Two main conclusions can be drawn from these analyses based on clinical samples of EDs patients from four different countries with very heterogeneous per-capita alcohol consumption and drinking cultures. First, exploratory factor analyses indicated that alcohol use disorders can be described as a single, unidimensional continuum without any clear cut distinctions between the criteria for dependence and abuse in all sites. This finding is in concordance with other reports from general population samples in Australia[3], the U.S.[2;23], samples of U.S. adolescents from clinical[24] and adjudicated, clinical, and community samples[25] and samples of treatment-seeking addicts[26] and psychiatric outpatients[27]. In these studies, as in the one reported here, even when some abuse items loaded on a second factor, a single unidimensional trait emerges as a much more parsimonious solution. Samples here of patients undergoing medical or injury treatment also strengthen the generalizability of the unidimensional finding for alcohol use disorders beyond community samples. These samples included patients that have been characterized as heavy chronic and acute drinkers[28;29]and, indeed, have a much higher prevalence of both alcohol use disorders and endorsement of alcohol
