Item response theory analyses of data from general population and clinical samples in the United States and elsewhere (42, 45, 47, 49, 57, 88) were used to determine the relationship of craving to the other substance use disorder criteria and whether its addition improved the diagnosis. Craving was measured using questions about a strong desire or urge to use the substance, or such a strong desire to use that one couldn’t think of anything else. Across studies, craving fit well with the other criteria and did not perturb their factor loadings, severity, or discrimination. Differential item functioning was generally no more pronounced for craving than for other criteria. In general population samples (e.g., the blue curve in Figure 2), craving fell within the midrange of severity (42). In clinical samples, craving was in the mid-to-lower range of severity, likely because 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
