The Hierarchical Taxonomy of Psychopathology (HiTOP): a quantitative nosology based on consensus of evidence

Roman Kotov, Robert F. Krueger, David Watson, David C. Cicero, Christopher C. Conway, Colin G. Deyoung, Nicholas R. Eaton, Miriam K. Forbes, Michael N. Hallquist, Robert D. Latzman, Stephanie N. Mullins-Sweatt, Camilo J. Ruggero, Leonard J. Simms, Irwin D. Waldman, Monika A. Waszczuk, Aidan G.C. Wright

    Research output: Contribution to journalReview articlepeer-review

    213 Citations (Scopus)


    Traditional diagnostic systems went beyond empirical evidence on the structure of mental health. Consequently, these diagnoses do not depict psychopathology accurately, and their validity in research and utility in clinicalpractice are therefore limited. The Hierarchical Taxonomy of Psychopathology (HiTOP) consortium proposed a model based on structural evidence. It addresses problems of diagnostic heterogeneity, comorbidity, and unreliability. We review the HiTOP model, supporting evidence, and conceptualization of psychopathology in this hierarchical dimensional framework. The system is not yet comprehensive, and we describe the processes for improving and expanding it. We summarize data on the ability of HiTOP to predict and explain etiology (genetic, environmental, and neurobiological), risk factors, outcomes, and treatment response. We describe progress in the development of HiTOP-based measures and in clinical implementation of the system. Finally, we review outstanding challenges and the research agenda. HiTOP is of practical utility already, and its ongoing development will produce a transformative map of psychopathology.

    Original languageEnglish
    Pages (from-to)83-108
    Number of pages26
    JournalAnnual Review of Clinical Psychology
    Publication statusPublished - 7 May 2021


    • internalizing
    • externalizing
    • factor analysis
    • structure
    • classification
    • nosology


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