, Volume 225, Issue 4, pp 803–810 | Cite as

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

  • Renske Penning
  • Adele McKinney
  • Lucien D. Bus
  • Berend Olivier
  • Karin Slot
  • Joris C. VersterEmail author
Original Investigation



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.


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.


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).


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


Alcohol Hangover Scale AHSS Questionnaire Measurement Severity Symptoms 



This study was funded by Utrecht University. The authors have no conflicts of interest to disclose. Joris Verster has received research support from Takeda Pharmaceuticals, Red Bull GmbH, and acted as consultant for Sanofi-Aventis, Transcept, Takeda, Sepracor, Red Bull GmbH, Deenox, Trimbos Institute, and CBD.


  1. Bendsten P, Jones AW, Helander A (1998) Urinary excretion of methanol and 5-hydroxytryptophol as biochemical markers of recent drinking in the hangover state. Alcohol Alcohol 33:431–438CrossRefGoogle Scholar
  2. Chapman LF (1970) Experimental induction of hangover. Q J Stud Alcohol 5:67–86PubMedGoogle Scholar
  3. Gjerde H, Christophersen AS, Moan IS et al (2010) Use of alcohol and drugs by Norwegian employees: A pilot study using questionnaires and analysis of oral fluid. J Occup Med Toxicol 15:13CrossRefGoogle Scholar
  4. Harburg E, Davis D, Cummings KM, Gunn R (1981) Negative affect, alcohol consumption and hangover symptoms among normal drinkers in a small community. J Stud Alcohol 42:998–1012PubMedGoogle Scholar
  5. Ling J, Stephens R, Heffernan TM (2010) Cognitive and psychomotor performance during alcohol hangover. Curr Drug Abuse Rev 3:80–87PubMedCrossRefGoogle Scholar
  6. McKinney A, Coyle K (2004) Next day effects of a normal night’s drinking on memory and psychomotor performance. Alcohol Alcohol 39:509–513Google Scholar
  7. Myrsten A, Rydberg U, Idestörm CM, Lamble R (1980) Alcohol intoxication and hangover: Modification of hangover: Modification of hangover by chlormethiazole. Psychopharmacol 69:117–125CrossRefGoogle Scholar
  8. Newlin DB, Pretorius MB (1990) Sons of alcoholics report greater hangover symptoms than sons of nonalcoholics: A pilot study. Alcoholism Clin Exp Res 14:713–716CrossRefGoogle Scholar
  9. Penning R, van Nuland M, Fliervoet LA, Olivier B, Verster JC (2010) The pathology of alcohol hangover. Curr Drug Abuse Rev 3:68–75PubMedCrossRefGoogle Scholar
  10. Penning R, McKinney A, Verster JC (2012) Alcohol hangover symptoms and their contribution to overall hangover severity. Alcohol Alcohol 47:248–252PubMedCrossRefGoogle Scholar
  11. Rohsenow DJ, Howland J, Minsky SJ, Greece J, Almeida A, Roehrs TA (2007) The acute hangover scale: A new measure of immediate hangover symptoms. Addictive Behav 32:1314–1320CrossRefGoogle Scholar
  12. Slutske WS, Piasecki TM, Hunt-Carter EE (2003) Development and initial validation of the hangover symptoms scale: Prevalence and correlates of hangover symptoms in college students. Alcoholism Clin Exp Res 27:1442–1450CrossRefGoogle Scholar
  13. Stephens R, Ling J, Heffernan TM, Heather N, Jones K (2008) A review of the literature on the cognitive effects of alcohol hangover. Alcohol Alcohol 43:163–170PubMedCrossRefGoogle Scholar
  14. Swift R, Davidson D (1998) Alcohol hangover: Mechanisms and mediators. Alcohol Health Res World 22:54–60PubMedGoogle Scholar
  15. Verster JC (2008) The alcohol hangover—a puzzling phenomenon. Alcohol Alcohol 43:124–126PubMedCrossRefGoogle Scholar
  16. Verster JC, van Herwijnen J, Olivier B, Kahler CW (2009) Validation of the Dutch version of the brief young adult alcohol consequences questionnaire (B-YAACQ). Addictive Behav 34:411–414CrossRefGoogle Scholar
  17. Verster JC, Stephens R, Penning R et al (2010) The alcohol hangover research group consensus statement on best practice in alcohol hangover research. Curr Drug Abuse Rev 3:116–126PubMedCrossRefGoogle Scholar
  18. Watson PE, Watson ID, Batt RD (1981) Prediction of blood alcohol concentrations in human subjects: Updating the Widmark equation. J Stud Alcohol 42:547–56PubMedGoogle Scholar
  19. Ylikhari RH, Huttunen MO, Eriksson CJ, Nikkilä EA (1974) Metabolic studies on the pathogenesis of hangover. Eur J Clin Invest 4:93–100Google Scholar

Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Renske Penning
    • 1
  • Adele McKinney
    • 2
  • Lucien D. Bus
    • 3
  • Berend Olivier
    • 1
  • Karin Slot
    • 1
  • Joris C. Verster
    • 1
    Email author
  1. 1.Division of Pharmacology, Utrecht Institute for Pharmaceutical SciencesUtrecht UniversityUtrechtThe Netherlands
  2. 2.School of PsychologyUniversity of UlsterDerryUK
  3. 3.Department of Pharmacotherapy and Pharmaceutical CareGroningen UniversityGroningenThe Netherlands

Personalised recommendations