Krueger Robert F, Kotov Roman, Watson David, Forbes Miriam K, Eaton Nicholas R, Ruggero Camilo J, Simms Leonard J, Widiger Thomas A, Achenbach Thomas M, Bach Bo, Bagby R Michael, Bornovalova Marina A, Carpenter William T, Chmielewski Michael, Cicero David C, Clark Lee Anna, Conway Christopher, DeClercq Barbara, DeYoung Colin G, Docherty Anna R, Drislane Laura E, First Michael B, Forbush Kelsie T, Hallquist Michael, Haltigan John D, Hopwood Christopher J, Ivanova Masha Y, Jonas Katherine G, Latzman Robert D, Markon Kristian E, Miller Joshua D, Morey Leslie C, Mullins-Sweatt Stephanie N, Ormel Johan, Patalay Praveetha, Patrick Christopher J, Pincus Aaron L, Regier Darrel A, Reininghaus Ulrich, Rescorla Leslie A, Samuel Douglas B, Sellbom Martin, Shackman Alexander J, Skodol Andrew, Slade Tim, South Susan C, Sunderland Matthew, Tackett Jennifer L, Venables Noah C, Waldman Irwin D, Waszczuk Monika A, Waugh Mark H, Wright Aidan G C, Zald David H, Zimmermann Johannes
Department of Psychology, University of Minnesota, Minneapolis, MN, USA.
Department of Psychiatry, Stony Brook University, Stony Brook, NY, USA.
World Psychiatry. 2018 Oct;17(3):282-293. doi: 10.1002/wps.20566.
Shortcomings of approaches to classifying psychopathology based on expert consensus have given rise to contemporary efforts to classify psychopathology quantitatively. In this paper, we review progress in achieving a quantitative and empirical classification of psychopathology. A substantial empirical literature indicates that psychopathology is generally more dimensional than categorical. When the discreteness versus continuity of psychopathology is treated as a research question, as opposed to being decided as a matter of tradition, the evidence clearly supports the hypothesis of continuity. In addition, a related body of literature shows how psychopathology dimensions can be arranged in a hierarchy, ranging from very broad "spectrum level" dimensions, to specific and narrow clusters of symptoms. In this way, a quantitative approach solves the "problem of comorbidity" by explicitly modeling patterns of co-occurrence among signs and symptoms within a detailed and variegated hierarchy of dimensional concepts with direct clinical utility. Indeed, extensive evidence pertaining to the dimensional and hierarchical structure of psychopathology has led to the formation of the Hierarchical Taxonomy of Psychopathology (HiTOP) Consortium. This is a group of 70 investigators working together to study empirical classification of psychopathology. In this paper, we describe the aims and current foci of the HiTOP Consortium. These aims pertain to continued research on the empirical organization of psychopathology; the connection between personality and psychopathology; the utility of empirically based psychopathology constructs in both research and the clinic; and the development of novel and comprehensive models and corresponding assessment instruments for psychopathology constructs derived from an empirical approach.
基于专家共识对精神病理学进行分类的方法存在缺陷,这促使了当代对精神病理学进行定量分类的努力。在本文中,我们回顾了在实现精神病理学的定量和实证分类方面所取得的进展。大量的实证文献表明,精神病理学通常更具维度性而非类别性。当将精神病理学的离散性与连续性作为一个研究问题来对待,而不是按照传统来决定时,证据显然支持连续性假说。此外,相关的一系列文献展示了精神病理学维度如何能够被安排在一个层次结构中,从非常宽泛的“光谱水平”维度到特定且狭窄的症状群。通过这种方式,定量方法通过在一个具有直接临床效用的详细且多样的维度概念层次结构中明确建模体征和症状之间的共现模式,解决了“共病问题”。事实上,与精神病理学的维度和层次结构相关的大量证据导致了精神病理学层次分类法(HiTOP)联盟的形成。这是一个由70名研究人员组成的团队,他们共同致力于研究精神病理学的实证分类。在本文中,我们描述了HiTOP联盟的目标和当前的重点。这些目标涉及对精神病理学实证组织的持续研究;人格与精神病理学之间的联系;基于实证的精神病理学结构在研究和临床中的效用;以及为源自实证方法的精神病理学结构开发新颖且全面的模型和相应的评估工具。