Alcohol Epidemiologic Survey (NLAES), craving cohered well with other DSM-IV alcohol dependence criteria, had the second highest discrimination and also the highest severity (with the exception of the abuse criterion of legal problems, which is proposed for exclusion in DSM-5). This indicates that the utility of craving will be most noticeable in distinguishing individuals with multi-symptom alcohol dependence but less so in those at low to moderate risk. That craving will add additional alcohol use disorder cases to DSM-5 diagnosis remains uncertain as, in our study and other epidemiological investigations (e.g. (Agrawal et al., 2011; Keyes, Krueger, Grant, & Hasin, 2010)), those reporting craving already met the burden of diagnosis. Therefore, as currently conceptualized craving, doesn’t significantly modify the epidemiology of alcohol use disorders but adds predictive utility in high risk individuals. Despite this significant overlap between craving and severity of alcohol dependence, a number of our candidate gene and a majority of the GWAS signals retained p-values ≤ 0.05 after adjusting for severity. This would suggest further specificity of these SNPs in the etiology of craving.
