Answering Questions About the Hierarchical Taxonomy of Psychopathology (HiTOP): Analogies to Whales and Sharks Miss the Boat

Abstract

In this commentary, we discuss questions and misconceptions about the Hierarchical Taxonomy of Psychopathology (HiTOP) raised by Haeffel et al. We explain what the system classifies and why it is descriptive and atheoretical, and we highlight benefits and limitations of this approach. We clarify why the system is organized according to patterns of covariation or comorbidity among signs and symptoms of psychopathology, and we discuss how it is designed to be falsifiable and revised in a manner that is responsive to data. We refer to the body of evidence for HiTOP’s external validity and for its scientific and clinical utility. We further describe how the system is currently used in clinics. In sum, many of Haeffel et al.’s concerns about HiTOP are unwarranted, and for those concerns that reflect real current limitations of HiTOP, our consortium is working to address them, with the aim of creating a nosology that is comprehensive and useful to both scientists and clinicians.