Reliability of Differential Item Functioning in Alcohol Use Disorder: Bayesian Meta-Analysis of Criteria Discrimination Estimates

Numerous studies leverage item response theory (IRT) methods to examine measurement characteristics of alcohol use disorder (AUD) diagnostic criteria. Less work has examined the consistency of AUD IRT parameter estimates, an essential step for establishing measurement invariance, making statements about symptom diagnosticity, and validating the theoretical construct. A Bayesian meta-analysis of IRT discrimination values for AUD criteria across 33 independent samples (Total N = 321,998) revealed that overall consistency of AUD criteria discriminations was low (generalized intraclass correlation range = .105-.249). However, specific study characteristics accounted for substantial variability, suggesting that the unreliability is partially systematic. We replicated evidence of differential item functioning (DIF) via established factors (e.g., age, gender), but the magnitudes were small compared with DIF associated with assessment instrument. These results offer practical recommendations regarding which instruments to use when specific AUD criteria are of interest and which criteria are most sensitive when comparing demographic groups.