Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-586b7cd67f-t7czq Total loading time: 0 Render date: 2024-11-30T20:11:01.703Z Has data issue: false hasContentIssue false

6b - A Hierarchical, Dimensional Approach Can Advance Personality Disorder Research: Commentary on Categorical Models of Personality Disorders

from Part II - Models

Published online by Cambridge University Press:  24 February 2020

By
Christopher C. Conway
Edited by
Carl W. Lejuez  and
Kim L. Gratz
Carl W. Lejuez
Affiliation:
University of Kansas
Kim L. Gratz
Affiliation:
University of Toledo, Ohio
Get access

Summary

Categorical rubrics are the prevailing approach to personality disorder (PD) assessment and diagnosis. Diagnostic manuals, funding bodies, and training programs tend to follow this categorical model. Yet there is now abundant evidence that PD categories are impeding research progress on personality pathology. This chapter describes an emerging dimensional perspective on personality problems, the Hierarchical Taxonomy of Psychopathology (HiTOP). The HiTOP framework encapsulates factor analytically derived higher- and lower-order dimensions of personality pathology, ranging from an overarching general factor of psychopathology at the hierarchy’s apex to homogeneous maladaptive personality traits and acute symptoms at the base. This multi-level system bypasses aspects of categorical PD diagnoses that researchers find problematic (e.g., comorbidity, within-diagnosis heterogeneity, and insufficient coverage of personality problems encountered in the clinic). HiTOP has the potential to renew field-wide interest in PD and streamline social, psychological, and biological research on personality pathology.

Keywords

diagnosisHierarchical Taxonomy of Psychopathology (HiTOP)nosologypersonality disorderresearch methods
Type
Chapter
Information
The Cambridge Handbook of Personality Disorders , pp. 140 - 142
Publisher: Cambridge University Press
Print publication year: 2020

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Achenbach, T. M. (1966). The classification of children’s psychiatric symptoms: A factor-analytic study. Psychological Monographs: General and Applied, 80, 1–37.Google Scholar
Conway, C. C., Forbes, M. K., Forbush, K. T., Fried, E. I., Hallquist, M. N., Kotov, R., … Eaton, N. R. (2019). A hierarchical taxonomy of psychopathology can transform mental health research. Perspectives on Psychological Science, 14, 419–436.Google Scholar
Eaton, N. R., Krueger, R. F., Keyes, K. M., Skodol, A. E., Markon, K. E., Grant, B. F., & Hasin, D. S. (2011). Borderline personality disorder co-morbidity: Relationship to the internalizing–externalizing structure of common mental disorders. Psychological Medicine, 41, 1041–1050.CrossRefGoogle Scholar
Hopwood, C. J., Kotov, R., Krueger, R. F., Watson, D., Widiger, T. A., Althoff, R. R., … Bornovalova, M. A. (2018). The time has come for dimensional personality disorder diagnosis. Personality and Mental Health, 12, 82–86.CrossRefGoogle ScholarPubMed
Hopwood, C. J., Malone, J. C., Ansell, E. B., Sanislow, C. A., Grilo, C. M., McGlashan, T. H., … Gunderson, J. G. (2011). Personality assessment in DSM-5: Empirical support for rating severity, style, and traits. Journal of Personality Disorders, 25, 305–320.Google Scholar
Keyes, K. M., Eaton, N. R., Krueger, R. F., McLaughlin, K. A., Wall, M. M., Grant, B. F., & Hasin, D. S. (2012). Childhood maltreatment and the structure of common psychiatric disorders. British Journal of Psychiatry, 200, 107–115.CrossRefGoogle ScholarPubMed
Kotov, R., Krueger, R. F., Watson, D., Achenbach, T. M., Althoff, R. R., Bagby, R. M., … Zimmerman, M. (2017). The Hierarchical Taxonomy of Psychopathology (HiTOP): A dimensional alternative to traditional nosologies. Journal of Abnormal Psychology, 126, 454–477.Google Scholar
Krueger, R. F., Caspi, A., Moffitt, T. E., & Silva, P. A. (1998). The structure and stability of common mental disorders (DSM-III-R): A longitudinal-epidemiological study. Journal of Abnormal Psychology, 107, 216–227.CrossRefGoogle ScholarPubMed
Krueger, R. F., Kotov, R., Watson, D., Forbes, M. K., Eaton, N. R., Ruggero, C. J., … Zimmermann, J. (2018). Progress in achieving quantitative classification of psychopathology. World Psychiatry, 17, 282–293.Google Scholar
Markon, K. E. (2010). Modeling psychopathology structure: A symptom-level analysis of Axis I and II disorders. Psychological Medicine, 40, 273–288.CrossRefGoogle ScholarPubMed
Robins, E., & Guze, S. B. (1970). Establishment of diagnostic validity in psychiatric illness: Its application to schizophrenia. American Journal of Psychiatry, 126, 983–987.Google Scholar
Sharp, C., Wright, A. G., Fowler, J. C., Frueh, B. C., Allen, J. G., Oldham, J., & Clark, L. A. (2015). The structure of personality pathology: Both general (‘g’) and specific (‘s’) factors? Journal of Abnormal Psychology, 124, 387–398.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×