The Diagnostic and Statistical Manual of Mental Disorders (DSM) has been criticized because evidence suggests that it lacks appropriate validity, reliability, and clinical utility, and the Hierarchical Taxonomy of Psychopathology (HiTOP) has been offered as a solution to these criticisms. Our goal in the present study was to compare clinician perceptions of these systems for the conceptualization of outpatient clinical cases. A sample of actively practicing clinicians (N = 143) rated three clinical vignettes using both diagnostic systems and then rated the two approaches on seven indices of clinical utility. HiTOP was favored for overall clinical utility score as well as utility for formulating effective interventions, communicating clinical information to the client, comprehensively describing psychopathology, describing global functioning, and ease of application. There was no preference between HiTOP and the DSM for communicating with other mental health providers. The DSM was not favored for any clinical utility outcome.
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