Do cognitive functions belong in the Hierarchical Taxonomy of Psychopathology (HiTOP) Model? A meta-analysis

Cognitive dysfunction is essential to conceptualizing, defining, and assessing much ofpsychopathology. Despite this prominence, cognitive abilities are not included in the prevailingempirically based classification system: the Hierarchical Taxonomy of Psychopathology(HiTOP). This gap exists because the factor analytic literature HiTOP is based on has solely usedreporter measures rather than neuropsychological tests needed to measure cognitive ability.Given HiTOP’s influence on research and clinical practice, the omission of cognitive functionsfrom the model is consequential. This study aimed to determine how cognitive abilities fit intothe empirical structure of psychopathology with a meta-analytic joint factor analysis. We pooleddata from three published meta-analyses into a single correlation matrix of 8 DSM disorders and7 cognitive functions. We then fit a series of models to the meta-analytic correlation matrix usingexploratory factor analysis, and correlated factors across levels to estimate the hierarchicalstructure. The highest level of the model included a general factor with strong loadings of alldisorders and cognitive functions (median l= |.51|, range = |.30| - |.64|). At the lowest level werethree superspectra including 1) psychosis and cognitive dysfunction, 2) externalizing, and 3)emotional dysfunction. Our results show cognitive abilities can be integrated into the HiTOPmodel and point to actionable next steps in research to accomplish this goal.