The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria for alcohol abuse and dependence serve as the basis for diagnosis in clinical work, prevalence estimation in epidemiology, and much of the etiological research reported in the literature. The alcohol dependence criteria in DSM-IV are based on the concept of the Alcohol Dependence Syndrome (ADS) (Edwards and Gross, 1976), in which dependence was considered to be a combination of physiological and psychological processes leading to increasingly impaired control over alcohol use even in the face of negative consequences. In their paper, Edwards and Gross (1976) introduced a bi-axial notion of alcohol-related problems in which the ADS forms one dimension or axis and alcohol-related consequences forms another dimension or axis. This bi-axial concept influenced the DSM-IV distinction between abuse criteria (mainly social, role functioning, or legal problems, or hazardous use, most commonly driving while intoxicated) and dependence criteria (tolerance, withdrawal, and numerous indicators of impaired control over use).
