Which item is NOT a DSM-5 criterion for Substance Use Disorder?

• A. Cravings
• B. Tolerance
• C. Social or interpersonal problems
• D. Sleep disturbances

Answer: (D)

Understand that Substance Use Disorder is diagnosed based on a specific set of 11 symptoms that span impaired control, social impairment, risky use, and physiological criteria like tolerance and withdrawal. A person meeting 2 or more of these symptoms within a 12-month period is diagnosed, with severity scaling by the number of criteria met.

Cravings fit squarely as a diagnostic symptom because a strong desire or urge to use is part of the impaired control domain. Tolerance is another physiological criterion, reflecting needing markedly more of the substance to achieve the same effect. Social or interpersonal problems reflect the social impairment domain, where use leads to failure to fulfill major obligations or ongoing relationship issues.

Sleep disturbances, while common in people who use substances or who are going through withdrawal, are not themselves one of the DSM-5 criteria for Substance Use Disorder. They can occur as part of withdrawal or secondary effects, but they do not constitute a diagnostic criterion on their own.