in three of the four alcohol consumption variables. Prior qualitative research in the scope of current nosological classifications [30] and quantitative analyses at the criterion level for an alcohol dependence diagnosis [31] has warned that not all criterions are similarly understood across different societies (such as impaired control and neglect of interests) and should be fine tuned for use in a cross-cultural context. While reports of cross-cultural differences in the prevalence of alcohol consumption variables, especially measures of heavy or harmful drinking, have previously been reported, this is the first report to show that differences on heavy drinking measures also abound in the context of the two parameters, severity and discrimination, on IRT analyses. Nevertheless, just a few of such DSM-IV criteria for alcohol dependence showed heterogeneity in estimates across sites. Most of the heterogeneity was found in abuse criteria and in alcohol consumption variables. These results also supported the finding from Saha [6] that even when some individual criteria show heterogeneity in severity and discrimination across subgroups (here among study sites) the total classification of the alcohol use disorder continuum is basically invariant. The addition of a consumption variable to the 11 criteria does not change the total performance
