We sought to examine whether endorsement of certain diagnostic criteria was associated with higher risk for severe AUD within the DSM-5 diagnostic scheme. IRT analyses revealed 6 high-risk criteria that reflect greater severity, and even after accounting for increasing criterion counts, there were significant differences among individuals who endorsed high- vs low-risk criteria. Moreover, individuals with mild-to-moderate AUD who endorsed 1 of these high-risk criteria were statistically indistinguishable from those with severe AUD with respect to theta EROs and P300 amplitude (after accounting for differences in criterion count). Individuals with moderate or high-risk mild-to-moderate AUD had the greatest hazards of progression to severe AUD across late adolescence and early adulthood. Overall, these analyses suggest that the presence of specific criteria are a superior indicator of risk for progression to severe AUD compared with criterion count alone. This difference is especially pronounced for the mild-to-moderate AUD group.
