Development and initial validation of the Hangover Symptoms Scale: prevalence and correlates of Hangover Symptoms in college students

Alcohol Clin Exp Res. 2003 Sep;27(9):1442-50. doi: 10.1097/01.ALC.0000085585.81711.AE.


Background: Despite its ubiquity, hangover has received remarkably little systematic attention in alcohol research. This may be due in part to the lack of a standard measure of hangover symptoms that cleanly taps the physiologic and subjective effects commonly experienced the morning after drinking. In the present study, we developed and evaluated a new scale, the Hangover Symptoms Scale (HSS), to potentially fill this void.

Methods: Participants were 1230 currently drinking college students (62% women, 91% Caucasian). They were administered a self-report inventory in which they reported the frequency of occurrence of 13 different hangover symptoms during the past 12 months. Participants also reported their history of alcohol involvement, alcohol-related problems, and family history of alcohol-related problems.

Results: On average, participants experienced 5 out of 13 different hangover symptoms in the past year; the three most common symptoms were feeling extremely thirsty/dehydrated, feeling more tired than usual, and headache. Higher scores on the HSS were significantly positively associated with the frequency of drinking and getting drunk and the typical quantity of alcohol consumed when drinking, a personal history of alcohol-related problems, and a family history of alcohol-related problems. After controlling for sex differences in alcohol involvement, women had higher scores on the HSS than men.

Conclusions: The HSS appears to capture a reasonably valid set of adjectives describing common hangover effects. It is hoped that the availability of a brief, valid hangover assessment such as the HSS will encourage further study of hangover's frequency, correlates, and consequences. Future research is needed to explore the performance of a re-worded HSS in laboratory settings, which may help bridge the gap between laboratory and survey investigations of hangover.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Alcohol Drinking / adverse effects
  • Alcohol Drinking / epidemiology*
  • Alcohol Drinking / genetics
  • Alcohol-Related Disorders / diagnosis
  • Alcohol-Related Disorders / epidemiology
  • Alcohol-Related Disorders / genetics
  • Alcoholism / genetics
  • Attitude to Health*
  • Cross-Sectional Studies
  • Ethanol / adverse effects*
  • Female
  • Health Surveys
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Missouri / epidemiology
  • Personality Inventory / statistics & numerical data*
  • Psychometrics / statistics & numerical data
  • Reproducibility of Results
  • Risk Assessment
  • Sex Factors
  • Students / psychology*
  • Students / statistics & numerical data*
  • Substance Withdrawal Syndrome / diagnosis
  • Substance Withdrawal Syndrome / epidemiology*
  • Substance Withdrawal Syndrome / genetics


  • Ethanol