TY - JOUR
T1 - Validity and utility of Hierarchical Taxonomy of Psychopathology (HiTOP)
T2 - II. Externalizing superspectrum
AU - Krueger, Robert F.
AU - Hobbs, Kelsey A.
AU - Conway, Christopher C.
AU - Dick, Danielle M.
AU - Dretsch, Michael N.
AU - Eaton, Nicholas R.
AU - Forbes, Miriam K.
AU - Forbush, Kelsie T.
AU - Keyes, Katherine M.
AU - Latzman, Robert D.
AU - Michelini, Giorgia
AU - Patrick, Christopher J.
AU - Sellbom, Martin
AU - Slade, Tim
AU - South, Susan C.
AU - Sunderland, Matthew
AU - Tackett, Jennifer
AU - Waldman, Irwin
AU - Waszczuk, Monika A.
AU - Wright, Aidan G. C.
AU - Zald, David H.
AU - Watson, David
AU - Kotov, Roman
AU - HiTOP Utility Workgroup
AU - Afzali, Kamran
AU - Bornovalova, Marina A.
AU - Carragher, Natacha
AU - Cicero, David C.
AU - Docherty, Anna R.
AU - First, Michael B.
AU - Fried, Eiko I.
AU - Hallquist, Michael N.
AU - Jonas, Katherine
AU - Markon, Kristian E.
AU - Morey, Les C.
AU - Mullins-Sweatt, Stephanie N.
AU - Naragon-Gainey, Kristin
AU - Nelson, Brady
AU - Olino, Thomas M.
AU - Patalay, Praveetha
AU - Pincus, Aaron L.
AU - Rodriguez-Seijas, Craig
AU - Rutter, Lauren A.
AU - Salum, Giovanni A.
AU - Shackman, Alexander J.
AU - Skodol, Andrew E.
AU - Tabb, Kathryn
AU - Wagner, Nicholas
AU - Watts, Ashley L.
AU - Uliaszek, Amanda A.
AU - Zimmermann, Johannes
AU - Zinbarg, Richard E.
PY - 2021/6
Y1 - 2021/6
N2 - The Hierarchical Taxonomy of Psychopathology (HiTOP) is an empirical effort to address limitations of traditional mental disorder diagnoses. These include arbitrary boundaries between disorder and normality, disorder co-occurrence in the modal case, heterogeneity of presentation within disorders, and instability of diagnosis within patients. This paper reviews the evidence on the validity and utility of the disinhibited externalizing and antagonistic externalizing spectra of HiTOP, which together constitute a broad externalizing superspectrum. These spectra are composed of elements subsumed within a variety of mental disorders described in recent DSM nosologies, including most notably substance use disorders and “Cluster B” personality disorders. The externalizing superspectrum ranges from normative levels of impulse control and self-assertion, to maladaptive disinhibition and antagonism, to extensive polysubstance involvement and personality psychopathology. A rich literature supports the validity of the externalizing superspectrum, and the disinhibited and antagonistic spectra. This evidence encompasses common genetic influences, environmental risk factors, childhood antecedents, cognitive abnormalities, neural alterations, and treatment response. The structure of these validators mirrors the structure of the phenotypic externalizing superspectrum, with some correlates more specific to disinhibited or antagonistic spectra, and others relevant to the entire externalizing superspectrum, underlining the hierarchical structure of the domain. Compared with traditional diagnostic categories, the externalizing superspectrum conceptualization shows improved utility, reliability, explanatory capacity, and clinical applicability. The externalizing superspectrum is one aspect of the general approach to psychopathology offered by HiTOP and can make diagnostic classification more useful in both research and the clinic.
AB - The Hierarchical Taxonomy of Psychopathology (HiTOP) is an empirical effort to address limitations of traditional mental disorder diagnoses. These include arbitrary boundaries between disorder and normality, disorder co-occurrence in the modal case, heterogeneity of presentation within disorders, and instability of diagnosis within patients. This paper reviews the evidence on the validity and utility of the disinhibited externalizing and antagonistic externalizing spectra of HiTOP, which together constitute a broad externalizing superspectrum. These spectra are composed of elements subsumed within a variety of mental disorders described in recent DSM nosologies, including most notably substance use disorders and “Cluster B” personality disorders. The externalizing superspectrum ranges from normative levels of impulse control and self-assertion, to maladaptive disinhibition and antagonism, to extensive polysubstance involvement and personality psychopathology. A rich literature supports the validity of the externalizing superspectrum, and the disinhibited and antagonistic spectra. This evidence encompasses common genetic influences, environmental risk factors, childhood antecedents, cognitive abnormalities, neural alterations, and treatment response. The structure of these validators mirrors the structure of the phenotypic externalizing superspectrum, with some correlates more specific to disinhibited or antagonistic spectra, and others relevant to the entire externalizing superspectrum, underlining the hierarchical structure of the domain. Compared with traditional diagnostic categories, the externalizing superspectrum conceptualization shows improved utility, reliability, explanatory capacity, and clinical applicability. The externalizing superspectrum is one aspect of the general approach to psychopathology offered by HiTOP and can make diagnostic classification more useful in both research and the clinic.
KW - HiTOP
KW - externalizing
KW - disinhibition
KW - antagonism
KW - Cluster B personality disorders
KW - substance use disorders
KW - antisocial personality disorder
KW - clinical utility
UR - http://www.scopus.com/inward/record.url?scp=85106247524&partnerID=8YFLogxK
U2 - 10.1002/wps.20844
DO - 10.1002/wps.20844
M3 - Article
C2 - 34002506
AN - SCOPUS:85106247524
SN - 1723-8617
VL - 20
SP - 171
EP - 193
JO - World Psychiatry
JF - World Psychiatry
IS - 2
ER -