Rethinking the Diagnosis of Mental Disorders: Data-Driven Psychological Dimensions, Not Categories, as a Framework for Mental-Health Research, Treatment, and Training

Abstract

Generations of psychologists have been taught that mental disorder can be carved into discrete categories, each qualitatively different from the others and from normality. This model is now outdated. A preponderance of evidence indicates that (a) individual differences in mental health (health vs. illness) are a matter of degree, not kind, and (b) broad mental-health conditions (e.g., internalizing) account for the tendency of narrower ones (e.g., depression, social anxiety, panic) to co-occur. With these observations in mind, we discuss an alternative diagnostic system, called the Hierarchical Taxonomy of Psychopathology (HiTOP), that describes the broad and specific components of mental disorder. It deconstructs traditional diagnostic categories, such as those listed in the Diagnostic and Statistical Manual of Mental Disorders, and recasts them in terms of profiles of dimensions. Recent findings support the utility of this approach for mental-health research and intervention efforts. HiTOP has the potential to put mental-health research, training, and treatment on a much sounder scientific footing.