The latent structure of alcohol use pathology in an epidemiological sample

Whether alcohol use pathology is more accurately conceptualized as a categorical construct, or as existing along a dimension remains an open question. Previous investigations of the latent structure of alcohol use pathology have yielded mixed results. The present study used a sample (N = 43,093) drawn from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) of the National Institute on Alcohol Abuse and Alcoholism. A factor analysis of items drawn from the Alcohol Consumption, Alcohol Abuse/Dependence (Alcohol Experiences), and Alcohol Treatment Utilization sections of the NESARC yielded three factors, labeled Functional Disturbance, Tolerance, and Frequency, which were used as indicators in a series of taxometric analyses. These analyses converged on a low base rate alcohol pathology taxon. The relevance of these findings for the diagnosis, etiology, further research, and treatment of alcohol use disorders is discussed.