Integrating the Hierarchical Taxonomy of Psychopathology (HiTOP) into clinical practice

Camilo J. Ruggero*, Roman Kotov, Christopher J. Hopwood, Michael First, Lee Anna Clark, Andrew E. Skodol, Stephanie N. Mullins-Sweatt, Christopher J. Patrick, Bo Bach, David C. Cicero, Anna Docherty, Leonard J. Simms, R. Michael Bagby, Robert F. Krueger, Jennifer L. Callahan, Michael Chmielewski, Christopher C. Conway, Barbara De Clercq, Allison Dornbach-Bender, Nicholas R. EatonMiriam K. Forbes, Kelsie T. Forbush, John D. Haltigan, Joshua D. Miller, Leslie C. Morey, Praveetha Patalay, Darrel A. Regier, Ulrich Reininghaus, Alexander J. Shackman, Monika A. Waszczuk, David Watson, Aidan G. C. Wright, Johannes Zimmermann

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

24 Citations (Scopus)
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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.

Original languageEnglish
Pages (from-to)1069-1084
Number of pages16
JournalJournal of consulting and clinical psychology
Issue number12
Publication statusPublished - Dec 2019


  • classification
  • diagnosis
  • nosology
  • psychopathology
  • treatment

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