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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

Carl W. Lejuez
Affiliation:
University of Kansas
Kim L. Gratz
Affiliation:
University of Toledo, Ohio
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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.

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Publisher: Cambridge University Press
Print publication year: 2020

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References

Achenbach, T. M. (1966). The classification of children’s psychiatric symptoms: A factor-analytic studyPsychological Monographs: General and Applied80, 137.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, 419436.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 disordersPsychological Medicine41, 10411050.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, 8286.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, 305320.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, 107115.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, 454477.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, 216227.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, 282293.Google Scholar
Markon, K. E. (2010). Modeling psychopathology structure: A symptom-level analysis of Axis I and II disordersPsychological Medicine40, 273288.CrossRefGoogle ScholarPubMed
Robins, E., & Guze, S. B. (1970). Establishment of diagnostic validity in psychiatric illness: Its application to schizophrenia. American Journal of Psychiatry, 126, 983987.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 Psychology124, 387398.Google Scholar

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