Alcohol use is a burden on the healthcare system and is among the leading causes of preventable deaths in the United States. There are eleven possible Alcohol use Disorder (AUD) symptoms and only two are required, resulting in a wide range of possible combinations of symptoms and thus widely divergent profiles of individuals with AUD. Further,  not all of the AUD symptoms are equally severe, and two individuals with two symptoms each may have completely different levels of severity. Despite these issues, many of our research and clinical decisions are made based on AUD clinical cutoffs. Cassie Boness talks about her work in understanding the diagnostic issues with AUD, including how she has used cognitive interviewing to better understand how people are understanding the symptoms of AUD. Cassie Boness is an intern at Western Psychiatric Hospital at the University of Pittsburgh Medical Center.