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.

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.