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      Progress in achieving quantitative classification of psychopathology : World Psychiatry

      1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 3 , 16 , 17 , 1 , 18 , 19 , 20 , 21 , 22 , 11 , 23 , 9 , 2 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 22 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 35 , 39 , 40 , 1 , 41 , 2 , 42 , 43 , 44 , 45
      World Psychiatry
      Wiley
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          Abstract

          <p class="first" id="d4891311e1757">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. </p>

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          Most cited references47

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          The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders Compared With Diagnosis-Specific Protocols for Anxiety Disorders

          Transdiagnostic interventions have been developed to address barriers to the dissemination of evidence-based psychological treatments, but only a few preliminary studies have compared these approaches with existing evidence-based psychological treatments.
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            Three Approaches to Understanding and Classifying Mental Disorder: ICD-11, DSM-5, and the National Institute of Mental Health’s Research Domain Criteria (RDoC)

            The diagnosis of mental disorder initially appears relatively straightforward: Patients present with symptoms or visible signs of illness; health professionals make diagnoses based primarily on these symptoms and signs; and they prescribe medication, psychotherapy, or both, accordingly. However, despite a dramatic expansion of knowledge about mental disorders during the past half century, understanding of their components and processes remains rudimentary. We provide histories and descriptions of three systems with different purposes relevant to understanding and classifying mental disorder. Two major diagnostic manuals-the International Classification of Diseases and the Diagnostic and Statistical Manual of Mental Disorders-provide classification systems relevant to public health, clinical diagnosis, service provision, and specific research applications, the former internationally and the latter primarily for the United States. In contrast, the National Institute of Mental Health's Research Domain Criteria provides a framework that emphasizes integration of basic behavioral and neuroscience research to deepen the understanding of mental disorder. We identify four key issues that present challenges to understanding and classifying mental disorder: etiology, including the multiple causality of mental disorder; whether the relevant phenomena are discrete categories or dimensions; thresholds, which set the boundaries between disorder and nondisorder; and comorbidity, the fact that individuals with mental illness often meet diagnostic requirements for multiple conditions. We discuss how the three systems' approaches to these key issues correspond or diverge as a result of their different histories, purposes, and constituencies. Although the systems have varying degrees of overlap and distinguishing features, they share the goal of reducing the burden of suffering due to mental disorder.
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              Linking antisocial behavior, substance use, and personality: an integrative quantitative model of the adult externalizing spectrum.

              Antisocial behavior, substance use, and impulsive and aggressive personality traits often co-occur, forming a coherent spectrum of personality and psychopathology. In the current research, the authors developed a novel quantitative model of this spectrum. Over 3 waves of iterative data collection, 1,787 adult participants selected to represent a range across the externalizing spectrum provided extensive data about specific externalizing behaviors. Statistical methods such as item response theory and semiparametric factor analysis were used to model these data. The model and assessment instrument that emerged from the research shows how externalizing phenomena are organized hierarchically and cover a wide range of individual differences. The authors discuss the utility of this model for framing research on the correlates and the etiology of externalizing phenomena. (c) 2007 APA
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                Author and article information

                Journal
                World Psychiatry
                World Psychiatry
                Wiley
                17238617
                October 2018
                October 2018
                September 07 2018
                : 17
                : 3
                : 282-293
                Affiliations
                [1 ]Department of Psychology; University of Minnesota; Minneapolis MN USA
                [2 ]Department of Psychiatry; Stony Brook University; Stony Brook NY USA
                [3 ]Department of Psychology; University of Notre Dame; Notre Dame IN USA
                [4 ]Department of Psychology; Macquarie University; Sydney NSW Australia
                [5 ]Department of Psychology; Stony Brook University; Stony Brook NY USA
                [6 ]Department of Psychology; University of North Texas; Denton TX USA
                [7 ]Department of Psychology; University at Buffalo, State University of New York; New York NY USA
                [8 ]Department of Psychology; University of Kentucky; Lexington KY USA
                [9 ]Department of Psychiatry; University of Vermont; Burlington VT USA
                [10 ]Psychiatric Research Unit; Slagelse Psychiatric Hospital; Slagelse Denmark
                [11 ]Department of Psychiatry; University of Toronto; Toronto ON Canada
                [12 ]Department of Psychology; University of South Florida; Tampa FL USA
                [13 ]Department of Psychiatry; University of Maryland; Baltimore MD USA
                [14 ]Department of Psychology; Southern Methodist University; Dallas TX USA
                [15 ]Department of Psychology; University of Hawaii; Honolulu HI USA
                [16 ]Department of Psychology; College of William and Mary; Williamsburg VA USA
                [17 ]Department of Developmental, Personality, and Social Psychology; Ghent University; Ghent Belgium
                [18 ]Department of Psychiatry; University of Utah; Salt Lake City UT USA
                [19 ]Department of Psychiatry; University of Michigan; Ann Arbor MI USA
                [20 ]Department of Psychiatry; Columbia University; New York NY USA
                [21 ]Department of Psychology; University of Kansas; Lawrence KS USA
                [22 ]Department of Psychology; Pennsylvania State University, State College; PA USA
                [23 ]Department of Psychology; University of California at Davis; Davis CA USA
                [24 ]Department of Psychology; Georgia State University; Atlanta GA USA
                [25 ]Department of Psychology; University of Iowa; Iowa City IA USA
                [26 ]Department of Psychology; University of Georgia; Athens GA USA
                [27 ]Department of Psychology; Texas A&M University, College Station; TX USA
                [28 ]Department of Psychology; Oklahoma State University; Stillwater OK USA
                [29 ]Department of Psychiatry, University Medical Center Groningen; University of Groningen; Groningen The Netherlands
                [30 ]Institute of Psychology, Health and Society; University of Liverpool; Liverpool UK
                [31 ]Department of Psychology; Florida State University; Tallahassee FL USA
                [32 ]Department of Psychiatry; Uniformed Services University; Bethesda MD USA
                [33 ]School for Mental Health and Neuroscience; Maastricht University; Maastricht The Netherlands
                [34 ]Department of Psychology; Bryn Mawr College; Bryn Mawr PA USA
                [35 ]Department of Psychology; Purdue University; West Lafayette IN USA
                [36 ]Department of Psychology; University of Otago; Dunedin New Zealand
                [37 ]Department of Psychology; University of Maryland; College Park MD USA
                [38 ]Department of Psychiatry; University of Arizona; Tucson AZ USA
                [39 ]National Drug and Alcohol Research Centre; University of New South Wales; Randwick NSW Australia
                [40 ]Department of Psychology; Northwestern University; Evanston IL USA
                [41 ]Department of Psychology; Emory University; Atlanta GA USA
                [42 ]Oak Ridge National Laboratory; University of Tennessee; Oak Ridge TN USA
                [43 ]Department of Psychology; University of Pittsburgh; Pittsburgh PA USA
                [44 ]Department of Psychology; Vanderbilt University; Nashville TN USA
                [45 ]Psychologische Hochschule Berlin; Berlin Germany
                Article
                10.1002/wps.20566
                6172695
                30229571
                b781460b-3e3c-4aa4-b4ab-0b41652b254d
                © 2018

                http://doi.wiley.com/10.1002/tdm_license_1.1

                http://onlinelibrary.wiley.com/termsAndConditions#vor

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