Alcohol use disorder symptoms are kinda detectable in daily life (but it depends on how they are operationalized)

Contemporary theoretical models articulate how people experience symptoms of alcohol use disorders (AUD) in their daily lives, but few studies have modeled these symptoms at the daily level. We estimated Rasch and 2PL IRT models in two ecological momentary assessment samples of regularly drinking young adults (n = 527, age 18 – 22, 45% female) assessed over 3,963 alcohol use days. Symptoms were relatively common on drinking days, especially symptoms related to consumption (such as time spent or larger/longer). Items related to consumption (e.g. tolerance, larger/longer) were more common than alcohol-related consequences (e.g. interpersonal consequences). The specific threshold or item used to define each AUD symptom could have a substantial impact on item parameters. Tolerance best loaded onto a factor of daily AUD symptoms when operationalized as sensitivity to the effects of alcohol, while larger/longer was best reflected as drinking much more than intended (e.g. 3+). Daily life research focusing only on alcohol-related consequences misses important information about common experiences of AUD symptoms in daily life. Further refinement of daily measures of AUD symptoms could help researchers understand how the disorder develops over time.