no case would have led to an additional DSM-5 SUD diagnosis among patients who had only one other criterion. In addition, while we did not have to drop legal problems to achieve unidimensionality of the SUD criteria as some studies did (Langenbucher et al., 2004; Saha et al., 2006), legal problems had low loadings on the unidimensional general substance use disorder factor and showed poor discrimination for each of the four substances. These results are consistent with a 1986 factor analytic study of alcohol rehabilitation patients (Svanum, 1986) that showed little relationship of alcohol-related legal problems to the other criteria, suggesting that the value of legal problems as a diagnostic criterion in clinical samples has not changed over the years. The present results contribute to the literature showing that legal problems are, at best, a weak or inconsistent indicator of the underlying substance use disorder latent construct and should be removed. Note that legal problems may be more important in specialized settings, where research and clinical planning should include separate assessments of this type of problem.
