Accounting for Zero Inflation Worsens the Psychometric Validity of the DSM-5 Substance Use Disorder Criterion Set

We estimated confirmatory factor analyses of the DSM-5 substance use disorder criterion set using data from the National Survey on Drug Use and Health (N = 165,249). When removing all-zero respondents to account for zero inflation, model performance (TLIs, RMSEAs) and loadings worsen considerably for ten of eleven drugs assessed.