Rapid Fire Oral Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2026

Psychopathology frameworks in psycho-oncology: A comparative evaluation of clinical utility (146580)

Annika Hegde 1 , Jai Carmichael 1 2 , Nicolas Hart 1 3 4 5 6 , Darren Haywood 1 7 8 9
  1. Human Performance Research Centre, INSIGHT Research Institute, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
  2. Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, VIC, Australia
  3. Caring Futures Institute, College of Health and Enablement, Flinders University, Adelaide, SA, Australia
  4. Exercise Medicine Research Institute, School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia
  5. Cancer and Palliative Care Outcomes Centre, Centre for Healthcare Transformation, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
  6. Institute for Health Research, University of Notre Dame Australia, Perth, WA, Australia
  7. Department of Mental Health, St. Vincent’s Hospital Melbourne, Fitzroy, VIC, Australia
  8. School of Population Health, Faculty of Health Sciences, Curtin University, Bentley, WA, Australia
  9. Centre for Mental Health and Brain Sciences, Swinburne University of Technology, Hawthorn, VIC, Australia

Background: Individuals living with or beyond a cancer diagnosis have a heightened risk of psychological distress and suicidal presentations. Research has shown many symptoms prescribed to mental health are common side effects of cancers and medical treatment. Whereby, the Diagnostic and Statistical Manual of Mental Disorders (DSM) has shown to have high comorbidity, within-symptom heterogeneity, and under/over diagnosis. Recent evidence has established empirical validity for a dimensional and hierarchical model of psychopathology (i.e., Hierarchical Taxonomy of Psychopathology; HiTOP). However, the framework’s clinical utility has yet to be assessed within psycho-oncology. Thus, we aimed to compare the clinical perceptions of HiTOP and the DSM. 

Methods: Adapting Balling et al.’s (2023) methodology, participants (i.e., psychologists regularly providing services to cancer survivors) were randomly assigned one of three cancer-focused vignettes. After assessing it through HiTOP and DSM systems, participants completed a six-domain clinical utility questionnaire. 

Results: A mixed-model ANOVA was used. Based on a power analysis, the target sample size was 60 clinicians, and the achieved sample size was 145 participants. Results showcased that HiTOP and DSM differed significantly in overall perceived clinical utility. Vignette content did not impact overall clinical utility ratings. Specifically, for five out of six clinical utility domains, the HiTOP system was evaluated more favourable than the DSM. Specifically, HiTOP scored higher in ease of application, communicating clinical information to the client, describing psychopathology, formulation of the case, and describing global functioning. There was no statistical significance between the DSM and HiTOP systems for communication about the individual to other health professionals. 

Conclusions: These findings suggest a need to reconsider dimensional, categorical frameworks in the assessment and treatment of mental health among cancer patients. This will guide further research into HiTOP's applicability, with the long-term goal of updating psycho-oncology practice to improve mental health outcomes.

  1. Balling, C. E., South, S. C., Lynam, D. R., & Samuel, D. B. (2023). Clinician perception of the clinical utility of the Hierarchical Taxonomy of Psychopathology (HiTOP) system. Clinical Psychological Science, 11(6). https://doi.org/10.1177/21677026221138818