Shortcomings of approaches to classifying psychopathology based on expert consensus have given rise to contemporary efforts to classify psychopathology quantitatively. In this paper, we review progress in achieving a quantitative and empirical classification of psychopathology. A substantial empirical literature indicates that psychopathology is generally more dimensional than categorical. When the discreteness versus continuity of psychopathology is treated as a research question, as opposed to being decided as a matter of tradition, the evidence clearly supports the hypothesis of continuity. In addition, a related body of literature shows how psychopathology dimensions can be arranged in a hierarchy, ranging from very broad "spectrum level'' dimensions, to specific and narrow clusters of symptoms. In this way, a quantitative approach solves the "problem of comorbidity'' by explicitly modeling patterns of co-occurrence among signs and symptoms within a detailed and variegated hierarchy of dimensional concepts with direct clinical utility. Indeed, extensive evidence pertaining to the dimensional and hierarchical structure of psychopathology has led to the formation of the Hierarchical Taxonomy of Psychopathology (HiTOP) Consortium. This is a group of 70 investigators working together to study empirical classification of psychopathology. In this paper, we describe the aims and current foci of the HiTOP Consortium. These aims pertain to continued research on the empirical organization of psychopathology; the connection between personality and psychopathology; the utility of empirically based psychopathology constructs in both research and the clinic; and the development of novel and comprehensive models and corresponding assessment instruments for psychopathology constructs derived from an empirical approach. (C) 2020 Published by Elsevier Masson SAS
Progress in achieving quantitative classification of psychopathology
Résumé:
Les lacunes des classifications de la psychopathologie fondĂ©es sur des consensus dâexperts ont conduit Ă de nombreuses tentatives actuelles pour classer la psychopathologie de maniĂšre quantitative. Dans cet article, nous passons en revue les progrĂšs accomplis dans la rĂ©alisation dâune classification quantitative et empirique de la psychopathologie. Une littĂ©rature empirique substantielle montre que la psychopathologie est gĂ©nĂ©ralement plus dimensionnelle que catĂ©gorielle. Et lorsque la distinction entre une psychopathologie discrĂšte et une psychopathologie continue est traitĂ©e comme une question de recherche, par opposition Ă une distinction basĂ©e sur un argument dâautoritĂ©, alors les preuves scientifiques soutiennent clairement lâhypothĂšse dâune psychopathologie continue. En outre, un corpus de littĂ©rature connexe montre comment les dimensions de la psychopathologie peuvent ĂȘtre organisĂ©es selon une hiĂ©rarchie qui va de dimensions trĂšs larges dâun niveau de type « spectre » Ă des groupes spĂ©cifiques et Ă©troits de symptĂŽmes. De cette maniĂšre, une approche quantitative rĂ©sout le « problĂšme de la comorbiditĂ© » en modĂ©lisant explicitement la cooccurrence entre les signes et les symptĂŽmes au sein dâune hiĂ©rarchie dĂ©taillĂ©e et variĂ©e, maniant des concepts dimensionnels qui ont une utilitĂ© clinique directe. De nombreuses preuves concernant la structure dimensionnelle et hiĂ©rarchique de la psychopathologie ont conduit Ă la formation du consortium Hierarchical Taxonomy of Psychopathology (HiTOP, taxonomie hiĂ©rarchique de la psychopathologie). Il sâagit dâun groupe de 70 chercheurs travaillant ensemble pour Ă©tudier la classification empirique de la psychopathologie. Dans cet article, nous dĂ©crivons les objectifs et les axes de recherches actuels du consortium HiTOP. Ces objectifs concernent la poursuite des recherches sur lâorganisation empirique de la psychopathologie ; le lien entre la personnalitĂ© et la psychopathologie ; lâutilitĂ© des construits empiriques de la psychopathologie, Ă la fois pour la recherche et pour la clinique ; et enfin, le dĂ©veloppement de nouveaux modĂšles exhaustifs et dâinstruments dâĂ©valuation correspondant aux construits psychopathologiques dĂ©rivĂ©s dâune approche empirique. /
Abstract:
Shortcomings of approaches to classifying psychopathology based on expert consensus have given rise to contemporary efforts to classify psychopathology quantitatively. In this paper, we review progress in achieving a quantitative and empirical classification of psychopathology. A substantial empirical literature indicates that psychopathology is generally more dimensional than categorical. When the discreteness versus continuity of psychopathology is treated as a research question, as opposed to being decided as a matter of tradition, the evidence clearly supports the hypothesis of continuity. In addition, a related body of literature shows how psychopathology dimensions can be arranged in a hierarchy, ranging from very broad âspectrum levelâ dimensions, to specific and narrow clusters of symptoms. In this way, a quantitative approach solves the âproblem of comorbidityâ by explicitly modeling patterns of co-occurrence among signs and symptoms within a detailed and variegated hierarchy of dimensional concepts with direct clinical utility. Indeed, extensive evidence pertaining to the dimensional and hierarchical structure of psychopathology has led to the formation of the Hierarchical Taxonomy of Psychopathology (HiTOP) Consortium. This is a group of 70 investigators working together to study empirical classification of psychopathology. In this paper, we describe the aims and current foci of the HiTOP Consortium. These aims pertain to continued research on the empirical organization of psychopathology; the connection between personality and psychopathology; the utility of empirically based psychopathology constructs in both research and the clinic; and the development of novel and comprehensive models and corresponding assessment instruments for psychopathology constructs derived from an empirical approach
Behavior and Development
Abstract: The current project reports on an initial investigation into the factor structure of the Infant Crying Questionnaire (ICQ), a measure designed to assess parental beliefs about infant crying, in a sample of 259 primiparous mothers. Exploratory factor analyses yielded evidence for a fivefactor structure to the ICQ, with two factors that may be conceptually viewed as infantoriented beliefs regarding infant crying (Attachment/Comfort and Crying as Communication) and three factors conceptually reflecting parent-oriented beliefs regarding infant crying (Minimization, Directive Control, and Spoiling). Each of the scales demonstrated strong internal consistency and was associated with concurrent measures of mothers' causal attributions about emotional responses to infant crying. Predictive validity to observed maternal sensitivity at 6 months and mother-reported infant behavioral problems at one year was demonstrated. The importance of a questionnaire method to assess parents' beliefs regarding infant crying in developmental research is discussed and future methodological directions are outlined. Infant crying | Maternal sensitivity | Exploratory factor analysis | Reliability
Unraveling the longâterm links among adolescent peer victimization and somatic symptoms : a 5âyear multiâinformant cohort study
Purpose
To examine the prospective associations among peer victimization and somatic symptoms across 5 years of adolescence using multiple informants and disaggregating effects at the withinâperson and betweenâperson level.
Methods
From age 13â17 years, 612 Canadian children (54% girls; 76% White) completed measures of peer victimization and somatic symptoms. Parents (89% mothers) reported on their child's somatic symptoms. We built autoregressive latent trajectory models with structured residuals, controlling for diagnosed medical and psychiatric conditions, sex, race/ethnicity, and socioeconomic status.
Results
Withinâperson, selfâreported somatic symptoms were stable across time and there were bidirectional associations between peer victimization and somatic symptoms across the 5âyear period. The magnitude of effect was strongest from somatic symptoms to peer victimization. Betweenâperson, being a girl or having a psychiatric diagnosis predicted higher mean levels and rising trajectories of somatic symptoms and higher mean levels of peer victimization. The level of peer victimization among nonâWhite participants increased over time. In the parentâreported model, somatic symptoms were less stable and did not predict peer victimization.
Conclusions
The results highlight the dynamic processes between peer victimization and somatic symptoms. Increased effort is needed to protect adolescents with psychiatric problems, girls, and ethnic minorities from peer abuse