Evidence map›Paper›PMID 34002506›Full record

ArticleWorld psychiatry : official journal of the World Psychiatric Association (WPA)2021

Validity and utility of Hierarchical Taxonomy of Psychopathology (HiTOP): II. Externalizing superspectrum.

Robert F Krueger, Kelsey A Hobbs, Christopher C Conway, Danielle M Dick, Michael N Dretsch, Nicholas R Eaton, Miriam K Forbes, Kelsie T Forbush, Katherine M Keyes, Robert D Latzman and 14 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in World psychiatry : official journal of the World Psychiatric Association (WPA), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 125 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
125citing papers in PubMed, 4 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

125 citing papers in PubMed, 4 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Inhibitory Control in Late Childhood as a Predictor of Antisocial Behavior in Adolescence and the Role of Social Context.Prevention science : the official journal of the Society for Prevention Research · 2025
    Trial
  6. Article
  7. Divergent disinhibition profiles linked to externalizing psychopathology.Journal of psychopathology and clinical science · 2026
    Article
  8. Article
  9. Article
  10. Article
  11. Child and adolescent psychiatry: challenges, solutions, opportunities, and future directions.World psychiatry : official journal of the World Psychiatric Association (WPA) · 2026
    Article
  12. Review
  13. Article
  14. Associations of Tonic and Phasic Irritability With Psychopathology Subfactors of the Hierarchical Taxonomy of Psychopathology.Clinical psychological science : a journal of the Association for Psychological Science · 2026
    Article
  15. Article
  16. Review
  17. Article
  18. Genomic insights into substance use and disinhibitory disorders.medRxiv : the preprint server for health sciences · 2026
    Article
  19. Article
  20. Article

65 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

24 authors.

Robert F KruegerDepartment of Psychology, University of Minnesota, Minneapolis, MN, USA.
Kelsey A HobbsDepartment of Psychology, University of Minnesota, Minneapolis, MN, USA.
Christopher C ConwayDepartment of Psychology, Fordham University, Bronx, NY, USA.
Danielle M DickDepartment of Psychology, Virginia Commonwealth University, Richmond, VA, USA.
Michael N DretschUS Army Medical Research Directorate - West, Walter Reed Army Institute of Research, Joint Base Lewis-McChord, WA, USA.
Nicholas R EatonDepartment of Psychology, Stony Brook University, Stony Brook, NY, USA.
Miriam K ForbesCentre for Emotional Health, Department of Psychology, Macquarie University, Sydney, NSW, Australia.
Kelsie T ForbushDepartment of Psychology, University of Kansas, Lawrence, KS, USA.
Katherine M KeyesDepartment of Epidemiology, Columbia University, New York, NY, USA.
Robert D LatzmanDepartment of Psychology, Georgia State University, Atlanta, GA, USA.
Giorgia MicheliniSemel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, CA, USA.
Christopher J PatrickDepartment of Psychology, Florida State University, Tallahassee, FL, USA.
Martin SellbomDepartment of Psychology, University of Otago, Dunedin, New Zealand.
Tim SladeMatilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW, Australia.
Susan C SouthDepartment of Psychological Sciences, Purdue University, West Lafayette, IN, USA.
Matthew SunderlandMatilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW, Australia.
Jennifer TackettDepartment of Psychology, Northwestern University, Evanston, IL, USA.
Irwin WaldmanDepartment of Psychology, Emory University, Atlanta, GA, USA.
Monika A WaszczukDepartment of Psychiatry, Stony Brook University, Stony Brook, NY, USA.
Aidan G C WrightDepartment of Psychology, University of Pittsburgh, Pittsburgh, PA, USA.
David H ZaldDepartment of Psychology, Vanderbilt University, Nashville, TN, USA.
David WatsonDepartment of Psychology, University of Notre Dame, Notre Dame, IN, USA.
Roman KotovDepartment of Psychiatry, Stony Brook University, Stony Brook, NY, USA.
HiTOP Utility Workgroup

Funding

U19 MIDlife in the United States-Diversity Supplement-WellsU19AG051426 · NIA · UNIVERSITY OF WISCONSIN-MADISON · PI CAROL D. RYFF · 2016 to 2026
$74.8M
Project 5 - Genetic architecture of alcohol use disorder using cross-trait genetic correlations and public next-generation sequencing studiesP50AA022537 · NIAAA · VIRGINIA COMMONWEALTH UNIVERSITY · PI JILL C BETTINGER · 2014 to 2026
$19.6M
The impact of adverse interpersonal experiences (AIE) on mild cognitive impairment (MCI) and risk for Alzheimer's disease and related dementias (ADRD) in ethnically diverse twinsR01AG053217 · NIA · UNIVERSITY OF MINNESOTA · PI Robert F Krueger, Glenn I Roisman · 2016 to 2026
$9.1M
Using the Genetic Architecture of Substance Use Disorders to Advance Gene Identification and Understanding of Pathways of RiskR01DA050721 · NIDA · VIRGINIA COMMONWEALTH UNIVERSITY · PI DANIELLE M DICK · 2020 to 2026
$3.9M
Twin, molecular, and developmental approaches to understanding alcohol misuseK02AA018755 · NIAAA · VIRGINIA COMMONWEALTH UNIVERSITY · PI DICK, DANIELLE M · 2010 to 2019
$1.3M
NIAAA NIH HHS K02 AA018755NIAAA NIH HHS P50 AA022537NIA NIH HHS R01 AG053217NIA NIH HHS U19 AG051426NIDA NIH HHS R01 DA050721
6 · The paper itself

Abstract

The Hierarchical Taxonomy of Psychopathology (HiTOP) is an empirical effort to address limitations of traditional mental disorder diagnoses. These include arbitrary boundaries between disorder and normality, disorder co-occurrence in the modal case, heterogeneity of presentation within dis-orders, and instability of diagnosis within patients. This paper reviews the evidence on the validity and utility of the disinhibited externalizing and antagonistic externalizing spectra of HiTOP, which together constitute a broad externalizing superspectrum. These spectra are composed of elements subsumed within a variety of mental disorders described in recent DSM nosologies, including most notably substance use disorders and "Cluster B" personality disorders. The externalizing superspectrum ranges from normative levels of impulse control and self-assertion, to maladaptive disinhibition and antagonism, to extensive polysubstance involvement and personality psychopathology. A rich literature supports the validity of the externalizing superspectrum, and the disinhibited and antagonistic spectra. This evidence encompasses common genetic influences, environmental risk factors, childhood antecedents, cognitive abnormalities, neural alterations, and treatment response. The structure of these validators mirrors the structure of the phenotypic externalizing superspectrum, with some correlates more specific to disinhibited or antagonistic spectra, and others relevant to the entire externalizing superspectrum, underlining the hierarchical structure of the domain. Compared with traditional diagnostic categories, the externalizing superspectrum conceptualization shows improved utility, reliability, explanatory capacity, and clinical applicability. The externalizing superspectrum is one aspect of the general approach to psychopathology offered by HiTOP and can make diagnostic classification more useful in both research and the clinic.

Indexed as

antagonismantisocial personality disorderclinical utilityCluster B personality disordersdisinhibitionexternalizingHiTOPsubstance use dis­orders

Identifiers

PMID34002506
PMCPMC8129870

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.