The Holmes and Rahe stress scale () is a list of 43
stressful life events that can contribute to
illness. 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 ...
s
Thomas Holmes and
Richard Rahe
Richard is a male given name. It originates, via Old French, from Old Frankish and is a compound of the words descending from Proto-Germanic ''*rīk-'' 'ruler, leader, king' and ''*hardu-'' 'strong, brave, hardy', and it therefore means 'strong ...
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 statisti ...
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
Cornell
Cornell University is a private statutory land-grant research university based in Ithaca, New York. It is a member of the Ivy League. Founded in 1865 by Ezra Cornell and Andrew Dickson White, Cornell was founded with the intention to teac ...
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
underwater demolitions training due to medical problems.
The scale was also assessed against different populations within the
United States
The United States of America (U.S.A. or USA), commonly known as the United States (U.S. or US) or America, is a country primarily located in North America. It consists of 50 U.S. state, states, a Washington, D.C., federal district, five ma ...
(with
African,
Mexican and
White American
White Americans are Americans who identify as and are perceived to be white people. This group constitutes the majority of the people in the United States. As of the 2020 Census, 61.6%, or 204,277,273 people, were white alone. This represented ...
groups).
The scale was also tested
cross-culturally, comparing
Japanese
and
Malaysia
Malaysia ( ; ) is a country in Southeast Asia. The federation, federal constitutional monarchy consists of States and federal territories of Malaysia, thirteen states and three federal territories, separated by the South China Sea into two r ...
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
The Life Events and Difficulties Schedule is a psychological measurement of the stressfulness of life events. It was created by psychologist
A psychologist is a professional who practices psychology and studies mental states, perceptual, cog ...
*
Diathesis–stress model
*
CernySmith Assessment
The CernySmith Assessment (CSA) is a comprehensive online questionnaire developed by Leonard J. Cerny II and David S. Smith that inquires about the impact of change and stress on productivity and resilience.
This self-discovery assessment for pe ...
Medical:
*
Allostatic load
*
Hypothalamic–pituitary–adrenal axis
*
Psychoneuroimmunology
References
{{reflist
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