Meta-analysis of structural evidence for the Hierarchical Taxonomy of Psychopathology (HiTOP) model.

Publisher: Cambridge University Press Country of Publication: England NLM ID: 1254142 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1469-8978 (Electronic) Linking ISSN: 00332917 NLM ISO Abbreviation: Psychol Med Subsets: MEDLINE

Publication: London : Cambridge University Press
Original Publication: London, British Medical Assn.

Psychopathology* ; Mental Disorders*/diagnosis; Humans ; Diagnostic and Statistical Manual of Mental Disorders ; Factor Analysis, Statistical ; Phenotype

Background: The Hierarchical Taxonomy of Psychopathology (HiTOP) is a classification system that seeks to organize psychopathology using quantitative evidence - yet the current model was established by narrative review. This meta-analysis provides a quantitative synthesis of literature on transdiagnostic dimensions of psychopathology to evaluate the validity of the HiTOP framework.
Methods: Published studies estimating factor-analytic models from diagnostic and statistical manual of mental disorders ( DSM) diagnoses were screened. A total of 120,596 participants from 35 studies assessing 23 DSM diagnoses were included in the meta-analytic models. Data were pooled into a meta-analytic correlation matrix using a random effects model. Exploratory factor analyses were conducted using the pooled correlation matrix. A hierarchical structure was estimated by extracting one to five factors representing levels of the HiTOP framework, then calculating congruence coefficients between factors at sequential levels.
Results: Five transdiagnostic dimensions fit the DSM diagnoses well (comparative fit index = 0.92, root mean square error of approximation = 0.07, and standardized root-mean-square residual = 0.03). Most diagnoses had factor loadings >|0.30| on the expected factors, and congruence coefficients between factors indicated a hierarchical structure consistent with the HiTOP framework.
Conclusions: A model closely resembling the HiTOP framework fit the data well and placement of DSM diagnoses within transdiagnostic dimensions were largely confirmed, supporting it as valid structure for conceptualizing and organizing psychopathology. Results also suggest transdiagnostic research should (1) use traits, narrow symptoms, and dimensional measures of psychopathology instead of DSM diagnoses, (2) assess a broader array of constructs, and (3) increase focus on understudied pathologies.

Keywords: Classification; Diagnosis; Factor analysis; Structural equation model; Taxonomy; Transdiagnostic

Date Created: 20210514 Date Completed: 20230504 Latest Revision: 20230607

20230608

10.1017/S0033291721001902

33988108