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Reconstructing Psychopathology: A data-driven reorganization of the symptoms in the Diagnostic and Statistical Manual of Mental Disorders

2023/11/30 by Miriam K. Forbes, Andrew Baillie, Philip J. Batterham +13 · 1 voice
Psychology · Arts and Humanities · #Mental Health Research Topics #Mental Health and Psychiatry

paper · pdf · doi:10.31234/osf.io/7um9a_v1

openalex publication_date 2023/11/30 · openalex created_date 2025/10/10 · openalex updated_date 2026/07/26

Abstract

In this study, we reduced the DSM-5 to its constituent symptoms and reorganized them based on patterns of covariation in individuals’ (n = 14,762) self-reported experiences of the symptoms to form an empirically derived hierarchical framework of clinical phenomena. Specifically, we used the points of agreement among hierarchical principal components analyses and hierarchical clustering, as well as between the randomly split primary (n = 11,762) and hold-out (n = 3,000) samples, to identify the robust constructs that emerged to form a hierarchy ranging from symptoms and syndromes up to very broad superspectra of psychopathology. The resulting model had noteworthy convergence with the upper levels of the Hierarchical Taxonomy of Psychopathology (HiTOP) framework and substantially expands on HiTOP’s current coverage of dissociative, elimination, sleep-wake, trauma-related, neurodevelopmental, and neurocognitive disorder symptoms. We also mapped some exemplar DSM-5 disorders onto our hierarchy; some formed coherent syndromes, whereas others were notably heterogeneous.

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