Holmes and Rahe stress scale
In 1967, psychiatrists Thomas Holmes and Richard Rahe examined the medical records of over 5,000 medical patients as a way to determine whether stressful life events might cause illnesses. Patients were asked to tally a list of 43 life events based on a relative score. A positive 0.1 correlation was found between their life events and their illnesses. Thus, the Social Readjustment Rating Scale (SRRS) or the Holmes and Rahe Stress Scale was born. However, this study can be perceived as unreliable since it asks participants to look back at their life events, making the data retrospective.
Scale for Adults
To measure stress according to the Holmes and Rahe Stress Scale, the number of "Life Change Units" that apply to events in the past year of an individual's life are added and the final score will give a rough estimate of how stress affects health.
| Life Event | Life Change Units |
|---|---|
| Death of a Spouse | 100 |
| Divorce | 73 |
| Marital Separation | 65 |
| Imprisonment | 63 |
| Death of a Close Family Member | 63 |
| Personal Injury or Illness | 53 |
| Marriage | 50 |
| Dismissal from Work | 47 |
| Marital Reconciliation | 45 |
| Retirement | 45 |
| Change in Health of Family Member | 44 |
| Pregnancy | 40 |
| Sexual Difficulties | 39 |
| Gain a New Family Member | 39 |
| Business Readjustment | 39 |
| Change in Financial State | 38 |
| Change in Frequency of Arguments | 35 |
| Major Mortgage | 32 |
| Foreclosure of Mortgage or Loan | 30 |
| Change in Responsibilities at Work | 29 |
| Child Leaving Home | 29 |
| Trouble with In-Laws | 29 |
| Outstanding Personal Achievement | 28 |
| Spouse Starts or Stops Work | 26 |
| Begin or End School | 26 |
| Change in Living Conditions | 25 |
| Revision of Personal Habits | 24 |
| Trouble with Boss | 23 |
| Change in Working Hours or Conditions | 20 |
| Change in Residence | 20 |
| Change in Schools | 20 |
| Change in Recreation | 19 |
| Change in Church Activities | 19 |
| Change in Social Activities | 18 |
| Minor Mortgage or Loan | 17 |
| Change in Sleeping Habits | 16 |
| Change in Number of Family Reunions | 15 |
| Change in Eating Habits | 15 |
| Vacation | 13 |
| Christmas | 12 |
| Minor Violation of Law | 11 |
Score of 300+: At risk of illness.
Score of 150-299+: Risk of illness is moderate (reduced by 30% from the above risk).
Score 150-: Only have a slight risk of illness.
Scale for minors
A modified scale has also been developed for non-adults. Similar to the adult scale, stress points for life events in the past year are added and compared to the rough estimate of how stress affects health.
| Life Event | Life Change Units |
|---|---|
| Getting married | 101 |
| Unwed pregnancy | 11 |
| Death of parent | 12 |
| Acquiring a visible deformity | 20 |
| Divorce of parents | 20 |
| Fathering an unwed pregnancy | 33 |
| Becoming involved with drugs or alcohol | 10 |
| Jail sentence of parent for over one year | 0 |
| Marital separation of parents | 0 |
| Death of a brother or sister | 0 |
| Change in acceptance by peers | 20 |
| Pregnancy of unwed sister | 10 |
| Discovery of being an adopted child | 0 |
| Marriage of parent to step-parent | 0 |
| Death of a close friend | 5 |
| Having a visible congenital deformity | 30 |
| Serious illness requiring hospitalization | 5 |
| Failure of a grade in school | 15 |
| Not making an extracurricular activity | 15 |
| Hospitalization of a parent | 5 |
| Jail sentence of parent for over 30 days | 0 |
| Breaking up with boyfriend or girlfriend | 10 |
| Beginning to date | 20 |
| Suspension from school | 5 |
| Birth of a brother or sister | 20 |
| Increase in arguments between parents | 27 |
| Loss of job by parent | 26 |
| Outstanding personal achievement | 26 |
| Change in parent's financial status | 15 |
| Accepted at college of choice | 23 |
| Being a senior in high school | 22 |
| Hospitalization of a sibling | 21 |
| Increased absence of parent from home | 38 |
| Brother or sister leaving home | 5 |
| Addition of third adult to family | 34 |
| Becoming a full fledged member of a church | 31 |
| Decrease in arguments between parents | 27 |
| Decrease in arguments with parents | 26 |
| Mother or father beginning work | 26 |
30
TOTAL SCORE= 714
If you have kids, you've got stress in your life. And if your child has special needs, you likely have more than your share. Although stress can be protective, as in the 'fight or flight' response when threatened with immediate harm, or a positive response which spurs us to action, too much stress over a long period of time can have very negative effects on our emotions and on our health.
Although you might not be able to control the stressful events in your life, you do have control over your response to them and the effect that they have on your life. The negative effects of stress can be reduced by such things as getting enough rest, exercise, good nutrition, and taking some time for yourself.
Score of 300+: At risk of illness.
Score of 150-299+: Risk of illness is moderate. (reduced by || 30% from the above risk)
Score 150-: Slight risk of illness.
Supporting Research
A study by Rahe (1970) was carried out to test the reliability of the stress scale as a predictor of illness. The scale was given to 2,500 US sailors and they were asked to rate scores of 'life events' over the previous six months. Over the next six months, detailed records were kept of the sailors' health. There was a +0.118 correlation between stress scale scores and illness. This seemingly small correlation is significant and supports the hypothesis of a link between life events and illness.
References
- Holmes, T.H. and Rahe, R.H.: The social readjustments rating scales, Journal of Psychosomatic Reasearch, 11:213-218, 1967
- Rahe RH, Arthur RJ. (1978). Life change and illness studies: past history and future directions. J. Human Stress, 4(1): 3-15.
- Rahe RH et al. (1972). Psychosocial predictors of illness behavior and failure in stressful training. J. health Soc. Behav. 13(4): 393-97.
- Rahe RH, Mahan JL, Jr. Arthur RJ. (1970). Prediction of near-future health change from subjects' preceding life changes. J. Psychosom. Res. 14(4): 401-6.
- Rahe RH et al. (2000). The stress and coping inventory: an educational and research instrument. Stress Medicine 16: 199-208.
Further Reading
Philip, Banyard (2002). Psychology in Practice: Health. UK: Hodder and Stoughton. pp. pp. 81-84. ISBN 0-340-84496-5.