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Risk factors (constructs which increase the likelihood or intensity of homesickness) and protective factors (constructs that decrease the likelihood or intensity of homesickness) vary by population. For example, a seafarers on board, the environmental stressors associated with a hospital, a military boot camp or a foreign country may exacerbate homesickness and complicate treatment. Generally speaking, however, risk and protective factors transcend age and environment.
The risk factors for homesickness fall into five categories: experience, personality, family, attitude and environment. More is known about some of these factors in adults—especially personality factors—because more homesickness research has been performed with older populations. However, a growing body of research is elucidating the etiology of homesickness in younger populations, including children at summer camp, hospitalized children and students.
- Experience factors: Younger age; little previous experience away from home (for which age can be a proxy); little or no previous experience in the novel environment; little or no previous experience venturing out without primary caregivers.
- Attitude factors: The belief that homesickness will be strong; negative first impressions and low expectations for the new environment; perceived absence of social support; high perceived demands (e.g., on academic, vocational or sports performance); great perceived distance from home
- Personality factors: Insecure attachment relationship with primary caregivers; low perceived control over the timing and nature of the separation from home; anxious or depressed feelings in the months prior to the separation; low self-directedness; high harm avoidance; rigidity; a wishful-thinking coping style.
- Family factors: Low decision control (e.g., caregivers forcing a young child to spend time away from home against her wishes); governments forcing a person to be in a novel environment (e.g., being drafted into military service away from home or being sentenced to prison); unsupportive caregiving; caregivers who express anxiety or ambivalence about the separation (e.g., "Have a great time away. I don't know what I'll do without you.")
- Environmental factors: High cultural contrast (e.g., different language, customs, food); threats to physical and emotional safety; dramatic alternations in daily schedule; lack of information about the new place; perceived discrimination
Finally, research has provided no support for a few factors that conventional wisdom had once held to be risk factors. These include: recent separation or divorce of primary caregivers; geographic distance from home; or recent geographic move. Most likely, it is not a change in family structure, distance or dwelling that predicts homesickness, but whether these changes have left unanswered (potentially preoccupying) questions in the person's mind.
Culture shock is an experience a person may have when one moves to a cultural environment which is different from one's own; it is also the personal disorientation a person may feel when experiencing an unfamiliar way of life due to immigration or a visit to a new country, a move between social environments, or simply transition to another type of life. One of the most common causes of culture shock involves individuals in a foreign environment. Culture shock can be described as consisting of at least one of four distinct phases: honeymoon, negotiation, adjustment, and adaptation.
Common problems include: information overload, language barrier, generation gap, technology gap, skill interdependence, formulation dependency, homesickness (cultural), infinite regress (homesickness), boredom (job dependency), response ability (cultural skill set). There is no true way to entirely prevent culture shock, as individuals in any society are personally affected by cultural contrasts differently.
Culture shock is a subcategory of a more universal construct called transition shock. Transition shock is a state of loss and disorientation predicated by a change in one's familiar environment that requires adjustment. There are many symptoms of transition shock, including:
- Anger
- Boredom
- Compulsive eating/drinking/weight gain
- Desire for home and old friends
- Excessive concern over cleanliness
- Excessive sleep
- Feelings of helplessness and withdrawal
- Getting "stuck" on one thing
- Glazed stare
- Homesickness
- Hostility towards host nationals
- Impulsivity
- Irritability
- Mood swings
- Physiological stress reactions
- Stereotyping host nationals
- Suicidal or fatalistic thoughts
- Withdrawal
Paris syndrome (, , "Pari shōkōgun") is a transient mental disorder exhibited by some individuals when visiting or going on vacation to Paris, as a result of extreme shock derived from their discovery that Paris is not what they had expected it to be. The syndrome is characterized by a number of psychiatric symptoms such as acute delusional states, hallucinations, feelings of persecution (perceptions of being a victim of prejudice, aggression, or hostility from others), derealization, depersonalization, anxiety, and also psychosomatic manifestations such as dizziness, tachycardia, sweating, and others, such as vomiting. Similar syndromes include Jerusalem syndrome and Stendhal syndrome. The condition is commonly viewed as a severe form of culture shock. It is particularly noted among Japanese travelers.
Professor Hiroaki Ota, a Japanese psychiatrist working in France, is credited as the first person to diagnose the condition in 1986. However, later work by Youcef Mahmoudia, physician with the hospital Hôtel-Dieu de Paris, indicates that Paris syndrome is "a manifestation of psychopathology related to the voyage, rather than a syndrome of the traveller." He theorized that the excitement resulting from visiting Paris causes the heart to accelerate, causing giddiness and shortness of breath, which results in hallucinations in the manner similar to the Stendhal syndrome described by Italian psychiatrist Graziella Magherini in her book "La sindrome di Stendhal".
As noted by Altman, McGoey & Sommer, it is important to observe the child, "in multiple contexts, on numerous occasions, and in their everyday environments (home, daycare, preschool)". It is beneficial to view parent and child interactions and behaviors that may contribute to SAD.
Dyadic Parent-Child Interaction Coding System and recently the Dyadic Parent-Child Interaction Coding System II (DPICS II) are methods used when observing parents and children interactions.
Separation Anxiety Daily Diaries (SADD) have also been used to “assess anxious behaviors along with their antecedents and consequences and may be particularly suited to SAD given its specific focus on parent–child separation” (Silverman & Ollendick, 2005). The diaries are carefully evaluated for validity.
At the preschool-aged stage, early identification and intervention is crucial. The communication abilities of young children are taken into consideration when creating age-appropriate assessments.
A commonly used assessment tool for preschool-aged children (ages 2–5) is the Preschool Age Psychiatric Assessment (PAPA). Additional questionnaires and rating scales that are used to assess the younger population include the Achenbach Scales, the Fear Survey Schedule for Infants and Preschoolers, and The Infant–Preschool Scale for Inhibited Behaviors.
Preschool children are also interviewed. Two interviews that are sometimes conducted are Attachment Doll-Play and Emotional Knowledge. In both of the assessments the interviewer depicts a scenario where separation and reunion occur; the child is then told to point at one of the four facial expressions presented. These facial expressions show emotions such as anger or sadness. The results are then analyzed.
Behavioral observations are also utilized when assessing the younger population. Observations enable the clinician to view some of the behaviors and emotions in specific contexts.
Disordered eating can represent a change in eating patterns caused by other mental disorders (e.g. clinical depression), or by factors that are generally considered to be unrelated to mental disorders (e.g. extreme homesickness).
Certain factors among adolescents tend to be associated with disordered eating, including perceived pressure from parents and peers, nuclear family dynamic, body mass index, negative affect (mood), self-esteem, perfectionism, drug use, and participation in sports that focus on leanness. These factors are similar among boys and girls alike. However, the reported incidence rates of are consistently and significantly higher in female than male participants, with 61% of females and 28% of males reporting disordered eating behaviors in a study of over 1600 adolescents.
Disordered eating describes a variety of abnormal eating behaviors that, by themselves, do not warrant diagnosis of an eating disorder.
Disordered eating includes behaviors that are common features of eating disorders, such as:
- Chronic restrained eating.
- Compulsive eating.
- Binge eating, with associated loss of control.
- Self-induced vomiting.
Disordered eating also includes behaviors that are not characteristic of any eating disorder, such as:
- Irregular, chaotic eating patterns.
- Ignoring physical feelings of hunger and satiety (fullness).
- Use of diet pills.
- Emotional eating.
- Night eating.
- "Secretive food concocting": the consumption of embarrassing food combinations, such as mashed potatoes mixed with sandwich cookies. See also Food craving § Pregnancy and Nocturnal sleep-related eating disorder § Symptoms and behaviors.