Notably, several studies using self-report instruments have revealed that not all aspects of alcohol involvement are interchangeable. While AUDIT can be used as a unidimensional screener (i.e., AUDIT-Total), previous research has shown that AUDIT can differentiate between two related but distinct facets of AUD: alcohol consumption (sum of items 1–3, “AUDIT-C”), which is necessary but not sufficient for a diagnosis of AUD, and problematic consequences of alcohol consumption (sum of items 4–10, “AUDIT-P”), which more closely resemble the diagnostic criteria of AUD. We previously found that AUDIT-C and AUDIT-P have distinct genetic relationships with clinically-defined AUD (6), as well as other forms of psychopathology. Surprisingly, AUDIT-C was positively associated with socioeconomic variables, negatively associated with some forms of psychopathology, and only moderately positively associated with alcohol dependence, whereas AUDIT-P exhibited strong positive associations with alcohol dependence and numerous other psychiatric disorders. Although this divergence might reflect true differences in the biology underlying alcohol consumption versus problems, it may be confounded by other factors, such as sources of selection bias, genetic heterogeneity among the individual items, and measurement error (1, 8).
