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



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.

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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.

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Correspondence to Joris C. Verster.



Alcohol Hangover Severity Scale (AHSS)

The day after alcohol consumption you may experience several symptoms or complaints.

Please indicate to what extent you experience the following at this moment:

(0 = absent, 10 = extreme)


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Penning, R., McKinney, A., Bus, L.D. et al. Measurement of alcohol hangover severity: development of the Alcohol Hangover Severity Scale (AHSS). Psychopharmacology 225, 803–810 (2013).

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  • Alcohol
  • Hangover
  • Scale
  • AHSS
  • Questionnaire
  • Measurement
  • Severity
  • Symptoms