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

Development

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), 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 reliability 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 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 (with African, Hispanic and White American groups). The scale was also tested cross-culturally, comparing Japanese and Malaysian groups with American populations.

Adults

To measure stress according to the Holmes and Rahe Stress Scale, the number of "Life Change Units" that apply to events in the past year of an individual's life are added and the final score will give 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.

Footnotes

^ 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.
^ Rahe RH, Arthur RJ (1978). "Life change and illness studies: past history and future directions". J Human Stress 4 (1): 3–15. PMID 346993.
^ 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.
^ 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. PMID 4648894 . http://www.jstor.org/pss/2136831 . Retrieved 2008-04-10 .
^ 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.
^ 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.
^ 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. doi:10.1177/002202217100200407 . http://jcc.sagepub.com/cgi/content/abstract/2/4/373 . Retrieved 2008-04-10 .

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