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15. Symptom-Level Explications of the Hierarchical Structure of Psychopathology
It is widely acknowledged that a hierarchical framework is the most appropriate way to organize a quantitative taxonomy of psychopathology. There also is growing consensus that dimensional nosological research must move beyond diagnostic comorbidity analyses in order to (a) avoid the methodological artifacts associated with diagnoses and (b) model more finely grained (and homogeneous) psychopathology dimensions. However, there has been little comprehensive work that brings these two approaches together. This study focuses on integrating different exploratory methods of modeling hierarchical structure—exploratory bifactor and bass-ackwards analysis—in order to facilitate the validation and interpretation of symptom-level metastructural models. Models were run using symptom-level epidemiological data from the 2000 British Office for National Statistics Survey of Psychiatric Morbidity (N = 8,405). These data include criteria from a broad array of disorders: major depression, mania, generalized anxiety, somatization, hypochondriasis, panic, agoraphobia, social phobia, specific phobia, obsessive-compulsive disorder, alcohol use disorder, substance use disorder, psychotic disorders, conduct disorder, and the 10 DSM personality disorders. Results are discussed in terms of (a) the overall structures that emerge using each method, (b) the constructs suggested by each factor, and (c) implications for efforts to develop and implement a quantitative dimensional taxonomy of psychopathology (e.g., HiTOP).