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Chunk #29 — Discussion — Implications for DSM-V — 2. Tolerance and Larger/Longer do not have consistent severity signals across samples

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Toward DSM-V: an item response theory analysis of the diagnostic process for DSM-IV alcohol abuse and dependence in adolescents.
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related to sex, ethnicity or other variables. The DSM-IV alcohol symptoms were assessed based on self-reports and one operationalization of the DSM-IV symptoms. Our adjudicated sample included only 179 subjects; although this is a respectable size, the estimates for this group should be interpreted with caution. The abuse and dependence thresholds that we propose are based on severity of AUDs and the utility of these diagnostic categories for prognostic or treatment response information is unknown. Finally, our data did not include an alternative measure of AUD severity that might help assess the alternative algorithm without using information from the current symptoms. In future studies, we hope to examine follow-up data on the current sample.