There are several strengths of the CSDP including a prospective design with alcohol and placebo testing at three phases, outstanding retention, and determination of drinking and AUD symptoms from early to middle adulthood. Most notably, we were able to attain near-perfect retention of participants across the decade. The inclusion of dual follow-up outcomes, i.e., categorical AUD diagnosis and trajectory analyses of symptom growth over time, provide a powerful picture of the development of alcohol problems (55). Related, as this longitudinal study began in 2004, many years prior to the 2013 release of the DSM-5, trajectory analysis was based on DSM-IV symptom counts for alcohol abuse and dependence. Thus, symptom counts may have been “undercounts” with actual symptom count severity likely higher if DSM-5 was available because the DSM-IV included the item for legal problems, which was determined to have infrequent endorsement (56), and did not include the item for craving, which is more often endorsed (57).
