Holmes And Rahe Stress Scale

Please select the life events that have occurred in the past year:

How stressed are you? And is that enough to make you sick?

Your ability to handle the demands placed on you is key to your experience of stress. So if several difficulties arise simultaneously, the stress can quickly mount. For example, starting a new job can be difficult but manageable to experience when everything else in your life is stable and positive.

But when it happens, when you’ve just moved into a new house, your partner is ill, or you’re struggling with money, you can have a hard time coping. The full impact of stress can be difficult to predict, as not all unusual events are equally difficult to deal with.

Holmes Rahe Stress Test

Holmes Rahe stress test is a simple, practical way to gauge your stress levels. It will help you better understand how your body reacts to stressful situations to take steps toward reducing your stress.

The 43-item Holmes Rahe Stress Test, developed in 1967 by psychiatrists Thomas Holmes and Richard Rahe, lists stressful life events ranging from getting into trouble at school to coping with a natural disaster. A stress test score is calculated based on the number of items that have been checked and many people wonder about Holmes and Rahe’s Stress scale validity.

Each stressful life event is given a specific score (0-4), with 100 being the average. The higher your stress score, the greater your risk for illness.

What is Holmes Rahe Stress Test, who uses it and why?

The Holmes Rahe Stress Scale was developed in 1967 by psychiatrists Thomas Holmes and Richard Rahe at the University of Washington Medical Center in Seattle, WA.

It is widely used to assess a person’s risk for illness over ten years, assist in diagnosing psychiatric disorders, and predict the outcome of cardiac surgery patients. It has been used on high-risk individuals undergoing testing to predict occupational safety.

“This test is a reliable, valid, and easy-to-use tool for stress assessment. Specific score thresholds can predict the likelihood of having an anxiety or depressive disorder at some subsequent time in the future. It is especially useful for those who doubt their ability to complete the test.”

“The Holmes Rahe Stress Test (H&R) has been validated extensively, and it has been used in large-scale epidemiologic studies to assess predictors of psychiatric disorders such as depression and anxiety.

Newer versions are available online, which improve on original one but do not yet surpass its reliability, validity, and ease of use.”

 What is the Holmes Rahe Stress Test used for?

The Holmes Rahe Stress Test was first developed in 1967 by psychiatrists Thomas Holmes and Richard Rahe to study patients at risk of illness from stressful events in their lives. It has since been used to assess patients undergoing cardiac surgery and those suffering from psychiatric disorders.

The test examines a person’s lifestyle and the amount of stress he or she may experience. It is an indicator of that person’s susceptibility to stress, which affects their health.

The purpose is to help those with high-stress levels overcome the negative effects by making changes in their lifestyles or addictions to lower the risk for illness and improve their health.

The test has been used on patients undergoing cardiac surgery, as well as to assess psychiatric disorders.

How to use a Holmes Rahe stress score to evaluate your health?

The Holmes Rahe Stress Test has been correlated with various diseases, and the higher the score, the greater the risk of developing specific diseases. To assess your risk, use the test as a guideline.

Although there is some subjective interpretation of which events are stressful, the test is a useful way to gauge your stress levels, so you can understand how your body reacts to stressful situations.

The following are some general tips for using a Holmes and Rahe Stress Test score to make informed decisions regarding your health:

  • Don’t ignore minor events; they could be very stressful.
  • Don’t be afraid to ask questions; this will increase your understanding of your situation.
  • Don’t be overly concerned about whether you “should” have a high score; stress is a normal reaction to any situation; pause to imagine how you might have responded differently to the same situation.
  • Don’t ignore your own body’s responses; this is important information so you can prevent occurrences of illness.
  • Don’t push yourself too hard in the first few weeks after completing the test; your body may likely be under a lot of stress, so take it easy and give your body time to recover.
  • Don’t be overly concerned with the possibility of having a “bad” score; your average score is similar to someone with a ninety-six percent chance of developing an illness, regardless of how stressful your life was.
  • Don’t dismiss symptoms that seem “unordinary”; it is best to listen to your body and not ignore any unusual symptoms that may signal an illness is on its way
  • Don’t be afraid to seek help if you think you are at risk of developing serious health problems; a Holmes and Rahe Stress Test score can assist in making an informed decision regarding the course of proper treatment
  • Don’t neglect your treatment plan and related activities; this will increase your chances of being successful in the long run.

 How does stress affect the body?

Stress affects the body in many different ways, some of which can be present even before you can consciously identify a stressful situation. The following are several ways that your body may react to stress. Remember, these are just general ways in which stress affects the body; there is a range of reactions that may occur depending on the circumstances:

  • Changes in blood sugar levels.
  • Digestive problems.
  • Muscle tension headaches and migraines.
  • Changes in sex drive.
  • Increased smoking, drinking, drug use, or other addictive behaviors.
  • Changes in weight gain or loss.
  • Fatigue and feelings of exhaustion.
  • Difficulty concentrating.
  • Increased susceptibility to a wide variety of illnesses.
  • Changes in sleep patterns.
  • Changes in mood, for instance, irritability and anxiety.
  • Inability to make decisions or stay on task.

 Ambien, Xanax and other benzodiazepines

Benzodiazepines are a class of central nervous system depressants that include valium, lorazepam, and others.

They are used as sleep aids or to treat anxiety disorders and can cause drowsiness and interfere with normal cognition and motor coordination.

Amphetamine, meth, cocaine, and other drugs?

Amphetamine, methamphetamine, and cocaine are central nervous system stimulants.

Their effects can include increased heart rate, blood pressure, body temperature, muscle tension, and other physical reactions.

The Holmes and Rahe Stress Scale?

The Holmes Rahe Stress Scale is used to assess the impact of stressful events on patients.

It can measure the relative risk of developing a stress-related illness or be used as a guideline to help you evaluate your health status and make informed decisions.

The following are examples of some of the items on the stressful events list provided by Holmes and Rahe Stress:

  • Death of a close family member or friend
  • Death of a close family pet
  • Being fired from work
  • Getting married
  • Committing a crime and going to jail for several days
Do read: Post-Traumatic Stress Disorder: Definition, Causes and Risk Factors

General Overview:

When you finish the Holmes Rahe Stress Scale, you will receive an evaluation of your “present situation” that assigns a point value to each event you have indicated has occurred.

Holmes Rahe developed a scoring system in which each stressful event is assigned a value. The points are added up, with a maximum score of 100; the higher your total score, the greater your risk of developing a stress-related illness.

High risk means you have an above-average chance (92%) of developing illness within ten years; a low risk means you have only about a seven percent chance (score below 39).

It has also been used in the assessment of patients with psychiatric disorders, as well as those undergoing testing, for the purpose of predicting occupational safety.


How much does one’s stress score increase after a year?

A stress score is calculated by adding the number of stressful events you reported in your year-long diary.

What happens if the stress in my life is less than it was the year before, but my score goes up?

If your total score increased after a year, this indicates that you have experienced more stressful events than you documented as occurring during the past 12 months.

Is a high score dangerous?

The highest possible stress index is 100, and this occurs when every event experienced during the past twelve months is considered stressful. As you can see from the chart, a score of 100 is associated with a 100% likelihood of developing stress-related illnesses (of whatever type) within the next ten years. A score of 50 indicates that you have about a 50% chance of developing any given stress-related illness during the next decade.

How many points can you have to qualify as high risk, and how many points exactly are considered low risk?

50 is considered a high-risk threshold, whereas the low-risk threshold is 39 or below.

What is a typical stress score range?

A hypothetical individual experiencing 3 stressful events per month during the past year would have an average total stress score of 12 (3 × 4 months = 12) and a stress index of 9. This means that this individual’s risk of developing health problems is no different from that of the average American.

What is the highest stress score? The lowest?

According to an official ranking given by Holmes & Rahe, a total of 100 points indicates the greatest level of stress possible.

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