A critical analysis of alcohol hangover research methodology for surveys or studies of effects on cognition

Abstract

Rationale

Alcohol hangover may be defined as an adverse effect of heavy alcohol consumption present after sufficient time has elapsed for the alcohol to have been eliminated from the blood. Understanding how hangover may impair performance is important for public safety; yet, there is relatively little hangover research. This paper outlines good practice for future studies.

Objectives

This paper presents a critical analysis of hangover methodology for surveys or studies of effects on cognition with human subjects and provides suggestions for optimum research practice for laboratory-based and naturalistic alcohol hangover studies.

Results

Four hangover symptom scales have been developed and subjected to psychometric testing. For retrospective assessment, we recommend the Hangover Symptoms Scale (HSS) or the Alcohol Hangover Severity Scale (AHSS). For concurrent assessment of hangover symptoms, we recommend either the Acute Hangover Scale (AHS), the five-item version of the HSS, or the AHSS. In research aiming to assess the cognitive effects of alcohol hangover, we suggest focusing on the cognitive domains of attention, memory and executive function, and we specify a number of tests within these cognitive domains that are likely to be sensitive to any decrements due to hangover. Finally, we argue that naturalistic studies should assess biological markers to improve the accuracy of estimates of alcohol consumption. Specifically, we recommend the assessment of ethyl glucuronide (EtG) for this purpose.

Conclusions

Recommendations are made with respect to assessing hangover symptoms, cognitive effects of hangover and biological markers of alcohol consumption.

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References

  1. Anderson S, Dawson J (1999) Neuropsychological correlates of alcoholic hangover. S Afr J Sci 95:145–147

    Google Scholar 

  2. Baddeley A (2012) Working memory: theories models and controversies. Annu Rev Psychol 63:1–29

    PubMed  Article  Google Scholar 

  3. Baker EL, Letz RE, Fidler AT, Stuart S, Plantamura D, Lyndon M (1985) A computer-based neurobehavioral evaluation system for occupational and environmental pidemiology: methodology and validation studies. Neurotoxicol Teratol 7:369–377

    CAS  Google Scholar 

  4. Berry CJ, Shanks DR, Henson RN (2008) A unitary signal-detection model of implicit and explicit memory. Trends Cogn Sci 12:367–373

    PubMed  Article  Google Scholar 

  5. Brown SW (2006) Timing and executive function: bidirectional interference between concurrent temporal production and randomization tasks. Mem Cogn 34:1464–1471

    Article  Google Scholar 

  6. Chait LD, Perry JL (1994) Acute and residual effects of alcohol and marijuana alone and in combination on mood and performance. Psychopharmacology 115:340–349

    CAS  PubMed  Article  Google Scholar 

  7. Collins WE, Schroeder DJ, Gilson RD, Guedry FE (1971) Effects of alcohol ingestion on tracking performance during angular acceleration. J Appl Psychol 55:559–563

    CAS  PubMed  Article  Google Scholar 

  8. Collins WE, Chiles WD (1980) Laboratory performance during acute intoxication and hangover. Hum Factors 22:445–462

    CAS  PubMed  Google Scholar 

  9. Conway ARA, Kane MJ, Bunting MF, Hambrick DZ, Wilhelm O, Engle RW (2005) Working memory span tasks: A methodological review and user’s guide. Psychon Bull Rev 12:769–786

    PubMed  Article  Google Scholar 

  10. Coulthard E, Singh-Curry V, Husain M (2006) Treatment of attention deficits in neurological disorders. Curr Opin Neurol 19:613–618

    CAS  PubMed  Article  Google Scholar 

  11. Dahl H, Stephanson N, Beck O, Helander A (2002) Comparison of urinary excretion characteristics of ethanol and ethyl glucuronide. J Anal Toxicol 26:201–204

    CAS  PubMed  Article  Google Scholar 

  12. Droenner P, Schmitt G, Aderjan R, Zimmer HA (2002) Kinetic model describing the pharmacokinetics of ethyl glucuronide in humans. Forensic Sci Int 28:24–29

    Article  Google Scholar 

  13. Eriksen BA, Eriksen CW (1974) Effects of noise letters upon identification of a target letter in a non-search task. Percept Psychophys 16:143–149

    Article  Google Scholar 

  14. Farrell S, Lewandowsky S (2010) Computational models as aids to better reasoning in psychology. Curr Dir Psychol Sci 19:329–335

    Article  Google Scholar 

  15. Finnigan F, Hammersley R (1992) The effects of alcohol on performance. In: Smith AP, Jones DM (eds) Handbook of human performance. Academic, London, pp 73–126

    Google Scholar 

  16. Finnigan F, Hammersley R, Cooper T (1998) An examination of next-day hangover effects after a 100mg/100ml dose of alcohol in heavy social drinkers. Addiction 93:1829–1838

    CAS  PubMed  Article  Google Scholar 

  17. Finnigan F, Schulze D, Smallwood J, Helander A (2005) The effects of self-administered alcohol-induced ‘hangover’ in a naturalistic setting on psychomotor and cognitive performance and subjective state. Addiction 100:1680–1689

    PubMed  Article  Google Scholar 

  18. Fisk AD, Scerbo MW (1987) Automatic and control processing approach to interpreting vigilance performance: a review and reevaluation. Hum Factors 29:653–660

    CAS  PubMed  Google Scholar 

  19. Goll M, Schmitt G, Ganssmann B, Aderjan RE (2002) Excretion profiles of ethyl glucuronide in human urine after internal dilution. J Anal Toxicol 26:262–266

    CAS  PubMed  Article  Google Scholar 

  20. Grange JA, Houghton G (in press) Task switching and cognitive control New York NY: Oxford University Press.

  21. Halter CC, Dresen S, Auwaerter V, Wurst FM, Weinmann W (2008) Kinetics in serum and urinary excretion of ethyl sulfate and ethyl glucuronide after medium dose ethanol intake. Int J Legal Med 122:123–128

    PubMed  Article  Google Scholar 

  22. Heffernan T, Clark R, Bartholomew J, Ling J, Stephens R (2010) Does binge drinking in teenagers affect their everyday prospective memory? Drug Alcohol Depend 109:73–78

    CAS  PubMed  Article  Google Scholar 

  23. Høiseth G, Bernard JP, Stephanson N, Normann PT, Christophersen AS, Mørland J, Helander A (2008) Comparison between the urinary alcohol markers EtG EtS and GTOL/5-HIAA in a controlled drinking experiment. Alcohol Alcohol 43:187–191

    PubMed  Article  Google Scholar 

  24. Høiseth G, Yttredal B, Karinen R, Gjerde H, Mørland J, Christophersen AS (2010) A Ethyl glucuronide concentrations in oral fluid blood and urine after volunteers drank 05 and 10 g/kg doses of ethanol. J Anal Toxicol 34:319–324

    PubMed  Article  Google Scholar 

  25. Howland J, Rohsenow DJ, Edwards EM (2008) Are some drinkers resistant to hangover? A literature review. Curr Drug Abuse Rev 1:42–46

    PubMed  Article  Google Scholar 

  26. Howland J, Rohsenow DJ, Greece JA, Littlefield CA, Almeida A (2010) The effects of binge drinking on college students’ next-day academic test-taking performance and mood state. Addiction 105:655–665

    PubMed Central  PubMed  Article  Google Scholar 

  27. Jaeggi SM, Buschkuehl M, Perrig WJ, Meier B (2010) The concurrent validity of the N-back task as a working memory measure. Memory 18:394–412

    PubMed  Article  Google Scholar 

  28. Jones K, Harrison Y (2001) Frontal lobe function, sleep loss and fragmented sleep. Sleep Med Rev 5:463–475

    PubMed  Article  Google Scholar 

  29. Kiesel A, Steinhauser M, Wendt M, Falkstein M, Jost K, Philipp A, Koch I (2010) Control and interference in task switching—a review. Psychol Bull 136:849–874

    PubMed  Article  Google Scholar 

  30. Kruisselbrink LD, Martin KL, Megeney M (2006) Physical and psychomotor functioning of females the morning after consuming low to moderate quantities of beer. J Stud Alcohol 67:416–420

    PubMed  Google Scholar 

  31. Laurell H, Törnros J (1983) Investigation of alcoholic hangover effects on driving performance. Blutalkohol 20:489–499

    Google Scholar 

  32. Lemon J, Chester G, Fox A, Greeley J, Nabke C (1993) Investigation of the “hangover” effects of an acute dose of alcohol on psychomotor performance. Alcohol Clin Exp Res 17:665–668

    CAS  PubMed  Article  Google Scholar 

  33. Lewis SS, Hutchinson MR, Zhang Y, Hund DK, Maier SF, Rice KC, Watkins LR (2013) Glucuronic acid and the ethanol metabolite ethyl-glucuronide cause toll-like receptor 4 activation and enhanced pain. Brain Behav Immun 30:24–32

    CAS  PubMed Central  PubMed  Article  Google Scholar 

  34. Ling J, Stephens R, Heffernan TM (2010) Cognitive and psychomotor performance during alcohol hangover. Curr Drug Abuse Rev 3:80–87

    PubMed  Article  Google Scholar 

  35. Logan GD, Cowan WB (1984) On the ability to inhibit thought and action: a theory of an act of control. Psychol Rev 91:295–327

    Article  Google Scholar 

  36. MacLeod CM (1991) Half a century of research on the Stroop effect: an integrative review. Psychol Bull 109:163–203

    CAS  PubMed  Article  Google Scholar 

  37. McKinney A, Coyle K (2007) Next-day effects of alcohol and an additional stressor on memory and psychomotor performance. J Stud Alcohol 68:446–454

    Google Scholar 

  38. McKinney A, Coyle K (2004) Next day effects of a normal night’s drinking on memory and psychomotor performance. Alcohol Alcohol 39:509–513

    PubMed  Article  Google Scholar 

  39. McKinney A, Coyle K, Penning R, Verster JC (2012) Next day effects of naturalistic alcohol consumption on tasks of attention. Human Psychopharmacol-Clin Exp 27:587–594

    Article  Google Scholar 

  40. Miyake A, Friedman NP, Emerson MJ, Witzki AH, Howerter A, Wager TD (2000) The unity and diversity of executive functions and their contributions to complex “frontal lobe” tasks: a latent variable analysis. Cogn Psychol 41:49–100

    CAS  PubMed  Article  Google Scholar 

  41. Norman DA, Shallice T (1986) Attention to action: willed and automatic control of behavior. In: Davidson RJ, Schwartz GE, Shapiro D (eds) Consciousness and self-regulation: advances in research and theory vol 4. Plenum, New York

    Google Scholar 

  42. Penning R, van Nuland M, Fliervoet LAL, Olivier B, Verster JC (2010) The pathology of alcohol hangover. Curr Drug Abuse Rev 3:68–75

    CAS  PubMed  Article  Google Scholar 

  43. Penning R, McKinney A, Bus LS, Olivier B, Slot K, Verster JC (2013) Measurement of alcohol hangover severity: development of the Alcohol Hangover Severity Scale (AHSS). Psychopharmacology 225:803–810

    CAS  PubMed  Article  Google Scholar 

  44. Perry RJ, Hodges JR (1999) Attention and executive deficits in Alzheimer’s disease. Crit Rev Brain 122:383–404

    Google Scholar 

  45. Piasecki TM, Slutske WS, Wood PK, Hunt-Carter EE (2010) Frequency and correlates of diary-measured hangoverlike experiences in a college sample. Psychol Addict Behav 24:163–169

    Google Scholar 

  46. Posner MI, Petersen SE (1990) The attention system of the human brain. Annu Rev Neurosci 13:25–42

    CAS  PubMed  Article  Google Scholar 

  47. Prat G, Adan A, Pérez-Pàmies M, Sànchez-Turet M (2008) Neurocognitive effects of alcohol hangover. Addict Behav 33:15–23

    PubMed  Article  Google Scholar 

  48. Robertson BM, Piasecki TM, Slutske WS, Wood PK, Sher KJ, Shiffman S, Heath AC (2012) Validity of the hangover symptoms scale: evidence from an electronic diary study. Alcohol Clin Exp Res 36:171–177

    PubMed Central  PubMed  Article  Google Scholar 

  49. Roehrs T, Yoon J, Roth T (1991) Nocturnal and next-day effects of ethanol and basal level of sleepiness. Hum Psychopharmacol 6:307–311

    CAS  Article  Google Scholar 

  50. Rohsenow DJ, Howland J, Arnedt JT, Almeida AB, Greece J, Minsky S, Kempler CS, Sales S (2010) Intoxication with bourbon versus vodka: effects on hangover sleep and next-day neurocognitive performance in young adults. Alcohol Clin Exp Res 34:1–10

    Article  Google Scholar 

  51. Rohsenow DJ, Howland J, Minsky S, Greece J, Almeida A, Roehrs TA (2007) The acute hangover scale: a new measure of immediate hangover symptoms. Addict Behav 32:1314–1320

    PubMed Central  PubMed  Article  Google Scholar 

  52. Rohsenow DJ, Howland J, Minsky S, Arnedt JT (2006) Effects of heavy drinking by maritime academy cadets on hangover perceived sleep and next-day ship power plant operation. J Stud Alcohol 67:406–415

    PubMed  Google Scholar 

  53. Rosvold HE, Mirsky AF, Sarason I, Bransome ED Jr, Beck LH (1956) A continuous performance test of brain damage. J Consult Psychol 20:343–350

    PubMed  Article  Google Scholar 

  54. Rutherford A, Markopoulos G, Bruno D, Brady-Van-den-Bos M (2012) Long-term memory: encoding to retrieval. In: Braisby N, Gellatly A (eds) Cognitive psychology . Oxford University Press, Oxford

    Google Scholar 

  55. Schacter DL (1987) Implicit memory: history and current status. J Exp Psychol 3:501–518

    Google Scholar 

  56. Sjøgren MD, Thomsen AN, Olsen AK (2000) Impaired neuropsychological performance in chronic nonmalignant pain patients receiving long-term oral opioid therapy. J Pain Symptom Manag 19:100–108

    Article  Google Scholar 

  57. Slutske WS, Piasecki TM, Hunt-Carter EE (2003) Development and initial validation of the hangover symptoms scale: prevalence and correlates of hangover in college students. Alcohol Clin Exp Res 27:1442–1450

    PubMed  Article  Google Scholar 

  58. Squire LR (1992) Declarative and nondeclarative memory: multiple brain systems supporting learning and memory. J Cogn Neurosci 4:232–243

    CAS  PubMed  Article  Google Scholar 

  59. Stephens R, Ling J, Heffernan TM, Heather N, Jones K (2008) A review of the literature on the cognitive effects of the alcohol hangover. Alcohol Alcohol 43:163–170

    PubMed  Article  Google Scholar 

  60. Streufert S, Pogash R, Braig D, Gingrich D, Kantner A, Landis R, Lonardi L, Roache J, Severs W (1995) Alcohol hangover and managerial effectiveness. Alcohol Clin Exp Res 19:1141–1146

    CAS  PubMed  Article  Google Scholar 

  61. Süß HM, Oberauer K, Wittmann WW, Wilhelm O, Schulze R (2002) Working-memory capacity explains reasoning ability-and a little bit more. Intelligence 30:261–288

    Article  Google Scholar 

  62. Swift R, Davidson D (1998) Alcohol hangover: mechanisms and mediators. Alcohol Health Res World 22:54–60

    CAS  PubMed  Google Scholar 

  63. Taylor JL, Dolhert N, Friedman L, Mementhaler M, Yesavage JA (1996) Alcohol elimination and simulator performance of male and female aviators: a preliminary report. Aviat Space Environ Med 67:407–413

    CAS  PubMed  Google Scholar 

  64. Törnros J, Laurell H (1991) Acute and hang-over effects of alcohol on simulated driving performance. Blutalkohol 28:24–30

    PubMed  Google Scholar 

  65. Turgay A, Binder C, Snyder R, Fisman S (2003) Long-term safety and efficacy of risperidone for the treatment of disruptive behavior disorders in children with subaverage IQs. Pediatrics 110:97–109

    Google Scholar 

  66. Vandierendonck A, Liefooghe B, Verbruggen F (2010) Task switching: interplay of reconfiguration and interference control. Psychol Bull 136:601–626

    PubMed  Article  Google Scholar 

  67. Verbruggen F, Logan GD (2008) Response inhibition in the stop-signal paradigm. Trends Cogn Sci 12:418–424

    PubMed Central  PubMed  Article  Google Scholar 

  68. Verbruggen F, Logan GD (2009) Models of response inhibition in the stop-signal and stop-change paradigms. Neurosci Biobehav Rev 33:647–661

    PubMed Central  PubMed  Article  Google Scholar 

  69. Verbruggen F, Chambers CD, Logan GD (2013) Fictitious inhibitory differences: how skewness and slowing distort the estimation of stopping latencies. Psychol Sci 24:352–362

    PubMed Central  PubMed  Article  Google Scholar 

  70. Verster JC (2008) The alcohol hangover—a puzzling phenomenon. Alcohol Alcohol 43:124–126

    PubMed  Article  Google Scholar 

  71. 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 3:116–126

    PubMed Central  PubMed  Article  Google Scholar 

  72. Verster JC, van Duin D, Volkerts ER, Schreuder AHCML, Verbaten MN (2003) Alcohol hangover effects on memory functioning and vigilance performance after an evening of binge drinking. Neuropsychopharmacology 28:740–746

    CAS  PubMed  Article  Google Scholar 

  73. Wiese JG, Shlipak MG, Browner WS (2000) The alcohol hangover. Ann Intern Med 132:897–902

    CAS  PubMed  Article  Google Scholar 

  74. Yesavage A, Leirer VO (1986) Hangover effects of aircraft pilots 14 h after alcohol ingestion: a preliminary report. Am J Psychiatry 143:1546–1550

    CAS  PubMed  Google Scholar 

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Acknowledgment

This research was supported by EU 7th Framework Marie Curie Research Fellowship Project No: 301424.

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Correspondence to Richard Stephens.

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Stephens, R., Grange, J.A., Jones, K. et al. A critical analysis of alcohol hangover research methodology for surveys or studies of effects on cognition. Psychopharmacology 231, 2223–2236 (2014). https://doi.org/10.1007/s00213-014-3531-4

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Keywords

  • Review
  • Alcohol hangover
  • Symptoms
  • Cognitive performance
  • Biological markers
  • Ethyl glucuronide