The hierarchical taxonomy of psychopathology (HiTOP) is a novel classification system that adopts both a dimensional and hierarchical approach to psychopathology to address shortcomings. However, the HiTOP framework is descriptive in nature and requires additional research to consider potential mechanisms for the onset and maintenance of psychopathology, such as cognitive-behavioral emotion regulation strategies. To redress this gap, a sample of 341 adults who endorsed ongoing mental health concerns completed self-report measures of emotion regulation strategies and psychopathology. The data revealed a three-spectra HiTOP model consisting of internalizing, thought disorder, and antagonistic externalizing. Results found that psychopathology was most strongly associated with avoidance, catastrophizing, expressive suppression, and self-blame. In contrast, adaptive strategies were generally unrelated to the HiTOP spectra. This pattern was strongest for internalizing, distress, and detachment. Fewer, yet noteworthy unique relationships between the strategies and specific spectra/subfactors were also found. These findings suggest that psychopathology may be best conceptualized as an overutilization of maladaptive emotion regulation strategies. Furthermore, the results indicate there is added benefit to considering these strategies within a hierarchical approach to psychopathology. These associations alert clinicians to potential treatment targets and contribute to an ongoing literature that seeks to identify underlying mechanisms of the structure of psychopathology.

<p>The standard of diagnosing and categorizing mental disorders in the United States has long been the Diagnostic and Statistical Manual of Mental Disorders (DSM), but the DSM has been criticized through evidence suggesting it lacks appropriate validity, reliability, and clinical utility. The Hierarchical Taxonomy of Psychopathology (HiTOP) has been offered as a solution to these criticisms. But the recommendation to replace the DSM and its categorical diagnostic system has been met with doubt and criticism by others in the field. A common sentiment in these critiques is a lack of evidence that the HiTOP dimensions are clinically useful or that clinicians would be open to applying them to their patients. The goal of the present study was to compare clinician perceptions of the HiTOP and DSM systems for the conceptualization of clinical cases. A sample of actively practicing clinicians (<i>n</i> = 143) rated one of three clinical vignettes using the HiTOP and DSM systems 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 intervention, communicating clinical information to the client, comprehensively describing client psychopathology, describing global functioning, and ease of applying the system to the individual. 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. These results suggest interest in HiTOP and dissatisfaction with the DSM among clinicians.</p>

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Pathological gambling and substance use disorders are highly prevalent and comorbid among veteran populations. These disorders also share genetic influences, although the underlying constructs and magnitude of their influence remain unclear. This project utilized the Hierarchical Taxonomy of Psychopathology (HiTOP) as a framework for modeling the underlying dimensions of psychopathology as latent factors and modeled genetic and environmental influences on substance use disorders and pathological gambling. Study 1 examined the structure of psychopathology for 15 common mental disorders in a sample of Vietnam-era veteran twins from the Harvard Drug Study (nMZ = 3,748 and nDZ = 2,996) to determine the appropriate location for pathological gambling within the HiTOP framework. The best fitting model included internalizing and externalizing spectra and an illicit substance use subfactor. Pathological gambling (loading = .30) loaded onto the externalizing spectrum with legal substance use, conduct disorder, antisocial personality disorder, and a subfactor that subsumed all six illicit substance use disorders. The best fitting model in Study 1 did not support the existence of a ‘p’ factor underlying all psychopathology. In Study 2, genetic and environmental components were modeled for the 15 disorders and 3 latent factors modeled in Study 1. Additive genetics explained from 10% (generalized anxiety disorder, panic disorder) to 49% (nicotine use) of the variance in specific disorders and from 24% (internalizing) to 46% (externalizing) of the variance of latent factors. Only cocaine use and conduct disorder demonstrated significant variance attributable to shared environment, the entirety of which occurred at the disorder-specific level. Only 9% of the genetic variance associated with alcohol use was shared across disorders, whereas 100% of genetic variance in cocaine and hallucinogen use was shared with latent factors. In total, 12% of the variance in risk for pathological gambling was associated with additive genetics, and 13% of that variance was shared via the externalizing spectrum. Findings highlight shared risk among illicit substance use disorders and among other disorders on the externalizing spectrum. These findings suggest externalizing and illicit substance use as transdiagnostic targets for treatments aimed at individuals with comorbid substance use disorders, pathological gambling, and other externalizing disorders.

The Diagnostic and Statistical Manual of Mental Disorders arranges co-occurring clusters of symptoms into distinct disorder categories, which theoretically have specific etiologies, pathologies, and treatments. However, researchers and clinicians alike have consistently found DSM diagnoses to have high rates of comorbidity, low diagnostic specificity, and no disorder has proven to be a discrete category. There is mounting evidence that dimensional taxonomies more accurately capture the underlying structure of mental illness and clinical presentations. The recently proposed hierarchical taxonomy of psychopathology presumes to address the issues of categorical nosologies using a data driven approach to create a dimensional model of psychopathology. However, heretofore there are no empirical examinations of HiTOP's ability to predict psychotherapy treatment outcomes. This study compared the predictive validity DSM, RDoC, and HiTOP criteria using natural language processing on free text narrative notes. Of the three GMM run, only the model using DSM criteria as predictors had adequate model fit. Additionally, none of the nosologies significantly predicted treatment course. Implications for the application of RDoC and HiTOP are discussed.

This work is trying to identify possible non-stimulatory effects and distant effects of muscle electrostimulation musculus quadriceps femoris based on a literature search. Furthermore evaluates the influence of High Tone Electrical Stimulation (HTEMS) muscles of lower limbs on the activity of the autonomic nervous system, expressed by heart rate variability, a spectral power in the individual frequency bands. Randomized crossover study involved 20 healthy subjects (12 men and 8 women), average age 24.6 ± 5.6 years. Heart rate variability was evaluated before application of HTEMS and immediately after. Measurements were performed with electrostimulator HiToP 191. The results did not show statistically significant increase in spectral power in the individual frequency bands. The study also deals with the reproducibility of measurements of sensitive and motor threshold for electrostimulation HTEMS method, which was confirmed. Powered by TCPDF (www.tcpdf.org)

This work is trying to identify possible non-stimulatory effects and distant effects of muscle electrostimulation musculus quadriceps femoris based on a literature search. Furthermore evaluates the influence of High Tone Electrical Stimulation (HTEMS) muscles of lower limbs on the activity of the autonomic nervous system, expressed by heart rate variability, a spectral power in the individual frequency bands. Randomized crossover study involved 15 healthy subjects (7 men and 8 women), average age 24.4 ± 2,5 years. Heart rate variability was evaluated in two situations: the situation without the application HTEMS and the situation with the aplication of HTEMS. Electrostimulation was done with HITOP 191. The results did not show statistically significant differences in all monitored components. The study also dealt with the reproducibility of measurements of perception and motor threshold for HTEMS.

La catégorisation actuelle du trouble de l’addiction dans le DSM-V fait face à plusieurs problèmes théoriques. D’abord, la catégorie nommée « Troubles liés à l’abus de substance et troubles addictifs » met en évidence le problème de l’exclusion par son manque de justification à inclure certains troubles du comportement, mais à en exclure d’autres, dans sa caractérisation. Le chevauchement constitue le deuxième problème que pose la catégorie du DSM-V, dans la mesure où certaines catégories censées être distinctes se recoupent en réalité. Les problèmes d’exclusion et de chevauchement remettent en question le fait de tracer ainsi les frontières entre catégories et en révèlent leur manque de validité conceptuelle. Et alors que la catégorie du trouble de l’addiction se heurte à ces problèmes, on peut douter de son utilité dans le traitement et la prise en charge des patients. Donc, par souci de fournir une classification en psychiatrie qui est valide et utile, il est nécessaire de redéfinir le trouble de l’addiction. Cela nous permettra de le classer autrement et adéquatement. Ainsi, nous défendons la thèse, dans ce mémoire, selon laquelle l’addiction ne renvoie pas à une entité discrète mais plutôt à un continuum, où coexistent deux phénomènes qu’il faut toutefois séparer : la motivation addictive et le trouble de l’addiction. Selon la définition que nous proposons, une taxonomie dimensionnelle, plutôt que catégorielle, représente mieux le trouble de l’addiction. Une telle approche possède le potentiel d’offrir de meilleurs outils aux cliniciens et aux chercheurs dans le traitement des personnes atteintes du trouble de l’addiction. / The categorization of addiction in the DSM-V faces many theoretical problems. First, the category named “Substance-use disorders and addictive disorders” emphasizes the problem of exclusion by its lack of justification to include certain behavioral disorders, whilst also excluding many other ones. Second, the category also induces the problem of overlapping, which refers to the way certain categories expected to be distinct actually intersect with each other. These problems of exclusion and overlapping raise some questions about the way the boundaries between categories are traced and reveal their lack of conceptual validity. Moreover, as categorization faces these theoretical problems, we can also doubt the usefulness of the category of addiction in the treatment and care of patients. Therefore, it is necessary to redefine addictive disorder in order to offer a classification that is valid and useful. Thus, in this memoir, we want to argue that addiction refers not to a discrete entity but to a continuum where two distinct phenomena coexist: addictive motivation and addictive disorder. According to our definition, dimensions, rather than categories, are much more appropriate to represent as is the disorder of addiction. This approach has the potential to offer better tools to clinicians and researchers in the treatment of people suffering from an addictive disorder.