Holmes and Rahe stress scale

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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


                      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.


  • 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.

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