ideal, and can result in unstable parameter estimates. In addition, for some of our analyses, we modeled the sexes jointly, though it is reasonable to expect that sex differences exist. For example, difficulty parameters for each symptom were higher for women than for men when examined separately. Importantly, qualitative differences between the sexes were limited; for example, while the difficulty parameter estimates differed, the ordering of the items based on difficulty is nearly identical across sexes. Quantitative sex differences, including measurement invariance across sex, should be explored further, but were beyond the scope of the current analyses. Finally, this sample consisted exclusively of Caucasian individuals, and our results are not necessarily applicable to other ethnicities. These limitations do not diminish the relevance of our overall findings, which suggest that the proposed DSM-5 alcohol use disorder criteria do not represent a substantial improvement above the current criteria in terms of diagnostic validity.
