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.

Examples of Stressful Life Events on the Holmes and Rahe Stress Scale

  • Death of a Spouse or Child (100 units): Experiencing the loss of a spouse or child, which can be emotionally devastating and lead to significant stress and grief.
  • Divorce (73 units): Going through a marital divorce, dealing with the legal process, emotional upheaval, and adjusting to a new life situation.
  • Marital Separation (65 units): Living apart from one’s spouse, facing uncertainty about the future of the relationship.
  • Detention in Jail or Related Institution (63 units): Being incarcerated or facing legal issues, which can be highly stressful and disruptive to one’s life.
  • Death of a Close Family Member (63 units): Coping with the loss of a close family member, such as a parent or sibling.
  • Major Personal Injury or Illness (53 units): Suffering a severe injury or illness that affects daily functioning and requires medical attention.
  • Marriage (50 units): Getting married, which can bring joy but also involves significant adjustments and responsibilities.
  • Being Fired from Employment (47 units): Losing a job, dealing with financial uncertainty and job search stress.
  • Marital Reconciliation (45 units): Attempting to reconcile with a separated or estranged spouse, facing emotional turmoil and uncertainty.
  • Retirement from Work (45 units): Transitioning to retirement, adjusting to a new routine and identity as a retiree.
  • Major Change in the Health or Behavior of a Family Member (44 units): Dealing with the health issues or behavioral changes of a family member, which can be emotionally challenging and require caregiving.
  • Pregnancy (40 units): Going through pregnancy, which involves physical and emotional changes and the anticipation of becoming a parent.
  • Sexual Difficulties (39 units): Facing challenges in one’s sexual life or relationship, which can lead to stress and emotional strain.
  • Gaining a New Family Member through Birth, Adoption, etc. (39 units): Welcoming a new family member, such as a child, through birth or adoption, which involves adjustments and responsibilities.
  • Major Business Readjustment (39 units): Going through significant changes in one’s business or work environment, such as a major restructuring or downsizing.
  • Major Change in Financial State, such as a Windfall or Bankruptcy (38 units): Experiencing a drastic change in financial circumstances, whether positive or negative.
  • Death of a Close Friend (37 units): Coping with the loss of a close friend, which can be emotionally impactful.
  • Changing to a Different Line of Work (36 units): Making a career change, which involves uncertainty and adjustments.
  • Major Change in the Number of Spousal Arguments Regarding Child-Rearing, Personal Habits, etc. (35 units): Experiencing significant conflict in a marital relationship, which can be stressful and emotionally draining.
  • Taking on a Home or Business Loan (31 units): Dealing with the financial responsibilities and stress associated with taking on significant debt.

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 Thinking Frameworks

Convergent vs. Divergent Thinking

Convergent thinking occurs when the solution to a problem can be found by applying established rules and logical reasoning. Whereas divergent thinking is an unstructured problem-solving method where participants are encouraged to develop many innovative ideas or solutions to a given problem. Where convergent thinking might work for larger, mature organizations where divergent thinking is more suited for startups and innovative companies.

Critical Thinking

Critical thinking involves analyzing observations, facts, evidence, and arguments to form a judgment about what someone reads, hears, says, or writes.


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.

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.

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.

Lindy Effect

The Lindy Effect is a theory about the ageing of non-perishable things, like technology or ideas. Popularized by author Nicholas Nassim Taleb, the Lindy Effect states that non-perishable things like technology age – linearly – in reverse. Therefore, the older an idea or a technology, the same will be its life expectancy.


Antifragility was first coined as a term by author, and options trader Nassim Nicholas Taleb. Antifragility is a characteristic of systems that thrive as a result of stressors, volatility, and randomness. Therefore, Antifragile is the opposite of fragile. Where a fragile thing breaks up to volatility; a robust thing resists volatility. An antifragile thing gets stronger from volatility (provided the level of stressors and randomness doesn’t pass a certain threshold).

Systems Thinking

Systems thinking is a holistic means of investigating the factors and interactions that could contribute to a potential outcome. It is about thinking non-linearly, and understanding the second-order consequences of actions and input into the system.

Vertical Thinking

Vertical thinking, on the other hand, is a problem-solving approach that favors a selective, analytical, structured, and sequential mindset. The focus of vertical thinking is to arrive at a reasoned, defined solution.

Maslow’s Hammer

Maslow’s Hammer, otherwise known as the law of the instrument or the Einstellung effect, is a cognitive bias causing an over-reliance on a familiar tool. This can be expressed as the tendency to overuse a known tool (perhaps a hammer) to solve issues that might require a different tool. This problem is persistent in the business world where perhaps known tools or frameworks might be used in the wrong context (like business plans used as planning tools instead of only investors’ pitches).

Peter Principle

The Peter Principle was first described by Canadian sociologist Lawrence J. Peter in his 1969 book The Peter Principle. The Peter Principle states that people are continually promoted within an organization until they reach their level of incompetence.

Straw Man Fallacy

The straw man fallacy describes an argument that misrepresents an opponent’s stance to make rebuttal more convenient. The straw man fallacy is a type of informal logical fallacy, defined as a flaw in the structure of an argument that renders it invalid.

Streisand Effect

The Streisand Effect is a paradoxical phenomenon where the act of suppressing information to reduce visibility causes it to become more visible. In 2003, Streisand attempted to suppress aerial photographs of her Californian home by suing photographer Kenneth Adelman for an invasion of privacy. Adelman, who Streisand assumed was paparazzi, was instead taking photographs to document and study coastal erosion. In her quest for more privacy, Streisand’s efforts had the opposite effect.


As highlighted by German psychologist Gerd Gigerenzer in the paper “Heuristic Decision Making,” the term heuristic is of Greek origin, meaning “serving to find out or discover.” More precisely, a heuristic is a fast and accurate way to make decisions in the real world, which is driven by uncertainty.

Recognition Heuristic

The recognition heuristic is a psychological model of judgment and decision making. It is part of a suite of simple and economical heuristics proposed by psychologists Daniel Goldstein and Gerd Gigerenzer. The recognition heuristic argues that inferences are made about an object based on whether it is recognized or not.

Representativeness Heuristic

The representativeness heuristic was first described by psychologists Daniel Kahneman and Amos Tversky. The representativeness heuristic judges the probability of an event according to the degree to which that event resembles a broader class. When queried, most will choose the first option because the description of John matches the stereotype we may hold for an archaeologist.

Take-The-Best Heuristic

The take-the-best heuristic is a decision-making shortcut that helps an individual choose between several alternatives. The take-the-best (TTB) heuristic decides between two or more alternatives based on a single good attribute, otherwise known as a cue. In the process, less desirable attributes are ignored.

Bundling Bias

The bundling bias is a cognitive bias in e-commerce where a consumer tends not to use all of the products bought as a group, or bundle. Bundling occurs when individual products or services are sold together as a bundle. Common examples are tickets and experiences. The bundling bias dictates that consumers are less likely to use each item in the bundle. This means that the value of the bundle and indeed the value of each item in the bundle is decreased.

Barnum Effect

The Barnum Effect is a cognitive bias where individuals believe that generic information – which applies to most people – is specifically tailored for themselves.

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.

Goodhart’s Law

Goodhart’s Law is named after British monetary policy theorist and economist Charles Goodhart. Speaking at a conference in Sydney in 1975, Goodhart said that “any observed statistical regularity will tend to collapse once pressure is placed upon it for control purposes.” Goodhart’s Law states that when a measure becomes a target, it ceases to be a good measure.

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.

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 in marketing can be associated with social proof.

Moore’s Law

Moore’s law states that the number of transistors on a microchip doubles approximately every two years. This observation was made by Intel co-founder Gordon Moore in 1965 and it become a guiding principle for the semiconductor industry and has had far-reaching implications for technology as a whole.

Disruptive Innovation

Disruptive innovation as a term was first described by Clayton M. Christensen, an American academic and business consultant whom The Economist called “the most influential management thinker of his time.” Disruptive innovation describes the process by which a product or service takes hold at the bottom of a market and eventually displaces established competitors, products, firms, or alliances.

Value Migration

Value migration was first described by author Adrian Slywotzky in his 1996 book Value Migration – How to Think Several Moves Ahead of the Competition. Value migration is the transferal of value-creating forces from outdated business models to something better able to satisfy consumer demands.

Bye-Now Effect

The bye-now effect describes the tendency for consumers to think of the word “buy” when they read the word “bye”. In a study that tracked diners at a name-your-own-price restaurant, each diner was asked to read one of two phrases before ordering their meal. The first phrase, “so long”, resulted in diners paying an average of $32 per meal. But when diners recited the phrase “bye bye” before ordering, the average price per meal rose to $45.


Groupthink occurs when well-intentioned individuals make non-optimal or irrational decisions based on a belief that dissent is impossible or on a motivation to conform. Groupthink occurs when members of a group reach a consensus without critical reasoning or evaluation of the alternatives and their consequences.


A stereotype is a fixed and over-generalized belief about a particular group or class of people. These beliefs are based on the false assumption that certain characteristics are common to every individual residing in that group. Many stereotypes have a long and sometimes controversial history and are a direct consequence of various political, social, or economic events. Stereotyping is the process of making assumptions about a person or group of people based on various attributes, including gender, race, religion, or physical traits.

Murphy’s Law

Murphy’s Law states that if anything can go wrong, it will go wrong. Murphy’s Law was named after aerospace engineer Edward A. Murphy. During his time working at Edwards Air Force Base in 1949, Murphy cursed a technician who had improperly wired an electrical component and said, “If there is any way to do it wrong, he’ll find it.”

Law of Unintended Consequences

The law of unintended consequences was first mentioned by British philosopher John Locke when writing to parliament about the unintended effects of interest rate rises. However, it was popularized in 1936 by American sociologist Robert K. Merton who looked at unexpected, unanticipated, and unintended consequences and their impact on society.

Fundamental Attribution Error

Fundamental attribution error is a bias people display when judging the behavior of others. The tendency is to over-emphasize personal characteristics and under-emphasize environmental and situational factors.

Outcome Bias

Outcome bias describes a tendency to evaluate a decision based on its outcome and not on the process by which the decision was reached. In other words, the quality of a decision is only determined once the outcome is known. Outcome bias occurs when a decision is based on the outcome of previous events without regard for how those events developed.

Hindsight Bias

Hindsight bias is the tendency for people to perceive past events as more predictable than they actually were. The result of a presidential election, for example, seems more obvious when the winner is announced. The same can also be said for the avid sports fan who predicted the correct outcome of a match regardless of whether their team won or lost. Hindsight bias, therefore, is the tendency for an individual to convince themselves that they accurately predicted an event before it happened.

Read Next: BiasesBounded RationalityMandela EffectDunning-Kruger EffectLindy EffectCrowding Out EffectBandwagon Effect.

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