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In an attempt to measure the impact of "life change events," Holmes and Psychologist Richard Rahe, working together in the 1940s and '50s, asked 5,000 people to rate the amount of social readjustment required for various events. The result is the widely used Holmes-Rahe scale. At the top is death of a spouse (100 stress points), followed by divorce (73), marital separation (65), imprisonment (63) and death of a close family member (63). Not all stressful events are unpleasant. Marriage rates 50; pregnancy, 40; buying a house, 31; and Christmas, 12. Holmes went on to show that in a sample of 88 young doctors, those who totaled 300 or more units on the scale had a 70% chance of suffering ulcers, psychiatric disturbances, broken bones or other health problems within two years of the various crises; those who scored under 200 had only a 37% incidence of such infirmities. The scale proved to be an effective prognosticator as well: by tallying up the life stress of healthy college football players, Holmes and Rahe were even able to predict which ones would be injured during the next season.
The impact of major life events on health has been reconfirmed many times. A study published earlier this year in the British medical journal Lancet reported that the incidence of fatal heart attacks rose sharply in Athens in the days following the 1981 earthquake there. Stanford Neurochemist Barchas has found that a high score on the Holmes-Rahe scale is linked to elevated levels of the hormones associated with stress: adrenaline (which scientists have re-christened epinephrine), norepinephrine and beta-endorphin. An Australian study of bereavement has shown that eight weeks after the death of their spouses, widows and widowers have diminished immune responses, leaving them more vulnerable to infection and cancer.
Some experts do not agree I that the Holmes-Rahe scale is the best measure of personal stress. By conducting a series of surveys, Psychologist Richard Lazarus, of the University of California at Berkeley, has become convinced that the everyday annoyances of life, or "hassles," contribute more to illness and depression than major life changes. Lazarus cites a poem by Charles Bukowski to illustrate his point:
.. .It's not the large things that send a man to the madhouse. . . no, it's the continuing series of small tragedies that send a man to the madhouse
not the death of his love but a shoelace that snaps with no time left...
The snapped-shoelace factor ties in with a number of recent studies. In a survey of 210 Florida police officers, Psychologists Charles Spielberger and Kenneth Grier of the University of South Florida found that far more stressful than responding to a felony in progress or making arrests while alone was the day-to-day friction of dealing with what the officers saw as an "ineffective" judicial system and "distorted" press accounts about their work. In other stress surveys, police sergeants in Houston groused about paper pushing more than physical danger; teachers ranked administrative details second only to inadequate salary; air traffic controllers, whose high rate of hypertension and ulcers has been attributed to job pressure, complained more about such mundane matters as management, shift schedules and "irrelevant"