not significantly relate to problem outcomes at 5-year follow-up 40. Consistent with prior evidence of the unreliability of this symptom, our results show that Larger/Longer is of much lower severity in adjudicated adolescents and also significantly different across community and clinical samples. An IRT-based study of DSM-IV symptoms for cannabis use disorders in this same sample also identified DIF in these two dependence items 41. A future IRT-based study of clinical and community adults might resolve whether these symptom differences are specific to adolescence. These items may warrant reconsideration in DSM-V because it is undesirable to have diagnostic symptoms that are less likely to be endorsed by clinically relevant persons, or are consistently misinterpreted by adolescents who are at greatest risk of developing these disorders.
