The Holmes and Rahe Stress Scale

Understanding the Impact of Long-term Stress

Are you "burning the candle at both ends?"

People use the word "stress" to describe a wide variety of situations - from your cell phone ringing while you're talking on another phone - to the feelings associated with intense work overload, or the death of a loved-one.

But perhaps the most useful and widely accepted definition of stress (mainly attributed to Richard S. Lazarus) is this: Stress is a condition or feeling experienced when a person perceives that "demands exceed the personal and social resources the individual is able to mobilize." In less formal terms, we feel stressed when we feel that "things are out of control".

Our ability to cope with the demands upon us is key to our experience of stress. For example, starting a new job might be a wholly exciting experience if everything else in your life is stable and positive. But if you start a new job when you've just moved into a new house, or your partner is ill, or you're experiencing money problems, you might find it very hard to cope.

How much of this does it take to push you "over the edge"? Not all unusual events are equally hard to deal with. For example, compare the stress of divorce with that of a change in responsibilities at work. Because of this, you need to be able to rate and measure your total stress score appropriately.

The Social Readjustment Rating Scale (SRRS), more commonly known as the Holmes and Rahe Stress Scale, was created to do just that. This tool helps us measure the stress load we carry, and think about what we should do about it.

This article looks at the Holmes and Rahe Stress Scale, and explains how you can use it to manage the stress in your life.

The Holmes and Rahe Stress Scale

In 1967, psychiatrists Thomas Holmes and Richard Rahe decided to study whether or not stress contributes to illness. They surveyed more than 5,000 medical patients and asked them to say whether they had experience any of a series of 43 life events in the previous two years.

Each event, called a Life Change Unit (LCU), had a different "weight" for stress. The more events the patient added up, the higher the score. The higher the score, and the larger the weight of each event, the more likely the patient was to become ill.

The Stress Scale

To score your stress levels, simply check the box in the right hand column next to all the events that have happened to you in the last year. Your score will automatically update.

This table is taken from "The Social Readjustment Rating Scale", Thomas H. Holmes and Richard H. Rahe, Journal of Psychosomatic Research, Volume 11, Issue 2, August 1967, Pages 213-218, Copyright © 1967 Published by Elsevier Science Inc. All rights reserved. Permission to reproduce granted by the publisher.

This scale must not be used in any way to cause harm to an individual's professional career.

Top of Form

Life Event		Value	Check if this applies
1	Death of spouse	100
2	Divorce	73
3	Marital separation	65
4	Jail term	63
5	Death of close family member	63
6	Personal injury or illness	53
7	Marriage	50
8	Fired at work	47
9	Marital reconciliation	45
10	Retirement	45
11	Change in health of family member	44
12	Pregnancy	40
13	Sex difficulties	39
14	Gain of new family member	39
15	Business readjustment	39
16	Change in financial state	38
17	Death of close friend	37
18	Change to a different line of work	36
19	Change in number of arguments with spouse	35
20	A large mortgage or loan	31
21	Foreclosure of mortgage or loan	30
22	Change in responsibilities at work	29
23	Son or daughter leaving home	29
24	Trouble with in-laws	29
25	Outstanding personal achievement	28
26	Spouse begins or stops work	26
27	Begin or end school/college	26
28	Change in living conditions	25
29	Revision of personal habits	24
30	Trouble with boss	23
31	Change in work hours or conditions	20
32	Change in residence	20
33	Change in school/college	20
34	Change in recreation	19
35	Change in church activities	19
36	Change in social activities	18
37	A moderate loan or mortgage	17
38	Change in sleeping habits	16
39	Change in number of family get-togethers	15
40	Change in eating habits	15
41	Vacation	13
42	Christmas	12
43	Minor violations of the law	11
0

Bottom of Form

Note: If you experienced the same event more than once, then to gain a more accurate total, add the score again for each extra occurrence of the event.

Score Interpretation

Score	Comment
300+	You have a high or very high risk of becoming ill in the near future.
150-299	You have a moderate to high chance of becoming ill in the near future.
<150	You have only a low to moderate chance of becoming ill in the near future.

What You Can Do About This

If you find that you are at a moderate or high level of risk , then an obvious first thing to do is to try to avoid future life crises.

While this is clearly easier said than done, you can usually avoid moving house, for example, close to when you retire, or when one of your children goes off to college; you can learn conflict resolution skills   to minimize conflict with other people; you can avoid taking on new obligations or engaging with new programs of study; and you can take things easy, and look after yourself.

For more on reducing stress, visit the Stress Tools area of Mind Tools.

Note 1:

Some scientists have suggested that the Holmes and Rahe Stress Scale is weak in certain areas. For example, some feel that different cultural groups react differently to different life events.

One study compared scores of Americans with those of Malaysians. Interestingly, Malaysians had different attitudes toward breaking the law and toward relationships than the Americans did, meaning that their experience of stress was different at the same score.

Keep cultural differences in mind as you score your own life events.

Note 2:

While it's useful to know about this idea so that you can take action with it, don't dwell on it, and don't let this knowledge affect your mood. Think positively!  

Note 3:

Stress can cause severe health problems and, in extreme cases, can cause death. You should take the advice of a suitably qualified health professional if you have any concerns over stress-related illnesses, or if stress is causing you significant or persistent unhappiness.

Key Points

The Holmes and Rahe Stress Scale is a well-known tool for measuring the amount of stress you’ve experienced within the past year. Taking the test can help you see clearly if you’re at risk of illness due to stress.

Warning: Stress can cause severe health problems and, in extreme cases, can cause death. While these stress management techniques have been shown to have a positive effect on reducing stress, they are for guidance only, and readers should take the advice of suitably qualified health professionals if they have any concerns over stress-related illnesses or if stress is causing significant or persistent unhappiness. Health professionals should also be consulted before any major change in diet or levels of exercise.

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