Researchers Propose New Mental Health Diagnostic Model

Glasses perched on stack of open booksThe Diagnostic and Statistical Manual of Mental Disorders, now in its fifth edition (DSM-5), is the preferred guide for diagnosing mental health conditions. However, an international group of psychologists and psychiatrists have developed an alternative to the DSM-5. The group has proposed evidence-based changes to current diagnostic standards. Details on the new guide, called the Hierarchical Taxonomy of Psychopathology (HiTOP), are published in the Journal of Abnormal Psychology.

HiTOP: New Model for Psychiatric Diagnosis

The DSM-5 relies on a categorical model for diagnosis. Other models, such as the World Health Organization’s International Classification of Diseases (ICD-10), use a similar approach. Under these models, a person must have a predetermined number of symptoms, regardless of symptom severity, to qualify for an official diagnosis.

The HiTOP uses a dimensional, hierarchical model that recognizes a continuum of mental health. Rather than seeing depression and other diagnoses as something a person either has or does not have, the HiTOP recognizes shades of gray and levels of severity.

The new approach uses statistical data to narrow the number of mental health diagnoses, achieve more accurate diagnostic outcomes, and identify symptoms that tend to appear together. HiTOP guidelines focus on prognosis, treatment, and symptom severity rather than categorization.

For example, rather than treating social anxiety as something a person either has or does not have, HiTOP identifies grades of social anxiety. Some people experience mild anxiety in social situations, while others experience debilitating fear. These varying dimensions of social anxiety make it a diagnosis of degree, where clinically significant social anxiety is treated as a more pronounced form of mild anxiety in social situations.

How Diagnostic Changes Could Affect Mental Health Treatment

Diagnostic standards can affect whether and to what extent mental health services are covered by insurance. Diagnostic guidelines that accurately capture and describe symptoms have the potential to help more people get effective treatment.

Mental health professionals also rely on these guidelines to differentiate conditions with similar symptoms. For instance, depression-like symptoms could be due to bipolar, posttraumatic stress, or borderline personality. Clear diagnostic guidelines can help people get accurate diagnoses more quickly, while avoiding medication and treatment for conditions that people do not have.

Because the HiTOP could eliminate the boundaries between having a diagnosed condition and not having enough symptoms for a diagnosis, these proposed diagnostic changes could also help to reduce stigma surrounding mental health conditions.


  1. Evidence-based diagnostic model for mental illness. (2017, March 23). Retrieved from
  2. Kotov, R., Krueger, R. F., Watson, D., Achenbach, T. M., Althoff, R. R., Bagby, R. M., . . . Zimmerman, M. (2017). The Hierarchical Taxonomy of Psychopathology (HiTOP): A dimensional alternative to traditional nosologies. Journal of Abnormal Psychology. doi:10.1037/abn0000258

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  • Taylor

    March 30th, 2017 at 12:59 PM

    Do you even know how upset and even angry I get when I constantly have to read that so much of what is considered for medical treatment is actually determined by the insurance companies? It makes me angry to think that some little nobody in nowheresville USA is deciding what kind of medical treatment I can receive and they are not even a trained clinician!

  • vickie

    March 31st, 2017 at 12:38 PM

    So will this eventually be the new standard?

  • Lorraine C.

    April 1st, 2017 at 5:39 AM

    It may reduce the number of diagnoses in DSM5 but that does not address how the patient arrived at that situation in the first place, the reasons for which can be very complex and do not neatly fit into a category. Cliniccal notes that match the Symptons in DSM 5 ore ICT10 are rather like a person going to court having received legal advice on case law and giving evidence to match case law which may not be true in the first place

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