Future Shock

Holmes and Rahe next took their list of life-changes to thousands of men and women in many walks of life in the United States and Japan. Each person was asked to rank order the specific items on the list according to how much impact each had. Which changes required a great deal of coping or adjustment? Which ones were relatively minor?

To Holmes' and Rahe's surprise, it turned out that there is widespread agreement among people as to which changes in their lives require major adaptations and which ones are comparatively unimportant. This agreement about the "impact-fullness" of various life events extends even across national and language barriers. (The work in the United States and Japan is now being supplemented by studies in France, Belgium and the Netherlands.) People tend to know and to agree on which changes hit the hardest.

Given this information, Holmes and Rahe were able to assign a numerical weight to each type of life change. Thus each item on their list was ranked by its magnitude and given a score accordingly. For example, if the death of one's spouse is rated as one hundred points, then moving to a new home is rated by most people as worth only twenty points, a vacation thirteen. (The death of a spouse, incidentally, is almost universally regarded as the single most impactful change that can befall a person in the normal course of his life.)

Now Holmes and Rahe were ready for the next step. Armed with their Life-Change Units Scale, they began to question people about the actual pattern of change in their lives. The scale made it possible to compare the "changefulness" of one person's life with that of another. By studying the amount of change in a person's life, could we learn anything about the influence of change itself on health?

To find out, Holmes, Rahe and other researchers compiled the "life change scores" of literally thousands of individuals and began the laborious task of comparing these with the medical histories of these same individuals. Never before had there been a way to correlate change and health. Never before had there been such detailed data on patterns of change in individual lives. And seldom were the results of an experiment less ambiguous. In the United States and Japan, among servicemen and civilians, among pregnant women and the families of leukemia victims, among college athletes and retirees, the same striking pattern was present: those with high life change scores were more likely than their fellows to be ill in the following year. For the first time, it was possible to show in dramatic form that the rate of change in a person's life – his pace of life – is closely tied to the state of his health.

"The results were so spectacular," says Dr. Holmes, "that at first we hesitated to publish them. We didn't release our initial findings until 1967."

Since then, the Life-Change Units Scale and the Life Changes Questio

Thus in August, 1967, Commander Ransom J. Arthur, head of the United States Navy Medical Neuropsychiatric Research Unit at San Diego, and Richard Rahe, now a Captain in Commander Arthur's group, set out to forecast sickness patterns in a group of 3000 Navy men. Drs. Arthur and Rahe began by distributing a Life Changes Questio

Each crew member was asked to tell what changes had occurred in his life during the year preceding the voyage. The questio

The questio

In short, the questio

For six months, the three cruisers remained at sea. Just before they were scheduled to return, Arthur and Rahe flew new research teams out to join the ships. These teams proceeded to make a fine-tooth survey of the ships' medical records. Which men had been ill? What diseases had they reported? How many days had they been confined to sick bay?

When the last computer runs were completed, the linkage between changefulness and illness was nailed down more firmly than ever. Men in the upper ten percent of life change units – those who had had to adapt to the most change in the preceding year – turned out to suffer from one-and-a-half to two times as much illness as those in the bottom ten percent. Moreover, once again, the higher the life change score, the more severe the illness was likely to be. The study of life change patterns – of change as an environmental factor – contributed significantly to success in predicting the amount and severity of illness in widely varied populations.

"For the first time," says Dr. Arthur, appraising life change research, "we have an index of change. If you've had many changes in your life within a short time, this places a great challenge on your body ... An enormous number of changes within a short period might overwhelm its coping mechanisms.

"It is clear," he continues, "that there is a co

The stakes in life-change research are high, indeed, for not only illness, but death itself, may be linked to the severity of adaptational demands placed on the body. Thus a report by Arthur, Rahe, and a colleague, Dr. Joseph D. McKean, Jr., begins with a quotation from Somerset Maugham's literary autobiography, The Summing Up: