Assessing the Link Between Stress and Health

Thomas Holmes and Richard Rahe concluded on the basis of their research that change-whether it be positive change or negative change-is stressful and that people who experience dramatic changes in their lives are at risk for illness and injury. They developed a method evaluating how much change and, consequently, how much stress is in a person's life called the Social Readjustment Rating Scale (SRRS). This SRRS is reproduced for you for the purposes of this experiment on the Record Form on page 300.

The purpose of this experiment is to investigate the relationship between stress, as measured by the SRRS, and illness and injury. To perform the exercise, you will need to find 10 cooperative and truthful volunteers who are willing to fill out a questionnaire that will take about 5 minutes. Try to find some volunteers who have experienced a high degree of stress in their lives and some who seem to have had very little stress. You will also need to make 10 copies of the Record Form printed below, one for each of the 10 subjects in this exercise.

Procedure

STEP 1 Give each subject a copy of the Record Form and ask him or her to fill it out as accurately as possible. Be sure to tell the subjects that they need not put their names on the forms and their identities will not be revealed to anyone who might look at the data.

STEP 2 Collect the Record Forms and thank the subjects for their help. Assign a subject number from 1 to 10 on the top of each form.

Analyzing the Data

STEP 1 Score each subject's SRRS by adding together all the numbers that correspond to the circled events on each subject's Record Form. Record these numbers in the appropriate positions on the chart in Table 15.1, along with the subject number on the top of the Record Form.

STEP 2 Record the answers given by each subject to Questions 1 through 6 in the spaces provided in Table 15.1.

STEP 3 Examine the trends in the data carefully to determine the relationship between high stress as measured by the SRRS and the amount of illness and injury experienced by individuals in these three categories.

Do your data show any indication of a relationship between stress and illness or injury? More specifically, do subjects whose SRRS scores fall above 300 report more visits to the doctor, more serious illnesses, more injuries, more trips to the doctor, etc., than those whose SRRS scores fall below 100?

One of the questions which is left largely unanswered in this approach to studying the relationship between stress and health is the question of causality: What causes what? Does stress cause a person to be at risk for illness and injury? Or does having more illnesses and injuries over a relatively brief span of time produce more stress? How would a biomedical model address this issue? What would a biopsychosocial model conclude? Can you think of ways to test these different explanations about the relationship between stress and health? Based on your reading of Chapter 15, do you think that stress produces an increased risk of illness and injury? What evidence would you use to support your answer?

SSRS Summary Report

Subjects whose scores are less than 100

Subject Number	SRSS Score	Q.1	Q.2	Q.3	Q.4	Q.5	Q.6

Subjects whose scores are between 100 and 300

Subject Number	SRSS Score	Q.1	Q.2	Q.3	Q.4	Q.5	Q.6

Subjects whose scores are greater than 300

Subject Number	SRSS Score	Q.1	Q.2	Q.3	Q.4	Q.5	Q.6

Participant Number

Instructions:Circle the events on the list below that you have experienced in your life during the past 12 months. When you have completed the task, fill out the information requested below. Thank you for your help and cooperation.

Rank     Life Event	Mean Value	Rank   Life Event	Mean Value
1. Death of spouse	100	23. Son or daughter leaving home (e.g., marriage, attending college, etc.)	29
2. Divorce	73	24. Trouble with in-laws	29
3. Marital separation from mate	65	25. Outstanding personal achievement	28
4. Detention in jail or other institution	63	26. Wife beginning or ceasing work outside the home	26
5. Death of a close family member	63	27. Beginning or ceasing formal schooling	26
6. Major personal injury or illness	53	28. Major change in living conditions (e.g., building a new home, remodeling, deterioration of home or neighborhood)	25
7. Marriage	50	29. Revision of personal habits (dress, manners, associations, etc.)	24
8. Being fired at work	47	30. Trouble with boss	23
9. Marital reconciliation with mate	45	31. Major change in working hours or conditions	20
10. Retirement from work	45	32. Change in residence	20
11. Major change in the health or behavior of a family member	44	33. Changing to a new school	20
12. Pregnancy	40	34. Major change in usual type and/or amount of recreation	19
13. Sexual difficulties	39	35. Major change in church activities (e.g., a lot more or a lot less than usual)	19
14. Gaining a new family member (e.g., through birth, adoption, oldster moving in, etc.)	39	36. Major change in social activities (e.g., clubs, dancing, movies, visiting, etc.)	18
15. Major business readjustment (e.g., merger, reorganization, bankruptcy, etc.)	39	37. Taking out a mortgage or loan for a lesser purchase (e.g., for a car, TV, freezer, etc.)	17
16. Major change in financial state (e.g., a lot worse off or a lot better off than usual)	38	38. Major change in sleeping habits (a lot more or a lot less sleep, or change in part of day when asleep)	16
17. Death of a close friend	37	39. Major change in number of family get-togethers (e.g., a lot more or a lot less than usual)	15
18. Changing to a different line of work	36	40. Major change in eating habits (a lot more or a lot less food intake, or very different meal hours or surroundings)	15
19. Major change in the number of arguments with spouse (e.g., either a lot more or a lot less than usual regarding child-rearing, personal habits, etc.)	35	41. Vacation	13
43. Minor violations of the law (e.g., traffic tickets, jaywalking, disturbing the peace, etc.)	11
20. Taking out a mortgage or loan for a major purchase (e.g., for a home, business, etc.)	31	42. Christmas	12
21. Foreclosure on a mortgage or loan	30	43. Minor violations of the law (e.g., traffic tickets, jaywalking, disturbing the peace, etc.	11
22. Major change in responsibilities at work (e.g. promotion, demotion, lateral transfer)	29

1. How many times have you been to the doctor during the past year?

2. Have you had any serious illnesses during the past year? yes no

3. Have you had any injuries during the last year that were serious enough to keep you home from work or school or which caused you to go to the doctor? If so, how many?

4. Do you think that you were sick more during the past year of your life than during most of the three or four years before? yes no

5. Do you think you experienced more injuries during the past year than you experienced during most of the three or four years before? yes no

6. Do you feel as if this past year has been more stressful, less stressful, or about equally stressful as the rest of your life typically has been?     more stressful     less stressful     about equally stressful