Validation of diagnostic criteria are usually based on comparability/similarity between entities. When applied to diagnostic criteria of psychiatric disorders, the outcome may be good quality psychometric validity of the diagnostic categories, but poor information on causality, mechanisms and specific interactions between diagnostic criteria. One major revision of the Substance-Related DSM-5 Workgroup was to add craving as a new diagnostic criterion despite it did not change the overall validity of the diagnostic category. The rationale for introducing craving was its quality as a prognostic marker of use, making it a potential to express etiology of use in substance use disorders.