What Is the Holmes and Rahe Stress Scale?

Woman seeing a therapist for stress.

Getty / Mixetto

What Is the Holmes and Rahe Stress Scale?

The Holmes and Rahe stress scale is a list of 43 stressful life events that can contribute to illness. The scale is used by health care professionals to help identify whether a person is experiencing a high amount of stress.

This can be helpful in determining whether someone is at risk for developing an illness, or if they may benefit from stress-reduction interventions.

History of the Holmes and Rahe Stress Scale

The Holmes and Rahe stress scale was developed in 1967 by psychiatrists Thomas Holmes and Richard Rahe while working at the University of Washington. The scale was based on a study of over 5,000 medical patients who were asked to rate the life-changing events they had experienced in the previous two years.

They originally designed the scale to be used in research to help identify possible links between stress and illness.

Since its inception, the Holmes and Rahe stress scale has been widely used by healthcare professionals. It is one of the most well-known and researched tools for measuring stress.

Items on the Holmes and Rahe Stress Scale

There are 43 items on the Holmes and Rahe stress scale. Each item is assigned a certain number of points, based on its perceived stressfulness. The total number of points a person scores can give an indication of their overall stress level. Some of the items on the scale include the following:

Scores on the Holmes and Rahe Stress Scale

Overall, total scores can range from 0 to 430 points.

  • A score of 300 or more on the Holmes and Rahe stress scale indicates high stress. This means that the person is at an increased risk of developing an illness.
  • A score between 150 and 299 points indicates a moderate amount of stress.
  • A score below 150 indicates a low amount of stress.

However, it is essential to remember that the scale is only meant to be used as a guide and that other factors, such as a person's individual stress tolerance, can also affect their risk for illness.

How to Administer the Holmes and Rahe Stress Scale

The Holmes and Rahe stress scale can be self-administered, or it can be administered by a healthcare professional.

  • If you are administering the scale yourself, you will need to recall the stressful events that have occurred in your life over the past year. For each event, you will need to note the date it occurred and the number of points it is worth. Once you have all of this information, you can add up your total score to get an idea of your overall stress level.
  • If a healthcare professional is administering the scale, they will likely ask you about stressful events that have occurred in your life over the past year. They will then record your answers and calculate your total score.

Interpreting the Results

If you have a high stress score on the Holmes and Rahe stress scale, it does not necessarily mean that you will develop an illness. However, it does indicate that you are at an increased risk. If you are experiencing a high amount of stress, it is important to take steps to reduce your stress level. This may include exercise, relaxation techniques, and counseling.

Impact of the Holmes and Rahe Stress Scale

The Holmes and Rahe stress scale is a widely used tool that can be helpful in identifying people who are at an increased risk for developing an illness. The scale can also be used to help design interventions to reduce stress levels. While the scale is not perfect, it can be a useful tool for both health care professionals and individuals.

Below are some of the potential impacts of using the Holmes and Rahe stress scale:

  • The scale can help healthcare professionals identify people who are at an increased risk for developing an illness.
  • The scale may aid in identifying individuals at risk for suicide attempts.
  • The scale can raise awareness about the importance of reducing stress.

Tips for Using the Holmes and Rahe Stress Scale

If you are using the Holmes and Rahe stress scale, there are a few things to keep in mind:

  • The scale should be used in conjunction with other information, such as a person's medical history, to make a more accurate assessment.
  • The scale should be used as a tool to help identify people who are at an increased risk for developing an illness. It should not be used to make a diagnosis.
  • The scale can be used to help design interventions to reduce stress levels. However, it is important to remember that these interventions should be tailored to the individual.

Potential Drawbacks

Despite the potential benefits of the Holmes and Rahe stress scale, there are also some potential pitfalls to using the scale. These include:

  • The scale does not take into account all possible stressors.
  • The scale does not take into account how a person copes with stress.
  • The scale cannot always accurately predict who will develop an illness.

A Word From Verywell

The Holmes and Rahe stress scale can be a useful tool for both individuals and health care professionals. However, it is important to keep in mind that the scale has its limitations. If you are using the scale, be sure to take into account all of the potential pitfalls.

Remember, the scale should be used as a tool to help identify people who are at an increased risk for developing an illness. It should not be used to make a diagnosis. If you are concerned about your stress level, talk to your doctor or a mental health professional. They can help you develop a plan to reduce your stress and improve your overall health.

4 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Holmes TH, Rahe RH. The Social Readjustment Rating ScaleJ Psychosom Res. 1967;11(2):213-218. doi:10.1016/0022-3999(67)90010-4

  2. The American Institute of Stress. The Holmes-Rahe Stress Inventory.

  3. de Sousa-Pereira N, Bocchi M, Motoori-Fernandes CY, et al. An association between chronic life stressors prior to diagnosis of breast cancerEXCLI J. 2021;20:1370-1378. Published 2021 Aug 31. doi:10.17179/excli2021-4005

  4. Blasco-Fontecilla H, Delgado-Gomez D, Legido-Gil T, de Leon J, Perez-Rodriguez MM, Baca-Garcia E. Can the Holmes-Rahe Social Readjustment Rating Scale (SRRS) be used as a suicide risk scale? An exploratory studyArch Suicide Res. 2012;16(1):13-28. doi:10.1080/13811118.2012.640616

By Arlin Cuncic
Arlin Cuncic, MA, is the author of "Therapy in Focus: What to Expect from CBT for Social Anxiety Disorder" and "7 Weeks to Reduce Anxiety."