Thread by @NTFabiano

Here is a data-driven reorganization of the symptoms in the DSM-5.

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These findings are from a study in @PsyArXiv which reduced the DSM-5 to its constituent symptoms and reorganized them based on patterns of covariation in individuals’ self-reported experiences of the symptoms to form a hierarchical framework. 2/10 osf.io/preprints/psya…

The points of agreement among hierarchical principal components analyses and hierarchical clustering, as well as between the randomly split primary (n=11,762) and hold-out (n=3,000) samples were used to identify the robust constructs that emerged to form a hierarchy. 3/10

There was marked convergence in the higher order constructs that emerged in each method. 4/10

Within each spectra, several robust lower order constructs emerged. 5/10

In nearly all cases there was evident heterogeneity in DSM-defined disorders such that their symptoms spanned multiple syndromes, subfactors, and/or (sub-)spectra. 6/10

However, the symptom level structure had noteworthy convergence with the quantitative psychopathology literature—particularly with the six core spectra of the @HiTOP_system. 7/10

With further testing of these findings and the accumulation of sufficient evidence, some of these points of difference between the structure in this paper and HiTOP could be incorporated in a formal revision of the HiTOP model. 8/10

Relative to the breadth of the DSM, the scope of this hierarchical structure expands substantially on the scope of HiTOP—from approximately 71 DSM disorders in the current HiTOP model to 167 disorders in this hierarchical structure. 9/10

This structure is an important step towards a comprehensive, empirically derived and supported classification system for psychopathology that can advance research and practice beyond the DSM by offering target constructs for neuroscience, genetics, and clinical psychology. 10/10

@aidangcw @ashleylwatts @Pbatterham @ACalear