Measurement of alcohol hangover severity: development of the Alcohol Hangover Severity Scale (AHSS)

Psychopharmacology (Berl). 2013 Feb;225(4):803-10. doi: 10.1007/s00213-012-2866-y. Epub 2012 Sep 25.


Objective: This study aims to develop a new alcohol hangover symptom severity scale and compare its effectiveness with the Hangover Symptoms Scale (HSS), the Acute Hangover Scale (AHS), and a one-item hangover score.

Methods: Data from 1,410 Dutch students (Penning et al., Alcohol Alcohol 47:248-252, 2012) on the severity of 47 hangover symptoms were re-analyzed to develop the Alcohol Hangover Severity Scale (AHSS). The psychometric properties of the AHSS were compared with those of the HSS and the AHS. A survey among 1,000 students compared the AHSS and HSS with a one-item hangover severity score. The AHSS was further tested in a naturalistic hangover experiment.

Results: The 12 items of the AHSS were fatigue, clumsiness, dizziness, apathy, sweating, shivering, nausea, heart pounding, confusion, stomach pain, concentration problems, and thirst. The Penning et al. (Alcohol Alcohol 47:248-252, 2012) data revealed that the predictive validity of the AHSS (92.4 %) for the overall hangover score was significantly higher than that of the HSS (81.5 %) and the AHS (71.0 %). The survey data (N = 966) showed that scores on the AHSS (39.7 %) and the HSS (47.6 %) only moderately predicted the one-item hangover score. A total of 119 subjects completed the naturalistic study. On average, they consumed 9.7 alcoholic consumptions, yielding a mean estimated blood alcohol concentration (BAC) of 0.16 %. During hangover, the AHSS score correlated significantly with the number of alcoholic consumptions (r = 0.38, p < 0.0001) and estimated BAC (r = 0.40, p < 0.0001).

Conclusions: The AHS, HSS, and AHSS all seem appropriate for application in hangover research. The use of a one-item hangover scale is not recommended.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Alcohol Drinking / epidemiology*
  • Alcohol Drinking / physiopathology
  • Alcoholic Intoxication / diagnosis
  • Alcoholic Intoxication / epidemiology*
  • Alcoholic Intoxication / physiopathology
  • Dizziness / diagnosis
  • Dizziness / epidemiology
  • Dizziness / physiopathology
  • Fatigue / diagnosis
  • Fatigue / epidemiology
  • Fatigue / physiopathology
  • Female
  • Health Surveys / methods
  • Humans
  • Male
  • Nausea / diagnosis
  • Nausea / epidemiology
  • Nausea / physiopathology
  • Netherlands / epidemiology
  • Psychometrics / methods
  • Severity of Illness Index*
  • Students*
  • Thirst / physiology
  • Universities*
  • Young Adult