at least once a week in the past year when introduced with others symptoms of the current DSM-IV criteria for alcohol abuse and dependence in an Item Response Theory analysis (IRT) tapped into the mildest range of the alcohol use disorder continuum (i.e., lower levels of severity) that was not captured by any other abuse or dependence criteria. Following the report of Saha [6], Helzer [7] discussed the evidence for the unidimensionality of substance use disorders and suggested that, for alcohol use disorders, the 5+/4+ criterion could be added to the categorical definition to strengthen the “mild to moderate range of dimensional definition”. While each dimension of the DSM diagnostic scheme is intended to describe maladaptive patterns of consumption[8], a level of consumption considered ‘maladaptive’ has not been included in the diagnostic nosology due, in part, to cross-cultural variation in normative drinking levels[9].
