From HiTOP to Bottom-Up: Examining the Empirical Structure of Psychopathology at Different Levels of Analysis

Psychiatric diagnostic covariation suggests that the underlying structure of psychopathology is not one of circumscribed disorders. Quantitative modeling of individual differences in diagnostic patterns has uncovered several broad transdiagnostic domains of mental disorder liability, which are reflected in the Hierarchical Taxonomy of Psychopathology (HiTOP). However, these spectra are distal from the ebb and flow of symptoms and maladaptive behavior in daily life. In contrast to approaches that seek to identify latent spectra, there has been a push toward understanding mental disorders as complex causal systems of specific dynamic processes of symptoms and behavior. In spite of the shared goal, these two perspectives and empirical thrusts are often presented as at odds with each other. In this talk I will first summarize research on the quantitative modeling of the structural psychopathology as well as the motivation to study mental illness as an ensemble of contextualized dynamic processes. I will then propose a conceptual and methodological integration of these two approaches. Finally, I will present data that support the link between work that has established transdiagnostic dimensions of psychopathology in cross-sectional data, and efforts to understand the contextualized dynamic processes that characterize mental disorders as they play out in daily life.