The large sample size and well-tested measurement instrument (AUDADIS) used in the NLAES serve as strengths of this study. Given the pros and cons shown for adding craving to DSM-V based on epidemiologic data, a clear conclusion cannot be drawn on the advisability of this addition. However, the results presented above constitute part of the information under consideration by the DSM-V substance disorders workgroup, and provision of this information to the larger scientific community enhances the transparency of the DSM-V process. Future research using latent variable modeling techniques should focus on generating additional items that could improve both the reliability and validity of the current alcohol diagnoses, and discussions should continue regarding the utility of modifying DSM diagnoses to more closely correspond to ICD.
