By Caroline Smith and the Mind Tools Team
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The Holmes and Rahe Stress Scale

Understanding the Impact of Long-term Stress

The Holmes & Rahe Stress Test

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Do you need to take a step back?

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 select Yes or No for each of the events in the Statements column that have happened to you in the last year. Then click Calculate My Total.

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.

Your last quiz results are shown.

You last completed this quiz on , at .

43 Statements to Answer

Yes No
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 (37)
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)
Total = 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
11-150

You have only a low to moderate chance of becoming ill in the near future.

150-299

You have a moderate to high chance of becoming ill in the near future.

300-600

You have a high or very high risk 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 & 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 (332)
  • Over a month ago Michele wrote
    Hi kkareem,

    It is always helpful to periodically assess your stress level. When the score is high, put measures in place to manage stress and improve your well-being.

    Michele
    Mind Tools Team
  • Over a month ago kkareem wrote
    Thanks for the stress management skill. the stress skill will help me to stay out of trouble to keep healthy.
  • Over a month ago Midgie wrote
    Hi KermeeSue and charlenemartel,
    Thanks for sharing and it sounds like both of you have experienced quite a few big stressful events recently. Even when you know you have had those experiences, doing a quiz like this one can re-confirm it and help you to do something about it.

    As KermeeSue said, humor and attitude can help you through. Charelenmartel, I encourage you to take a step back and focus on taking care of you first and foremost. Perhaps some extreme self-care and nuturing could be a priority to help you get through everything.

    Wishing you both all the best and please have a look at our other resources related to stress management to see if you can pick up a few ideas and strategies. If we can be of help, just let us know.

    Midgie
    Mind Tools Team
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