Most psychotherapy research is based on the traditional categorical system. Barring a few exceptions, psychotherapy research has not established specific psychotherapy approaches that are effective for specific diagnoses. This is because of the problems identified in these diagnoses. The Hierarchical Taxonomy of Psychopathology (HiTOP) attempts to address this gap in the research.
The HiTOP consortium is a group of clinical researchers promoting the idea that diagnoses should be based on the best available evidence about how people differ from one another. It has been articulated to address the limitations currently plaguing psychiatry.
Applying an artificial boundary to identify mental illness can result in unstable diagnoses, as one symptom can change the diagnosis from present to absent. It also leaves many people with symptoms that do not reach the threshold untreated, although they suffer significant impairment. The HiTOP system proposes to view mental health as a spectrum because the problems are challenging to categorize, as they lie on the continuum between pathology and normality.
The HiTOP system simplifies the classification of most patients labeled with more than one disorder simultaneously. The HiTOP solution is to classify psychopathology dimensions at multiple levels of hierarchy. This allows doctors and researchers to focus on the finer symptom in detail or assess broader problems as necessary.
Evidence-based models of psychopathology such as HiTOP could potentially revolutionize the field's understanding of mental disorders. At a general level, HiTOP helps explain vexing issues like comorbidity and heterogeneity and connects diagnosis to models of individual differences commonly used in basic science. It also provides a theoretically neutral language that can help integrate ideas about treatment from different psychological traditions.
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