Holmes and Rahe stress scale
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The Holmes and Rahe stress scale () is a list of 43 stressful life events that can contribute to
illness A disease is a particular abnormal condition that negatively affects the structure or function of all or part of an organism, and that is not immediately due to any external injury. Diseases are often known to be medical conditions that ar ...
. The test works via a point accumulation score which then gives an assessment of risk. The American Institute of Stress for instance, regards a score of 300 or more as an "80% chance of health breakdown within the next 2 years". While there is good evidence that chronic stress can lead to ill health, there is not much evidence to support the ranking of stressful life events in this manner.


Development

In 1967,
psychiatrist A psychiatrist is a physician who specializes in psychiatry, the branch of medicine devoted to the diagnosis, prevention, study, and treatment of mental disorders. Psychiatrists are physicians and evaluate patients to determine whether their sy ...
s Thomas Holmes and Richard Rahe examined the medical records of over 5,000 medical patients as a way to determine whether stressful events might cause illnesses. Patients were asked to tally a list of 43 life events based on a relative score. A positive
correlation In statistics, correlation or dependence is any statistical relationship, whether causal or not, between two random variables or bivariate data. Although in the broadest sense, "correlation" may indicate any type of association, in statistics ...
of 0.118 was found between their life events and their illnesses. Their results were published as the Social Readjustment Rating Scale (SRRS), known more commonly as the Holmes and Rahe Stress Scale. Subsequent validation has supported the links between stress and illness.


Supporting research

Rahe carried out a study in 1970 testing the
validity Validity or Valid may refer to: Science/mathematics/statistics: * Validity (logic), a property of a logical argument * Scientific: ** Internal validity, the validity of causal inferences within scientific studies, usually based on experiments ** ...
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, which was sufficient to support the hypothesis of a link between life events and illness. In conjunction with the
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medical index assessing, the stress scale correlated with visits to medical dispensaries, and the H&R stress scale's scores also correlated independently with individuals dropping out of stressful
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s training due to medical problems. The scale was also assessed against different populations within the
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(with
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, Mexican and
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groups). The scale was also tested cross-culturally, comparing
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ese and
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n groups with American populations.


Adults

The sum of the life change units of the applicable events in the past year of an individual's life gives a rough estimate of how stress affects health. 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.


Non-adults

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. 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.


See also

* Life-Events and Difficulties Schedule *
Diathesis–stress model The diathesis-stress model, also known as the vulnerability–stress model, is a psychological theory that attempts to explain a disorder, or its trajectory, as the result of an interaction between a predispositional vulnerability, the diathesis ...
* CernySmith Assessment Medical: *
Allostatic load Allostatic load is "the wear and tear on the body" which accumulates as an individual is exposed to repeated or chronic stress. The term was coined by Bruce McEwen and Eliot Stellar in 1993. It represents the physiological consequences of chro ...
*
Hypothalamic–pituitary–adrenal axis The hypothalamic–pituitary–adrenal axis (HPA axis or HTPA axis) is a complex set of direct influences and feedback interactions among three components: the hypothalamus (a part of the brain located below the thalamus), the pituitary gland (a ...
*
Psychoneuroimmunology Psychoneuroimmunology (PNI), also referred to as psychoendoneuroimmunology (PENI) or psychoneuroendocrinoimmunology (PNEI), is the study of the interaction between psychological processes and the nervous and immune systems of the human body. It is ...


References

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Further reading

* Rahe RH et al. (2000). The stress and coping inventory: an educational and research instrument. Stress Medicine 16: 199-208.
Life, Change, and Stress (Holmes & Rahe) - The Neuron
Medical scales Psychological stress Psychological tests and scales