The Holmes and Rahe Stress Scale

Understanding the Impact of Long-term Stress

The Holmes and Rahe Stress Test

Are you "burning the candle at both ends?"

© iStockphoto/Anyka

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.

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

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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Comments (19)
  • Midgie wrote Over an hour ago
    patriciaworthen, it's great that your score puts you in the 'low to moderate' category. Continue to take good care of yourself and put strategies in place to deal with anything stressful that may arise.
  • Midgie wrote Over an hour ago
    Hi Em,
    Your high score might not absolutely mean that 'You have a high or very high risk of becoming ill in the near future'. It is however an indicator that you have been through alot recently. I would encourage you to seek any support that might help you deal with and process those experiences.
  • Em wrote Over an hour ago
    711 is it really tha bad. . . I mean how accurate are these things?
  • patriciaworthen wrote This month
    I have low to moderate chance of becoming Ill in the near future,
  • Yolande wrote This month
    Crystalj27, look after yourself carefully and try and find some calm in this busy life. Try & get enough sleep, get some exercise if possible and make use of your support system.
  • Crystalj27 wrote This month
    I have a moderate to high chance of becoming ill in the near future due to my stress levels.
  • Yolande wrote This month
    I hope you'll be careful Serena and make sure that you take real good care of yourself.
  • Serena wrote This month
    I have a moderate to high chance of becoming ill in the near future wow.
  • Midgie wrote This month
    HI everyone,
    Thanks for all your comments. Doing this test which gives specific point values to typical stressful situations helps people realize that alot has been going on.

    When we have a high score, that might be a good indicator for some, what I call, 'extreme self care' and nurture ourselves.

    From past experience, I have found that when I've gone through extreme stress periods, something had to give. I had to let go of a few things or allow myself to not worry about getting a particular job done by the end of the day, as it could wait until tomorrow!

    So, holding up the mirror to ourselves, seeing that we have gone through alot of stuff and being gentle is a good thing. From there, we can be so much more effective in all else we do!

    Midgie
  • quentin wrote This month
    I was not surprised at all of my evaluation. I already know that I stress.
Show all comments

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