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The Hierarchical Taxonomy of Psychopathology (HiTOP) in psychiatric practice and research

Published online by Cambridge University Press:  02 June 2022

Roman Kotov*
Stony Brook University, Stony Brook, New York, USA
David C. Cicero
University of North Texas, Denton, Texas, USA
Christopher C. Conway
Fordham University, New York, New York, USA
Colin G. DeYoung
University of Minnesota, Minneapolis, Minnesota, USA
Alexandre Dombrovski
University of Pittsburgh, Pittsburgh, Pennsylvania, USA
Nicholas R. Eaton
Stony Brook University, Stony Brook, New York, USA
Michael B. First
Columbia University College of Physicians and Surgeons, New York, New York, USA New York State Psychiatric Institute, New York, New York, USA
Miriam K. Forbes
Macquarie University, Sydney, Australia
Steven E. Hyman
Stanley Center for Psychiatric Research at the Broad Institute of Harvard and MIT, Cambridge, Massachusetts, USA
Katherine G. Jonas
Stony Brook University, Stony Brook, New York, USA
Robert F. Krueger
University of Minnesota, Minneapolis, Minnesota, USA
Robert D. Latzman
Takeda, Cambridge, Massachusetts, USA
James J. Li
University of Wisconsin-Madison, Madison, Wisconsin, USA
Brady D. Nelson
Stony Brook University, Stony Brook, New York, USA
Darrel A. Regier
Uniformed Services University, Bethesda, Maryland, USA Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland, USA
Craig Rodriguez-Seijas
University of Michigan, Ann Arbor, Michigan, USA
Camilo J. Ruggero
University of North Texas, Denton, Texas, USA
Leonard J. Simms
University at Buffalo, Buffalo, NY, USA
Andrew E. Skodol
University of Arizona College of Medicine, Tucson, Arizona, USA
Irwin D. Waldman
Emory University, Atlanta, Georgia, USA
Monika A. Waszczuk
Rosalind Franklin University of Medicine and Science, North Chicago, Illinois, USA
David Watson
University of Notre Dame, Notre Dame, IN, USA
Thomas A. Widiger
University of Kentucky, Lexington, Kentucky, USA
Sylia Wilson
University of Minnesota, Minneapolis, Minnesota, USA
Aidan G. C. Wright
University of Pittsburgh, Pittsburgh, Pennsylvania, USA
Author for correspondence: Roman Kotov, E-mail:


The Hierarchical Taxonomy of Psychopathology (HiTOP) has emerged out of the quantitative approach to psychiatric nosology. This approach identifies psychopathology constructs based on patterns of co-variation among signs and symptoms. The initial HiTOP model, which was published in 2017, is based on a large literature that spans decades of research. HiTOP is a living model that undergoes revision as new data become available. Here we discuss advantages and practical considerations of using this system in psychiatric practice and research. We especially highlight limitations of HiTOP and ongoing efforts to address them. We describe differences and similarities between HiTOP and existing diagnostic systems. Next, we review the types of evidence that informed development of HiTOP, including populations in which it has been studied and data on its validity. The paper also describes how HiTOP can facilitate research on genetic and environmental causes of psychopathology as well as the search for neurobiologic mechanisms and novel treatments. Furthermore, we consider implications for public health programs and prevention of mental disorders. We also review data on clinical utility and illustrate clinical application of HiTOP. Importantly, the model is based on measures and practices that are already used widely in clinical settings. HiTOP offers a way to organize and formalize these techniques. This model already can contribute to progress in psychiatry and complement traditional nosologies. Moreover, HiTOP seeks to facilitate research on linkages between phenotypes and biological processes, which may enable construction of a system that encompasses both biomarkers and precise clinical description.

Invited Review
Copyright © The Author(s), 2022. Published by Cambridge University Press

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