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The Hierarchical Taxonomy of Psychopathology consortium aims to develop a comprehensive self-report measure to assess psychopathology dimensionally. The current research describes the initial conceptualization, development, and item selection for the thought disorder spectrum and related constructs from other spectra. The thought disorder spectrum is defined primarily by the positive and disorganized traits and symptoms of schizophrenia-spectrum disorders. The Thought Disorder Sub-Workgroup identified and defined 16 relevant constructs and wrote 10 to 15 items per each construct. These items were administered, along with detachment and mania items, to undergraduates and people with serious mental illness. Three hundred and sixty-five items across 25 scales were administered. An exploratory factor analysis of the scale scores suggested a two-factor structure corresponding to positive and negative symptoms for two samples. The mania scales loaded with the positive factor, while the detachment scales loaded with the negative factor. Item-level analyses resulted in 19 preliminary scales, including 215 items that cover the range of thought disorder pathology, and will be carried forward for the next phase of data collection/analysis.

ObjectiveDiagnosis is a cornerstone of clinical practice for mental health care providers, yet traditional diagnostic systems have well-known shortcomings, including inadequate reliability, high comorbidity, and marked within-diagnosis heterogeneity. The Hierarchical Taxonomy of Psychopathology (HiTOP) is a data-driven, hierarchically based alternative to traditional classifications that conceptualizes psychopathology as a set of dimensions organized into increasingly broad, transdiagnostic spectra. Prior work has shown that using a dimensional approach improves reliability and validity, but translating a model like HiTOP into a workable system that is useful for health care providers remains a major challenge.MethodThe present work outlines the HiTOP model and describes the core principles to guide its integration into clinical practice.ResultsPotential advantages and limitations of the HiTOP model for clinical utility are reviewed, including with respect to case conceptualization and treatment planning. A HiTOP approach to practice is illustrated and contrasted with an approach based on traditional nosology. Common barriers to using HiTOP in real-world health care settings and solutions to these barriers are discussed.ConclusionsHiTOP represents a viable alternative to classifying mental illness that can be integrated into practice today, although research is needed to further establish its utility. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

The categorical model of personality disorder classification in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (5th ed. [DSM-5]; American Psychiatric Association, 2013 ) is highly and fundamentally problematic. Proposed for DSM-5 and provided within Section III (for Emerging Measures and Models) was the Alternative Model of Personality Disorder (AMPD) classification, consisting of Criterion A (self-interpersonal deficits) and Criterion B (maladaptive personality traits). A proposed alternative to the DSM-5 more generally is an empirically based dimensional organization of psychopathology identified as the Hierarchical Taxonomy of Psychopathology (HiTOP; Kotov et al., 2017 ). HiTOP currently includes, at the highest level, a general factor of psychopathology. Further down are the five domains of detachment, antagonistic externalizing, disinhibited externalizing, thought disorder, and internalizing (along with a provisional sixth somatoform dimension) that align with Criterion B. The purpose of this article is to discuss the potential inclusion and placement of the self-interpersonal deficits of the DSM-5 Section III Criterion A within HiTOP.

For more than a century, research on psychopathology has focused on categorical diagnoses. Although this work has produced major discoveries, growing evidence points to the superiority of a dimensional approach to the science of mental illness. Here we outline one such dimensional system-the Hierarchical Taxonomy of Psychopathology (HiTOP)-that is based on empirical patterns of co-occurrence among psychological symptoms. We highlight key ways in which this framework can advance mental-health research, and we provide some heuristics for using HiTOP to test theories of psychopathology. We then review emerging evidence that supports the value of a hierarchical, dimensional model of mental illness across diverse research areas in psychological science. These new data suggest that the HiTOP system has the potential to accelerate and improve research on mental-health problems as well as efforts to more effectively assess, prevent, and treat mental illness.

The university participant pool is a key resource for behavioral research, and data quality is believed to vary over the course of the academic semester. This crowdsourced project examined time of semester variation in 10 known effects, 10 individual differences, and 3 data quality indicators over the course of the academic semester in 20 participant pools (N = 2696) and with an online sample (N = 737). Weak time of semester effects were observed on data quality indicators, participant sex, and a few individual differences—conscientiousness, mood, and stress. However, there was little evidence for time of semester qualifying experimental or correlational effects. The generality of this evidence is unknown because only a subset of the tested effects demonstrated evidence for the original result in the whole sample. Mean characteristics of pool samples change slightly during the semester, but these data suggest that those changes are mostly irrelevant for detecting effects.

Disturbances in the perception of self are thought to be central to the development of psychosis. Self-concept clarity (SCC) is the extent to which one's beliefs about oneself are internally consistent, stable, and clear. Participants with schizophrenia (N = 54) and healthy controls (N = 32) completed the Me Not-Me Decision Task (MNMDT), in which they decided whether 60 adjectives (30 pairs of antonyms) did or did not describe themselves. SCC is conceptualized as the number of consistent responses. Participants also completed the Self-Concept Clarity Scale (SCCS). Compared to healthy controls, participants with schizophrenia scored lower on the MNMDT and SCCS, and scores were negatively correlated with positive and negative symptoms. In a simultaneous regression, SCCS scores were uniquely associated with positive symptoms, whereas MNMDT scores were uniquely associated with negative symptoms. This suggests that people with schizophrenia have decreased self-concept clarity that is related to positive and negative symptoms.

Many social-cognitive models of psychotic-like symptoms posit a role for self-concept and aberrant salience. Previous work has shown that the interaction between aberrant salience and self-concept clarity is associated with self-reported psychotic-like experiences. In the current research with two structured interviews, the interaction between aberrant salience and self-concept clarity was found to be associated with interview-rated psychotic-like experiences. The interaction was associated with psychotic-like experiences composite scores, delusional ideation, grandiosity, and perceptual anomalies. In all cases, self-concept clarity was negatively associated with psychotic-like experiences at high levels of aberrant salience, but unassociated with psychotic-like experiences at low levels of aberrant salience. The interaction was specific to positive psychotic-like experiences and not present for negative or disorganized ratings. The interaction was not mediated by self-esteem levels. These results provide further evidence that aberrant salience and self-concept clarity play an important role in the generation of psychotic-like experiences.

Previous research suggests that people with schizophrenia have difficulty learning from positive feedback and when learning needs to occur rapidly. However, they seem to have relatively intact learning from negative feedback when learning occurs gradually. Participants are typically given a limited amount of acquisition trials to learn the reward contingencies and then tested about what they learned. The current study examined whether participants with schizophrenia continue to display these deficits when given extra time to learn the contingences. Participants with schizophrenia and matched healthy controls completed the Probabilistic Selection Task, which measures positive and negative feedback learning separately. Participants with schizophrenia showed a deficit in learning from both positive feedback and negative feedback. These reward learning deficits persisted even if people with schizophrenia are given extra time (up to 10 blocks of 60 trials) to learn the reward contingencies. These results suggest that the observed deficits cannot be attributed solely to slower learning and instead reflect a specific deficit in reinforcement learning.

Despite the common use of either psychometric or clinical methods for identifying individuals at risk for psychosis, previous research has not examined the correspondence and extent of convergence of these 2 approaches. Undergraduates (n = 160), selected from a larger pool, completed 3 self-report schizotypy scales: the Magical Ideation Scale, the Perceptual Aberration Scale, and the Revised Social Anhedonia Scale. They were administered the Structured Interview for Prodromal Syndromes. First, high correlations were observed for self-report and interview-rated psychotic-like experiences (rs between .48 and .61, p < .001). Second, 77% of individuals who identified as having a risk for psychosis with the self-report measures reported at least 1 clinically meaningful psychotic-like experience on the Structured Interview for Prodromal Syndromes. Third, receiver operating characteristic curve analyses showed that the self-report scales can be used to identify which participants report clinically meaningful positive symptoms. These results suggest that mostly White undergraduate participants who identify as at risk with the psychometric schizotypy approach report clinically meaningful psychotic-like experiences in an interview format and that the schizotypy scales are moderately to strongly correlated with interview-rated psychotic-like experiences. The results of the current research provide a baseline for comparing research between these 2 approaches.

The nature of emotion deficits in schizophrenia and anhedonia is still unclear, and understanding the nature of these deficits could help improve treatment of chronic symptoms and functional disability. An important mechanism in emotional functioning is attention to affective information. People with schizophrenia (n = 48) and a nonpsychiatric comparison group (n = 28) completed an affective interference task, a task used to assess attention to affective information. Given that the affective interference task also involves prepotent response inhibition, participants also completed a very similar, but nonaffective, cognitive interference task that involves prepotent inhibition but does not require attention to affective information. Results revealed that people with schizophrenia exhibited decreased affective interference on trials with a shorter length of time between the onset of the cue and onset of the target but increased cognitive interference at all time lengths between the cue and target onsets used in the study. In addition, decreased affective interference was associated with increased anhedonia and increased reports of wanting to ignore positive emotions. In contrast, increased cognitive interference was associated with increased communication disturbances and alogia. Overall, these results suggest that there may be a decrease in attention to affective information in schizophrenia and that affective interference is related to anhedonia. At the same time, these results provide further evidence of cognitive control prepotent inhibition deficits in schizophrenia, which are related to communication disturbances and alogia.

This study examined the psychometric properties of the Intention Scale for Providers-Direct Items (ISP-D; 16 items), a questionnaire for assessing therapists' evidence-based practice attitudes, subjective norms, perceived behavioral control, and behavioral intentions. Participants were community mental health providers from the State of Hawaii. A confirmatory factor analysis provided support for a revised 14-item ISP-D measure that fits the data reasonably well. Subscales of this revised ISP-D demonstrated acceptable to good internal consistency, with the exception of the Perceived Behavioral Control subscale. The majority of convergent validity correlation patterns between the ISP-D and related constructs were significant and in predicted directions. [ABSTRACT FROM AUTHOR]

The associations among normal personality and many mental disorders are well established, but it remains unclear whether and how symptoms of schizophrenia and schizotypal traits align with the personality taxonomy. This study examined the joint factor structure of normal personality, schizotypy, and schizophrenia symptoms in people with psychotic disorders (n = 288) and never-psychotic adults (n = 257) in the Suffolk County Mental Health Project. First, we evaluated the structure of schizotypal (positive schizotypy, negative schizotypy, and mistrust) and normal traits. In both the psychotic-disorder and never-psychotic groups, the best-fitting model had 5 factors: neuroticism, extraversion, conscientiousness, agreeableness, and psychoticism. The schizotypy traits were placed on different dimensions: negative schizotypy went on (low) extraversion, whereas positive schizotypy and mistrust went on psychoticism. Next, we added symptoms to the model. Numerous alternatives were compared, and the 5-factor model remained best-fitting. Reality distortion (hallucinations and delusions) and disorganization symptoms were placed on psychoticism, and negative symptoms were placed on extraversion. Models that separated symptom dimensions from trait dimensions did not fit well, arguing that taxonomies of symptoms and traits are aligned. This is the first study to show that symptoms of psychosis, schizotypy, and normal personality reflect the same underlying dimensions. Specifically, (low) extraversion, negative schizotypy, and negative symptoms form one spectrum, whereas psychoticism, positive schizotypy, and positive and disorganized symptoms form another. This framework helps to understand the heterogeneity of psychosis and comorbidity patterns found in psychotic disorders. It also underscores the importance of traits to understanding these disorders. [ABSTRACT FROM AUTHOR]

Anomalous self-experiences (ASEs) are among the first symptoms to appear in the prodrome, predict the development of psychosis over and above clinical symptoms, and are common in people with schizophrenia. Although there are well-validated phenomenological interviews for assessing ASEs, there are no self-report measures. The current research describes 4 studies designed to develop and validate a new scale to assess ASEs: the Inventory of Psychotic-Like Anomalous Self-Experiences (IPASE). In Study 1, an overinclusive item pool was generated based on phenomenological descriptions of ASEs, and items were kept or discarded based on factor loadings in an exploratory factor analysis. Five factors were extracted including disturbances in Cognition, Consciousness, Self-Awareness and Presence, Somatization, and Transitivism/Demarcation. The 5-factor structure was confirmed in Study 2, and the scale showed measurement invariance between sexes. IPASE scores were correlated with self-report and task measures of self-processing including self-concept clarity, self-consciousness, and self-esteem as well as measures of psychotic-like experiences. In Study 3, people with positive schizotypy had higher IPASE scores than a negative schizotypy and comparison group. In Study 4, people with schizophrenia had higher IPASE scores than healthy controls. Overall, the IPASE displayed strong psychometric qualities and is a brief alternative to resource-intensive phenomenological interviews in clinical, at-risk, and general population samples. (PsycINFO Database Record [ABSTRACT FROM AUTHOR]

Social-cognitive models posit a role of Anomalous Self-Experiences (ASEs), disturbances in the subjective experience of the self, in the development and maintenance of psychosis. Theorists have suggested that ASEs may underlie the social-cognitive deficits that are common in people with schizophrenia. Positive symptoms, negative symptoms, and ASEs may interfere with the ability to perceive, use, understand, and manage emotions. In the current study, 45 people with schizophrenia and 28 healthy controls completed the Inventory of Psychotic-Like Anomalous Self-Experiences (IPASE), the Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT), and were rated on the Positive and Negative Syndrome Scale (PANSS). Participants with schizophrenia had higher IPASE scores and lower MSCEIT scores than the comparison group. In a series of simultaneous regressions, ASEs, but not positive or negative symptoms, were associated with Total MSCEIT scores and the Using Emotions branch score. In contrast, positive symptoms, but not ASEs or negative symptoms were associated with Perceiving and Managing Emotions branches. Both ASEs and positive symptoms independently contributed to Emotional Experiencing scores. The severity of negative symptoms was not associated with deficits in any MSCEIT scores. These results suggest unique roles for ASEs and positive symptoms in emotion processing deficits in people with schizophrenia. [ABSTRACT FROM AUTHOR]

Social anhedonia and introversion, two closely related constructs associated with decreased positive emotions and decreased sociability, are common in schizophrenia-spectrum personality disorders. In light of a myriad of mixed findings regarding positive emotionality in anhedonia, there has been a call to reconceptualize 'anhedonia.' To clarify the nature of social anhedonia, we used confirmatory factor analysis to investigate the relationship between social anhedonia and introversion. Findings were consistent with the conceptualization of social anhedonia as a separate construct from introversion-the best fitting model was one in which social anhedonia and introversion measures loaded separately. Also consistent with the conceptualization of social anhedonia as separate, we found evidence that it was associated with aspects of alexithymia above and beyond any relationship with introversion. Overall, these results have implications for the understanding of social anhedonia and for the use of it as a discriminating factor between personality disorders characterized by introversion. [ABSTRACT FROM AUTHOR]

Schizotypy refers to traits similar to schizophrenia symptoms and is related to cluster A personality disorders. Previous factor analytic studies have found a positive schizotypy factor distinct from a negative factor. However, some evidence suggests that the positive factor may itself be multidimensional, but the factor structure of positive schizotypy is still unclear. The current study provided converging evidence through four different analyses that positive schizotypy is multidimensional. First, a factor model with three positive schizotypy factors (paranoia, referential thinking, and cognitive-perceptual) fit the data better than models with fewer than three factors. Second, a factor model with a second-order (i.e., higher-order) positive schizotypy factor fit the data significantly worse than a factor model without a second-order factor in which first-order factors were allowed to correlate freely, suggesting that the second-order factor does not completely account for relations among the first-order factors. Third, a Schmid-Leiman transformation found that even after accounting for the second-order factor that meaningful variance was attributed to the first-order factors. Finally, the three positive schizotypy factors displayed differential relations with five-factor model personality traits. Overall, results suggest that positive schizotypy is composed of correlated but distinct factors. [ABSTRACT FROM AUTHOR]

Bipolar spectrum disorders have traditionally been thought to be chronic in course. However, recent epidemiologic research suggests that there may be developmentally limited forms of bipolar disorder. Two large, nationally representative studies reveal a strikingly high prevalence of bipolar disorders in emerging adulthood (5.5%-6.2% among 18-24-year-olds) that appear to resolve substantially during the latter half of the 3rd decade of life (3.1 %-3.4% among 25-29-year-olds). Although ascertainment bias due to early mortality, institutionalization, incarceration, and homelessness may account for some of this reduction, the prevalence distribution suggests a high incidence in late adolescence and emerging adulthood that appears to resolve spontaneously in most cases. There were very few differences across age groups in symptom endorsement and comorbid diagnoses, suggesting that 18-24-year-olds that meet criteria for bipolar diagnoses experience clinically significant impairment and associated consequences of the disorder. More fine-grained longitudinal research is needed to determine whether developmentally limited forms of bipolar disorder exist and, if so, what markers might distinguish these forms of the disorder from more chronic courses. [ABSTRACT FROM AUTHOR]

The present study aimed to further validate the Loss of Control Over Eating Scale (LOCES) for use with undergraduate men and women with and without eating disorder (ED) symptoms. A total of 261 participants completed the LOCES and the Eating Disorder Examination - Questionnaire (EDE-Q) and were identified as non-clinical or having probable ED symptomatology based on previously used EDE-Q cutoff scores. Results indicated that the LOCES and its subscales were significantly associated with and a significant predictor of global ED pathology and binge episode frequency. The LOCES behavioral subscale appeared to be a stronger predictor of episode frequency compared to other subscales. The ED pathology groups reported significantly higher LOCES scores compared to the non-ED pathology groups. Binary logistic regression analyses revealed that the LOCES was able to accurately distinguish between those with ED pathology and those without ED pathology in the majority of cases. Findings from the present study suggest that the LOCES is highly predictive of ED pathology, strongly associated with ED cognitions and behaviors, and an accurate index for global eating disorder pathology. Future directions for research are discussed. [ABSTRACT FROM AUTHOR]

The university participant pool is a key resource for behavioral research, and data quality is believed to vary over the course of the academic semester. This crowdsourced project examined time of semester variation in 10 known effects, 10 individual differences, and 3 data quality indicators over the course of the academic semester in 20 participant pools ( N = 2696) and with an online sample ( N = 737). Weak time of semester effects were observed on data quality indicators, participant sex, and a few individual differences—conscientiousness, mood, and stress. However, there was little evidence for time of semester qualifying experimental or correlational effects. The generality of this evidence is unknown because only a subset of the tested effects demonstrated evidence for the original result in the whole sample. Mean characteristics of pool samples change slightly during the semester, but these data suggest that those changes are mostly irrelevant for detecting effects. [ABSTRACT FROM AUTHOR]