Hierarchical Taxonomy Models

The Hierarchical Taxonomy of Psychopathology (HiTOP) is a model of psychopathology that attempts to bridge between the discipline of psychopathology (defined as the descriptions, called symptoms, of a patient’s behaviour and experiences in a way that allows objective communication about them) and clinical psychopathology (defined as the attempt to group the psychopathology descriptions into classifications (nosology), called syndromes) and then represent these psychopathologies in a complete construct. The idea of discrete psychiatric disorders due to Kraepelin and used extensively in this work fails to face up to the fact that the claim for such discreteness is contradicted by the extensive comorbidity of these symptoms, their overlapping risk factors as well as poor diagnostic reliability. The psychopathology of children and adolescents is better predicted in clinical samples with the HiTOP model. There are six spectra in the HiTOP model that constitute the structure of personality pathology, namely, somatoform, internalising (negative affectivity), thought disorder, externalising (disinhibited), externalising (antagonistic), and detachment (i.e. social withdrawal). Clinical studies of Australian children and adolescents show data that is well explained by internalising and externalising. For example, maltreatment of children, especially emotional abuse, alters both internalising and externalising.