College Students Who Endorse A Sub‐Threshold Number of DSM‐5 Alcohol Use Disorder Criteria: Alcohol, Tobacco, and Illicit Drug Use in DSM‐5 Diagnostic Orphans

<p> <strong> Objectives: </strong> Diagnostic orphans (DOs) represent a group of individuals with no formal diagnosis, despite endorsing some criteria of an alcohol use disorder (AUD). Prior research has indicated that rates of DSM&hyphen;IV DOs in college are high and closely resemble those with an alcohol abuse diagnosis across pertinent alcohol use risk factors. However, signi&filig;cant changes to the DSM&hyphen;IV AUD criteria have been made for the current DSM&hyphen;5 manual, which may impact how DOs are classi&filig;ed. This study examined the unique alcohol and illicit drug use characteristics of a group of 2,620 DSM&hyphen;5 DOs in college and tested whether DOs differed from those with and without a DSM&hyphen;5 AUD across pertinent alcohol and drug use risk factors.</p><p> <strong> Methods: </strong> Participants were 2,620 DSM&hyphen;5 DO undergraduate college students, between the ages of 18 and 30, recruited from three public universities in the Southeastern, United States.</p><p> <strong> Results: </strong> Diagnostic orphans represented 19.6% (n &frac14; 506) of the sample; with the most frequently endorsed criteria being tolerance and consuming alcohol in hazardous situations. DOs reported signi&filig;cantly greater alcohol consumption, alcohol and drug related problems, and illicit drug use compared to those with no DSM&hyphen;5 AUD diagnosis. Alternatively, DOs reported signi&filig;cantly lower alcohol use and illicit drug use compared to those with a DSM&hyphen;5 AUD.</p><p> <strong> Conclusion: </strong> The present &filig;ndings indicate that DSM&hyphen;5 DOs in college represent a distinct group of drinkers relative to those with and without a DSM&hyphen;5 AUD. Current screening initiatives should target this group to prevent future escalation of problem drinking.</p>