AN ECOLOGICAL INVESTIGATION OF HANGOVER SEVERITY AND TIME COURSE _______________________________________ A Dissertation presented to the Faculty of the Graduate School at the University of Missouri-Columbia _______________________________________________________ In Partial Fulfillment of the Requirements for the Degree Doctor of Philosophy _____________________________________________________ by ERIN HUNT-CARTER Dr. Thomas Piasecki, Dissertation Supervisor DECEMBER 2010 The undersigned, appointed by the dean of the Graduate School, have examined the dissertation entitled AN ECOLOGICAL INVESTIGATION OF HANGOVER SEVERITY AND TIME COURSE presented by Erin E. Hunt-Carter, a candidate for the degree of doctor of philosophy, and hereby certify that, in their opinion, it is worthy of acceptance. Professor Thomas M. Piasecki Professor Wendy S. Slutske Professor Kenneth J. Sher Professor Dennis K. Miller Professor Daniel C. Vinson Thank you to my wonderful husband, Brent. I would not have completed this without your endless encouragement and kindness. Thank you to my parents, Toni and John Hunt, and my parents-in-law, Sondra and Guy Carter. Their support and many hours of babysitting were invaluable. Thank you to my sister, Meghan Hunt, for being riotously funny and supporting me through this process. Finally, I’d like to thank my children, Ian and Anna Carter, for keeping me grounded and reminding me what is truly important in life. ACKNOWLEDGEMENTS It is a pleasure to thank those who made this dissertation possible. First, I would like to express my gratitude to my doctoral advisor, Dr. Thomas Piasecki. He generously welcomed me into his lab, and enabled me to gain invaluable experience with ecological momentary assessment. I could not have completed this dissertation without his patient advice, extensive knowledge, and encouragement. His love of words and Brobdingnagian sense of humor made him a pleasure to work with. I am also grateful to Dr. Wendy Slutske, who served as my advisor through the completion of my comprehensive exams. Being a part of her lab was tremendous fun, and in it I developed a passion for the study of addictions, grew tremendously as a researcher, and made lifelong friends. I owe her a great debt for her time, knowledge and support. Dr. Kenneth Sher played a strong role in shaping my career development. His efforts influenced my interest in alcoholism, and provided me with opportunities in the study of addictions that I could not have found elsewhere. I also appreciate the time and guidance he provided as a member of my committee. I would also like to thank the other members of my committee, Dr. Dennis Miller, and Dr. Daniel Vinson. Their advice and expertise were invaluable. Finally, I would like to thank Dr. Phil Wood for the good-humored and sanity- saving statistical advice he provided as I was completing this dissertation. ii TABLE OF CONTENTS ACKNOWLEDGEMENTS ................................................................................................ ii LIST OF TABLES ...............................................................................................................v LIST OF FIGURES ......................................................................................................... viii ABSTRACT ....................................................................................................................... ix Chapter 1. INTRODUCTION…………………………………………………………………1 The Potential Relation Between Hangover and Alcohol Use Disorders……..…..2 Time Course and Severity of Hangover…………………………………………..8 The Present Study……………………………………………………………….18 2. METHOD……………………………………………………………………..….19 Participants……………………………………………………………………….19 Procedure………………………………………………………………………...21 Electronic Diaries…………………………….…………………………………..22 Measures……………………………………………………...………………….23 Statistical Analyses………………………………………………………………29 3. RESULTS………………………………………………...………………………33 Descriptive Analyses of Hangover………………………………………………33 Symptoms at Morning Report……………………………………………………34 Comparing post-drinking and hangover days……………………………...…….36 Time Course of Hangover…………………………………………………..……37 Craving Alcohol and Hangover………………………………………………….43 Hangover Day Drinking……………………………………………………….....45 4. DISCUSSION…………………………………………………………………….46 iii REFERENCES ............................................................................................................…..54 TABLES ............................................................................................................................63 FIGURES ...........................................................................................................................97 VITA ..................................................................................................................………..109 iv LIST OF TABLES Table Page 1. Hangover Symptoms Generated by a Sample of 377 College Students……………...63 2. Results of Model Predicting Enthusiasm at Morning Report on Post-Drinking and Hangover Days Relative to Post-Abstention Days………………………………….64 3. Results of Model Predicting Distress at Morning Report on Post-Drinking and Hangover Days Relative to Post-Abstention Days……………….…………………65 4. Results of Model Predicting Excitement at Morning Report on Post-Drinking and Hangover Days Relative to Post-Abstention Days…………………………………66 5. Results of Model Predicting Happiness at Morning Report on Post-Drinking and Hangover Days Relative to Post-Abstention Days……………………………...….67 6. Results of Model Predicting Sadness at Morning Report on Post-Drinking and Hangover Days Relative to Post-Abstention Days…………………………………68 7. Results of Model Predicting Sluggishness at Morning Report on Post-Drinking and Hangover Days Relative to Post-Abstention Days…………………………………69 8. Results of Model Predicting Feeling Buzzed at Morning Report on Post-Drinking and Hangover Days Relative to Post-Abstention Days …………………………………70 9. Results of Model Predicting Dizziness at Morning Report on Post-Drinking and Hangover Days Relative to Post-Abstention Days………………………………….71 10. Results of Model Predicting Headache at Morning Report on Post-Drinking and Hangover Days Relative to Post-Abstention Days…………………...…………....72 11. Results of Model Predicting Nausea at Morning Report on Post-Drinking and Hangover Days Relative to Post-Abstention Days………………………………...73 12. Results of Models Predicting Symptoms at Morning Report on Hangover Days Relative to Post-Drinking Days …………………………………………………..74 13. Results of Model Predicting Craving for Alcohol at Morning Report on Post- Drinking and Hangover Days Relative to Post-Abstention Days…………………75 14. Results of Simple Time Course Models Predicting Symptoms from Time and Day Type …………………………………………………………………………..……76 v 15. Results of Time Course Models Predicting Enthusiasm on Post-Drinking and Hangover Days Relative to Post-Abstention Days Including Covariates and Significant Interactions…………………………………………………………....77 16. Results of Time Course Models Predicting Distress on Post-Drinking and Hangover Days Relative to Post-Abstention Days Including Covariates and Significant Interactions………………………………………………..……………………….79 17. Results of Time Course Models Predicting Excitement on Post-Drinking and Hangover Days Relative to Post-Abstention Days Including Covariates and Significant Interactions……………………………………………………………80 18. Results of Time Course Models Predicting Happiness on Post-Drinking and Hangover Days Relative to Post-Abstention Days Including Covariates and Significant Interactions…………………………………………………..………..82 19. Results of Time Course Models Predicting Sadness on Post-Drinking and Hangover Days Relative to Post-Abstention Days Including Covariates and Significant Interactions……………………………………………………………………..….84 20. Results of Time Course Models Predicting Sluggishness on Post-Drinking and Hangover Days Relative to Post-Abstention Days Including Covariates and Significant Interactions…………………………...……………………………….85 21. Results of Time Course Models Predicting Buzz on Post-Drinking and Hangover Days Relative to Post-Abstention Days Including Covariates and Significant Interactions…………………………………………………………...……………87 22. Results of Time Course Models Predicting Dizziness on Post-Drinking and Hangover Days Relative to Post-Abstention Days Including Covariates and Significant Interactions……………………………..……………………………..88 23. Results of Time Course Models Predicting Headache on Post-Drinking and Hangover Days Relative to Post-Abstention Days Including Covariates and Significant Interactions…………………………………………………………....89 24. Results of Time Course Models Predicting Nausea on Post-Drinking and Hangover Days Relative to Post-Abstention Days Including Covariates and Significant Interactions………………………………………………………………………...91 25. Results of Time Course Models Predicting Craving for Alcohol on Post-Drinking and Hangover Days Relative to Post-Abstention Days Including Covariates and Significant Interactions……………………………………………………………92 26. Results of Models Comparing Symptom Severity on Hangover Days with Post- Abstinence and Post-Drinking Days by Time of Day………………...…………..93 vi 27. Results of Models Comparing Craving on Hangover Days with Post-Abstinence and Post-Drinking Days by Time of Day……………………………………...………95 28. Results of Model Predicting Total Number of Drinks Consumed on Post-Drinking and Hangover Days Relative to Post-Abstention Days……...……………………96 vii LIST OF FIGURES Figure Page 1. Unadjusted Self-Reported Symptom Scores at Morning Report by Day Type………97 2. Unadjusted Enthusiasm Scores by Day Type………………………………………...98