Journal of mental health (Abingdon, England) · 2026
From symptoms to spectra: testing the hierarchical taxonomy of psychopathology structure and its relation to functional outcomes.
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Sanchez-Garcia Manuel, Lozano O M, Rossi Gina, De la Rosa-Cáceres Ana, Díaz-Batanero Carmen
Аннотация
BACKGROUND: Mental disorders are highly prevalent and frequently comorbid, contributing to substantial functional impairment and reduced quality of life. The Hierarchical Taxonomy of Psychopathology provides a dimensional, empirically derived framework that organizes psychopathology hierarchically, addressing limitations of traditional categorical nosologies.
AIMS: Examine (1) the latent structure of HiTOP using dimensional measures aligned with the model, and (2) associations between hierarchical dimensions and functional outcomes, including global functioning and personality functioning.
METHODS: 1085 participants from community (n = 742) and clinical (n = 343) samples completed measures assessing internalizing, externalizing, detachment, and thought disorder domains, as well as functional impairment (WHODAS 2.0) and personality functioning (LPFS-BF 2.0).
RESULTS: Confirmatory factor analyses supported unidimensionality of individual HiTOP factors, and a hierarchical model indicated robust higher-order spectra and a general p-factor. Associations with external outcomes increased across hierarchical levels, with internalizing spectra and the p-factor showing the strongest correlations with functional and personality impairment. Self-functioning was more closely linked to internalizing and detachment dimensions, whereas interpersonal functioning related primarily to externalizing processes.
CONCLUSIONS: These findings provide empirical support for HiTOP's hierarchical structure and highlight its clinical utility for predicting real-world functional outcomes, underscoring the importance of transdiagnostic, dimensional approaches in assessment and intervention.
AIMS: Examine (1) the latent structure of HiTOP using dimensional measures aligned with the model, and (2) associations between hierarchical dimensions and functional outcomes, including global functioning and personality functioning.
METHODS: 1085 participants from community (n = 742) and clinical (n = 343) samples completed measures assessing internalizing, externalizing, detachment, and thought disorder domains, as well as functional impairment (WHODAS 2.0) and personality functioning (LPFS-BF 2.0).
RESULTS: Confirmatory factor analyses supported unidimensionality of individual HiTOP factors, and a hierarchical model indicated robust higher-order spectra and a general p-factor. Associations with external outcomes increased across hierarchical levels, with internalizing spectra and the p-factor showing the strongest correlations with functional and personality impairment. Self-functioning was more closely linked to internalizing and detachment dimensions, whereas interpersonal functioning related primarily to externalizing processes.
CONCLUSIONS: These findings provide empirical support for HiTOP's hierarchical structure and highlight its clinical utility for predicting real-world functional outcomes, underscoring the importance of transdiagnostic, dimensional approaches in assessment and intervention.