Validity of the hangover symptoms scale: evidence from an electronic diary study

Abstract

Background: The Hangover Symptoms Scale (HSS) assesses the frequency of 13 symptoms experienced after drinking in the past year. Cross-sectional analyses in college drinkers showed preliminary evidence for the validity of the HSS (Slutske et al., 2003). The current investigation extended this work by examining the construct validity of the HSS in an ecological momentary assessment investigation.

Methods: Frequent drinkers (N = 404) carried electronic diaries to track their daily experiences over 3 weeks. Each morning, the diary assessed prior-night drinking behaviors, the presence of current hangover, and intensity of current headache and nausea.

Results: Adjusting for sex and body mass, the HSS significantly predicted diary endorsement of hangover (OR = 2.11, 95% CI = 1.78 to 2.49, p < 0.001). Participants who endorsed the HSS headache and nausea items were especially likely to report the elevations of corresponding symptoms in diary records made the morning after drinking. HSS scores incrementally predicted hangover when the number of drinks consumed in the episode was covaried but did not moderate the relationship between the number of drinks and diary hangover reports.

Conclusions: The HSS appears to be a valid tool for hangover research. Higher HSS scores identify individuals who complain of "real world" hangovers and who may be especially likely to display particular symptoms after a night of drinking. Past hangovers predicted future hangovers, suggesting hangovers do not necessarily discourage or inhibit future drinking, at least across the several-week time interval studied here. There is a need to develop and evaluate complementary measures that can more directly index individual differences in hangover susceptibility in survey designs.

Copyright © 2011 by the Research Society on Alcoholism.

Figures

Figure 1

Percentage of participants (bars), percentage of diary hangovers (solid line) and cumulative percentage of diary hangovers (dashed line) as a function of HSS scores.

Figure 2

Model-adjusted means and 95% confidence intervals for immediate reports of headache (top panel) and nausea (bottom panel) on mornings after abstention and mornings after drinking among drinkers who did versus did not endorse the corresponding item on the HSS scale.