3 ms·

HITOP sounds even worse with a spectrum for everything. It sounds less like a system for diagnoses and more a subjective, self reported way of classifying all h

HITOP sounds even worse with a spectrum for everything. It sounds less like a system for diagnoses and more a subjective, self reported way of classifying all humans.

Mathnerd314 2y ago
If you look at the suggested measures, you will see that for example, the Big-5 personality traits are on there. https://renaissance.stonybrookmedicine.edu/sites/default/files/HiTOP%20measures%20online.pdf https://renaissance.stonybrookmedicine.edu/sites/default/fil.... Although self-reported, I wouldn't say Big-5 is "subjective". The measures have good test-retest validity and many independent scales have been developed and found to be strongly correlated. I would argue this means Big-5 is not just "you answered this question on this scale" - it is measuring something deeper, maybe not personality per se but at least a mental attitude. I could easily see extending this sort of measurement process to all of the traits in DSM, and I think it is a worthwhile goal. There are two issues I have with HiTOP though. First, they haven't actually developed and published the scales, or even a concise and reliable description of them. For example, if you look for Big-5 scales, you will find that only extraversion and neuroticism are well-defined. The other dimensions aren't replicable. Just by listing Big-5 and not adding any caveats, it is clear that HiTOP isn't taking a critical view of these measures. In terms of actual, usable scales, there are just the ICD-11 and DSM-5 AMPD personality models, and combining these into a concise scale is active research. In this area, the HiTOP project has accomplished little so far besides drawing attention to these and other models. There is a 405-question battery https://hitop.unt.edu/clinical-tools/hitop-digital-assessment-and-tracker-hitop-dat.html https://hitop.unt.edu/clinical-tools/hitop-digital-assessmen..., but it hasn't been validated. Second, I find the goals somewhat confused and the distinction between categorical and dimensional somewhat artificial. For example in https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5811364/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5811364/, the proposal is to have a number of traits and to rate their severity. This model isn't particularly different from the current DSM - it is just that now rather than a "diagnosis of autism" one is rated as having a "severe autism trait". It is possible to have multiple diagnoses in the DSM and similarly in the proposed model it is possible to have multiple traits. About the only real difference is that diagnoses are going to be redefined to be one level above, what could be termed a meta-diagnosis in the current DSM. This is presumably going to be more strictly trait-based, and the traits are going to be de-duplicated, so that there are fewer differential diagnoses to deal with. You can see the proposed grouping here: https://renaissance.stonybrookmedicine.edu/HITOP/AboutHiTOP https://renaissance.stonybrookmedicine.edu/HITOP/AboutHiTOP. I don't see much issue with such groupings, but I also don't see it as a big change. Despite them saying it's a new framework that bears no relationship to the current one, I think all the current labels will still be around for a while, and it doesn't seem hard to fit all the DSM-5 labels into the new framework either as traits or as diagnoses (syndromes).

HITOP sounds even worse with a spectrum for everything. It sounds less like a system for diagnoses and more a subjective, self reported way of classifying all humans.

Mathnerd314 2y ago

If you look at the suggested measures, you will see that for example, the Big-5 personality traits are on there. https://renaissance.stonybrookmedicine.edu/sites/default/files/HiTOP%20measures%20online.pdf https://renaissance.stonybrookmedicine.edu/sites/default/fil.... Although self-reported, I wouldn't say Big-5 is "subjective". The measures have good test-retest validity and many independent scales have been developed and found to be strongly correlated. I would argue this means Big-5 is not just "you answered this question on this scale" - it is measuring something deeper, maybe not personality per se but at least a mental attitude. I could easily see extending this sort of measurement process to all of the traits in DSM, and I think it is a worthwhile goal. There are two issues I have with HiTOP though. First, they haven't actually developed and published the scales, or even a concise and reliable description of them. For example, if you look for Big-5 scales, you will find that only extraversion and neuroticism are well-defined. The other dimensions aren't replicable. Just by listing Big-5 and not adding any caveats, it is clear that HiTOP isn't taking a critical view of these measures. In terms of actual, usable scales, there are just the ICD-11 and DSM-5 AMPD personality models, and combining these into a concise scale is active research. In this area, the HiTOP project has accomplished little so far besides drawing attention to these and other models. There is a 405-question battery https://hitop.unt.edu/clinical-tools/hitop-digital-assessment-and-tracker-hitop-dat.html https://hitop.unt.edu/clinical-tools/hitop-digital-assessmen..., but it hasn't been validated. Second, I find the goals somewhat confused and the distinction between categorical and dimensional somewhat artificial. For example in https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5811364/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5811364/, the proposal is to have a number of traits and to rate their severity. This model isn't particularly different from the current DSM - it is just that now rather than a "diagnosis of autism" one is rated as having a "severe autism trait". It is possible to have multiple diagnoses in the DSM and similarly in the proposed model it is possible to have multiple traits. About the only real difference is that diagnoses are going to be redefined to be one level above, what could be termed a meta-diagnosis in the current DSM. This is presumably going to be more strictly trait-based, and the traits are going to be de-duplicated, so that there are fewer differential diagnoses to deal with. You can see the proposed grouping here: https://renaissance.stonybrookmedicine.edu/HITOP/AboutHiTOP https://renaissance.stonybrookmedicine.edu/HITOP/AboutHiTOP. I don't see much issue with such groupings, but I also don't see it as a big change. Despite them saying it's a new framework that bears no relationship to the current one, I think all the current labels will still be around for a while, and it doesn't seem hard to fit all the DSM-5 labels into the new framework either as traits or as diagnoses (syndromes).