Since clinical utility is the highest priority in revising diagnostic criteria for DSM-5 (American Psychiatric Association), understanding the proposed changes in clinical samples is important. We therefore examined the proposed changes to DSM-5 SUD criteria among adult patients in substance abuse treatment settings. In this study, clinicians administered a highly reliable semi-structured diagnostic interview (Hasin et al., 2006b) and four substances were addressed: alcohol, cannabis, cocaine and heroin. We examined these questions: (1) could the unidimensionality of the DSM-IV abuse and dependence criteria be confirmed in this sample? (2) Did evidence support adding craving and dropping legal problems? (3) Was differential item functioning found by patient demographic or clinical characteristics? (4) Did adding abuse criteria and craving add significantly to the information offered by the dependence criteria alone?
