Do Cognitive Functions Belong in the Hierarchical Taxonomy of Psychopathology Model? A Meta-Analysis

Abstract

Cognitive dysfunction is essential to conceptualizing, defining, and assessing much of psychopathology. Despite this prominence, cognitive abilities are not included in the prevailing empirically based classification system: the Hierarchical Taxonomy of Psychopathology (HiTOP). This gap exists because the factor-analytic literature the HiTOP is based on has solely used reporter measures rather than neuropsychological tests needed to measure cognitive ability. Given HiTOP’s influence on research and clinical practice, the omission of cognitive functions from the model is consequential. This study aimed to determine how cognitive abilities fit into the empirical structure of psychopathology with a meta-analytic joint factor analysis. We pooled data from three published meta-analyses into a single correlation matrix of eight disorders from the Diagnostic and Statistical Manual of Mental Disorders and seven cognitive functions. We then fit a series of models to the meta-analytic correlation matrix using exploratory factor analysis and correlated factors across levels to estimate the hierarchical structure. The highest level of the model included a general factor with strong loadings of all disorders and cognitive functions (median λ = |.51|, range = |.30| to |.64|). At the lowest level were three superspectra: psychosis and cognitive dysfunction, externalizing, and emotional dysfunction. Our results show cognitive abilities can be integrated into the HiTOP model and point to actionable next steps in research to accomplish this goal.