In summary, these analyses provide equivocal support for the proposed changes to diagnostic criteria for DSM-5 AUD. The changes are unlikely to result in a dramatic difference in the prevalence of alcohol problems. The severity of alcohol problems in the subset of the sample with an unstable diagnostic status (i.e., those who would meet criteria for a DSM-5 diagnosis but were unaffected under DSM-IV guidelines, and vice versa) is low based on number of symptoms and patterns of comorbidity; thus, one “mild” phenotype is being exchanged for another. The factor and IRT analyses indicate that the LP criterion is not critically informative and its exclusion from the DSM-5 criteria is unlikely to be problematic. Regarding the biometrical comparison of the DSMIV and DSM-5 diagnoses, although there are significant AUD-specific genetic factors at play, the two diagnoses are very strongly genetically correlated. The new diagnostic criteria robustly index familial risk, fulfilling a critical validator of psychiatric illnesses (Robins and Guze, 1970). However, this is true of the DSM-IV criteria as well. Future analyses could be aimed at clarifying diagnosis-specific genetic influences,
