The findings of this study must be interpreted with some caution in light of the fact that the measures used to validate AUD severity were, like the symptom items used to measure severity, based on self report. If the likelihood of completely and accurately reporting AUD symptom item indicators was correlated with the likelihood of completely and accurately reporting consumption, psychological functioning, family history of alcoholism, symptoms of antisociality and age at first drink, this could lead to overestimation of the correlation between severity and the outcome measures. External measures, e.g., collateral reports or records-based information, would provide a more unbiased assessment of validity. Likewise, the prognostic value of the severity scales might better be tested prospectively, as could be done using data from Wave 2 of the NESARC. However, there is no reason to think that externally or prospectively derived outcome measures would lead to different conclusions regarding the validity of the relative severity ranking of the AUD criteria. Similarly, whereas the slopes for the risk curves linking AUD severity and the various outcomes might be slightly exaggerated as
