lowest end, thus calling into question the DSM-IV hierarchy of abuse and dependence (Saha et al., 2006). Likewise, Proudfoot et al. (2006) found that the abuse criteria of hazardous drinking legal problems and drinking despite social/interpersonal problems were among the most severe criteria in an IRT analysis of a representative Australian population sample. Kahler and Strong (2006) reported similar findings when modeling the NESARC abuse and dependence symptoms rather than criteria, and they also found that any given criterion was associated with varying levels of severity depending on how it was operationalized. The impact of operationalization on criterion severity was also highlighted by a recent report (Harford et al., 2009) based on the National Survey on Drug Use in Households (NSDUH), in which the ranking of the 11 AUD criteria not only varied by age and gender but also differed from the ranking based on the NESARC (Saha et al., 2006).
