Approximate reading time: 7 minutes

Most stressors that we encounter are not nearly as intense as the ones described above. Many potential stressors we face involve events or situations that require us to make changes in our ongoing lives and require time as we adjust to those changes. Examples include death of a close family member, marriage, divorce, and moving (Figure W.11).

In the 1960s, two psychiatrists, Thomas Holmes and Richard Rahe, were curious about how different life events, whether good or bad, could affect a person’s health. They thought that any big change in someone’s usual way of life could be stressful. To explore this, they created a list called the Social Readjustment Rating Scale (SRRS), which included 43 different life events that might require a person to adjust in some way (Holmes & Rahe, 1967).

What’s interesting is that this list includes events that many people would usually think of as happy or positive, like getting married or going on vacation. These events are examples of “eustress”, which is a kind of stress that can actually be beneficial or feel positive. However, Holmes and Rahe also believed that if you experience too many of these life changes in a short period, it could increase your chances of getting physically sick.

To make their scale, they asked 394 people to give a number to each event on the list, based on how much they thought it would shake up someone’s life. These numbers gave an average score for each event, called “life change units” or LCUs (Rahe, McKeen, & Arthur, 1967). The scores ranged from 11 to 100, with higher numbers indicating more significant life changes. For example, the death of a spouse was at the top of the list with 100 LCUs, and divorce was next with 73 LCUs. Other high-ranking events included personal injury or illness, marriage, and losing a job. On the lower end, things like changing your eating habits or going on a vacation had fewer LCUs.

To use the scale, people would check off any events they had experienced in the past year. Then, they’d add up the LCUs for each checked event to get a total score that represented the amount of change in their life. Interestingly, the way people rated these events was pretty consistent, even across different cultures. This scale helped show that life changes, big or small, can have a real impact on our health. Agreement on the amount of adjustment required by the various life events on the SRRS is highly consistent, even cross-culturally (Holmes & Masuda, 1974).

Table adapted from Holmes & Rahe (1967).

The Social Readjustment Rating Scale (SRRS) provides researchers a simple, easy-to-administer way of assessing the amount of stress in people’s lives, and it has been used in hundreds of studies (Thoits, 2010). Despite its widespread use, the scale has been subject to criticism.

First, many of the items on the SRRS are vague; for example, death of a close friend could involve the passing of a long-absent childhood friend that requires little social readjustment (Dohrenwend, 2006).

Second, some have challenged its assumption that undesirable life events are no more stressful than desirable ones (Derogatis & Coons, 1993).

Third, most of the available evidence suggests that, at least as far as mental health is concerned, undesirable or negative events are more strongly associated with poor outcomes (such as depression) than desirable, positive events (Hatch & Dohrenwend, 2007).

Fourth, perhaps the most serious criticism, is that the scale does not take into consideration respondents’ appraisals of the life events it contains. As you recall, the appraisal of a stressor is a key element in the conceptualization and overall experience of stress. Being fired from work may be devastating to some but a welcome opportunity to obtain a better job for others.

Despite these criticisms, the SRRS remains one of the most well-known instruments in the study of stress, and it is a useful tool for identifying potential stress-related health outcomes (Scully et al., 2000).

Correlational Research

The Holmes and Rahe Social Readjustment Rating Scale (SRRS) uses the correlational research method to identify the connection between stress and health. That is, respondents’ LCU scores are correlated with the number or frequency of self-reported symptoms indicating health problems. These correlations are typically positive; as LCU scores increase, the number of symptoms increase. Consider all the thousands of studies that have used this scale to correlate stress and illness symptoms: if you were to assign an average correlation coefficient to this body of research, what would be your best guess? How strong do you think the correlation coefficient would be? Why can’t the SRRS show a causal relationship between stress and illness? If it were possible to show causation, do you think stress causes illness or illness causes stress? Or both?

Given the extensive research utilizing the Holmes and Rahe Social Readjustment Rating Scale (SRRS) to correlate stress with illness symptoms, an average correlation coefficient might reasonably be guessed to fall in the low to moderate range (e.g., 0.2 to 0.5). This range suggests a positive but not overwhelmingly strong relationship, where higher levels of stress (as measured by LCU scores) are associated with a greater number of health symptoms. The SRRS cannot show a causal relationship between stress and illness because it relies on correlational data, which can indicate a relationship between two variables but cannot definitively prove that one causes the other. Factors such as individual differences, environmental influences, and third variables could influence both stress and health outcomes. While it’s plausible that stress can lead to illness by compromising the immune system, illness can also increase stress levels, indicating a bidirectional relationship.

Similar to the stress induced by major life changes, occupational stressors present another critical aspect of how our daily environments and roles can contribute to our overall stress levels.