A Hierarchical Model of the Symptom-Level Structure of Psychopathology in Youth

Abstract

More comprehensive modeling of psychopathology in youth is needed to facilitate a developmentally informed expansion of the Hierarchical Taxonomy of Psychopathology (HiTOP) model. In this study, we examined a symptom-level model of the structure of psychopathology in children and adolescents—most aged 11 to 17 years—bringing together data from large clinical, community, and representative samples ( N = 18,290) covering nearly all major forms of mental disorders and related content domains (e.g., aggression). The resulting hierarchical and dimensional model was based on the points of convergence among three statistical approaches and included 15 narrow dimensions nested under four broad dimensions of (a) internalizing, (b) externalizing, (c) eating pathology, and (d) uncontrollable worry, obsessions, and compulsions. We position these findings within the context of the existing literature and articulate implications for future research. Ultimately, these findings add to the rapidly growing literature on the structure of psychopathology in youth and move a step closer toward quantifying (dis)continuities in psychopathology’s structure across the life span.