An event-level investigation of hangovers' relationship to age and drinking

The role of effortful control in mitigating negative consequences associated with emerging adult drinking

BACKGROUND

Identifying factors that protect against alcohol-related negative consequences associated with emerging adult drinking is a critical public health issue. It has been proposed that high levels of self-regulation moderate risks associated with drinking, decreasing alcohol-related negative consequences. Past research testing this possibility is limited by a lack of advanced methodology for testing moderation and failure to consider facets of self-regulation. This study addressed these limitations.

METHODS

Three hundred fifty-four community emerging adults (56% female; predominantly non-Hispanic Caucasian (83%) or African American (9%)) were assessed annually for 3 years. Moderational hypotheses were tested using multilevel models and the Johnson-Neyman technique was used to examine simple slopes. Data were organized such that repeated measures (level 1) were nested within participants (level 2) to test cross-sectional associations. Self-regulation was operationalized as effortful control and its facets (attentional, inhibitory, and activation control).

RESULTS

We found evidence of moderation. The association between alcohol use during a heavy drinking week and consequences weakened as effortful control increased. This pattern was supported for two facets (attentional and activation control), but not for inhibitory control. Regions of significance results revealed that this protective effect was only evident at very high levels of self-regulation.

CONCLUSIONS

The results provide some evidence that very high levels of attentional and activation control protect against alcohol-related negative consequences associated with drinking. Emerging adults who are very high in attentional and activation control are likely better able to control their attention and engage in goal-directed behavior, like leaving a party at a reasonable hour, or attending school and/or work when experiencing the punishing effects of a hangover. Results emphasize the importance of distinguishing facets of self-regulation when testing self-regulation models.

Male, but not female, Sprague Dawley rats display enhanced fear learning following acute ethanol withdrawal (hangover)

The present studies investigated the effects of withdrawal from a single binge-like dose of ethanol (hangover) on fear conditioning in male and female Sprague Dawley rats. In Experiment 1, males and females were given 0 or 3.5 g/kg ethanol intraperitoneally (i.p.) and then conditioned to contextual fear 24 h post injection. Withdrawal from acute ethanol enhanced expression of the conditioned freezing response in males, but not in females. Experiment 2 demonstrated that in males, withdrawal from acute ethanol administered 24 h prior to conditioning enhanced contextual fear conditioning, but not auditory-cued fear conditioning. In Experiment 3, male and female rats were given 3.5 g/kg ethanol, and blood ethanol concentrations (BECs) were assessed at various time points for determination of ethanol clearance. Female rats cleared ethanol at a higher rate than males, with 10 h required for females and 14 for males to eliminate ethanol from their systems. Because females cleared ethanol faster than males, in Experiment 4, females were conditioned 18 h after ethanol administration to keep the interval between ethanol clearance and fear conditioning similar to that of males. Withdrawal from acute ethanol given 18 h prior to conditioning did not affect both contextual and auditory-cued fear conditioning in females. In summary, these results highlight sex differences in the impact of withdrawal from acute ethanol (hangover) on fear learning; suggesting that males are more sensitive to hangover-associated enhancement of negative affect than females.

Do alcohol-related consequences and how they are evaluated predict consumption during and days until the next drinking event?

Objective: Alcohol-related consequences are most often examined as outcomes of alcohol use. However, it is also possible that experiencing consequences may predict future drinking behavior. The predictive power of consequences on future drinking behavior may involve both objective experiences of consequences and subjective evaluations of those consequences (i.e., how positive, how negative). The purpose of the present study was to understand how positive and negative alcohol-related consequences-and evaluations of those consequences-predict elements of the next drinking event among college students. Method: 96 participants reported alcohol use and related consequences over a 28-day daily assessment period. Results: Survival analysis and multilevel modeling were used to examine the influence of positive and negative consequences from a given drinking event on latency to and number of drinks consumed at the next drinking event. Contrary to hypotheses, subsequent drinking was not impacted by recent consequences nor how they were perceived. Conclusions: Though theoretically, experiencing alcohol consequences may impact proximal drinking behavior, findings suggest that, in the current sample, other factors have greater importance in the latency between drinking events and amount of alcohol consumed. Future work should continue to identify event-level predictors that impact behavior at the next drinking event, and ways drinkers attempt to avoid repetition of drinking consequences other than simply drinking less (e.g., protective behavioral strategies), as such factors would be valuable targets for intervention. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Alcohol intoxication, but not hangover, differentially impairs learning and automatization of complex motor response sequences

Behavioral automatization usually makes us more efficient and less error-prone, but may also foster dysfunctional behavior like alcohol abuse. Yet, it has remained unclear whether alcohol itself causes the shift from controlled to habitual behavior commonly observed in alcohol use disorder (AUD). We thus investigated how the acute and post-acute effects of binge drinking affect the automatization of motor response sequences and the execution of automated vs. controlled motor response sequences. N = 70 healthy young men performed a newly developed automatization paradigm once sober and once after binge drinking (half of them intoxicated and half of them hungover). While we found no significant effects of alcohol hangover, acute intoxication (~ 1.2 ‰) had two dissociable effects: Firstly, it impaired the automatization of complex motor response sequence execution. Secondly, it eliminated learning effects in response selection and pre-motor planning processes. The results suggest that alcohol hangover did not affect controlled or automated processes, and disprove the assumption that alcohol intoxication generally spares or facilitates motor response sequence automatization. As these effects could be specific to the investigated explicit learning context, acute intoxication might potentially still improve the execution of pre-existing automatisms and/or the implicit acquisition of motor response sequence automatisms.

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.

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.

Sleep after Heavy Alcohol Consumption and Physical Activity Levels during Alcohol Hangover

Alcohol consumption can negatively affect sleep quality. The current study examined the impact of an evening of alcohol consumption on sleep, and next day activity levels and alcohol hangover. n = 25 healthy social drinkers participated in a naturalistic study, consisting of an alcohol and alcohol-free test day. On both days, a GENEactiv watch recorded sleep and wake, and corresponding activity levels. In addition, subjective assessments of sleep duration and quality were made, and hangover severity, and the amount of consumed alcoholic beverages were assessed. Alcohol consumption was also assessed in real-time during the drinking session, using smartphone technology. The results confirmed, by using both objective and subjective assessments, that consuming a large amount of alcohol has a negative impact on sleep, including a significant reduction in objective sleep efficiency and significantly lower self-reported sleep quality. Activity levels during the hangover day were significantly reduced compared to the alcohol-free control day. Of note, next-morning retrospective alcohol consumption assessments underestimated real-time beverage recordings. In conclusion, heavy alcohol consumption impairs sleep quality, which is associated with increased next day hangover severity and reduced activity levels. The outcome of this study underlines that, in addition to retrospectively reported data, real-time objective assessments are needed to fully understand the effects of heavy drinking.

After how many drinks does someone experience acute consequences-determining thresholds for binge drinking based on two event-level studies

BACKGROUND AND AIMS

The threshold of 4+/5+ drinks per occasion has been used for decades in alcohol research to distinguish between non-risky versus risky episodic drinking. However, no study has assessed the validity of this threshold using event-level data. This study aimed to determine the optimal thresholds for the detection of five acute alcohol-related consequences (hangover, blackout, risky sex, fights and injury) using data from two event-level studies.

DESIGN

An event-level study to assess the ability to use the number of drinks consumed to discriminate between nights with and without consequences using the area under the receiver operating characteristic (AUROC) curve. Optimal thresholds were determined using the Youden Index based on sensitivity and specificity. Separate thresholds were estimated for gender and age groups (16-17 versus 18-25).

SETTING

Lausanne and Zurich, Switzerland.

PARTICIPANTS

Three hundred and sixty-nine participants aged 16-25 years.

MEASUREMENTS

On 3554 weekend nights, participants reported total number of alcoholic drinks consumed the previous night and acute consequences (hangover, blackout, risky sex, fights and injury) FINDINGS: Hangover was the most frequently reported consequence and injury the least for both genders. Throughout age groups and studies, optimal thresholds for any consequence, and for hangover only, were equal to 4+/5+ (40+/50+ g alcohol) while those for blackouts, risky sex, fights and injuries were up to three drinks higher. Adolescents tended to experience consequences more often and at slightly lower drinking levels than did adults. For all consequences but injuries, the optimal thresholds were one to two drinks lower for women than for men.

CONCLUSIONS

Event-level data collection techniques appear particularly suitable to estimate thresholds at which acute alcohol-related consequences occur. Binge drinking thresholds of 4+/5+ (women/men) drinks, equivalent to 40+/50+ g pure alcohol, predict the occurrence of consequences accurately in general but are too low to predict severe acute alcohol-related consequences.

Long-term changes in the effects of episode-specific drinking to cope motivation on daily well-being

To further understand the role of drinking to cope (DTC) motivation in the development of drinking-related problems during young adulthood, we tested whether the association between episode-specific levels of nighttime DTC motivation and next-day negative affect and self-control depletion symptoms (SCDS) changed from college years to postcollege years (5 years later). We also examined whether these changes were moderated by recent life stress, adult social role attainment and gender, and whether mean levels of these variables were associated with changes in drinking-related problems from college to postcollege years. Participants (N = 927; 54% women) completed a 30-day daily diary during college and again 5 years later in which they reported their previous night's drinking level and motivation and their current negative affect and SCDS. We assessed drinking-related problems at both waves and recent life stress and adult social roles at Wave 2. DTC motivation was positively associated with next-day levels of negative affect and SCDS. The effect of DTC motivation on anxiety and SCDS became stronger over time. The effect of DTC motivation on depressive affect and anger (a) decreased across time among individuals who attained more adult roles and (b) was weaker among individuals who reported lower levels of postcollege life stress. Mean levels of postcollege DTC motivation was indirectly related to changes in drinking-related problems from college to postcollege through mean levels of negative affect and SCDS. Our findings indicate that DTC might exert its unique long-term effects on alcohol use disorders through disruption of daily emotion-regulation processes. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

The effects of alcohol hangover on future drinking behavior and the development of alcohol problems

INTRODUCTION

Alcohol hangover experiences in young adulthood have been shown to predict more subsequent alcohol problems. Hangover susceptibility appears to be partially heritable and related to family history of alcohol use disorders. However, very little is known about the developmental course of these associations and whether they are accounted for by an individual's drinking history. The goal of this study is to investigate the prospective and unique relationships between family history of alcohol use disorders, severity of alcohol hangover experiences in adolescence, and later alcohol use and related problems measured over 13years.

METHODS

Participants were first assessed on family history at age 12-14, prior to initiating drinking, and re-assessed annually on hangover severity, drinks per drinking day (DPDD), and alcohol-related problems throughout the 13-year follow-up period (n=205; 59% male).

RESULTS

In mixed effects negative binomial regression models, greater family history density scores predicted more future DPDD (Incidence Rate Ratio [IRR]=1.19, p=0.04), alcohol problems (IRR=1.64, p=0.05), and future hangover severity (IRR=1.24; p=0.01). In turn, greater hangover severity predicted more future DPDD (IRR=1.03; p=0.002) and alcohol problems (IRR=1.12, p<0.001), and hangover severity mediated the relationship between family history and alcohol use/problems. All models controlled for participant age, sex, and past drinking behavior (where relevant).

CONCLUSIONS

These results advance the alcohol hangover experience during late adolescence as a clinically relevant and uniquely informative marker of future alcohol use and problems, above and beyond that of prior personal or familial drinking history.

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.

Hangover resistance in a Canadian University student population

Background

Resistance to alcohol hangover may be a risk factor for alcohol use disorder. Previous research to establish the prevalence of hangover resistance in a drinking population has either not used comparable intoxication levels or has considered hangover resistance over a limited time frame. The purpose of this study was to examine the prevalence of lifetime hangover negative (LHN) drinkers across comparable eBAC values ranging from 0 to 500 mg/dl.

Methods

Students at an eastern Canadian university were surveyed about their heaviest drinking episode in the past month and indicated whether they had ever experienced a hangover in their lifetime (LHN) and, if they had, the hangover severity they experienced the next day. eBACs were calculated and the percentage of LHN drinkers was computed at each 10 mg/dl eBAC increment from 0 to 500 mg/dl.

Results

Most LHN drinkers (58% female, 71% male) had an eBAC on their heaviest drinking occasion below 80 mg/dl. Above eBACs of 80 mg/dl, 5.8% of female and 5.1% of male drinkers were lifetime hangover negative.

Conclusions

The results suggest that only a small percentage of heavy drinkers lay claim to being lifetime hangover negative.

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The estimated BAC of more than half of male and female lifetime hangover negative drinkers was below 80 mg%.

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Approximately 5% of drinkers registering estimated BAC’s beyond 80 mg% claim to be lifetime hangover negative.

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Biological and psychological hypotheses are proposed to explain why heavy drinkers may be lifetime hangover negative.

Does familial risk for alcohol use disorder predict alcohol hangover?

AIMS

Positive family history of alcohol use disorder (FHP), a variable associated with propensity for alcohol use disorder (AUD), has been linked with elevated hangover frequency and severity, after controlling for alcohol use. This implies that hangover experiences may be related to AUD. However, inadequate control of alcohol consumption levels, low alcohol dose and testing for hangover during the intoxication phase detract from these findings. Here, we present further data pertinent to understanding the relationship between family history and alcohol hangover.

METHODS

Study 1 compared past year hangover frequency in a survey of 24 FHP and 118 family history negative (FHN) individuals. Study 2 applied a quasi-experimental naturalistic approach assessing concurrent hangover severity in 17 FHP and 32 FHN individuals the morning after drinking alcohol. Both studies applied statistical control for alcohol consumption levels.

RESULTS

In Study 1, both FHP status and estimated blood alcohol concentration on the heaviest drinking evening of the past month predicted the frequency of hangover symptoms experienced over the previous 12 months. In Study 2, estimated blood alcohol concentration the previous evening predicted hangover severity but FHP status did not.

CONCLUSIONS

FHP, indicating familial risk for AUD, was not associated with concurrent hangover severity but was associated with increased estimates of hangover frequency the previous year.