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The Holmes and Rahe Stress Scale

Understanding the Impact of Long-term Stress


People use the word "stress" to describe a wide variety of situations - from your cell phone ringing while you're talking on another phone - to the feelings associated with intense work overload, or the death of a loved-one. But perhaps the most useful and widely accepted definition of stress (mainly attributed to ichard !. "a#arus$ is this% !tress is a condition or feeling e&perienced when a person perceives that "demands e&ceed the personal and social resources the individual is able to mobili#e." 'n less formal terms, we feel stressed when we feel that "things are out of control". (ur ability to cope with the demands upon us is key to our e&perience of stress. )or e&ample, starting a new *ob might be a wholly e&citing e&perience if everything else in your life is stable and positive. But if you start a new *ob when you've *ust moved into a new house, or your partner is ill, or you're e&periencing money problems, you might find it very hard to cope. +ow much of this does it take to push you "over the edge", -ot all unusual events are e.ually hard to deal with. )or e&ample, compare the stress of divorce with that of a change in responsibilities at work. Because of this, you need to be able to rate and measure your total stress score appropriately. /he !ocial ead*ustment ating !cale (! !$, more commonly known as the +olmes and ahe !tress !cale, was created to do *ust that. /his tool helps us measure the stress load we carry, and think about what we should do about it. /his article looks at the +olmes and ahe !tress !cale, and e&plains how you can use it to manage the stress in your life.

The Holmes and Rahe Stress Scale


'n 0123, psychiatrists /homas +olmes and ichard ahe decided to study whether or not stress contributes to illness. /hey surveyed more than 4,555 medical patients and asked them to say whether they had e&perience any of a series of 67 life events in the previous two years. 8ach event, called a "ife 9hange :nit ("9:$, had a different "weight" for stress. /he more events the patient added up, the higher the score. /he higher the score, and the larger the weight of each event, the more likely the patient was to become ill.

The Stress Scale

/o score your stress levels, simply check the bo& in the right hand column ne&t to all the events that have happened to you in the last year. ;our score will automatically update. This table is taken from "The Social Readjustment Rating Scale", Thomas H. Holmes and Richard H. Rahe, Journal of Psychosomatic Research, Volume , !ssue ", #ugust $%&, Pages " '(" ), *o+yright , $%& Published by -lse.ier Science !nc. #ll rights reser.ed. Permission to re+roduce granted by the +ublisher. This scale must not be used in any /ay to cause harm to an indi.idual0s +rofessional career. < =ind /ools "td, 0114->551. Life Event ?eath of spouse " ?ivorce $ =arital separation ' @ail term & ?eath of close family member % Personal in*ury or illness # =arriage ( )ired at work ) =arital reconciliation ! etirement 9hange in health of family member " Pregnancy $ !e& difficulties

Value Check if this applies !! #$ %& %$ %$ &$ &! '# '& '& '' '! $)

' Aain of new family member & Business read*ustment % 9hange in financial state # ?eath of close friend ( 9hange to a different line of work ) 9hange in number of arguments with spouse

$) $) $( $# $% $& $ $! ") ") ") "( "% "% "& "' "$ "! "!

"! B large mortgage or loan " )oreclosure of mortgage or loan "" 9hange in responsibilities at work "$ !on or daughter leaving home "' /rouble with in-laws "& (utstanding personal achievement "% !pouse begins or stops work "# Begin or end schoolCcollege "( 9hange in living conditions ") evision of personal habits $! /rouble with boss $ 9hange in work hours or conditions $" 9hange in residence

$$ 9hange in schoolCcollege $' 9hange in recreation $& 9hange in church activities $% 9hange in social activities $# B moderate loan or mortgage $( 9hange in sleeping habits $) 9hange in number of family gettogethers

"! ) ) ( # % & & $ "

'! 9hange in eating habits ' Dacation '" 9hristmas '$ =inor violations of the law *our Total

+ote, 'f you e&perienced the same event more than once, then to gain a more accurate total, add the score again for each e&tra occurrence of the event.

!core 'nterpretation
Score 755E Comment ;ou have a high or very high risk of becoming ill in the near future. ;ou have a moderate to high chance of becoming ill in the near future.

045->11

F045

;ou have only a low to moderate chance of becoming ill in the near future.

-hat *ou Can .o /0out This


'f you find that you are at a moderate or high level of risk, then an obvious first thing to do is to try to avoid future life crises. Ghile this is clearly easier said than done, you can usually avoid moving house, for e&ample, close to when you retire, or when one of your children goes off to collegeH you can learn conflict resolution skills to minimi#e conflict with other peopleH you can avoid taking on new obligations or engaging with new programs of studyH and you can take things easy, and look after yourself. )or more on reducing stress, visit the !tress /ools area of =ind /ools. +ote , !ome scientists have suggested that the +olmes and ahe !tress !cale is weak in certain areas. )or e&ample, some feel that different cultural groups react differently to different life events. (ne study compared scores of Bmericans with those of =alaysians. 'nterestingly, =alaysians had different attitudes toward breaking the law and toward relationships than the Bmericans did, meaning that their e&perience of stress was different at the same score. Ieep cultural differences in mind as you score your own life events. +ote ", Ghile it's useful to know about this idea so that you can take action with it, don't dwell on it, and don't let this knowledge affect your mood. /hink positivelyJ +ote $, !tress can cause severe health problems and, in e&treme cases, can cause death. ;ou should take the advice of a suitably .ualified health professional if you have any concerns over stress-related illnesses, or if stress is causing you significant or persistent unhappiness.

1e2 3oints

/he +olmes and ahe !tress !cale is a well-known tool for measuring the amount of stress youKve e&perienced within the past year. /aking the test can help you see clearly if youKre at risk of illness due to stress. Warning: Stress can cause se.ere health +roblems and, in e1treme cases, can cause death. 2hile these stress management techni3ues ha.e been sho/n to ha.e a +ositi.e effect on reducing stress, they are for guidance only, and readers should take the ad.ice of suitably 3ualified health +rofessionals if they ha.e any concerns o.er stress(related illnesses or if stress is causing significant or +ersistent unha++iness. Health +rofessionals should also be consulted before any major change in diet or le.els of e1ercise.