Applying the HiTOP-TBI Model: Scoring Methods and External Correlates of Transdiagnostic Psychopathology Following Traumatic Brain Injury

Resumen de los autores

Traditional diagnostic systems (i.e., the DSM and ICD) present challenges in characterizing psychopathology following traumatic brain injury (TBI). To address this, we recently developed the Hierarchical Taxonomy of Psychopathology Following TBI (HiTOP-TBI) model, an empirical taxonomy that organized 57 psychopathology symptom/trait components into hierarchical dimensions based on latent variable modeling. However, the applied measurement of these dimensions and their relationship with external factors of potential relevance to post-TBI psychopathology remain unclear. To facilitate application of the model, we compared methods for quantifying ten HiTOP-TBI dimensions and examined their associations with sociodemographics, injury factors, and clinical outcomes. Data were analyzed from 410 adults with moderate-severe TBI (Mage=48.81, range=19.42–79.43), who completed the HiTOP-TBI assessment battery between 0.40 and 35.42 years post injury (M=12.77, SD=9.10). We assessed whether simpler scoring methods (i.e., factor score estimates, weighted, and unweighted sum-scores) adequately approximated the more complex latent-variable representations of the HiTOP-TBI dimensions. We then examined associations with sociodemographics, injury factors, and clinical outcomes, assessing comparability in results across the four scoring methods. To assess the utility of different levels within the HiTOP-TBI hierarchy, we compared the performance of models representing the general psychopathology, internalizing and externalizing spectra, and seven lower-order factors in predicting sociodemographics, injury factors, and clinical outcomes. Model performance was evaluated by balancing explanatory power against parsimony using the Bayesian Information Criterion (BIC). We found that unweighted sum-scores closely approximated more complex representations of the HiTOP-TBI dimensions (all rs ≥.89), supporting the utility of the simplest scoring method in practice. Across all three levels of the hierarchy, higher HiTOP-TBI scores, reflecting more severe psychopathology, were generally associated with younger age, male sex, lower education, unemployment, being single, and a pre-injury history of mental health treatment, while injury factors showed minimal associations. Additionally, higher scores on nearly all HiTOP-TBI dimensions were associated with greater functional disability, lower life satisfaction, and an increased likelihood of receiving mental health treatment. Standardized effect sizes varied by .02 on average across the four scoring methods (range=.00–.14). Models based on the General Problems factor (the highest-order level of the hierarchy) provided the most parsimonious account of many factors. However, second- and lower-order dimensions showed improved performance for sex, age, functional disability, and life satisfaction, indicating that greater hierarchical specificity may be informative for selected correlates.

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Cómo citar (APA 7)

Samiotis, A., Ponsford, J., Forbes, M. K., Tiego, J., Gould, K. R., Kotov, R., Fornito, A., Spitz, G., & Carmichael, J. (2026). Applying the HiTOP-TBI Model: Scoring Methods and External Correlates of Transdiagnostic Psychopathology Following Traumatic Brain Injury. https://doi.org/10.31234/osf.io/mszyh_v1