Part of a series on
Psychology
Outline History Subfields
Basic psychology Abnormal Affective neuroscience Affective science Behavioral genetics Behavioral neuroscience Behaviorism Cognitive/Cognitivism Cognitive neuroscience Social Comparative Cross-cultural Cultural Developmental Differential Ecological Evolutionary Experimental Gestalt Intelligence Mathematical Moral Neuropsychology Perception Personality Positive Psycholinguistics Psychophysiology Quantitative Social Theoretical
Applied psychology Anomalistic Applied behavior analysis Assessment Clinical Coaching Community Consumer Counseling Critical Educational Ergonomics Feminist Forensic Health Industrial and organizational Legal Media Medical Military Music Occupational health Pastoral Political Psychometrics Psychotherapy Religion School Sport and exercise Suicidology Systems Traffic
Concepts Behavior Behavioral engineering Behavioral genetics Behavioral neuroscience Cognition Competence Consciousness Consumer behavior Emotions Feelings Human factors and ergonomics Intelligence Mind Psychology of religion Psychometrics
Lists Counseling topics Disciplines Organizations Outline Psychologists Psychotherapies Research methods Schools of thought Timeline Topics
Psychology portal

The Holmes and Rahe stress scale (/reɪ/)^[1] 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".^[2] 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.^[3]

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),^[4] known more commonly as the Holmes and Rahe Stress Scale. Subsequent validation has supported the links between stress and illness.^[5]

Supporting research

Rahe carried out a study in 1970 testing the validity of the stress scale as a predictor of illness.^[6] 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.^[7]

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.^[7] The scale was also assessed against different populations within the United States (with African, Mexican and White American groups).^[8] The scale was also tested cross-culturally, comparing Japanese^[9] and Malaysian^[10] 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.^[11][12]

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
• CernySmith Assessment

Medical:

• Allostatic load
• Hypothalamic–pituitary–adrenal axis
• Psychoneuroimmunology

References

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