No standardized way of grouping consequences has been developed to date. In fact, scaling or grouping of negative consequences from drinking remains one of the most controversial areas within alcohol research (36–39), partly because the items included on any particular measure can affect scores. For example, one analysis of general population survey data (40) found that the single item of driving after drinking accounted for a substantial proportion of persons meeting DSM-IV criteria for alcohol abuse. The selection of negative consequences for grouping is especially important for cross-national comparisons because culture may influence the extent that it is even possible to experience specific consequences (as an obvious example, drinking and driving is less likely to be a problem in countries where few people have access to cars). In addition, specific consequences may be linked to specific country drinking patterns (41, 42), a relationship that might be obscured if negative consequences were simply summed and treated as unidimensional.
