Is homesickness a mini-grief? Development of a dual process model.

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DOI: 10.1177/2167702615585302
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Theoretical/Methodological/Review Article
Although mild feelings of homesickness (HS) are a nor-
mal response to leaving loved ones and home, HS is
deeply harrowing for those who experience it intensely.
It seems to be a universal phenomenon, familiar to per-
sons across very different cultures and societies when
they leave home temporarily or permanently. Both chil-
dren and adults appear prone to it, and it has been asso-
ciated with inability to function well in daily life as well
as a variety of mental and physical health consequences
(see, e.g., Stroebe, Schut, & Nauta, in press; Thurber &
Walton, 2012; van Tilburg, Vingerhoets, & van Heck,
1996). For example, HS is associated with anxiety, loneli-
ness, social isolation, and depression; it can exacerbate
preexisting mood and anxiety disorders or precipitate
new problems, ranging from insomnia, memory prob-
lems, and appetite changes to gastrointestinal difficulties,
immune deficiencies, or even diabetes (Thurber &
Walton, 2012). It has also been distinguished (conceptu-
ally) from related conditions, namely, separation anxiety,
school phobia, translocation syndrome, and relocation
effects (Baier & Welch, 1992). In extreme cases, sufferers
may be unable to sustain sojourns away, returning home
prematurely if possible; some decide to avoid future sep-
arations from home altogether (cf. van Vliet, 2001).
Yet HS has rarely been regarded as a topic of clinical
interest. For example, despite the severity of reactions and
consequences for some adults and children, HS has not
been defined as a formal diagnostic term; it is not included
as a category of mental disorder in either the fourth or
fifth edition of the Diagnostic and Statistical Manual of
Mental Disorders (American Psychiatric Association [APA],
1994, 2013). In our view, the nature and (clinical) signifi-
cance of HS need further investigation and conceptual
585302CPXXXX10.1177/2167702615585302Stroebe et al.Is Homesickness a Mini-Grief?
research-article2015
Corresponding Author:
Margaret Stroebe, Department of Clinical & Health Psychology,
Utrecht University, Box 80140, 3508 TC Utrecht, Netherlands
E-mail: M.S.Stroebe@UU.NL
Is Homesickness a Mini-Grief ?
Development of a Dual Process Model
Margaret Stroebe1,2, Henk Schut1, and Maaike H. Nauta2
1Department of Clinical & Health Psychology, Utrecht University and 2Department of Clinical Psychology
& Experimental Psychopathology, University of Groningen
Abstract
Homesickness (HS) is associated with mental and physical health problems and is thus of clinical concern. In some
highly influential theoretical models and widely used questionnaires, HS spans home-related losses and new-locality
adjustments. A differentiated approach is needed: Evidence suggests that distinct manifestations are associated with
these two domains. Collapsing home- and new-place-related phenomena has impeded understanding of separation-
from-home-specific aspects. Thus, we propose a dual process model of coping with HS (DPM-HS). According to this
framework, HS is fundamentally a separation phenomenon, a “mini-grief,” involving different (though possibly mutually
exacerbating) stressors from new place ones. It follows that HS should be narrowly defined; separate examination
of home–new place stressors, correlates, and consequences is mandatory; regulatory cognitive-emotional processes
and incremental effects due to new place stressors need charting. Following DPM-HS principles, HS prevention and
treatment should not only focus on distraction and adjustment, but also pay attention to missing home aspects and
emotion-regulation strategies.
Keywords
homesickness; grief; health; dual process model; separation; relocation; emotion regulation; coping
Received 10/20/14; Revision accepted 4/13/15
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2 Stroebe et al.
clarification. Notably, although associated with a range of
problems, there is still lack of clarity in the scientific lit-
erature as to the definition of HS and theoretical frame-
works, making it difficult to evaluate the appropriateness
of diagnostic categorization or to develop theory-based
prevention and treatment programs. For instance, it has
remained unclear whether the health problems outlined
earlier are due to separation difficulties or to troubles
adjusting to a new environment. For example, though
diabetes has been associated with HS (Thurber & Walton,
2012), it would seem likely that unfavorable changes in
diet in the new environment (cf. Cornelis etal., 2014)
rather than missing family and yearning for home cook-
ing would be responsible for increases in the occurrence
of this disease. Thus, the purpose of this article is to pro-
vide a scientific framework to streamline and guide HS
research.
We propose that HS is a grief-like phenomenon, similar
in terms of underlying processes, manifestations, and con-
sequences to those associated with the death of a loved
person (cf. Archer, Ireland, Amos, Board, & Currid, 1998;
Fisher & Hood, 1988; Stroebe, van Vliet, Hewstone, &
Willis, 2002). There are several important parallels. Like
grief following bereavement, HS occurs in connection
with separation from loved ones (although, in the former,
the loss is irrevocable, whereas in the latter case it is not).
Feelings of yearning and longing for these persons are
paramount both in bereavement (cf. O’Connor & Sussman,
2014; Stroebe, Schut, & Stroebe, 2007) and in HS (e.g.,
Archer etal., 1998; van Tilburg & Vingerhoets, 2005). Just
as bereaved persons may long for lost aspects of their
previous lives, so too, within the HS domain, longing may
extend to the home environment, with some missing peo-
ple, others missing various aspects of home more (cf.
Vingerhoets, 2005). Attachment features prominently in
scientific explanations in both areas, with Bowlby’s (1980)
attachment theory frequently used as a scientific frame-
work (e.g., in the bereavement field: Mikulincer & Shaver,
2008; Wijngaards-de Meij et al., 2007; in the HS field:
Brewin, Furnham, & Howes, 1989; Fisher, 1989; van Vliet,
2001). A consequence of both types of separation is also
the necessity for adaptation to the changed situation: in
the case of bereavement, to the world without the loved
person; in the case of locating away from home, to the
new environment and its various demands. Difficulties
associated with the latter, new place stressors—although
related—are different from separation phenomena per se.
It is important that they may be associated with different
psychological problems. The two domains thus require
distinct scientific treatment, but systematic examination of
these components separately has been lacking in the
available scientific literature.
To enhance understanding of the difficulties and cop-
ing processes associated with the HS life stressor, this
article offers a novel approach, a dual process model of
coping with homesickness (labeled the DPM-HS). The
main premise underlying this model is that HS is funda-
mentally a “mini-grief,” a separation, not new place adjust-
ment, experience. It is important that we argue for a
differential rather than integrative perspective, one that
identifies specific patterns of reactions, sequelae and out-
comes consequent to leaving home (the “home” factor).
Thus, we seek to unravel the manifestations and phenom-
ena of HS as a mini-grief, and distinguish these from new
place ones (the “new place” factor). Following the reason-
ing outlined earlier, the theoretical model must take the
latter into account too, because the transition from home
necessarily involves not only giving up the old but also
adjusting to the new, and difficulties in the one domain
may exacerbate those in the other. If we are to understand
coping processes—that is, how people go about dealing
with transitions from home—we need to adopt such a
dual perspective and examine phenomena in each domain
distinctly. Furthermore, having postulated such dual
stressors, integration of a dynamic, emotion regulation
coping process within the model becomes a necessity. It
is neither possible for a person to attend to the different
types of stressors at the same time, nor is it adaptive to
focus exclusively on the one or the other. This process
needs to be captured in the theoretical model. To this
end, the current article first reviews contemporary defini-
tions and theoretical approaches, then further explains
the development of the novel DPM-HS, describing its
main parameters as well as its implications for interven-
tion. Finally, examples are given as to how this differential
approach can guide future empirical research.
Contemporary Views on
Homesickness: Home and New Place
Domains
Definitions of HS
A lack of consensus among researchers about coverage of
home and new place domains is reflected in the range of
HS definitions in the scientific literature (see Table 1).
Although experts claim “reasonable concordance” across
definitions (Fisher, Elder, & Peacock, 1990, p. 16), inspec-
tion of these shows a striking discrepancy: Some regard HS
as covering (a) attachment to home (persons or place) and
(b) strain in trying to cope with a novel environment (e.g.,
Archer etal., 1998; Fisher etal., 1990). Others have focused
exclusively on the attachment to home aspect (e.g.,
Thurber, 2005; Thurber & Walton, 2012; Vingerhoets, 2005).
Otherwise, conceptual agreement on features of HS is
apparent. Descriptions typically center around missing
home and family, longing to be at home and to see family
members and familiar places and circumstances,
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Is Homesickness a Mini-Grief? 3
Table 1. Definitions of Homesickness (HS)
Author/s Definition Features
Archer etal. (1998) “. . . covers reactions to a number of circumstances which
involve separation from familiar and loved people and
places” (p. 205).
Home and new place—Understood as an
attachment/separation reaction but also
including response to absence of habitual
places and activities in the new location.
Baier and Welch
(1992)
It involves a pervasive feeling of sadness and thoughts
about the place left, and longing for home or family may
be accompanied by somatic complaints (see their Table
1, p. 56).
They provide criteria for HS using content
analysis technique, distinguishing it from
other concepts, including relocation effects.
Eurelings-Bontekoe
etal. (2000; cf.
Eurelings-Bontekoe
etal., 1994)
“. . . a depression-like reaction to leaving a familiar
environment, characterized by ruminative thoughts
about home and the desire to go back to the familiar
environment” (p. 444).
Likened to depression.
Fisher etal. (1990) “. . . a term used to describe the total distress reaction
created by leaving home” (p. 15); “. . . a complex
cognitive-emotional-motivational state characterized by
preoccupation with home and accompanied by grief-like
symptoms” (p. 16).
They talk about “reasonable concordance”
(p. 16) in use of the HS term (across
dictionaries, researchers and [non]sufferers).
But some focus on the home, others include
adaptation to present environment, as
reflected in operationalizations.
McCann (1941) Its central core is “the frustration of a strong, emotionally
charged desire to return home” (p.179).
He uses HS and nostalgia interchangeably.
Likens HS/nostalgia to lovesickness and to
grief over the death of loved one.
Nijhof and Engels
(2007)
“. . . a negative emotional state characterized by recurrent
thoughts of home, missing friends, the desire to go
back to the familiar environment and often co-occurring
physical complaints” (p. 710).
Focus on the home and make clear that
physical complaints are a correlate.
Porritt and Taylor
(1981)
“. . . a form of grief or separation reaction and . . . includes
strong components of seeking to re-establish and
maintain valued attachments” (p. 58).
Attachment focus.
Stroebe etal. (2002) Suggest HS is a “mini-grief” phenomenon, incorporating
depression as result of absence from home and longing
for home and family while in new place.
Noted inclusion of disliking new environment
in some definitions, and inclusion of this in
their empirical investigation.
Thurber (2005);
Thurber and
Walton (2012)
“The distress or impairment caused by an actual or
anticipated separation from home” (2012, p. 1). It is
characterized by preoccupying thoughts of home and
attachment objects (2005, p. 555). “. . . unique hallmark
of preoccupying thoughts of home and attachment
objects” (2012, p. 1).
Noteworthy for separating out the home factor
from the current environment one, focusing
on the “unique hallmark” of home variables’
impact. Anticipatory HS included.
van Tilburg etal.
(1996)
“. . . refers to the commonly experienced state of distress
among those who have left their house and home and
find themselves in a new and unfamiliar environment. It
is generally represented as an intense longing for home
accompanied by a depressive mood and a variety of
somatic complaints” (p. 899).
Link to depressive mood.
van Vliet (2001) “. . . a state of distress characterized by adjustment
difficulties and intense longing for home and ruminations
about home after having left home” (pp.14–15).
“. . . a state (missing family and friends, loneliness)
triggered by the event ‘relocation’ bringing about an
imbalance between the demands of the new situation
(adjustment difficulties) and the available resources
(personal and social” (p. 115).
See also p. 114: considers concept and
mediating processes.
Dual processes: home and new environment
related.
NB He reasons that severe HS (leading, e.g.,
to depression and anxiety) would “fit the
DSM-IV definition of an adjustment disorder”
(p.115).
Vingerhoets (2005) “HS reflects problems with separation from the home
environment” (p. 14).
A strict definition in line with single dimension
approach.
Watt and Badger
(2009)
Differentiate HS “arising in separation from the old location
as well as HS arising in entry to the new location”
(p.526).
Emphasize the loss of the interpersonal
relationships. A dual process approach,
acknowledging new location problems but
focusing for clarity on lost relationships from
the home environment.
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4 Stroebe et al.
and preoccupation with home-related thoughts. These
feelings of longing are often said to be accompanied by
anxiety and depression, ranging from mild to severe. And
even though some leave (mal)adjustment to the new envi-
ronment out of the HS definition itself, most investigators
acknowledge that HS is sometimes associated with (or
leads to) stress and maladaptation to the new environ-
ment. For example, after defining HS in terms of problems
of separation from home, Vingerhoets (2005) went on to
state that HS “interferes with adjustment to the new situa-
tion” (p. 13). Nevertheless, he goes on to state explicitly,
“By contrast, distress caused by adjustment problems in
new environments should not be labelled HS” (p. 13).
As reflected in the definitions in Table 1, researchers
generally make efforts to distinguish HS from its out-
comes, such as depression, anxiety, physical symptoms,
or illnesses, not least to avoid conceptual overlap
(although it is clear that depression and anxiety about
leaving home are closely linked with HS). To illustrate,
somatic symptoms may be considered either as an elicit-
ing factor of HS, or a result of it, but should not be a
defining characteristic. In the case of boarding school
children, Fisher, Frazer, and Murray (1986) explained, “It
may be the case that minor illnesses create homesickness
because love and attention of family members is sought
by a pupil who feels ill” (p. 45). On the other hand,
physical symptoms may also be a sign of distress.
Theoretical approaches
Although much empirical research in the HS area has
been problem- rather than theory-driven, some research-
ers have adopted a variety of theoretical perspectives to
guide their investigations of HS (for reviews, see, e.g.,
Fisher, 1989; Thurber & Sigman, 1998; van Vliet, 2001;
Vingerhoets, 2005). Currently applied theoretical
approaches are summarized in Table 2 (for an earlier,
more detailed overview, see Thurber & Sigman, 1998).
For present purposes, these have been categorized
according to their main focus on HS (a) as a separation
reaction (home factor; what is missed from the old envi-
ronment) or (b) as relating to the demands that are made
on the person in the new environment (new place factor;
including stressors such as students’ studies).
Paralleling the diversity in definitions, as also shown in
Table 2, some researchers consider HS to be a phenome-
non within the first “home” dimension, either explicitly
(van Vliet, 2001) or implicitly (e.g., Thurber & Sigman,
1998) in line with attachment theory (e.g., Bowlby, 1973).
However, many include (or even focus predominantly on)
the second new place dimension. Of importance in the
current context, an initial formulation by Stroebe et al.
(2002) drew attention to the mini-grief-like quality of HS,
likening it to bereavement experience.1 Stroebe et al.
(2002) also noted the need for new-environment adapta-
tion (adjustment to ongoing-life without the loved one in
the case of bereavement), in line with the dual process
model of coping with bereavement (DPM; see Table 2).
But perhaps the most influential approach in shaping sub-
sequent scientific investigation has been that of Fisher,
variously labeled and with some adaptations across time
(see Table 2). Although Fisher conceived of HS as pre-
dominantly a leaving home phenomenon caused by losing
the proximity with family and friends, over the years she
developed her perspective to include adjustment to the
new environment as a major dimension in her theorizing
about HS. An early statement also illustrates her multi-
causal approach: “Environmental relocations are a neces-
sary but not a sufficient condition for HS; features of the
new place combine with personality factors to precipitate
the experience” (Fisher, Murray, & Frazer, 1985, p. 181).
Some others have also included predisposing traits in their
explanations of HS (e.g., Eurelings-Bontekoe, 1997; van
Tilburg, de Waal, Vingerhoets, & van Heck, 1999).
As indicated earlier, there are two main concerns regard-
ing existing perspectives. To elaborate, the first has to do
with the coverage of home–new place domains. Exclusive
focus on the home factor precludes examination of the
complex adaptation process that is inherent to the new
place experience; there are good reasons to argue that new
place factors should be taken into account—they may
exacerbate home-related difficulties. However, combining
new environment adjustment with separation phenomena
prevents identification of the specific underlying mecha-
nisms, precise causes of difficulties, and direct conse-
quences of leaving home (the same applies to understanding
maladjustment to the new environment). In other words,
integrating separation and new place phenomena may
obscure identification of separate constructs which, for rea-
sons set out later, are valuable to study apart. In short, we
advocate a differential approach. Rather than investigating
new place and home adjustment in an integrative manner,
HS should be defined as a separation phenomenon, inves-
tigated distinctly and independently, but with parallel
examination of new place stressors and difficulties.
Our second concern has to do with the frequent lack of
attention to coping processes. Table 2 indicates whether or
not the models include dynamic regulatory processes as a
central component in their taxonomies. It can be seen that
in hardly any of the models is there consideration of such
processes; there is no explicit integration of these coping
mechanisms or identification of (mal)adaptive processes.
Yet these seem to be essential components for any type of
HS model, particularly in view of the stressful nature of
attending to home—or dealing with dual home and new
place stressors—and of doing unrelated, “time-out” things:
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Is Homesickness a Mini-Grief? 5
Homesick persons need to regulate their cognitions, emo-
tions, and behavior to adjust. This may also be a crucial
component for interventions (we return to this later). Many
of the fundamental principles included in different, exist-
ing models can be integrated and built on to address these
concerns.
Table 2. Theoretical Approaches Applied to Homesickness
Theoretical approach and selected HS
references Explanation Home–new place focus
Regulatory coping
processes (cognitive,
behavioral, emotional)
Attachment theory
B owlby (1973, 1980); van Vliet (2001);
Thurber and Sigman (1998), Thurber
and Walton (2012)
Anxiety and distress on separation
from loved ones and home
(especially among insecurely
attached)
Home Not central
Attentional/competing demand/
resources model
F isher etal. (1986); Fisher (1988,
1990); Porritt and Taylor (1981); also
see Burt (1993)
(see also “multicausal model/
job strain model”) Competing
demands; new environment fails
to provide distraction to overcome
distressing thoughts of home
Home and new place
combined
Distraction processes
Belongingness theory
Watt and Badger (2009)
Humans have innate drive for
minimum number of lasting
interpersonal relationships;
relocation threatens belongingness
needs (loss of old relationships),
which is one cause of HS
(acknowledges others)
Home Not central
Cognitive stress theory
van Vliet (2001)
Severe adjustment difficulties to new
environment cause HS (combined
with missing family and friends)
New place focus (and
home, combining with
attachment theory)
Not central
Dual process model (DPM)
S troebe and Schut (1999; 2010; for HS:
Stroebe etal., 2002)
HS likened to bereavement:
attachment (see “attachment
theory”), separation, and loss,
designated as “mini-grief”
Home focus (and new
place)
Oscillation process
for bereavement,
not elaborated
specifically for HS
Joint theoretical approach
Brewin etal. (1989)
4 bodies of knowledge postulated
to account for specific HS
phenomena: expectancy,
attachment, social support, social
affiliation
Home and new place
combined
Not central
Multicausal model/job strain model
Fisher (1989)
Thoughts of home occupy attention,
precluding investment in new
environment; intensity of HS will
decrease attentional ability; there
is a finite amount of attentional
resources, precluding investment in
new environment, resulting in HS
Home and new place
combined
Not central
Personality
B eck etal. (2003); Eurelings-Bontekoe
etal. (1994); van Tilburg, de Wall,
etal. (1999)
Personality (traits) are (largely)
responsible for HS
Emphasis on
predispositional factors
rather than home or
new environment
Not central
T wo-process model of control and
coping
Thurber and Weisz (1997a, 1997b)
Focuses on the impact of perceived
control and coping style for
understanding childhood HS, as
related to developmental changes
Intervention-oriented, so
despite home focus,
focus on new place
features too
Control—regulatory
cognitive/emotional/
behavioral processes
Two-stage risk model (based on job-
strain model; Fisher, 1989)
F isher etal. (1985); Fisher etal.
(1986); van Tilburg etal. (1996);
Eurelings-Bontekoe (1997)
Covers/integrates different
models, including relocation and
personality factors
New place combined
with other (e.g.,
personality factors)
Not central
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6 Stroebe et al.
The Dual Process Model of Coping
With Homesickness
Rationale and development of the
model
In line with our argument that HS is best understood as
primarily a separation, “mini-grief” phenomenon, our
model of adaptive coping with HS is based on the bereave-
ment-specific DPM (Stroebe & Schut, 1999, 2010), labeled
the DPM-HS (see Fig. 1). The DPM-HS provides a frame-
work for separate consideration of home-related phenom-
ena from new place ones, the former being central to—the
essence of—HS. As well as these different types of stress-
ors (and their associated complications), the model postu-
lates a regulatory coping process. The four features of the
DPM-HS taxonomy that most clearly distinguish it from
other HS models are (a) the distinction and separate con-
sideration of the two types of stressor, only one of which
is fundamentally considered to be “homesickness” (HS is a
mini-grief); (b) the postulation of a regulatory, adaptive
coping process; (c) identification of separate complica-
tions associated with leaving home and HS versus adapt-
ing to the new environment; and (d) potential spiraling of
HS difficulties due to home and new place stressors “trig-
gering” each other, causing incremental difficulties.
Outline of the DPM-HS parameters
1. The home- and new-place-related stressors
described for HS parallel the two types of stressors
experienced in bereavement, the so-called loss-
oriented versus restoration-oriented ones postu-
lated by Stroebe and Schut (1999). In the DPM-HS,
home-related factors cover the concentration on
and coping with the separation experience itself
(see Fig. 1). This separation is the essence of HS,
just as the essence of grieving is the death of the
loved person. Away-related stressors are those to
do with the new locality (e.g., among students,
new social and academic roles and identities are to
be formed). These involve efforts to adjust to the
concurrent, changed, and demanding situation.
Thus, they are not directly the result of separation
per se (e.g., students living at home but starting
college could experience them), but rather have to
do with adjusting to new challenges. However,
because the latter may exacerbate missing home
(e.g., difficulty with studies or coping with finances
may cause yearning for home where these trou-
bles did not exist), inclusion of this class of stress-
ors in the DPM-HS is considered necessary.
2. The dynamic regulatory coping mechanism,
labeled oscillation, also depicted in Figure 1, is
distinctive too for the DPM-HS, differentiating it
from earlier HS-specific models. The rationale
behind this feature is that one cannot attend to
home-related and new-place-related stressors at
the same time. Healthy adaptation requires shift-
ing from one to the other domain, as well as tak-
ing time off addressing either type of concern,
Home-
Related Problems
Grief (yearning,
pining, longing)
Intrusion of home &
loved ones
Attempts to stay
close
Avoidance of
adaptation to new
place
Everyday life
experience
New Place-
Related Problems
Adjusting to life changes
Coping with new
challenges (intellectual,
social, economic etc.)
Dealing with new roles /
identities / relationships
Distraction from /
avoidance of HS
oscillation
Emotion regulation difficulties
(Intrusion-avoidance)
Separation
anxiety Adjustment
problems
Fig. 1. A dual process model of coping with homesickness.
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Is Homesickness a Mini-Grief? 7
when coping does not take place, which is also
recuperative.
As elaborated next, if there is unrelenting,
ruminative, home-directed thought/coping, it will
be maladaptive.
3. The DPM-HS enables classification of specific
separation-related complications/pathologies, dis-
tinguishing these from new-place ones. There are
reasons to argue that home-related complications
incorporate different debilities from new-place-
related ones (we review the evidence later).
Furthermore, complications can arise due to dis-
turbance of the oscillation process. To illustrate,
for a minority of persons with extreme HS, home
preoccupation can take up a large portion of
everyday life experience, leaving little time or
energy for attention to other activities, and avoid-
ance of coping with the challenges in the new
place. When intense HS feelings pertain, home
orientation becomes counterproductive. There is
lack of the “oscillation” identified earlier, there is
little or none of the healthy cognitive-emotional
regulation in which attention is paid to adjusting
to the new environment as well as separating
from home—and taking time off from coping with
either type of stressor (e.g., continued involve-
ment with one’s hobbies, which provide “time
out” and serve adaptive functions).
4. Finally, the conceptual analysis of HS as a funda-
mentally grief-like but nevertheless “dual process”
experience also allows for the possibility of under-
standing spiraling difficulties.2 This principle is
also fundamental to the DPM-HS, based as it is on
the previous three features. Given the two types of
stressor (home and new place), with different pat-
terns of correlates and complications, incremental
difficulties may occur, especially if emotion regu-
lation across the two domains does not take place.
For example, for a severely homesick person,
problems in the new place may escalate through
lack of attention to them (e.g., neglecting aca-
demic subjects may affect performance, which in
turn may raise anxiety about succeeding at col-
lege, and make one miss home even more).
Furthermore, maladjustment to the new place
may, for example, lead to comorbid symptomatol-
ogy (e.g., general anxiety, depression) and exacer-
bate HS (just as longing for the familiar home
environment may intensify maladjustment to the
new one). In this context, it is important to note
that maladjustment difficulties are not always fea-
tures of HS; they can occur in its absence too, and
HS can be experienced without the occurrence of
difficulties in adjusting to the new environment.
So although they may occur in tandem, this also
speaks for considering them separately: These
home and new place domains are interlinked,
but—not least for the sake of scientific clarity—
independent consideration is needed.
New definition of HS according to the
DPM-HS
The previously mentioned features typify the DPM-HS,
differentiate it from existing models of HS and lead us to
a new definition, one that takes these parameters into
account. Consequently, we define HS as a “mini-grief,” a
negative emotional state primarily due to separation from
home and attachment persons, characterized by longing
for and preoccupation with home, and often with diffi-
culties adjusting to the new place.
The DPM-HS: Evidence
Before examining the evidence for the four postulated
DPM-HS parameters, given the parallels between the
bereavement-DPM and the DPM-HS, one could look to
research in the former to inform the latter domain. A
number of teams have conducted research using the
DPM framework, including the evaluation of DPM-
derived interventions, but the body of evidence for the
bereavement model is limited (although the trend is
favorable, compared with empirical validation of other
models of loss, such as the stage, phase or task models).
Some significant contributions were collected in a special
issue on the DPM in Omega: Journal of Death and Dying
(Richardson, 2010). In commenting on the set of articles,
Carr (2010) pointed out that there is much research still
to be done. On the other hand, she remarked that some
promising support for the model is emerging; it has also
been widely cited and used in clinical guidelines and set-
tings (e.g., Malkinson, 2007; Wilson, 2014). So far, studies
have examined specific parameters of the model and
evidence is often indicative rather than conclusive. For
example, Shear and colleagues (Shear, 2010; Shear, Frank,
Houck, & Reynolds, 2005) used a randomized control
trial to evaluate an intervention for complicated grief
using DPM principles. DPM treatment (based on regula-
tion of loss- and restoration-focused training) was more
beneficial to bereaved clients than standard CBT treat-
ment. In the absence of process analysis (and a noninter-
vention control group), although consistent with the
DPM, these findings do not provide strong support for it.
The DPM loss and restoration parameters received pre-
liminary investigation by Wijngaards et al. (2008) in a
study of bereaved parent couples whose child had died.
Differences in dealing with loss versus restoration stress-
ors were linked with patterns of adjustment over time;
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8 Stroebe et al.
results suggested the importance of differentiating these
two types of stressor. Moving on to the DPM-HS, is there
evidence for the model in terms of the four specific
parameters?
1. Differentiation of home and new place stressors.
Two sorts of results support this feature of the
DPM-HS. First, quite simply, items representing the
two types of stressor typically emerge as distinct
clusters in factor analyses (e.g., Archer etal., 1998;
Stroebe etal., 2002; van Vliet, 2001). It is clear that
this alone does not provide convincing ground for
separate treatment (many questionnaires incorpo-
rate different factors). Second, and perhaps more
pertinent, examination of the few studies providing
separate information on correlates associated with
the two types of stressors reveals some differential
patterns: The home factor indeed seems to be asso-
ciated with different correlates from the new place
factor. Specific, stronger correlates with the home
factor include intrusions (Archer etal., 1998), and
worries related to home problems (Fisher, Fraser, &
Murray, 1984). Some correlates have been related
to both the home and new place factor, including
depression, but with different strengths. Relatively,
the new place factor (adjustment difficulties) has
been shown to be more strongly related to depres-
sion than the home factor (Longo & Kim-Spoon,
2013; Stroebe etal., 2002). Also, lack of perceived
control and state anxiety were more strongly related
to the new place factor than to the home factor
(Flett, Endler, & Besser, 2009); in addition, the new
place factor was associated with worries regarding
school work. Autonomous individuals experienc-
ing adjustment difficulties may be especially at risk
for developing depressive symptoms (Beck, Taylor,
& Robbins, 2003). Loneliness in students was more
strongly related to adjustment difficulties than to
missing family and friends (van Vliet, 2001) and
was, in turn, related to negative health conse-
quences including depression and anxiety. In the
same study, protective factors such as extraversion
or having a best friend in the same city proved
more influential with regard to adjustment difficul-
ties for students than to missing home. Also, in
expats, adjustment difficulties (and not missing
home) had the strongest relationship with loneli-
ness and health complaints, of all the included vari-
ables (van Vliet, 2001). Finally, perhaps also
indicative of separate concerns, although not sur-
prising, missing friends and family was endorsed
foremost by relocated students, both relocated and
home-living college students equally reported
adjustment difficulties (Stroebe etal., 2002).
Taken together, the limited empirical evidence
reviewed earlier seems to indicate that the home
factor is associated with specific, HS-related con-
cepts such as intrusions and worries relating to
home, and less strongly with broader problem
areas, whereas the new place factor has stronger
relations with health problems, including depres-
sion and anxiety. It remains to be seen whether
the former is more closely associated with separa-
tion anxiety symptoms than the latter factor, as
would be predicted following the DPM-HS.
2. The postulation of a regulatory, adaptive HS cop-
ing process. Although coping scales have been
developed by Thurber (e.g., Thurber & Weisz,
1997a, 1997b) for children and van Tilburg (van
Tilburg, Vingerhoets, & van Heck, 1997) for adults,
relatively little research on HS coping processes
has so far been conducted, leaving questions
about the efficacy of such regulatory strategies in
dealing with HS open. On a descriptive level, chil-
dren at summer camp report a mixture of coping
strategies (Thurber & Wiesz, 1997b). Among the
five most frequent coping strategies that youth
thought were most effective, three referred to reg-
ulatory strategies, like “thinking positively to feel
better” and “simply changing feelings to feel bet-
ter” and “reframing time.” The other most frequent
and best appreciated items were on adjusting to
the new place (“playing fun activities”) and cop-
ing with missing home (“renewing a connection
with home, e.g., by writing a letter”). Even though
the children reported that these strategies worked
best for them, it remains to be investigated whether
interventions based on these strategies would be
effective in reducing HS. We will return to that
later. Some further leads on the regulatory pro-
cesses come from looking at dysfunction, at dis-
turbance of oscillation, where there is “fixation”
on home, characterized by persistent, repetitive
thought or rumination. Ruminative activity has
been identified as a distinguishing aspect of HS
(Bell & Bromnick, 1998); rumination about home
has been found to be integral to HS (Fisher, 1989).
Although this is hardly evidence for the impor-
tance of oscillation, it suggests a direction for
research, discussed later: to examine processes
underlying ruminative ways of coping with HS.
3. Identification of separate home and new place
complications. Complications of home-related
stressors may include separation anxiety disorder
(SAD), whereas complications related to new
place stressors may be maladjustment disorders,
as is highlighted in Figure 1. Support for the HS–
separation anxiety (SA) link has come from
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Is Homesickness a Mini-Grief? 9
conceptual, diagnostic and empirical sources. SA
and HS share central features (while incorporating
distinct ones too), with HS mentioned as a possi-
ble manifestation of SAD in DSM-5 (APA, 2013,
p.192). Missing people and home has been pos-
tulated as central in SAD (cf. Baier & Welch, 1992).
An essential feature of SAD listed in DSM-5 is
“excessive fear or anxiety concerning separation
from home or attachment figures.” Some of the
diagnostic criteria are related to or overlapping
with HS, such as “reluctant or refuse to attend
camp, to sleep at friends’ homes, or to go on
errands.”3 In DSM-5, SAD is also described with a
possible manifestation of becoming homesick and
feeling uncomfortable “to the point of misery
when away from home” (APA, 2013, p. 192).4
There is some empirical support for the connec-
tion between HS in terms of missing home and
people—not new place stressors—and SA, exam-
ined in most detail by Flett etal. (2009). In this
study, SA and HS were both measured among stu-
dents living away from home. Trait SA and HS
were found to be associated (with state anxiety
identified as a mediator between them). However,
the correlation between SA and HS was quite
modest (r = .22), suggesting considerable inde-
pendence of these two phenomena. Nevertheless,
items in a self-report scale developed for measur-
ing SA (the Adult Separation Anxiety Questionnaire;
Manicavasagar, Silove, Wagner, & Drobny, 2003)
also demonstrate conceptual overlap with HS—
missing home and people. Further consideration
of the precise nature of the relationship between
HS and SA, for example, in terms of such concep-
tual overlap/distinction, and relative severity, is
called for (see also Flett etal., 2009).
Turning to potential complications associated
with the new place, syndromes have been identi-
fied that would seem also (if not predominantly)
to do with the new place. “Adjustment problems”
are postulated in this domain in Figure 1.
Adjustment disorders are described in the DSM-5:
“the development of emotional or behavioral
symptoms in response to an identifiable stressor”
(APA, 2013, p. 286). In line with our suggestion to
separate home and new place factors, studies on
adjustment disorder stress the importance of dif-
ferentiating between intrusions and avoidance of
reminders of the stressor, and difficulty adapting
to the new situation (e.g., Maercker etal., 2008).
Other syndromes have been linked conceptu-
ally with new place adaptation. School phobia,
relocation, and translocation effects figure promi-
nently—and explicitly—among these (cf. Baier &
Welch, 1992). School phobia has been described
as an emotionally paralyzing, depression- rather
than SA-related, resistance to attending school.
Relocation effects can encompass HS but are a
more pervasive emotional experience following a
move from home, sometimes leading to isolation,
anxiety, anger, and depression. Translocation
effects relate to forced—sometimes involuntary—
relocation, for example, of vulnerable patients.
Responses include deterioration in psychological
and physical functioning.
4. Potential “spiraling” of HS difficulties due to home
and new place stressors. To our knowledge, evi-
dence for an incremental relationship between
home and new place complications does not yet
exist. What has been well established is that HS is
associated with other syndromes and disorders in
complex ways. It can exacerbate preexisting mood
and anxiety disorders, and precipitate new mental
and physical health disorders (Thurber & Walton,
2012). In line with the previous point (3), the
occurrence of different types of complications
associated with home on one hand, and new
place stressors on the other hand, also supports
the proposition that there may be not only devel-
opment but also escalation of comorbid symptom-
atology across the two domains.
Prevention and Treatment Implications
Taken together, the evidence presented earlier remains
preliminary, even as it provides some rationale to con-
tinue following a DPM-HS approach. The lines of argu-
ment have implications for planning prevention and
treatment, and such interventions could also be designed
to test parameters of the model (we return to this later).
The DPM-HS advocates balanced attention to both home
and new place stressors. In the context of prevention of
HS, both factors are implicit in some guidelines already
developed by researchers. For instance, Thurber’s
Multimodal Homesickness Prevention Package (see
Thurber, 2005) was successful in decreasing HS in youth
going to summer camp, by preparing them with various
interventions aimed at both adjustment to the new place
and missing home. The necessity for oscillation, for emo-
tional and cognitive regulation, has been less explicit. In
the context of treatment, investigators have emphasized
new place factors. For example, Fisher (1989) focused on
adjustment to the new and the development of skills and
management strategies for coping with relocation (con-
sidering HS as rather symptomatic of maladjustment to
the new environment). Nejad, Pak, and Zarghar (2013)
developed a social skills training to decrease HS in female
students, and reported beneficiary effects. Rather in line
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10 Stroebe et al.
with the latter approach, some have advocated a focus
on distractive and physical activities, in accordance with
the idea that HS is experienced more during passive
mental tasks than active physical ones (e.g., Fisher, 1989).
To date, many summer camps or (international) student
exchange programs stress the importance of distraction
and getting involved in the new situation as major strate-
gies for coping with HS. Examination of summer camp
and student exchange program websites, for example,
shows that contact with home is often very restricted and
may be viewed as a source of HS rather than an oppor-
tunity to cope with HS. Yet following the DPM-HS per-
spective, attention to home factors as well as to emotion
regulation strategies would be integral to adjustment too.
The latter approach is represented in the following
statement by van Tilburg (personal communication, 2012):
Distraction is much more preferred over contact
with or thinking about home. A place for thoughts
about home should be reserved for times when we
feel good. In times when we feel bad, we need the
safety of home the most and thus relinquish to our
feelings, but it serves us best to become oriented on
the new environment: “What is fun here?” “How
can I beat loneliness, sadness, boredom in my new
environment?” This increases self-efficacy, social
support (in the new environment), and adjustment.
It is evident that although thoughts of home are consid-
ered conducive to adaptation, excessive rumination
would not be. It may also be important to stress the
necessity of accepting feelings of HS at times. It may not
be conducive to adaptation to focus only on the new
place factors, which may hamper the emotion regulation
process too.
Even if HS is regarded as fundamentally a missing home
phenomenon, in designing prevention or treatment pro-
grams, it is consistent with the DPM-HS to address stressful
features of the new place, for those persons and in situa-
tions where these are pertinent. These difficulties can
interact and can be correlated with HS or consequences of
it. Thurber’s (2005) approach is compatible with our dual
approach, in that attention to the two dimensions is clearly
identifiable and integrated in his training program. Building
in the oscillation principle would bring this approach even
further in line with the DPM-HS.
Figure 2 illustrates components of intervention follow-
ing the DPM-HS. This framework integrates the types of
prevention training principles outlined by Thurber (2005).
It incorporates not only home and new place stressor
Home-related
• Practice before going away
for longer period
• Provide specific times to
connect with (write/contact/
think about) home
• Think of things a beloved
person would say to make you
feel better
• Children: Prepare surrogate
caregivers to help with coping
(using both home and new
place strategies)
Take time off
coping
New place-related
• Be active, look for nice activities
& people, distraction
• Find someone specific to talk to
(counsellor, sympathetic other)
• Look at bright side, positively
• Facilitate competence re. new
place tasks
• Allocate (limited) time for
thinking about new place
stressors
• Making a home-away-from-home
Coping/regulatory
strategies incorporating:
• Home-oriented stressors:
–Approach (e.g., think about)
–Avoidance (stop thinking about)
• New place-oriented stressors:
–Approach (e.g., think about)
–Avoidance (stop thinking about)
Fig. 2. Dual process model: potential intervention strategies.
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Is Homesickness a Mini-Grief? 11
guidance but also a regulatory process in which individu-
als learn skills to balance between approaching home-
related feelings and temporarily avoiding the present
context, as well as approaching the current context and
avoiding the home-related feelings (it is clear that further
specification of these ideas would be necessary for devel-
opment of intervention protocols). Such an approach
allows for the fact that one size does not fit all in helping
the homesick; individual tailoring is called for. In our
view, adoption of the perspective represented in Figure 2
would assist development of more explicit interventions,
ensuring that people receive an appropriate combination
of home- and new-place-directed strategies and guidance
in regulation and control (i.e., both confronting and
avoiding). For example, regulation guidance may start
with psychoeducation about HS and associated feelings,
thoughts, and behaviors, as well as introducing coping
strategies to handle emotions, including acceptance of
negative emotions.
New lines of research suggested by the
DPM-HS
To explore possibilities for future research, we again struc-
ture according to the four main DPM-HS parameters.
1. HS as a mini-grief and distinct examination of new-
place-related reactions. This feature of the DPM-HS
requires a narrower directive for research, with HS
restricted to separation from home phenomena. Of
the empirical studies investigating HS to date,
roughly half failed to distinguish between home
and new place factors (i.e., adopting a broad con-
cept of HS and, e.g., aggregating across the home
and new place items in questionnaires), whereas
others either described home and new place fac-
tors separately or operationalized HS as a home-
only concept (Stroebe etal., in press). New place
dimensions need to be taken into account, but with
distinct investigation. Following this, narrower
scope is also called for in measurement instru-
ments. Many instruments extend to adjustment to
the new (as well as missing the old) environment
(e.g., Fisher & Hood’s, 1987, Dundee Relocation
Inventory or Archer et al.’s (1998) Homesickness
Questionnaire).5 Although some investigators
include subscale analyses, conclusions have typi-
cally been drawn on the basis of total scores. By
contrast, the DPM-HS perspective would suggest
the development of a “mini-grief” questionnaire,
possibly derived from an existing measure (one
with good psychometric qualities), selecting items
loading on the missing home/people factors. New
place adjustment could similarly—separately—be
assessed using an appropriate, non-HS scale. Then,
the range of correlates and consequences as well
as clinical conditions associated with (a) leaving
home and (b) adjusting to the new place need to
be plotted. Patterns of comorbidity (e.g., depres-
sion; anxiety disorders) associated with (a) and
(b) need establishing.
2. Emotion regulation research. Research on coping
can examine the functions of the emotion regula-
tory “oscillation” process in a finer-grained man-
ner than has so far been done. Testing the necessity
of a regulatory process for adaptation is difficult.
Applying monitoring techniques over time would
be one approach to understanding the dynamic
nature of such coping processes. An alternative
approach is to look at the impact of lack of oscil-
lation, how and why it may be related to malad-
justment. It could be argued that rumination about
home, characteristic of HS, reflects a lack of oscil-
lation. In the bereavement area, rumination has
been interpreted as an experiential (cognitive or
behavioral) avoidance process (Bonanno, Papa,
Lalande, Zhang, & Noll, 2005; Eisma etal., 2013;
Eisma etal., 2014; Shear, 2010; for a review, see
Stroebe, Boelen, et al., 2007): Rumination has
been found to increase and perpetuate symptom-
atology, because it is linked with specific avoid-
ance—rather than confrontational—processes
(Eisma etal., 2013; Eisma etal., 2014). Such avoid-
ance strategies block integration of the death in
one’s autobiographical knowledge base or accep-
tance of the stark reality of loss. Generalizing to
the HS situation, it seems plausible that rumina-
tion in HS reflects a lack of integration/acceptance
that one must leave home and loved ones behind
(and embrace the new place and persons). There
is also the possibility of a different maladaptive
avoidant process: Some homesick persons may try
hard to block thoughts of home and avoid home-
related triggers, which may not be adaptive either;
home links should also be a part of being away
(without getting trapped in rumination). So
although avoidance can be an important, normal
coping strategy with regard to separation and loss,
when overused or used in a rigid manner, it can
lead to the development of complications (cf.
Shear, 2010), rigid avoidance of home-related
thoughts and may lead to or maintain HS. However,
it may still be difficult to predict the nature of the
HS outcome. SA may be evident, but it could also
lead to depression (or loneliness) or other anxiety
disorders, including social phobia (avoidance of
others). Again, such concerns call for further
empirical investigation.
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12 Stroebe et al.
3. Complications. It has already become evident that
empirical investigation on the precise relation-
ships between adjustment disorders, home, and
new place stressors is needed. This is suggested
both by the lack of clarity in the DSM as well as
absence of empirical evidence so far. Differential
associations would support the usefulness of pos-
tulating the DPM-HS parameters. For example,
conducting further research to confirm that SA is
more closely related to home than to new place
difficulties and to document the precise relation-
ship between HS and SA phenomena would be a
useful starting point.
New directions in research in general and the
bereavement field in particular (cf. Fried et al.,
2015) suggest additional, novel possibilities. To
illustrate, depressive symptoms have been associ-
ated with homesickness and adjustment disorder
(Beck etal., 2003; van Tilburg, 2005). Perhaps the
depression of leaving home is different from the
depression of adjusting to the new place. There
may be unique symptom profiles reflecting differ-
ent associations with depression. Novel network
models offer an alternative perspective to the
common cause (of depression) framework. In
these approaches, depressive symptoms are
understood not as passive and interchangeable
indicators of a latent disease, but as distinct enti-
ties with autonomous causal power that influence
each other (Borsboom & Cramer, 2013; Cramer,
Waldorp, van der Maas, & Borsboom, 2010). In
other words, symptoms do not cluster because of
a common cause—they cluster because they influ-
ence each other across time. Depression would
not be conceptualized as a latent variable, but is
understood to be constituted by the causal asso-
ciations among symptoms. Following the DPM-HS
one would predict that different clusters of depres-
sive symptoms would emerge in relationship to
home versus new place difficulties, indicating that
there are unique interactions of symptoms (e.g.,
loneliness may fuel HS, whereas feeling that peo-
ple are unfriendly may fuel maladjustment to the
new place).
4. Spiraling difficulties. Precise associations with HS
in terms of comorbidity, the precipitation of new
conditions, or exacerbation of old ones need to be
further established. An important line for further
investigation would be to identify comorbidity,
precipitating, and exacerbating conditions in rela-
tionship to missing home separately from new
place adaptation. To test the hypothesis that home
and new place stressors lead to incremental com-
plications, longitudinal research and exact plotting
of the onset (and etiology) of complications or dis-
orders is called for. One way to study such tempo-
ral relations in a naturalistic way is by using a diary
approach as in the experience sampling method
(ESM; e.g., Walz, Nauta, & Aan Het Rot, 2014). ESM
may be particularly suitable to study HS because
HS fluctuates over time and is context-dependent.
Daily reports on HS and supposed antecedent and
consequent factors could be administered, and
time series analyses could test the supposed
temporal relations between the factors.
Along different lines but also from a research perspec-
tive, one could usefully develop a randomized controlled
clinical trial to test the effectiveness of a (partly preven-
tive) intervention for HS difficulties. For instance, this
could be based on DPM-HS principles of dealing with
home and new place factors, as well as the regulation
process, and tested against regular practice for dealing
with HS (or against an intervention working on either the
home or new place factor), and a nonintervention condi-
tion. Such a study would need to incorporate outcome
measures on the home and new place factors separately,
as well as examining differential correlates in terms of
psychopathology. Moreover, including mediators into the
model, such as reports on the various coping strategies,
could shed more light on the mechanisms of change. It is
hoped that such a design would provide a differentiated
view on the effectiveness of the intervention (and—at
least indirectly—test parameters of the DPM-HS).
Summary
We have argued the case for viewing HS as fundamen-
tally a separation from home and family phenomenon, as
reflected in our definition of HS as a “mini-grief,” and as
represented in the formulation of DPM-HS. Features of
this model distinguish it from earlier theoretical
approaches, which have implications for scientific
research and potentially, clinical practice. In particular,
the proposed model is unique in its emphasis on (a) the
differentiation between, and separate investigation of,
home and new place stressors, (b) the identification of
different types of difficulties and psychopathological out-
comes associated with each of these domains, and (c) the
need for inclusion of regulatory processes in the model.
Directions for empirical research based on these basic
theoretical parameters were suggested earlier. Our objec-
tive has been to increase understanding of the phenom-
ena and manifestations of HS, particularly in relation to
its antecedents and consequences. It is clear that the next
step is to empirically test components of the model, as
suggested earlier. Pending the results of such research, it
is hoped that the DPM-HS will, in due course, provide
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Is Homesickness a Mini-Grief? 13
theory-driven, empirically tested guidelines to improve
prevention and treatment for those who suffer from HS.
Practical implications can be derived from the model,
ones that may be beneficial for professionals who
encounter individuals with HS and their families, for
instance in hospitals, at school camps, during exchange
programs, during military missions, or in freshman years.
Ultimately, this approach should be useful for clinicians
working with children, adolescents and adults suffering
intensely from HS.
Author Contributions
M. Stroebe and H. Schut developed the theoretical perspective.
M. Stroebe, H. Schut, and M. Nauta reviewed the relevant theo-
retical and clinical literature. M. Stroebe drafted the initial ver-
sion of the article, which was revised by all authors. All authors
approved the final version of the article for submission.
Declaration of Conflicting Interests
The authors declared that they had no conflicts of interest with
respect to their authorship or the publication of this article.
Notes
1. Archer etal. (1998) also drew on the grief literature to derive
their HS scale (which included assessment of new-location
strains too).
2. Our taxonomy focuses on the dynamic, adaptive coping pro-
cess in dealing with the two types of stressors. It is clear that other
factors such as personality or social support may affect HS too.
3. Many children also experience SA in the home environment,
if the attachment figure is not present, whereas HS is relevant
only outside the familiar environment, suggesting distinctive
features between the two.
4. Although SAD is considered more serious than HS (Baier &
Welch, 1992), HS is described as one of the possible symptoms
of SAD, rather than as a qualification in terms of severity, which
would speak against HS being simply SA at a subsyndromal level.
5. It is noteworthy that HS measures for children and adoles-
cents generally focus on the home rather than new place stress-
ors (e.g., Thurber & Weisz, 1997b).
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