It is important to recognize several limitations to this study that could have affected results and potential clinical inferences. First, results were limited by study characteristics such as available assessment instruments, types of treatment, and demographic homogeneity. It should also be noted that the items used to develop the alcohol continuum used here, while generally mapping well onto Jellinek’s theory, were not generated for this purpose and may not correspond directly to each of his developmental stages. Finally, the representation of “severity” in this model is an abstract representation of a location on an alcohol dependence continuum that will not necessarily map onto some aspects of clinical severity that impact important treatment decisions. For example, such factors may be central in determining need for hospitalization but not be directly related to a core alcohol dependence continuum, such as health risks associated with comorbid medical conditions, or acute suicidal ideation. Although we believe that greater severity scores would generally translate to greater clinical concern, future research should further test the implications of IRT alcoholism severity indicators for clinical work with alcoholic patients.
