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

Advanced clinical symptoms of the antihangover compound HK-GCM-H01 in healthy Koreans

A hangover is a combination of negative mental and physical symptoms, such as headache, diarrhea, and loss of appetite, that occur after alcohol consumption and can vary depending on individual genetic and environmental factors. To quickly relieve these hangover symptoms, a new hangover relief compound called HK-GCM-H01 has been developed. This compound, HK-GCM-H01, consists of fermented rice germ extracts, yeast extract mixtures, cili extract powder, and concentrated nipafam powder, all of which are known to relieve hangover symptoms. The safety and clinical symptoms of HK-GCM-H01 were evaluated, along with the pharmacokinetic properties of alcohol and acetaldehyde after its administration. This study was conducted on 50 healthy Korean men using a randomized, double-blind, placebo-controlled, single-intake, crossover design. To evaluate clinical symptoms, Acute Hangover Scale and Alcohol Hangover Severity Scale were used, and the pharmacokinetic evaluation parameters included the maximum plasma concentration, the time to peak plasma concentration, the terminal half-life, and the area under the plasma concentration-time curve from X hours to Y hours. A significant reduction in clinical symptoms was observed after alcohol consumption in the group that consumed HK-GCM-H01 with added hangover relief compound, as was a significant decrease in blood exposure to acetaldehyde compared to the placebo group. There were no adverse events or significant changes in liver function indicators reported during the safety evaluation. These findings indicate that HK-GCM-H01 is safe and significantly reduces plasma concentrations of acetaldehyde, the main cause of hangover, suggesting that it improves hangover symptoms.

Effects of alcohol hangover on attentional resources during a verbal memory/psychomotor tracking dual attention task

BACKGROUND

Alcohol hangover (AH) is associated with impaired attention and memory performance. However, whether this effect is related to reduced attentional resources remains unclear.

AIMS

A dual-attention paradigm was employed to assess the effects of AH on attentional resources, delayed memory recognition, and the interaction between attentional load and AH. Mental effort and perceived performance during AH and control conditions were also assessed.

METHODS

A seminaturalistic, crossover design was used. In total, 25 healthy social drinkers aged 18-35 years, visited the laboratory following a typical night out drinking (Hangover condition) and after alcohol abstinence (control) between 8:30 am and 12:30 pm, with conditions counterbalanced. Attentional load was manipulated via the presence (dual attention) or absence of psychomotor tracking during verbal memory encoding. Perceived mental effort and performance were measured using the NASA-TLX. Participants' recollected alcohol consumption was used to compute estimated blood alcohol level (eBAC).

RESULTS

Compared with the control visit, AH was associated with reduced recognition accuracy (particularly more false negatives), higher "tracking costs" (poorer accuracy) in the dual attention condition, increased ratings of "mental demand," "effort," and "frustration," and lower ratings of task performance. There was also a significant main effect of attentional load with poorer recognition accuracy and response time in the dual attention condition. There were no significant interaction effects between hangover and attentional load.

CONCLUSION

These findings suggest that reduced attentional resources contribute to the cognitive deficits associated with AH including impaired memory consolidation. They further suggest that while hungover, participants are aware of these deficits but are unable to compensate.

The Relationship between Alcohol Hangover Severity, Sleep and Cognitive Performance; a Naturalistic Study

Alcohol hangover (AH) has been associated with poor sleep due to the negative effects of alcohol intoxication on sleep quantity and sleep quality. The aim of the current study was to further explore the relationship between AH severity and sleep using a naturalistic study design. A further aim was to determine whether quantitative aspects of sleep were a mediating influence on the relationship between AH severity and cognitive performance. As part of the naturalistic study design, 99 drinkers were recruited following a night of drinking in an Australian state capital, with breath alcohol concentration (BrAC) measured as participants were leaving the entertainment district. The following morning at home, participants answered online questions regarding their drinking behaviour on the previous evening, current AH symptoms and sleep quality. Participants also completed an online version of the Trail-Making Test B (TMT-B) to assess cognitive performance. The findings reveal the duration of nightly awakenings to be negatively related to six individual AH symptoms as well as overall AH severity. The number of nightly awakenings, sleep quality and total sleep time correlated with four AH symptoms including overall AH severity. Total AH severity accounted for a moderate amount of variance (11%) in the time to complete the TMT-B. These findings confirm that alcohol consumption negatively affects sleep, which is related to higher next-day hangover severity ratings and poorer cognitive performance.

Eye Tracking Studies Exploring Cognitive and Affective Processes among Alcohol Drinkers: a Systematic Review and Perspectives

Acute alcohol intoxication and alcohol use disorders are characterized by a wide range of psychological and cerebral impairments, which have been widely explored using neuropsychological and neuroscientific techniques. Eye tracking has recently emerged as an innovative tool to renew this exploration, as eye movements offer complementary information on the processes underlying perceptive, attentional, memory or executive abilities. Building on this, the present systematic and critical literature review provides a comprehensive overview of eye tracking studies exploring cognitive and affective processes among alcohol drinkers. Using PRISMA guidelines, 36 papers that measured eye movements among alcohol drinkers were extracted from three databases (PsycINFO, PubMed, Scopus). They were assessed for methodological quality using a standardized procedure, and categorized based on the main cognitive function measured, namely perceptive abilities, attentional bias, executive function, emotion and prevention/intervention. Eye tracking indexes showed that alcohol-related disorders are related to: (1) a stable pattern of basic eye movement impairments, particularly during alcohol intoxication; (2) a robust attentional bias, indexed by increased dwell times for alcohol-related stimuli; (3) a reduced inhibitory control on saccadic movements; (4) an increased pupillary reactivity to visual stimuli, regardless of their emotional content; (5) a limited visual attention to prevention messages. Perspectives for future research are proposed, notably encouraging the exploration of eye movements in severe alcohol use disorders and the establishment of methodological gold standards for eye tracking measures in this field.

University Students' Hangover May Affect Cognitive Research

University students are the most employed category of participants in cognitive research. However, researchers cannot fully control what their participants do the night before the experiments (e.g., consumption of alcohol) and, unless the experiment specifically concerns the effects of alcohol consumption, they often do not ask about it. Despite previous studies demonstrating that alcohol consumption leads to decrements in next-day cognitive abilities, the potential confounding effect of hangover on the validity of cognitive research has never been addressed. To address this issue, in the present study, a test-retest design was used, with two groups of university students: at T0, one group was constituted by hungover participants, while the other group was constituted by non-hungover participants; at T1, both groups were re-tested in a non-hangover state. In particular, the tests used were two versions of a parity judgment task and an arithmetic verification task. The results highlight that: (a) the response times of university students experiencing a hangover are significantly slower than those of non-hangover students and (b) the response times of hungover students are slower than those of the same students when re-tested in a non-hangover state. Additionally, it was also observed that the prevalence of hungover students in the university campus varies depending on the day of the week, with a greater chance of enrolling hungover participants on specific days. In light of the latter result, the recruitment of university students as participants in cognitive experiments might lead researchers to erroneously attribute their results to the variables they are manipulating, ignoring the effects of the potential hangover state.

Prevalence of Hangover Resistance According to Two Methods for Calculating Estimated Blood Alcohol Concentration (eBAC)

Hangover resistance may be linked to an increased risk of continuing harmful drinking behaviours as well as involvement in potentially dangerous daily activities such as driving while hungover, mainly due to the absence of negative consequences (i.e., hangover symptoms) the day after alcohol consumption. The aim of this study was to examine the occurrence of claimed alcohol hangover resistance relative to estimated blood alcohol concentration (eBAC). A total of 1198 participants completed an online survey by answering questions regarding their demographics, alcohol consumption and occurrence of hangover. Two methods were used to calculate eBAC, one based on the modified Widmark Equation (N = 955) and the other from an equation averaging the total body water (TBW) estimates of Forrest, Watson, Seidl, Widmark and Ulrich (males only) (N = 942). The percentage of participants who claimed to be hangover resistant decreased rapidly with increasing eBAC and only a small number of hangover resistant drinkers remained at higher eBACs. Comparisons of the eBACs calculated by the two methods revealed significantly higher BACs when using the modified Widmark equation. These findings suggest that additional research for eBAC calculations is needed to improve accuracy and comprehensiveness of these equations for future alcohol hangover research.

Effects of Rapid Recovery on Alcohol Hangover Severity: A Double-Blind, Placebo-Controlled, Randomized, Balanced Crossover Trial

The aim of this study was to evaluate the efficacy of putative hangover treatment, Rapid Recovery, in mitigating alcohol hangover (AH) symptom severity. Using a double-blind, randomized, placebo-controlled, balanced crossover design, 20 participants attended the laboratory for two evenings of alcohol consumption, each followed by morning assessments of AH severity. Participants were administered Rapid Recovery and placebo on separate visits. In the first testing visit, participants self-administered alcoholic beverages of their choice, to a maximum of 1.3 g/kg alcohol. Drinking patterns were recorded and replicated in the second evening testing visit. In the morning visits, AH severity was assessed using questionnaires measuring AH symptom severity and sleep quality, computerized assessments of cognitive functioning as well as levels of blood biomarkers of liver function (gamma-glutamyl transferase (GGT)) and inflammation (high-sensitive C-reactive protein (hs-CRP)). There were no differences in the blood alcohol concentrations (BAC) obtained in the Rapid Recovery (mean = 0.096%) and placebo (mean = 0.097%) conditions. Participants reported significantly greater sleep problems in the Rapid Recovery compared to placebo condition, although this difference was no longer significant following Bonferroni's correction. There were no other significant differences between Rapid Recovery and placebo. These data suggest that Rapid Recovery has no significant effect on alcohol hangover nor on associated biomarkers.

The Effects of Alcohol Hangover on Mood and Performance Assessed at Home

The current study evaluated the next day consequences of a social night of drinking compared to a no alcohol night, with standardised mood and portable screen-based performance measures assessed in the morning at participants' homes, and a breathalyser screen for zero alcohol. A mixed sex group (n = 20) took part in the study. Participants reported consuming on average 16.9 units (135 g) alcohol, resulting in a hangover rating of 60 (out of 100) compared to 0.3 following the no alcohol night. Statistical significance comparisons contrasting the hangover with the no alcohol condition revealed an increase in negative mood and irritability during hangover and an (unexpected) increase in risk and thrill seeking. Performance scores showed an overall slowing of responses across measures, but with less impact on errors. The results support the description of hangover as a general state of cognitive impairment, reflected in slower responses and reduced accuracy across a variety of measures of cognitive function. This suggests a general level of impairment due to hangover, as well as increased negative mood. The use of a naturalistic design enabled the impact of more typical levels of alcohol associated with real life social consumption to be assessed, revealing wide ranging neurocognitive impairment with these higher doses. This study has successfully demonstrated the sensitivity of home-based assessment of the impact of alcohol hangover on a range of subjective and objective measures. The observed impairments, which may significantly impair daily activities such as driving a car or job performance, should be further investigated and taken into account by policy makers.

Pain Catastrophising Predicts Alcohol Hangover Severity and Symptoms

Alcohol hangover is a cause of considerable social and economic burden. Identification of predictors of alcohol hangover severity have the potential to contribute to reductions in costs associated with both absenteeism/presenteeism and health care. Pain catastrophising (PC) is the tendency to ruminate and describe a pain experience in more exaggerated terms. The current study examines the possibility that this cognitive coping strategy may influence experience of alcohol hangover. The aims of the current study were to (1) examine the relationship between hangover severity and PC, (2) explore and identify discreet factors within the Acute Hangover Scale (AHS) and (3) explore whether independent factors/dimensions of acute hangover are differentially predicted by PC. A retrospective survey (n = 86) was conducted in which participants completed the Acute Hangover Scale (AHS); the Pain Catastrophising Scale (PCS); a questionnaire pertaining to the amount of alcohol consumed; and a demographic information questionnaire. Regression analyses showed a significant relationship between PC and hangover severity scores and demonstrated that PC was, in fact, a stronger predictor of perceived hangover severity than estimated peak blood alcohol concentrations (eBACs). Factor analysis of the AHS scale, resulted in the identification of two distinct symptom dimensions; ‘Headache and thirst’, and ‘Gastric and cardiovascular’ symptoms. Regression analyses showed that both eBAC and PCS score were significantly associated with ‘Headache and thirst’. However, only PCS score was associated with ‘Gastric and cardiovascular’ symptoms. These novel findings implicate a role for cognitive coping strategies in self-reports of alcohol hangover severity, and may have implications for understanding behavioural response to hangover, as well as suggesting that hangover and PC may be important factors mediating the motivation to drink and/or abuse alcohol, with potential implications in addiction research. Furthermore, these findings suggest that distinct alcohol hangover symptoms may be associated with different mechanisms underlying the experience of alcohol hangover.

Cognitive performance and mood after a normal night of drinking: A naturalistic alcohol hangover study in a non-student sample

AIMS

The alcohol hangover is typically investigated in student samples. However, alcohol hangovers are also reported by non-student drinkers, beyond the age and drinking behaviors of a student sample. The aim of this study was to investigate the effects of a normal night of alcohol consumption on next-day cognitive performance in a non-student sample.

METHODS

Participants (N = 45) were recruited from a public drinking setting and participated in a naturalistic study comprising of a hangover test day and alcohol-free control day. On each test day, mood and hangover severity were assessed and participants completed a cognitive test battery consisting of a Stroop test, Eriksen's flanker test, spatial working memory test, free recall test, choice reaction time test, and intra-extra dimensional set shifting test.

RESULTS

On the hangover day, significantly impaired performance was revealed on all tests, except the intra-extra dimensional set shifting test. On the hangover day, significantly lower mood scores were observed for alertness and tranquility.

CONCLUSION

The current study in a non-student sample confirms previous findings in student samples that cognitive functioning and mood are significantly impaired during alcohol hangover.

Exacerbation of Hangover Symptomology Significantly Corresponds with Heavy and Chronic Alcohol Drinking: A Pilot Study

Alcohol hangover is a combination of mental, sympathetic, and physical symptoms experienced the day after a single period of heavy drinking, starting when blood alcohol concentration approaches zero. How individual measures/domains of hangover symptomology might differ with moderate to heavy alcohol consumption and how these symptoms correlate with the drinking markers is unclear. We investigated the amount/patterns of drinking and hangover symptomology by the categories of alcohol drinking. We studied males and females in three groups: 12 heavy drinkers (HD; >15 drinks/week, 34–63 years old (y.o.)); 17 moderate drinkers (MD; 5–14 drinks/week, 21–30 y.o.); and 12 healthy controls (social/light drinkers, SD; <5 drinks/week, 25–54 y.o.). Demographics, drinking measures (Timeline followback past 90 days (TLFB90), Alcohol Use Disorders Identification Test (AUDIT)), and alcohol hangover scale (AHS) were analyzed. Average drinks/day was 5.1-times greater in HD compared to MD. Average AHS score showed moderate incapacity, and individual measures and domains of the AHS were significantly elevated in HD compared to MD. Symptoms of three domains of the AHS (mental, gastrointestinal, and sympathetic) showed domain-specific significant increase in HD. A domain-specific relation was present between AUDIT and specific measures of AHS scores in HD, specifically with the dependence symptoms. Exacerbation in hangover symptomology could be a marker of more severe alcohol use disorder.

Effects of Alcohol Hangover on Cognitive Performance: Findings from a Field/Internet Mixed Methodology Study

Results from studies into the cognitive effects of alcohol hangover have been mixed. They also present methodological challenges, often relying on self-reports of alcohol consumption leading to hangover. The current study measured Breath Alcohol Concentration (BAC, which was obtained via breathalyzer) and self-reported drinking behavior during a night out. These were then related to hangover severity and cognitive function, measured over the internet in the same subjects, the following morning. Volunteers were breathalyzed and interviewed as they left the central entertainment district of an Australian state capital. They were provided with a unique identifier and, the following morning, logged on to a website. They completed a number of measures including an online version of the Alcohol Hangover Severity Scale (AHSS), questions regarding number and type of drinks consumed the previous night, and the eTMT-B-a validated, online analogue of the Trail Making Test B (TMT-B) of executive function and working memory. Hangover severity was significantly correlated with one measure only, namely the previous night's Breath Alcohol Concentration (r = 0.228, p = 0.019). Completion time on the eTMT-B was significantly correlated with hangover severity (r = 0.245, p = 0.012), previous night's BAC (r = 0.197, p = 0.041), and time spent dinking (r = 0.376, p < 0.001). These findings confirm that alcohol hangover negatively affects cognitive functioning and that poorer working memory and executive performance correlate with hangover severity. The results also support the utility and certain advantages of using online measures in hangover research.

A systematic review of the next-day effects of heavy alcohol consumption on cognitive performance

BACKGROUND AND AIMS

Studies examining the next-day cognitive effects of heavy alcohol consumption have produced mixed findings, which may reflect inconsistencies in definitions of 'hangover'. Recent consensus has defined hangover as 'mental and physical symptoms, experienced the day after a single episode of heavy drinking, starting when blood alcohol concentration (BAC) approaches zero'. In light of this, we aimed to review the literature systematically to evaluate and estimate mean effect sizes of the next-day effects of heavy alcohol consumption on cognition.

METHODS

Embase, PubMed and PsycNET databases were searched between December 2016 and May 2018 using terms based on 'alcohol' and 'hangover'. Studies of experimental designs which reported the next-day cognitive effects of heavy alcohol consumption in a 'hangover' group with BAC < 0.02% were reviewed. A total of 805 articles were identified. Thirty-nine full-text articles were screened by two independent reviewers and 19 included in the systematic review; 11 articles provided sufficient data to be included in the meta-analysis; 1163 participants across 19 studies conducted since 1970 were included in the analysis. Data for study design, hangover severity, BAC at testing and cognitive performance were extracted and effect estimates calculated.

RESULTS

The systematic review suggested that sustained attention and driving abilities were impaired during hangover. Mixed results were observed for: psychomotor skills, short- (STM) and long-term memory (LTM) and divided attention. The meta-analysis revealed evidence of impairments in STM [g = 0.64, 95% confidence interval (CI) = 0.15-1.13], LTM (Hedges' g = 0.59, 95% CI = 0.01-1.17) sustained attention (g = 0.47, 95% CI = 0.07-0.87) and psychomotor speed (Hedges' g = 0.66, 95% CI = 0.31-1.00) during alcohol hangover.

CONCLUSION

The research literature suggests that alcohol hangovers may involve impaired cognitive functions and performance of everyday tasks such as driving.

The impact of expectancy on cognitive performance during alcohol hangover

OBJECTIVE

Knowing the purpose of a clinical study may provoke expectancies among subjects that may influence the study outcome. For example, expectancies about a drug effect may cause subjects to put in more effort to counteract these effects on performance tasks, or cause stress or other mood alterations in anticipation of expected adverse effects. The objective of this study was to investigate to what extent expectancy effects will influence the magnitude of cognitive performance decrement in the alcohol hangover state.

RESULTS

Forty subjects with a mean (SD) age of 24.0 (7.4) years old participated in a naturalistic study to examine the alcohol hangover effects on cognitive performance. Subjects in the expectancy group were informed of the purpose of the study. In the control group subjects were told that the purpose of the study was to investigate the effects of time of day on cognitive performance. Subjects consumed a mean (SD) of 12.9 (10.0) alcoholic drinks the night before testing. Cognitive tests included the Stroop test, Eriksen's flanker test, a divided attention test, intra-extra dimensional set shifting test, spatial working memory test, and free word recall test. Expectancy effects did not differentially affect cognitive performance in the alcohol hangover state.

Alcohol Hangover Increases Conflict Load via Faster Processing of Subliminal Information

The detrimental effects of acute alcohol intoxication and long-term alcohol (ab)use on cognition are well-known. Yet, only little is known about the cognitive effects of an acute alcohol hangover, even though it might affect executive functions associated with workplace performance or driving skills. Given that alcohol hangover may increase the speed of information accumulation, we assessed the behavioral effects of conflict load (induced by a subliminal prime) on cognitive control, as assessed via the Flanker effect. We employed a counter-balanced within-subject design, where n = 25 healthy young males were tested once after a sober night and once after a night of experimentally induced heavy drinking of cheap brandy/red wine (2.6375 g alcohol per estimated liter of body water within 2–3 h). Alcohol hangover neither increased the cognitive conflicts induced by consciously processed distractors alone (i.e., the Flanker effect), nor modulated conflict adaptation (i.e., the Gratton effect). Instead, hangover potentiated the detrimental effects of conflicting subliminal primes on top-down cognitive conflicts. This effect was likely due to an increase in the speed of information accumulation from visual stimuli and the resulting increase in subliminal conflict load induced by incompatible primes. We further found the size of this effect to be positively correlated with age and subjective sleepiness during the hangover state, but the hangover effect remained significant even after correcting for those covariates. We further found no correlation of the behavioral effect with the subjective overall rating of hangover symptoms or the maximal breath alcohol concentration reached during prior intoxication. Taken together, our findings suggest that alcohol hangover may affect cognitive performance due to an increase in non-conscious processing of visual distractors. While the size of this effect might increase with age and sleepiness, it is not entirely dependent on those covariates and not necessarily related to subjective ratings of general hangover symptoms/impairment.

Pharmacological manipulation of the ghrelin system and alcohol hangover symptoms in heavy drinking individuals: Is there a link?

Ghrelin, an orexigenic peptide synthesized in the stomach, is a key player in the gut-brain axis. In addition to its role in regulating food intake and energy homeostasis, ghrelin has been shown to modulate alcohol-related behaviors. Alcohol consumption frequently results in hangover, an underexplored phenomenon with considerable medical, psychological, and socioeconomic consequences. While the pathophysiology of hangover is not clear, contributions of mechanisms such as alcohol-induced metabolic/endocrine changes, inflammatory/immune response, oxidative stress, and gut dysbiosis have been reported. Interestingly, these mechanisms considerably overlap with ghrelin's physiological functions. Here, we investigated whether pharmacological manipulation of the ghrelin system may affect alcohol hangover symptoms. Data were obtained from two placebo-controlled laboratory studies. The first study tested the effects of intravenous (IV) ghrelin and consisted of two experiments: a progressive-ratio IV alcohol self-administration (IV-ASA) and a fixed-dose IV alcohol clamp. The second study tested the effects of an oral ghrelin receptor inverse agonist (PF-5190457) and included a fixed-dose oral alcohol administration experiment. Alcohol hangover data were collected the morning after each alcohol administration experiment using the Acute Hangover Scale (AHS). IV ghrelin, compared to placebo, significantly reduced alcohol hangover after IV-ASA (p = 0.04) and alcohol clamp (p = 0.04); PF-5190457 had no significant effect on AHS scores. Females reported significantly higher hangover symptoms than males following the IV-ASA experiment (p = 0.04), but no gender × drug condition (ghrelin vs. placebo) effect was found. AHS total scores were positively correlated with peak subjective responses, including 'stimulation' (p = 0.08), 'sedation' (p = 0.009), 'feel high' (p = 0.05), and 'feel intoxicated' (p = 0.03) during the IV-ASA. IV ghrelin blunted the positive association between alcohol sedation and hangover as shown by trend-level drug × sedation effect (p = 0.08). This is the first study showing that exogenous ghrelin administration, but not ghrelin receptor inverse agonism, affects hangover symptoms. Future research should investigate the potential mechanism(s) underlying this effect.

Proceeding of the 8th Alcohol Hangover Research Group Meeting

Alcohol hangover is one of the most commonly experienced consequences of alcohol consumption. An alcohol hangover develops as the blood alcohol concentrations (BAC) approaches zero, and is characterized by a general feeling of misery. More insight into the pathology of an alcohol hangover needs to be gained, in order to enhance the understanding of the area, and as a potential contribution to the innovation of a preventative or hangover curing treatment. The Alcohol Hangover Research Group (AHRG) was founded to support the area of alcohol hangover. This proceeding describes the latest findings in the area of alcohol hangovers, and future research plans, discussed at the 8th Alcohol Hangover Research Group meeting, held on June 25, 2016, New Orleans, USA. Novel insight in potential causes, consequences, and treatment of alcohol hangover were revealed during the meeting, as well as further research plans to examine biomarkers of recent alcohol consumption, immune functioning, alcohol metabolism, and potential treatments.

Hangover in Post-College-Aged Drinkers: Psychometric Properties of the Hangover Symptom Scale (HSS) and the Hangover Symptom Scale-Short Form (HSS-5)

BACKGROUND

Alcohol hangovers have been found to be a common and costly consequence of alcohol misuse. However, there is only limited psychometric support for instruments to accurately measure hangovers beyond the college-age years. This study investigated the psychometric properties of the Hangover Symptom Scale (HSS) and the Hangover Symptom Scale-Short Form (HSS-5) including the internal consistency, convergent and discriminant validity, construct validity, and the measurement invariance of these scales between light and heavy drinkers, individuals with a positive and negative family history of alcohol use disorder (AUD), and men and women in a post-college-aged sample. The association of the HSS and HSS-5 with alcohol use problems was also tested.

METHODS

Participants were 294 nonalcoholic light and heavy social drinkers (age range 21 to 35 years; 57.8% male) enrolled in the Chicago Social Drinking Project. They completed the HSS as part of a take-home packet completed outside of the laboratory. The psychometric properties of the HSS and HSS-5 were tested.

RESULTS

Stronger psychometric support was found for the HSS-5 relative to the full HSS. While both measures demonstrated strong internal consistency reliability, convergent and discriminant validity, and an association with alcohol use problems, only the HSS-5 showed construct validity as determined by confirmatory factor analysis. Further, only the HSS-5 showed measurement invariance between men and women, light and heavy drinkers, and individuals with a positive and negative family history of AUD.

CONCLUSIONS

This was the first study to examine the psychometric properties of the HSS and HSS-5 in a post-college-aged sample and the first to investigate the measurement invariance of these measures as a function of sex, drinking history, and family history of AUD. This study supports the use of the HSS-5 as a reliable and valid brief measure of frequency of hangover symptoms.

An effective hangover treatment: Friend or foe?

Background

The purpose of this study was to examine whether drinkers would change their alcohol consumption behavior if an effective hangover treatment became available.

Methods

An online survey was held among Dutch students, aged 18–30 years, who recently had a hangover. Participants were asked (1) whether they would buy an effective hangover treatment if it became available and (2) whether using such a product would increase their alcohol consumption. In a follow-up survey, the same participants could clarify their answers in detail.

Results

A total of 1837 subjects completed the survey: 69.9% of the participants indicated they would buy an effective hangover treatment if available, 8.1% answered “no”, and 22.1% did not know. Only 13.4% stated that using such a treatment would increase their alcohol consumption. The majority of 71.6% stated it would not increase their alcohol consumption and 15.1% did not know. The follow-up survey was completed by N = 471 participants, of which 11.9% stated consuming more alcohol, 70.3% reported not to drink more alcohol, and 17.8% did not know. Motives for not consuming more alcohol were “The risk of having a hangover does not influence my drinking behavior” (24.2%), and “alcohol is a harmful substance” (20.3%).

Discussion

Social drinkers second the need for an effective hangover treatment. However, according to the vast majority of them, the availability of an effective hangover treatment would not result in an increase of alcohol consumption.

Biomarkers of the alcohol hangover state: Ethyl glucuronide (EtG) and ethyl sulfate (EtS)

INTRODUCTION

The aim of this study was to investigate the usefulness of ethyl glucuronide (EtG) and ethyl sulfate (EtS) as biomarkers of the hangover state.

METHODS

Thirty-sixhealthy social drinkers participated in this study, being of naturalistic design. Eighteen participants experience regular hangovers (the hangover group), whereas the other 18 claim to not experience a hangover (the hangover-immune group). On a control day (alcohol-free) day and a post-alcohol day, urine EtG and EtS concentrations were determined and hangover severity assessed.

RESULTS

Urinary EtG and EtS concentrations were significantly increased on post-alcohol day compared to the control day (p = .0001). Both EtG and EtS concentrations did not significantly correlate with the overall hangover score, nor with the estimated peak blood alcohol concentrations and number of alcoholic drinks. EtG correlated significantly only with the individual hangover symptom "headache" (p = .033; r = .403). No significant correlations were found with the EtG to EtS ratio. EtG and EtS concentrations significantly correlated with urine ethanol concentrations.

CONCLUSIONS

Although urine EtG and EtS concentration did not significantly correlate to estimated peak blood alcohol concentrations or the number of alcoholic drinks consumed, a significant correlation was found with urine ethanol concentration. However, urine EtG and EtS concentrations did not significantly correlate with overall hangover severity.

Improved memory for information learnt before alcohol use in social drinkers tested in a naturalistic setting

Alcohol is known to facilitate memory if given after learning information in the laboratory; we aimed to investigate whether this effect can be found when alcohol is consumed in a naturalistic setting. Eighty-eight social drinkers were randomly allocated to either an alcohol self-dosing or a sober condition. The study assessed both retrograde facilitation and alcohol induced memory impairment using two independent tasks. In the retrograde task, participants learnt information in their own homes, and then consumed alcohol ad libitum. Participants then undertook an anterograde memory task of alcohol impairment when intoxicated. Both memory tasks were completed again the following day. Mean amount of alcohol consumed was 82.59 grams over the evening. For the retrograde task, as predicted, both conditions exhibited similar performance on the memory task immediately following learning (before intoxication) yet performance was better when tested the morning after encoding in the alcohol condition only. The anterograde task did not reveal significant differences in memory performance post-drinking. Units of alcohol drunk were positively correlated with the amount of retrograde facilitation the following morning. These findings demonstrate the retrograde facilitation effect in a naturalistic setting, and found it to be related to the self-administered grams of alcohol.

The breathtaking truth about breath alcohol readings of zero

INTRODUCTION

It has been postulated that the hangover state starts when breath alcohol concentration is zero.

METHODS

Data from 2 studies that assessed ethanol in breath, blood and urine were compared.

RESULTS

The data revealed that ethanol may still be present in the blood and urine during the hangover state, despite breath analyser readings of zero.

DISCUSSION

As ethanol is still present in the body despite zero breath alcohol readings, the current consensus to postpone cognitive testing in hangover studies until breath alcohol concentration is zero should be reconsidered.

The effect of alcohol hangover on choice response time

The effect of alcohol hangover on cognitive processing has received little attention. We explored the effect of alcohol hangover on choice response time (RT), a dominant dependent variable (DV) in cognitive research. Prior research of the effect of hangover on RT has produced mixed findings; all studies reviewed relied exclusively on estimates of central tendency (e.g. mean RT), which has limited information value. Here we present novel analytical methods by going beyond mean RT analysis. Specifically, we examined performance in hangover conditions (n=31) across the whole RT distribution by fitting ex-Gaussian models to participant data, providing a formal description of the RT distribution. This analysis showed detriments to performance under hangover conditions at the slower end of the RT distribution and increased RT variance under hangover conditions. We also fitted an explicit mathematical process model of choice RT - the diffusion model - which estimates parameters reflecting psychologically-meaningful processes underlying choice RT. This analysis showed that hangover reduced information processing efficiency during response selection, and increased response caution; changes in these parameters reflect hangover affecting core decisional-components of RT performance. The implications of the data as well as the methods used for hangover research are discussed.

Predicting perceived safety to drive the morning after drinking: The importance of hangover symptoms

INTRODUCTION AND AIMS

People driving the day after drinking are at risk of impaired performance and accidents due to continued intoxication or the effects of alcohol hangover. Drivers are poor at estimating their own blood alcohol concentration, and some drive despite believing they are over the legal limit. It is therefore important to identify other factors influencing perceived ability to drive 'the morning after'. This study tested how accurately participants estimated their legal driving status, and the contribution of beliefs and hangover symptoms to the prediction of perceived driving safety.

DESIGN AND METHODS

This cross-sectional study involved 193 students completing a questionnaire and alcohol breath test the morning after heavy alcohol consumption. Indicators of subjective intoxication, severity of hangover symptoms, estimated legal status and perceived safety to drive were measured. A hierarchical linear regression analysis was conducted.

RESULTS

No participants thought they were under the English legal limit when they were not, and 47% thought they were over the limit when they were in fact legally permissible to drive. However, 20% of those believing they were over the limit nevertheless rated themselves as safe to drive. Hangover symptoms added 17% variance to the prediction of perceived safety to drive, over and above objective and subjective measures of intoxication.

DISCUSSION AND CONCLUSIONS

Perceived severity of hangover symptoms influence beliefs about driving ability: When judging safety to drive, people experiencing less severe symptoms believe they are less impaired. If this finding is robust, health promotion campaigns should aim to correct this misapprehension. [Cameron E, French D. Predicting perceived safety to drive the morning after drinking: The importance of hangover symptoms. Drug Alcohol Rev 2016;35:442-446].