The Life Change Model

The Life Change Model Image by: Anfuehrer

The adage, “You’ll worry yourself sick,” is not just an old wives’ tale. Prolonged stress can have an impact on our health. But it’s not only negative pressures that cause stress. Change – even positive change – can affect our wellbeing. How can we identify which events in our lives have the biggest impact, and how at risk are we of falling ill because of them? 

Change and Your Health

Most of us know that an event need not be of crisis proportions to cause stress. Sometimes seemingly small, everyday events cause stress - and very often this event is some sort of a change in our lives.

Observing this led researchers to study the fact that any life change, even positive changes, can have a detrimental impact on health. The life-change model assumes that all changes in a person’s life – large or small, desirable or undesirable – can act as stressors, and that the accumulation of several small changes can be as powerful as one major change.

To measure the impact of life changes, two researchers (Thomas Holmes and Richard Rahe) devised the Social Readjustment Rating Scale (SRRS), also known as the Holmes and Rahe Stress Scale. In this scale, the number of 'Life Change Units' (LCUs) that apply to events in the past year of an individual's life are added. The life change units are in essence stress potential values.That is, they give an indication of how stressed the individual is likely to be, and directly related to that, how many health problems they are likely to experience.

Researchers found that 93% of health problems (infections, allergies, bone and muscle injuries, and psychosomatic illness) affected patients who, during the previous year, had been exposed to events with LCU values totalling 150 or more. Although a minor life change was not sufficient to constitute a serious stressor, the cumulative impact of many events could be considered a crisis. The greater the numbers of LCUs, the greater the risk of illness.  Of those exposed to:

  • Mild crisis (150 – 199 LCUs) – 37% reported illness;

  • Moderate crisis (200 – 299 LCUs) – 51% reported illness;

  • Major crisis (more than 300 LCUs) – 79% reported illness.

Clearly, change in our lives can be considered stressful, and stressful life events do play some part in producing physical and psychological illness for many people.

Of course we are all unique individuals and so vary in the way we handle change, as well as in our personal interpretation of the change event. Personal characteristics can also modify the impact of the life changes on our health. Many people have illnesses that do not seem to be preceded by identifiable stressors, and others undergo stress but do not seem to get sick.

The Social Readjustment Rating Scale

Using the Social Readjustment Rating Scale as a guide, assess your own levels of stress and the likelihood of falling ill. Tick all the change events which have happened to you in the past year and add up your score.

Life eventLife change units

Death of a spouse

100

 

Divorce

73

 

Marital separation

65

 

Imprisonment

63

 

Death of a close family member

63

 

Personal injury or illness

53

 

Marriage

50

 

Dismissal from work

47

 

Marital reconciliation

45

 

Retirement

45

 

Change in health of family member

44

 

Pregnancy

40

 

Sexual difficulties

39

 

Gain a new family member

39

 

Business readjustment

39

 

Change in financial state

38

 

Death of a close friend

37

 

Change to different line of work

36

 

Change in frequency of arguments

35

 

Major mortgage

32

 

Foreclosure of mortgage or loan

30

 

Change in responsibilities at work

29

 

Child leaving home

29

 

Trouble with in-laws

29

 

Outstanding personal achievement

28

 

Spouse starts or stops work

26

 

Begin or end school

26

 

Change in living conditions

25

 

Revision of personal habits

24

 

Trouble with boss

23

 

Change in working hours or conditions

20

 

Change in residence

20

 

Change in schools

20

 

Change in recreation

19

 

Change in church activities

19

 

Change in social activities

18

 

Minor mortgage or loan

17

 

Change in sleeping habits

16

 

Change in number of family reunions

15

 

Change in eating habits

15

 

Vacation

13

 

Christmas

12

 

Minor violation of law

11

 

Score of 300+: At strong risk of illness.

Score of 150-299: Risk of illness is moderate (reduced by 30% from the above risk).

Score of less than 150: Only slight risk of illness.

Non-Adults

A modified scale has also been developed for non-adults. Similar to the adult scale, stress points for life events in the past year are added and compared to the rough estimate of how stress affects health.

Life EventLife Change Units

Death of parent

100

 

Unplanned pregnancy/abortion

100

 

Getting married

95

 

Divorce of parents

90

 

Acquiring a visible deformity

80

 

Fathering a child

70

 

Jail sentence of parent for over one year

70

 

Marital separation of parents

69

 

Death of a brother or sister

68

 

Change in acceptance by peers

67

 

Unplanned pregnancy of sister

64

 

Discovery of being an adopted child

63

 

Marriage of parent to stepparent

63

 

Death of a close friend

63

 

Having a visible congenital deformity

62

 

Serious illness requiring hospitalization

58

 

Failure of a grade in school

56

 

Not making an extracurricular activity

55

 

Hospitalization of a parent

55

 

Jail sentence of parent for over 30 days

53

 

Breaking up with boyfriend or girlfriend

53

 

Beginning to date

51

 

Suspension from school

50

 

Becoming involved with drugs or alcohol

50

 

Birth of a brother or sister

50

 

Increase in arguments between parents

47

 

Loss of job by parent

46

 

Outstanding personal achievement

46

 

Change in parent's financial status

45

 

Accepted at college of choice

43

 

Being a senior in high school

42

 

Hospitalization of a sibling

41

 

Increased absence of parent from home

38

 

Brother or sister leaving home

37

 

Addition of third adult to family

34

 

Becoming a fully- fledged member of a church

31

 

Decrease in arguments between parents

27

 

Decrease in arguments with parents

26

 

Mother or father beginning work

26

 

Score of 300+: At strong risk of illness.

Score of 150-299: Risk of illness is moderate (reduced by 30% from the above risk).

Score of less than 150: Slight risk of illness.