IRT analyses can characterize the severity signal of individual DSM-IV symptoms. Our results are highly consistent with those of a previous study of DSM-IV alcohol symptoms in adolescents with severity parameters that were low for Tolerance and Social Problems, but high for Withdrawal and Quit/Control 18. Also consistent with previous reports, the symptoms Neglect Roles, Time Spent, and Activities Given Up had higher discrimination values, while Quit/Control and Withdrawal were less discriminating 4, 18. Quit/Control has been identified as problematic because many teens do not meet symptoms for dependence until they make a positive behavioral change by attempting to quit or control their use 35. Notably, our results were highly consistent with the previous study of adolescents though each study used a different structured clinical interview to assess DSM-IV AUD symptoms 18. As displayed in Figure 2, the alcohol abuse and dependence symptoms are most informative at levels of severity greater than 2 SDs above the mean, suggesting that the symptoms are most informative in adolescents with very severe alcohol problems as compared with what is observed in the general population (i.e., standardized to the community sample).
