University of Pittsburgh, PA, USA.
Univeristy of Michigan, USA.
Assessment. 2024 Jan;31(1):199-215. doi: 10.1177/10731911231194996. Epub 2023 Sep 14.
Researchers and clinicians working within the : Fifth Edition, Text Rev (-5-TR) framework face a difficult question: what does it mean to have an evidence-based assessment of a nonevidence-based diagnostic construct? Alternative nosological approaches conceptualize psychopathology as (a) hierarchical, allowing researchers to move between levels of description and (b) dimensional, eliminating artificial dichotomies between disorders and the dichotomy between mental illness and mental well-being. In this article, we provide an overview of ongoing efforts to develop validated measures of transdiagnostic nosologies (i.e., the Hierarchical Taxonomy of Psychopathology; HiTOP) with applications for measurement-based care. However, descriptive models like HiTOP, which summarize patterns of covariation among psychopathology symptoms, do not address dynamic processes underlying the problems associated with psychopathology. Ambulatory assessment, well-suited to examine such dynamic processes, has also developed rapidly in recent decades. Thus, the goal of the current article is twofold. First, we provide a brief overview of developments in constructing valid measures of the HiTOP model as well as developments in ambulatory assessment practices. Second, we outline how these parallel developments can be integrated to advance measurement-based treatment. We end with a discussion of some major challenges for future research to address to integrate advances more fully in transdiagnostic and ambulatory assessment practices.
研究人员和临床医生在第五版文本修订版(-5-TR)框架内工作,面临着一个难题:如何对缺乏证据的诊断结构进行基于证据的评估?替代的分类方法将精神病理学概念化为 (a) 分层的,允许研究人员在描述的不同层次之间移动,以及 (b) 维度的,消除了疾病之间以及精神疾病和精神健康之间的人为二分法。在本文中,我们概述了正在进行的努力,以开发经过验证的跨诊断分类学(即,心理病理学的分层分类法;HiTOP)的测量方法,适用于基于测量的护理。然而,像 HiTOP 这样的描述性模型,总结了精神病理学症状之间的协变模式,并不能解决与精神病理学相关的问题背后的动态过程。适合检查这些动态过程的动态评估也在近几十年中迅速发展。因此,本文的目标有两个。首先,我们简要概述了构建 HiTOP 模型有效测量方法的发展以及动态评估实践的发展。其次,我们概述了如何整合这些平行的发展来推进基于测量的治疗。最后,我们讨论了一些重大挑战,这些挑战需要未来的研究来解决,以更全面地整合跨诊断和动态评估实践的进展。