20 or 24, “early adult onset”; (3) individuals with at least 2 AUD symptoms at age 29 and one previous age, “persistent course”; and (4) individuals with 0 AUD symptoms at age 29 but at least 2 AUD symptoms at a previous age, “desistent course.”6 The strengths of the rationally-constructed approach include its simplicity, flexibility, and the ability to integrate information gleaned across settings and studies to develop theoretically coherent groups. However, the primary weakness of this approach is the subjective construction of groups. In the Hicks et al. study, for example, one might ask, why four groups? Why an AUD symptom cut-off of 2? Why those specific age permutations?
