Всемирная психиатрия. №2 2020

Валидность и возможности клинического применения иерархической систематики психопатологии (HiTOP): I. Надспектр психоза

Roman Kotov1, Katherine G. Jonas1, William T. Carpenter2, Michael N. Dretsch3, Nicholas R. Eaton4, Miriam K. Forbes5, Kelsie T. Forbush6, Kelsey Hobbs7, Ulrich Reininghaus8,9,10, Tim Slade11, Susan C. South12, Matthew Sunderland11, Monika A. Waszczuk1,Thomas A. Widiger13, Aidan G.C. Wright14, David H. Zald15, Robert F. Krueger7, David Watson16, HiTOP Utility Workgroup*

1Department of Psychiatry, Stony Brook University, Stony Brook NY, USA; 2Department of Psychiatry, University of Maryland, Baltimore MD, USA; 3Walter Reed Army Institute of Research, US Army Medical Research Directorate – West, Silver Spring MD, USA; 4Department of Psychology, Stony Brook University, Stony Brook NY, USA; 5Department of Psychology, Macquarie University, Sydney Australia, 6Department of Psychology, University of Kansas, Lawrence KS, USA; 7Department of Psychology, University of Minnesota, Minneapolis MN, USA; 8Department of Public Mental Health, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Germany; 9ESRC Centre for Society and Mental Health, King's College London, London UK; 10Centre for Epidemiology and Public Health, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London UK; 11Matilda Centre for Research in Mental Health and Substance Abuse, University of Sydney, Sydney NSW, Australia; 12Department of Psychological Sciences, Purdue University, West Lafayette IN, USA; 13Department of Psychology, University of Kentucky, Lexington KY, USA; 14Department of Psychology, University of Pittsburgh, Pittsburgh PA, USA; 15Department of Psychology, Vanderbilt University, Nashville TN, USA; 16Department of Psychology, University of Notre Dame, South Bend IN, USA; *Участники Рабочей Группы HiTOP перечислены в Приложении

Стр. 151-172

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Опубликовано: 1 июня 2020

Аннотация / Abstract

a:2:{s:4:"TEXT";s:65532:"a:2:{s:4:"TYPE";s:4:"HTML";s:4:"TEXT";s:112277:"Консорциум Иерархической Таксономии (систематики) психопатологии (HiTOP) был сформирован специалистами по психиатрической нозологии с целью обобщения данных из исследований об организации психопатологии и создания системы, основанной на них1. Эта попытка обусловлена недостатками традиционных классификаций: условностью границ между психопатологией и нормой, нестабильностью диагностических категорий, гетерогенностью проявлений расстройств, частой коморбидностью и неспособностью учитывать доклинические случаи. Система HiTOP справляется с этими проблемами путем: а) определения психопатологии в терминах дименсий психологических функций, строго ранжированных от нормы до патологии; б) определения дименсий, основывающихся на наблюдаемой ковариации между признаками, симптомами и дезадаптивным поведением; и в) комбинирования этих первичных дименсий в более широкие спектры.Дименсиональный подход позволяет решить проблему условности границ психопатологии и диагностической нестабильности, о чем свидетельствует высокая ретестовая надежность дименсиональных подходов в психопатологии2-5. Более того, ни один пациент не исключается из системы, поскольку лица с подпороговыми симптомами или необычными профилями симптомов могут быть охарактеризованы с помощью совокупности нескольких дименсий. Модель HiTOP снижает гетерогенность внутри конструктов путем группировки вместе связанных симптомов и отнесения несвязанных симптомов к разным дименсиям6-9. В такой системе коморбидность определяется через отнесение связанных состояний к одному спектру. Иерархическая организация позволяет гибко описывать пациента в терминах широкого спектра дименсий и более узких поддименсий, в зависимости от желаемого уровня точности.Система HiTOP в данный момент включает шесть спектров высшего порядка: интернализация, соматоформные состояния, расторможенная экстернализация, антагонистическая экстернализация, расстройства мышления и отреше...

Консорциум Иерархической Таксономии (систематики) психопатологии (HiTOP) был сформирован специалистами по психиатрической нозологии с целью обобщения данных из исследований об организации психопатологии и создания системы, основанной на них1. Эта попытка обусловлена недостатками традиционных классификаций: условностью границ между психопатологией и нормой, нестабильностью диагностических категорий, гетерогенностью проявлений расстройств, частой коморбидностью и неспособностью учитывать доклинические случаи. Система HiTOP справляется с этими проблемами путем: а) определения психопатологии в терминах дименсий психологических функций, строго ранжированных от нормы до патологии; б) определения дименсий, основывающихся на наблюдаемой ковариации между признаками, симптомами и дезадаптивным поведением; и...

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