A dimensional model is being considered as a replacement for the existing categorical Diagnostic Statistical Manual (DSM) system of classifying psychological disorders. If the new Hierarchical Taxonomy of Psychopathology (HiTOP) model prevails, psychological profile scores will replace diagnostic labels, and cutoff scores will replace categories.
DSM has served as a valuable common language for researchers, clinicians, and insurance companies since 1952. However, the system is under increasing scrutiny and criticism today, as new research has revealed its deep flaws. This has given rise to calls for replacing it with HiTOP, a dimensional model based on how psychopathology is organized.
HiTOP looks to empirically identify psychopathology structures by combining individual signs and symptoms into homogeneous components or traits. Besides assembling them into empirically derived syndromes, HiTOP groups them into psychopathology spectra. According to its proponents, the new system will provide a more helpful guide and enable psychologists to study and treat characteristics common to multiple conditions.
The HiTOP model is new. However, research on its efficacy has shown promising results. Among researchers and clinicians, the limitations of the current diagnostic system have been an open secret for many years now, and a change has been long overdue. The good news is that, with the growing debate around HiTOP, such a change may be in view.
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