In conclusion, estimates of the prevalence of AUDs based on the DSM-5 proposed revisions appear to be largely consistent with estimates from DSM-IV while adding a small subset of less severely affected individuals who were previously classified as diagnostic orphans. While DSM-5 classification of moderate versus severe AUDs is more dimensional than DSM-IV and has the advantage of capturing individuals with fewer criteria, it is limited in distinguishing at higher levels of vulnerability. The assumption that individuals with 4+ criteria are equally affected may not be accurate and future efforts may wish to distinguish amongst those diagnosed with “severe” DSM-5 AUDs with greater refinement. In addition, our analyses underscore the importance of revisiting the definitions of certain criteria, such as hazardous use and craving. With this opportunity to clarify the content of these criteria, we may be able to improve, not only upon the scope of diagnosis of AUDs, but also individual criteria which have been known to have psychometric inconsistencies.
