The Hierarchical Taxonomy of Psychopathology (HiTOP) consortium's transdiagnostic dimensional model of psychopathology has considerable support; however, this model has been underresearched in individuals at clinical high risk for psychosis (CHR-P), a population that may advance the model. CHR-P individuals not only have attenuated psychotic symptoms that vary in severity, but also have many comorbid diagnoses and varied clinical outcomes, including disorders with uncertain relations to HiTOP (e.g., obsessive-compulsive disorder). The present study used self-report and interview data from North American Prodrome Longitudinal Study-3 (710 CHR, 96 controls) to replicate the HiTOP model and test specific hypotheses regarding disorders with uncertain relations to its dimensions. Additionally, the present study examined the HiTOP model in relation to childhood trauma, declines in social functioning, and development of full psychosis. Confirmatory factor analysis indicated that the HiTOP model's fit was nearly adequate (e.g., comparative fit index = .89), though several theory-relevant modifications were indicated. Additionally, specific tests were conducted to gain a more fine-grained perspective on how disorders with less clear prior evidence were related to the HiTOP model. Notable findings from these analyses include bipolar spectrum disorders relating to the psychosis super spectrum (i.e., .39 loading), and obsessive-compulsive disorder showing a complex pattern of loadings (e.g., internalizing and psychosis). The final model parsimoniously accounted for childhood trauma (e.g., super spectra rs = .22-.32), associations with current functioning, and predicted future conversion to a psychotic disorder (e.g., super spectra R² = .13). Overall, these results inform the HiTOP model and suggest its promise for CHR-P research. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

中文翻译：

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临床高危精神病的精神病理学分层分类：验证和扩展。


精神病理学层次分类法（HiTOP）联盟的精神病理学跨诊断维度模型得到了相当大的支持；然而，该模型在临床精神病高危人群（CHR-P）中的研究不足，这一人群可能会推进该模型。 CHR-P个体不仅有严重程度不同的减轻的精神病症状，而且有许多合并症诊断和不同的临床结果，包括与HiTOP不确定关系的疾病（例如强迫症）。本研究使用北美 Prodrome 纵向研究 3（710 CHR，96 名对照）的自我报告和访谈数据来复制 HiTOP 模型并测试与其维度关系不确定的疾病的具体假设。此外，本研究还检验了 HiTOP 模型与童年创伤、社会功能下降和完全精神病发展的关系。验证性因素分析表明，HiTOP 模型的拟合度几乎足够（例如，比较拟合指数 = 0.89），尽管指出了一些与理论相关的修改。此外，还进行了特定测试，以便更详细地了解先前证据不太明确的疾病与 HiTOP 模型的关系。这些分析的显着发现包括与精神病超谱（即0.39负荷）相关的双相谱系障碍，以及显示出复杂负荷模式的强迫症（例如内化和精神病）。最终模型简单地解释了童年创伤（例如，超谱 rs = .22-.32）、与当前功能的关联，并预测未来转化为精神障碍（例如，超谱 R² = .13）。 总体而言，这些结果为 HiTOP 模型提供了信息，并表明其对 CHR-P 研究的前景。 （PsycInfo 数据库记录 (c) 2024 APA，保留所有权利）。