This is the first study to address a range of proposed DSM-5 changes in SUD criteria in a clinical sample. We examined dimensionality, criterion severity and discrimination, differential item functioning and total information for the DSM-IV abuse and dependence criteria and craving for four substances: alcohol, cannabis, cocaine and heroin. Consistent findings across analytic methods and substances supported combining DSM-IV abuse and dependence criteria into criteria for a single disorder, because the criteria all were indicators of a unidimensional SUD latent trait. However, as was found in other samples, legal problems as a criterion occurred rarely and had low factor loadings and discrimination parameters across substances. Craving fit well within the unidimensional structure but did not add unique information to that already offered by the DSM-IV dependence criteria. Some differential item functioning was found by age, race/ethnicity and by psychiatric status, suggesting the need for further study to understand this better. Finally, compared to the DSM-IV dependence criteria, adding three DSM-IV abuse criteria (excluding legal) and craving significantly increased the total information available from the criteria sets for alcohol, cannabis and heroin, although not for cocaine.
