What is the Holmes and Rahe stress scale? The Holmes and Rahe stress scale in a nutshell

The Holmes and Rahe stress scale was developed by psychiatrists Thomas Holmes and Richard Rahe in 1967. The pair wanted to know if the most stressful life events could predict future illness. The Holmes and Rahe stress scale is a list of 43 stressful situations an individual can experience that can lead to illness.

Understanding the Holmes and Rahe stress scale

After examining the medical records of 5,000 patients, Holmes and Rahe discovered a strong correlation between illness and the most stressful life events. These situations were then ranked on a scale from most stressful to least stressful, providing clarity on the sort of life situations deleterious to human health.

The reliability of the scale was then tested in 1970 with a study involving 2,500 U.S. Navy personnel. Rahe asked each sailor to rank their most stressful life events and then monitored them for six months to see if any event correlated with visits to the doctor. Once again, Rahe found that the more stressful an event, the higher likelihood of illness.

The top ten most stressful events on the Holmes and Rahe scale

Holmes and Rahe found a total of 43 events contributing to illness. Each event was assigned a specific life change unit score according to how traumatic it was felt across a large sample of study participants. 

For the sake of brevity, we will take a look at the top twenty events and their associated score below:

  1. Death of a spouse or child – 100 units.
  2. Divorce – 73 units.
  3. Marital separation – 65 units.
  4. Detention in jail or related institution – 63 units.
  5. Death of a close family member – 63 units.
  6. Major personal injury or illness – 53 units.
  7. Marriage – 50 units.
  8. Being fired from employment – 47 units.
  9. Marital reconciliation – 45 units.
  10. Retirement from work – 45 units.
  11. Major change in the health or behavior of a family member – 44 units.
  12. Pregnancy – 40 units.
  13. Sexual difficulties – 39 units.
  14. Gaining a new family member through birth, adoption, etc. – 39 units.
  15. Major business readjustment – 39 units.
  16. Major change in financial state, such as a windfall or bankruptcy – 38 units.
  17. Death of a close friend – 37 units.
  18. Changing to a different line of work – 36 units.
  19. Major change in the number of spousal arguments regarding child-rearing, personal habits, and so forth – 35 units.
  20. Taking on a home or business loan – 31 units.

Calculating stress levels and the risk of illness

To calculate stress levels and the associated risk of illness, the individual must run through the list of events and determine how many they’ve been subject to in the last twelve months. If the same event occurred twice, then it should be counted twice.

Then, the life change unit score for each should be added together to form a total score.

  • For scores over 300, there is an 80% chance of illness.
  • For scores between 150-299, there is a 50% chance of illness.
  • For scores of less than 150, there is a 30% chance of illness.

The types of illnesses stress can cause are not overly surprising. They may include chronic back and neck pain, obesity, depression, diabetes, anxiety, and gastrointestinal disorders. Chronic stress can also accelerate the aging process and the progression of Alzheimer’s disease.

Key takeaways:

  • The Holmes and Rahe stress scale describes a list of 43 stressful situations an individual can experience that can lead to illness. It was developed by psychiatrists Thomas Holmes and Richard Rahe in 1967.
  • The Holmes and Rahe stress scale is backed by several studies which resulted in a list of 43 stressful life events. The top five most stressful situations are the death of a spouse or child, marital divorce, marital separation, jail, and the death of a close family member.
  • The Holmes and Rahe stress scale estimates the likelihood of becoming ill based on the total life change unit score for events experienced in a twelve-month period. 

Connected Business Concepts

First-Principles Thinking

First-principles thinking – sometimes called reasoning from first principles – is used to reverse-engineer complex problems and encourage creativity. It involves breaking down problems into basic elements and reassembling them from the ground up. Elon Musk is among the strongest proponents of this way of thinking.

Ladder Of Inference

The ladder of inference is a conscious or subconscious thinking process where an individual moves from a fact to a decision or action. The ladder of inference was created by academic Chris Argyris to illustrate how people form and then use mental models to make decisions.

Six Thinking Hats Model

The Six Thinking Hats model was created by psychologist Edward de Bono in 1986, who noted that personality type was a key driver of how people approached problem-solving. For example, optimists view situations differently from pessimists. Analytical individuals may generate ideas that a more emotional person would not, and vice versa.

Second-Order Thinking

Second-order thinking is a means of assessing the implications of our decisions by considering future consequences. Second-order thinking is a mental model that considers all future possibilities. It encourages individuals to think outside of the box so that they can prepare for every and eventuality. It also discourages the tendency for individuals to default to the most obvious choice.

Lateral Thinking

Lateral thinking is a business strategy that involves approaching a problem from a different direction. The strategy attempts to remove traditionally formulaic and routine approaches to problem-solving by advocating creative thinking, therefore finding unconventional ways to solve a known problem. This sort of non-linear approach to problem-solving, can at times, create a big impact.

Moonshot Thinking

Moonshot thinking is an approach to innovation, and it can be applied to business or any other discipline where you target at least 10X goals. That shifts the mindset, and it empowers a team of people to look for unconventional solutions, thus starting from first principles, by leveraging on fast-paced experimentation.


The concept of cognitive biases was introduced and popularized by the work of Amos Tversky and Daniel Kahneman in 1972. Biases are seen as systematic errors and flaws that make humans deviate from the standards of rationality, thus making us inept at making good decisions under uncertainty.

Bounded Rationality

Bounded rationality is a concept attributed to Herbert Simon, an economist and political scientist interested in decision-making and how we make decisions in the real world. In fact, he believed that rather than optimizing (which was the mainstream view in the past decades) humans follow what he called satisficing.

Dunning-Kruger Effect

The Dunning-Kruger effect describes a cognitive bias where people with low ability in a task overestimate their ability to perform that task well. Consumers or businesses that do not possess the requisite knowledge make bad decisions. What’s more, knowledge gaps prevent the person or business from seeing their mistakes.

Occam’s Razor

Occam’s Razor states that one should not increase (beyond reason) the number of entities required to explain anything. All things being equal, the simplest solution is often the best one. The principle is attributed to 14th-century English theologian William of Ockham.

Mandela Effect

The Mandela effect is a phenomenon where a large group of people remembers an event differently from how it occurred. The Mandela effect was first described in relation to Fiona Broome, who believed that former South African President Nelson Mandela died in prison during the 1980s. While Mandela was released from prison in 1990 and died 23 years later, Broome remembered news coverage of his death in prison and even a speech from his widow. Of course, neither event occurred in reality. But Broome was later to discover that she was not the only one with the same recollection of events.

Crowding-Out Effect

The crowding-out effect occurs when public sector spending reduces spending in the private sector.

Bandwagon Effect

The bandwagon effect tells us that the more a belief or idea has been adopted by more people within a group, the more the individual adoption of that idea might increase within the same group. This is the psychological effect that leads to herd mentality. What is marketing can be associated with social proof.

Read Next: BiasesBounded RationalityMandela EffectDunning-Kruger

Main Free Guides:

scale? The Holmes and Rahe stress scale in a nutshell">

About The Author

Scroll to Top