Dr. Aidan Wright
University of Pittsburg

The Clinical Baby and the Diagnostic Bathwater

Contemporary psychiatric diagnostic systems (e.g., the Diagnostic and Statistical manual of Mental Disorders) have well-documented limitations, which lead to a poor representation of psychopathology as it manifests in patients. As a result, accurate and meaningful assessment and diagnosis is challenging, identifying etiological and maintenance mechanisms is limited, and effective treatment development is hampered. Several prominent approaches have emerged to provide empirically-based alternatives to traditional diagnostic systems. In the current talk, I will discuss promise and potential pitfalls of one such approach, the recently developed Hierarchical Taxonomy of Psychopathology (HiTOP) system, which is based on quantitative structural models of mental disorders. In replacing the existing categorical system with a series of hierarchically organized dimensions, the HiTOP system addresses many of the problematic issues with the current diagnostic system. At the same time, despite these benefits, by focusing so heavily on the between-person structure of psychopathology, the HiTOP runs the risk of losing sight of important clinical features associated with the dynamic within-person processes and mechanisms that drive psychiatric dysfunction. I will present work on how to integrate the study of quantitative hierarchical models with clinically relevant within-person dynamic processes and new directions in developing personalized models of psychopathology.