Holmes and Rahe stress scale

The Holmes and Rahe stress scale is a list of 43 stressful life events that can contribute to illness.


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 events might cause illnesses. Patients were asked to tally a list of 43 life events based on a relative score. A positive correlation of 0.118 was found between their life events and their illnesses.

Their results were published as the Social Readjustment Rating Scale (SRRS),[1] known more commonly as the Holmes and Rahe Stress Scale. Subsequent validation has supported the links between stress and illness.[2]

Supporting research

Rahe carried out a study in 1970 testing the validity of the stress scale as a predictor of illness.[3] 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.[4]

In conjunction with the Cornell 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.[4] The scale was also assessed against different populations within the United States (with African, Mexican and White American groups).[5] The scale was also tested cross-culturally, comparing Japanese[6] and Malaysian[7] groups with American populations.


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.

Life event Life change units
Death of a spouse100
Marital separation65
Death of a close family member63
Personal injury or illness53
Dismissal from work47
Marital reconciliation45
Change in health of family member44
Sexual difficulties39
Gain a new family member39
Business readjustment39
Change in financial state38
Death of a close friend37
Change to different line of work36
Change in frequency of arguments35
Major mortgage32
Foreclosure of mortgage or loan30
Change in responsibilities at work29
Child leaving home29
Trouble with in-laws29
Outstanding personal achievement28
Spouse starts or stops work26
Beginning or end of school26
Change in living conditions25
Revision of personal habits24
Trouble with boss23
Change in working hours or conditions20
Change in residence20
Change in schools20
Change in recreation19
Change in church activities19
Change in social activities18
Minor mortgage or loan17
Change in sleeping habits16
Change in number of family reunions15
Change in eating habits15
Major Holiday12
Minor violation of law11

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.


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.[8][9]

Life Event Life Change Units
Death of parent100
Unplanned pregnancy/abortion100
Getting married95
Divorce of parents90
Acquiring a visible deformity80
Fathering a child70
Jail sentence of parent for over one year70
Marital separation of parents69
Death of a brother or sister68
Change in acceptance by peers67
Unplanned pregnancy of sister64
Discovery of being an adopted child63
Marriage of parent to stepparent63
Death of a close friend63
Having a visible congenital deformity62
Serious illness requiring hospitalization58
Failure of a grade in school56
Not making an extracurricular activity55
Hospitalization of a parent55
Jail sentence of parent for over 30 days53
Breaking up with boyfriend or girlfriend53
Beginning to date51
Suspension from school50
Becoming involved with drugs or alcohol50
Birth of a brother or sister50
Increase in arguments between parents47
Loss of job by parent46
Outstanding personal achievement46
Change in parent's financial status45
Accepted at college of choice43
Being a senior in high school42
Hospitalization of a sibling41
Increased absence of parent from home38
Brother or sister leaving home37
Addition of third adult to family34
Becoming a full-fledged member of a church31
Decrease in arguments between parents27
Decrease in arguments with parents26
Mother or father beginning work26

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



  1. Holmes TH, Rahe RH (1967). "The Social Readjustment Rating Scale". J Psychosom Res. 11 (2): 213–8. doi:10.1016/0022-3999(67)90010-4. PMID 6059863.
  2. Rahe RH, Arthur RJ (1978). "Life change and illness studies: past history and future directions". J Human Stress. 4 (1): 3–15. doi:10.1080/0097840X.1978.9934972. PMID 346993.
  3. Rahe RH, Mahan JL, Arthur RJ (1970). "Prediction of near-future health change from subjects' preceding life changes". J Psychosom Res. 14 (4): 401–6. doi:10.1016/0022-3999(70)90008-5. PMID 5495261.
  4. Rahe RH, Biersner RJ, Ryman DH, Arthur RJ (1972). "Psychosocial predictors of illness behavior and failure in stressful training". J Health Soc Behav. 13 (4): 393–7. doi:10.2307/2136831. JSTOR 2136831. PMID 4648894.
  5. Komaroff AL, Masuda M, Holmes TH (1968). "The social readjustment rating scale: a comparative study of Negro, Mexican and white Americans". J Psychosom Res. 12 (2): 121–8. doi:10.1016/0022-3999(68)90018-4. PMID 5685294.
  6. Masuda M, Holmes TH (1967). "The Social Readjustment Rating Scale: a cross-cultural study of Japanese and Americans". J Psychosom Res. 11 (2): 227–37. doi:10.1016/0022-3999(67)90012-8. PMID 6059865.
  7. Woon, T.H.; Masuda, M.; Wagner, N.N.; Holmes, T.H. (1971). "The Social Readjustment Rating Scale: A Cross-Cultural Study of Malaysians and Americans". Journal of Cross-Cultural Psychology. 2 (4): 373–386. doi:10.1177/002202217100200407. Retrieved 2008-04-10.
  8. http://www.irdo.si/irdo-2014/referati/d-zenko-marn.pdf
  9. "Holmes and Rahe Stress Scale". prezi.com.

Further reading

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