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Chunk #14 — Overarching Issues — Should Any Criteria Be Added? — Craving

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DSM-5 criteria for substance use disorders: recommendations and rationale.
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of high prevalence (57). Some studies suggested that craving was redundant with other criteria (47, 49). Using visual inspection to compare item response theory total information curves for the DSM-5 substance use disorder criteria with and without craving produced inconsistent results (42, 47, 88). Using statistical tests to compare total information curves, the addition of craving to the dependence criteria did not significantly add information (45, 57). However, when craving and the three abuse criteria were added, total information was increased significantly for nicotine, alcohol, cannabis, and heroin, although not for cocaine use disorders (45, 57). Clinicians expressed enthusiasm about adding craving at work group presentations and on the DSM-5 web site. In the end, while the psychometric benefit in adding a craving criterion was equivocal, the view that craving may become a biological treatment target (a nonpsychometric perspective) prevailed. While awaiting the development of biological craving indicators, clinicians and researchers can assess craving with questions like those used in the item response theory studies (42, 45, 47, 49, 57, 88).