This article outlines the Phase 1 efforts of the HiTOP Measure Development group for externalizing constructs, which include disinhibited externalizing, antagonistic externalizing, attention deficit hyperactivity disorder, substance use, and externalizing/maladaptive behaviors. We provide background on the constructs included and the process and issues involved in developing a measure for this diverse range of psychopathology symptoms, traits, and behaviors.
AshersonP.YoungA. H.Eich-HochliD.MoranP.PorsdalV.DeberdtW. (2014). Differential diagnosis, comorbidity, and treatment of attention-deficit/hyperactivity disorder in relation to bipolar disorder or borderline personality disorder in adults. Current Medical Research Opinion, 30(8), 1657-1672. https://doi.org/10.1185/03007995.2014.915800
4.
BachB.SellbomM.KongerslevJ.SimonsenE.KruegerR. F.MulderR. (2017). Deriving ICD-11 personality domains from DSM-5 traits: Initial attempt to harmonize two diagnostic systems. Acta Psychiatrica Scandinavica, 136(1), 108-117. https://doi.org/10.1111/acps.12748
5.
BeckerS. P.LangbergJ. M. (2014). Attention-deficit/hyperactivity disorder and sluggish cognitive tempo dimensions in relation to executive functioning in adolescents with ADHD. Child Psychiatry and Human Development, 45(1), 1-11. https://doi.org/10.1007/s10578-013-0372-z
6.
BozhilovaN. S.MicheliniG.KuntsiJ.AshersonP. (2018). Mind wandering perspective on ADHD. Neuroscience Biobehavior Review, 92(September), 464-476. https://doi.org/10.1016/j.neubiorev.2018.07.010
7.
CarragherN.KruegerR. F.EatonN. R.MarkonK. E.KeyesK. M.BlancoC.SahaT. D.HasinD. S. (2014). ADHD and the externalizing spectrum: Direct comparison of categorical, continuous, and hybrid models of liability in a nationally representative sample. Social Psychiatry + Psychiatric Epidemiology, 49(8), 1307-1317. https://doi.org/10.1007/s00127-013-0770-3
8.
ClarkL. A.RoE. (2014). Three-pronged assessment and diagnosis of personality disorder and its consequences: Personality functioning, pathological traits, and psychosocial disability. Personality Disorders: Theory, Research, and Treatment, 5(1), 55-69. https://doi.org/10.1037/per0000063
9.
ClarkL. A.WatsonD. (2008). Temperament: An organizing paradigm for trait psychology. In JohnO. P.RobinsR. W.PervinL. A. (Eds.), Handbook of personality: Theory and research (3rd ed., pp. 265-286). Guilford Press.
10.
CostaP. T.Jr.McCraeR. R. (2008) The Revised NEO Personality Inventory (NEO PI-R). Psychological Assessment Resources.
ForbesM. K.KotovR.RuggeroC. J.WatsonD.ZimmermanM.KruegerR. F. (2017). Delineating the joint hierarchical structure of clinical and personality disorders in an outpatient psychiatric sample. Comprehensive Psychiatry, 79(November), 19-30. https://doi.org/10.1016/j.comppsych.2017.04.006
13.
FrankeB.MicheliniG.AshersonP.BanaschewskiT.BilbowA.BuitelaarJ. K.CormandB.FaraoneS. V.GinsbergY.HaavikJ.KuntsiJ.LarssonH.LeschK.-P.Ramos-QuirogaA.RéthelyiJ. M.RibasesM.ReifA. (2018). Live fast, die young? A review on the developmental trajectories of ADHD across the lifespan. European Neuropsychopharmacology, 28(10), 1059-2088. https://doi.org/10.1016/j.euroneuro.2018.08.001
HerzhoffK.TackettJ. L. (2016). Subfactors of oppositional defiant disorder: Converging evidence from structural and latent class analysis. Journal of Child Psychology and Psychiatry, 57(1), 18-29. https://doi.org/10.1111/jcpp.12423
16.
JonesS. E.MillerJ. D.LynamD. R. (2011). Personality, antisocial behavior, and aggression: A meta-analytic review. Journal of Criminal Justice, 39(4), 329-337. https://doi.org/10.1016/j.jcrimjus.2011.03.004
17.
KitsuneGLKuntsiJCostelloHFrangouSHosangGMMcLoughlinGAshersonP. (2016). Delineating ADHD and bipolar disorder: a comparison of clinical profiles in adult women. Journal of Affective Disorders. 2016;192:125–133. https://doi.org/10.1016/j.jad.2015.12.024
18.
KotovR.KruegerR. F.WatsonD.AchenbachT. M.AlthoffR. R.BagbyR. M.BrownT. A.CarpenterW. T.CaspiA.ClarkL. A.EatonN. R.ForbesM. K.ForbushK. T.GoldbergD.HasinD.HymanS. E.IvanovaM. Y.LynamD. R.MarkonK.. . . ZimmermanM. (2017). The Hierarchical Taxonomy of Psychopathology (HiTOP): A dimensional alternative to traditional nosologies. Journal of Abnormal Psychology, 126(4), 454-477. https://doi.org/10.1037/abn0000258
19.
KotovR.RuggeroC. J.KruegerR. F.WatsonD.YuanQ.ZimmermanM. (2011). New dimensions in the quantitative classification of mental illness. Archives of General Psychiatry, 68(10), 1003-1011. https://doi.org/10.1001/archgenpsychiatry.2011.107
20.
KruegerR. F.MarkonK. E.PatrickC. J.BenningS. D.KramerM. D. (2007). Linking antisocial behavior, substance use, and personality: An integrative quantitative model of the adult externalizing spectrum. Journal of Abnormal Psychology, 116(4), 645-666. https://doi.org/10.1037/0021-843X.116.4.645
21.
KruegerR. F.SouthS. C. (2009). Externalizing disorders: Cluster 5 of the proposed meta-structure for DSM-V and ICD-11. Psychological Medicine, 39(12), 2061-2070. https://doi.org/10.1017/S0033291709990328
22.
LynamD. R.MillerJ. D. (2019). The basic trait of Antagonism: An unfortunately underappreciated construct. Journal of Research in Personality, 81(August), 118-126. https://doi.org/10.1016/j.jrp.2019.05.012
23.
McCabeG. A.WidigerT. A. (2020). A comprehensive comparison of the ICD-11 and DSM–5 section III personality disorder models. Psychological Assessment, 32(1), 72-84. https://doi.org/10.1037/pas0000772
24.
MicheliniG.PalumboI. M.DeYoungC. G.LatzmanR.KotovR. (2020). Linking RDoC and HiTOP: A new interface for advancing psychiatric nosology and neuroscience. Clinical Psychology Review, 86(June), 102025. https://doi.org/10.1016/j.cpr.2021.102025
25.
MillerJ.D.LynamD.R. (2001). Structural models of personality and their relation to antisocial behavior: A meta-analytic review. Criminology, 39, 765-792.
26.
MillerJ. D.LynamD. R. (2015). Understanding psychopathy using the basic elements of personality. Social and Personality Psychology Compass, 9(5), 223–237. https://doi.org/10.1111/spc3.12170
27.
NiggJ. T.KaralunasS. LFeczkoE.FairD. A. (2020). Toward a revised nosology for attention-deficit/hyperactivity disorder heterogeneity. Biological Psychiatry: Cognitive Neuroscience and Neuroimaging, 5(8), 726-737. https://doi.org/10.1016/j.bpsc.2020.02.005
28.
PatrickC. J.FowlesD. C.KruegerR. F. (2009). Triarchic conceptualization of psychopathy: Developmental origins of disinhibition, boldness, and meanness. Development and Psychopathology, 21(3), 913-938. https://doi.org/10.1017/S0954579409000492
29.
RuggeroC.KotovR.HopwoodC.FirstM.SkodolA.CiceroD.DochertyA.PatrickC. J.Mullins-SweattS. N.BachB. S.SimmsL. J.ClarkL. A.BagbyM.KruegerR. F.ZimmermanM.CallahanJ.ChmielewskiM.ConwayC.De ClercqB. J.. . . ZimmermanJ. (2019). Integrating the Hierarchical Taxonomy of Psychopathology into Clinical Practice. Journal of Consulting and Clinical Psychology, 87(12), 1069-1084. https://doi.org/10.1037/ccp0000452
30.
SimmsL. J.WrightA. G. C.CiceroD.KotovR.Mullins-SweattS. N.SellbomM.WatsonD.WidigerT. A.ZimmermanJ. (2021). Development of measures for the Hierarchical Taxonomy of Psychopathology (HiTOP): A collaborative scale development project. Assessment. Advance online publication. https://doi.org/10.1177/10731911211015309
31.
SkirrowC.AshersonP. (2013). Emotional lability, comorbidity and impairment in adults with attention-deficit hyperactivity disorder. Journal of Affective Disorders, 147(1-3), 80-86. https://doi.org/10.1016/j.jad.2012.10.011
32.
SleepC. E.CroweM. L.CarterN. T.LynamD. R.MillerJ. D. (2020). Uncovering the structure of antagonism. Personality Disorders: Theory, Research, and Treatment. Advance online publication. https://doi.org/10.1037/per0000416
33.
TellegenA. (1985). Structures of mood and personality and their relevance to assessing anxiety with an emphasis on self-report. In TumaA. H.MaserJ. D. (Eds.), Anxiety and the anxiety disorders (pp. 681-706). Lawrence Erlbaum. https://doi.org/10.4324/9780203728215-49
34.
VaidyaJ. G.LatzmanR. D.MarkonK. E.WatsonD. (2010). Age differences on measures of disinhibition during young adulthood. Personality and Individual Differences, 48(7), 815-820. https://doi.org/10.1016/j.paid.2010.02.002
35.
VizeC. E.CollisonK. L.LynamD. R. (2020). The importance of antagonism: Explaining similarities and differences in psychopathy and narcissism’s relations with aggression and externalizing outcomes. Journal of Personality Disorders, 34(6), 842-854. https://doi.org/10.1521/pedi_2020_34_342
36.
WatsonD.ClarkL. A. (1993). Behavioral disinhibition versus constraint: A dispositional perspective. In WegnerD. M.PennebakerJ. W. (Eds.), Handbook of mental control (pp. 506-527). Prentice Hall.
37.
WhitesideS. P.LynamD. R. (2001). The five factor model and impulsivity: Using a structural model of personality to understand impulsivity. Personality and Individual Differences, 30(4), 669-689. https://doi.org/10.1016/S0191-8869(00)00064-7
38.
World Health Organization. (2016). The ICD-10 Version 2016: Classification of Mental and Behavioural Disorders: Clinical descriptions and diagnostic guidelines. World Health Organization.
39.
World Health Organization. (2019). International Classification of Diseases (11th ed.): Diagnostic guidelines: Personality disorders and related traits. Author.
40.
WrightA. G.SimmsL. J. (2015). A metastructural model of mental disorders and pathological personality traits. Psychological Medicine, 45(11), 2309-2319. https://doi.org/10.1017/S0033291715000252