As noted here, addition or exclusion of a more frequently endorsed aspect of a criterion set (e.g. drinking and driving) can result in across-study heterogeneity. This concern is not specific to AUD diagnoses. Psychometric work on DSM-IV mania found that nuanced differences in item phraseology could produce pronounced variations in the architecture of the construct (37). For DSM-5, these challenges could be overcome with further guidance from the working group regarding how individual criteria are to be operationalized.
