Validity of the hangover symptoms scale: evidence from two diary studies

Abstract

Individual differences in hangover deserve study because they could be markers of important traits or processes such as loss of control, impulsivity, tolerance, or acute inflammatory responses. The Hangover Symptoms Scale (HSS) was developed to assess the frequency of 13 hangover-like symptoms experienced after drinking in the past year (Slutske et al., 2003). Cross-sectional analyses in a sample of college drinkers (Slutske et al., 2003) showed preliminary evidence for the validity of the HSS. The current investigation extended this work by examining the predictive validity of the HSS in two ecological momentary assessment (EMA) studies (Ns = 129 and 404) focused on alcohol use among smokers and nonsmokers. In both studies, participants carried electronic diaries in their natural environments to track their daily experiences. Each morning, the diary assessed any drinking behaviors from the prior night, the presence of hangover that morning, and current levels of hangover symptoms. Adjusting for sex and number of drinks in the episode, the HSS predicted diary endorsement of hangover (OR = 1.13, 95% CI = 1.09-1.18) in the larger sample only. A variety of analyses assessing whether the HSS identifies individuals who are especially susceptible to hangover produced mixed results. Findings are discussed in terms of their implications for the practical use of HSS scores in hangover research, the interpretation of HSS correlates, and the need to develop additional measures of individual differences in hangover susceptibility to advance hangover research.