Predicting Psychological Adjustment of Missionary Kids
Repatriating to the United States
Kristel W. Headley, Ph.D.
Mark Rehfuss, Ph.D.
Elisabeth Suarez, Ph.D
Kathleen Arveson, Ph.D.
Regent University
1 ABSTRACT
Correlations between gender, number of countries lived in, and attendance at a high school
reentry program and depression, anxiety, stress, overall Depression Anxiety Stress Scales
(DASS-21) scores, and psychological well-being among young adult missionary kids (MKs)
repatriating to the United States to attend college were examined. Gender was identified as a
significant predictor of psychological well-being, depression, stress, and overall DASS-21
scores. No significant predictors of anxiety were identified. Neither attending a high school
transition program nor the number of countries lived in were significant predictors of any
dependent variables. Implications for parents, counselors, MKs, and mission agencies are
discussed.
2 Predicting Psychological Adjustment of Missionary Kids
Repatriating to the United States
Limited research has been conducted regarding the transition missionary kids (MKs)
experience when repatriating to the United States to attend college (Lambiri, 2005). The present
study obtained data regarding the depression, anxiety, stress, and psychological well-being of
MKs measured at the beginning of their reentry to the United States. These data were examined
for correlations to gender, attending a high school reentry program, number of countries lived in,
number of years spent in the passport country, and the number of years the participant lived at
boarding school.
Review of Related Literature
During the mid- to late 1980s, Pollock (1989) emphasized the need for increased parental
education and understanding to transform the third culture experience from a “cause of injury” to
a “positive, healthy experience” (p. 18). This experience of living between cultures does appear
to affect MKs: in one study, 35.6% had seen a psychologist, psychiatrist, or received professional
counseling, and 19.6% of the females studied had sexual contact with someone 4 or more years
older than them before the age of 18 (Priest, 2003). Potential pitfalls for MKs include identity
problems, adjustment problems, and emotional problems (Choi, 2004). These children have been
raised in a world that is foreign to the American way of life, yet they are often expected to
quickly readjust to American culture with little or no difficulty. Without an understanding of the
transition experienced by MKs returning to the United States to attend college, their potential
may remain untapped. Existing research is retrospective in nature and simply has not captured
the transition experience from an immediate, quantitative perspective.
3 One of the earliest transitions experienced by many MKs is the transition to living at a
boarding school. As homeschooling has become more accessible and popular, the number of
MKs living at boarding school has decreased (Gould, 2006). The transition to boarding school
triggers a grief reaction and ultimately, emotional detachment from the family unit:
When separation from parents is an objectively unchangeable fact, active protest as a way
of asserting control is futile. This is why MK grief involves little active protest. MK
coping is characterized instead by secondary control responses that are used to bring the
self into line with the world; MKs detach emotionally from their parents and adjust to
institutional life. (Gould, 2006, p. 161)
This pattern of emotional detachment and anticipatory grief may extend to
the reentry process as well as other transitions that mark the MK life, although this has not been
explicitly addressed in the research literature. However, being sent to boarding school does not
automatically imply that a child will struggle indeterminately throughout his or her life cycle. In
fact, boarding school may facilitate reentry adjustment to college and has also associated with
higher levels of parental attachment (Huff, 2001; also echoed in Hervey, 2009 and Bikos et al.,
2009). These findings have been echoed elsewhere: boarding school was a mediating factor for
MKs who had difficulties with their parents (Kietzman, Pike, Jones, & Lingenfelter, 2008, p.
460). Likewise, those who attended boarding school tend to form closer bonds with peers, thus
easing the transition to college (White, 1983).
Another variable identified in the literature that may affect reentry is the issue of prior
transitions. Huff (2001, p. 260) identified that MKs who experienced 10 or fewer transitions
overseas reported higher levels of grief than their counterparts who experienced 11 or more
transitions. Those with more transitions, however, reported higher levels of social adjustment
than their peers with fewer transitions.
4 Some have hypothesized that providing as much preparation as possible is beneficial for
cross-cultural sojourners (Rogers & Ward, 1993). Participants who had the opportunity to
participate in reentry programs identified that these were helpful because the program helped
ease the isolation of the MK and also helped them begin to deal with the emotional process of
reentry (Bikos et al., 2009, p. 740). Reentry seminars may have a positive effect on MK
depression, anxiety, stress, and psychological well-being levels (Davis et al., 2010). The results
of Davis et al. (2010) are consistent with the findings of Choi (2004) and Koteskey (2008),
indicating increased depression, anxiety, and stress during MK repatriation. These results also
seem to echo the broader research regarding TCK transitions (Pollock & Van Reken, 2009;
Storti, 2003).
The effects of MK repatriation do appear to differ between genders. Among
internationally mobile adolescents, females are more likely to experience difficulty during
transition because of their greater concern with interpersonal relationships and competing desires
for both mobility and stability (Gerner & Perry, 2000, p. 327. For females, “psychological crisis
occurs in disconnection” (Walters & Auton-Cuff, 2009, p. 765), indicating the severe loss of
relationship that can be experienced during transition for females. Males, on the other hand,
were more excited to see their lives and opportunities unfolding, which may have mitigated any
increased sense of grief or loss. While this issue has not been fully explored with MKs, it does
appear to warrant further attention.
The present study adds to the current body of research in a number of ways. First, many
of the studies conducted have been retrospective in nature. This study, however, allows for realtime observation of the strengths and difficulties experienced by MKs as they reenter the United
States to attend college. The current body of literature identifies that some difficulties are
5 associated with reentry. Other than the role of gender, however, there is little research
identifying what sorts of demographic factors might correlate with success or difficulty during
transition. The present study examined the correlation between various demographic factors
(participant gender, whether the participant attended a high school transition/reentry program,
the number of years the participant lived in his or her passport country, the number of countries
participants lived in, and the number of years participants lived at boarding school) on
participants’ overall Psychological General Well-Being Index (PGWBI) score, the overall
Depression Anxiety Stress Scales (DASS-21) scale, the DASS-21 depression subscale, the
DASS-21 anxiety subscale, and the DASS-21 stress subscale.
Methods and Procedures
Participants
Participants were 186 MKs ages 17 to 19 attending the MK Reentry Seminar sponsored
by the Narramore Foundation in 2009, 2010, and 2011. Parents provided permission for the
participation of any subjects under the age of 18. Any participants who had already attended
college in the United States were eliminated from the sample.
Instrumentation
Demographic information. Participants were asked to complete a demographic form,
which recorded information including birth date, current age, gender, ethnicity, mission agency,
whether their high school provided an MK transition program, number of years lived in the
passport country, number of years the participant lived in a boarding facility, future plans
(college, work, etc.), primary language spoken in the home, and countries lived in.
Depression Anxiety Stress Scales. The DASS-21 is a 21-item self-report test in the
public domain (Lovibond & Lovibond, 1995a). Normed on nonclinical populations, it assumes
6 that depression and anxiety represent extreme occurrences of normal emotional reactions
(Lovibond & Lovibond, 1995b). Chief strengths of the DASS include its combined brevity and
psychometrically sound assessment of depression, anxiety, and stress (Brown , Chorpita,
Korotitsch, & Barlow, 1997). The factor structure of the depression and anxiety scales has been
identified as nearly identical to the factor structure identified in the Beck Depression Inventory
and the Beck Anxiety Inventory (Lovibond, 1998; Lovibond & Lovibond, 1995b) and is highly
consistent between both clinical and nonclinical samples (Brown et al., 1997).
Convergent and discriminant validity for the DASS is acceptable for the depression,
anxiety, and stress scales—.91, .84, and .90, respectively (Lovibond & Lovibond, 1995a). The
reliabilities of the anxiety, depression, and stress subscales are also acceptable, with Cronbach’s
alpha of .87, .94, and .91, respectively (Antony, Bieling, Cox, Enns, & Swinxon, 1998, p. 179).
While the discriminant validity of the DASS is not ideal, this is common to self-report
inventories of depression and anxiety (Crawford & Henry, 2003).
The DASS is interpreted through the use of cutoff scores: normal (0-78), mild (78-87),
moderate (87-95), severe (95-98), and extremely severe (98-100). These norms were developed
primarily on university students (Lovibond & Lovibond, 1995a). The effects of gender and other
demographic variables do not need to be taken into consideration for the DASS (Crawford &
Henry, 2003), and the DASS has been normed on both Australian (Lovibond & Lovibond,
1995a) and United Kingdom (Crawford & Henry, 2003) samples. The DASS has also been
studied with various racial and ethnic groups and has found to be reliable and valid across
cultural groups (Imam, 2008; Norton, 2007). It is noteworthy that the DASS-21 has already
made an appearance in the missionary research literature, indicating that this tool may be
7 appropriate for use with those who have lived cross-culturally (Selby, Braunack-Mayer, et al.,
2009; Selby, Moulding, et al., 2009).
Psychological General Well-Being Index. The PGWBI was designed to capture
subjective experiences of self-reported affective well-being or distress. Six nonoverlapping
subscales are included in the self-report PGWBI: anxiety, depressed mood, positive well-being,
self-control, general health, and vitality. Each subscale has three to five items, for a total of 22
items, and each item is scored from 0 (most negative option) to 5 (most positive option). The
overall score range for the index is 0 to 110, and scores can also be identified for each of the six
subscales (Dupuy, 1984).
This index was normed on over 1,200 individuals ranging in age from 14 to 75 years,
with findings that the subscales can be used for group comparisons and that the items in the
PGWBI are also valid for an overall score. It is sensitive to changes in one’s overall
psychological well-being, with its validity confirmed in comparison to the National Health
Examination, medical history items, and 14 mental health scales, including the Lie and Validity
scales of the Minnesota Multiphasic Personality Inventory (Dupuy, 1984). This scale has been
used for a variety of applications, including the differences in well-being between various
socioeconomic groups, various health issues, and multiple other issues, both medical and
psychological (Dupuy, 1984; Helvik, Jacobsen, & Hallberg, 2006). It is not sensitive to various
pathologies but merely to one’s overall sense of well-being (Dupuy, 1984, p. 181). The test is
available in a number of languages and has been validated for use in several countries (Grossi et
al., 2006).
Discriminant validity of the PGWBI indicates that this index does discriminate
adequately between those with mental illnesses and those who do not have mental illnesses
8 (Dupuy, 1984, p. 177). The PGWBI also exhibits adequate internal consistency reliability, with
Cronbach’s alpha correlations between 0.90 and 0.94 (Dupuy, 1984). With regard to test–retest
reliability, scores that were initially low tended to rise on retest, while high initial scores tended
to drop on retest (Dupuy, 1984, p. 179). The PGWBI has been tested on individuals ages 14 to
74 in various studies of this index (Dupuy, 1984, pp. 180-181).
Procedure
Participants completed the DASS-21 and the PGWBI on the first full day of the MK
Reentry Seminar. Demographic data were gathered as well. These measures were administered
to the participants by qualified mental health professional staff of the MK Reentry Seminar.
Data were entered and reviewed for accuracy, outliers, and other statistical concerns.
Descriptive Statistics
Only 166 participants were included in statistical testing due to missing responses. Any
participants missing data on the demographic sheet specific to the independent variables were
eliminated from the sample, as were participants missing more than one response to any subscale
on the DASS-21 or the PGWBI. Any remaining missing answers on the DASS-21 or PGWBI
were calculated using the average of the responses to other questions on the same subscale. No
discernable patterns were present in questions missing responses.
Participants reported a mean age of 17.96 years, representing 64 mission agencies and
having lived in 86 countries. Participants reported that they had lived in an average of 2.92
countries. On average, participants reported having spent 3-5 years in the passport country as
measured by both the median and the mode. One hundred eight participants (66%) did not
participate in a high school transition program, notably similar to the number of participants who
denied living in a boarding home.
9 Table 1
Demographic Information
Demographic
f
Number of years spent in the
Demographic
f
Race
passport country
Caucasian
140
0-2 years
30
Asian
20
3-5 years
81
African American
3
6-9 years
24
Hispanic
1
10-12 years
15
Other
2
more than 12 years
16
Number of countries lived in
Number of years lived in a
1 country
1
boarding home
116
2 countries
69
0 years
4
3 countries
52
1 year
12
4 countries
35
2 years
8
5 countries
4
3 years
8
6 countries
4
4 years
2
7 countries
1
5 years or more
17
Table 2 identifies the descriptive statistics for each of the dependent variables, indicating
the mean and the standard deviation for all participants as well as for each gender. It is
noteworthy that, even at a glance, the scores of the MKs appear quite elevated on the overall
DASS-21 scores and subscale scores when compared with the norming group. For the overall
10 DASS-21 score, 75% of the MKs in this sample exhibited clinically elevated scores (Lovibond &
Lovibond, 1995a). This is in contrast to the PGWBI, for which 56% of respondents exhibited
positive well-being (score 73-110), 21% reported severe distress, and 22% reported moderate
distress (Chassany et al., 2004).
Table 2
Descriptive Statistics
Instrument
Males
Females
All participants
Depression subscale of DASS-21
M = 6.93
SD = 7.41
M = 5.61
SD = 6.40
M = 8.68
SD = 7.49
M = 21.22
SD = 18.97
M = 80.52
SD = 12.16
M = 11.47
SD = 8.51
M = 8.04
SD = 6.48
M = 14.94
SD = 8.52
M = 34.01
SD = 19.89
M = 67.47
SD = 16.39
M = 9.37
SD = 8.32
M = 6.92
SD = 6.54
M = 12.04
SD = 8.62
M = 28.07
SD = 20.44
M = 73.52
SD = 15.93
Anxiety subscale of DASS-21
Stress subscale of DASS-21
Total DASS-21 score
Total PGWBI score
Testing Assumptions
Independent variables were examined for collinearity; significant collinearity was
identified between years lived at boarding school and attending a high school reentry program (p
< .001), years lived at boarding school and number of countries lived in (p < .01), estimated
years in the passport country and years lived at boarding school (p < .05), and estimated years in
the passport country to total number of countries lived in (p < .01). On this basis, the variables
for estimated number of years in the passport country and years lived at boarding school were
eliminated from the study. Correlations are reported in Table 3.
11 Table 3
Intercorrelations Among and Between Descriptive Statistics for Key Study Variables
Gender
Variables
Gender
Years lived at
boarding
school
Attending a
high school
reentry
program
Number of
countries lived
in
Estimated
years in
passport
country
Pearson
Correlation
Sig. (2tailed)
N
Pearson
Correlation
1
166
.105
Years
lived at
boarding
school
.105
Attending
a high
school
reentry
program
.078
Number
of
countries
lived in
.101
Estimated
years in
passport
country
-.113
.180
.315
.197
.149
166
1
166
.423**
166
.232**
166
.023
.000
.003
.769
166
1
166
.150
166
-.037
.054
.632
166
1
166
-.231**
Sig. (2tailed)
N
Pearson
Correlation
.180
166
.078
166
.423**
Sig. (2tailed)
N
Pearson
Correlation
.315
.000
166
.101
166
.232**
166
.150
Sig. (2tailed)
N
Pearson
Correlation
.197
.003
.054
166
-.113
166
.023
166
-.037
166
-.231**
.149
.769
.632
.003
166
166
166
166
Sig. (2tailed)
N
*p < .001 (2-tailed).
12 .003
166
1
166
The data were examined for outliers. Any outlying scores on the dependent variables
were adjusted to the extreme score recommendation based on Mahalanobis’ distance and the
corresponding critical chi-square values (χ2(3) = 16., p = .001). The total DASS scores, each of
the DASS scale scores, and the PGWBI scores required transformation to correct for skew.
After transformation, only the PGWBI met the normality assumption (D(166) = .06, p = .20).
Thus, a simultaneous regression was performed on the PGWBI scores, and a logistic regression
was performed on the DASS total score, depression score, stress score, and anxiety score.
Since the DASS total score and its subscales violated the assumption of normality, the
scores of the DASS were transformed into dichotomous categorical variables following the
guidelines provided by Lovibond and Lovibond (1995a), which classify DASS-21 scores
according to their severity. However, to arrive at dichotomous variables, the scores were
transformed as normal (encompassing the normal range) and elevated (encompassing mild,
moderate, severe, and extremely severe scores). A linear regression was conducted to evaluate
collinearity among the three remaining predictors (gender, number of countries lived in, and
attending a high school reentry program), including another examination of Mahalanobis’
distance and the χ2 criteria. Since tolerance statistics for all three IVs were greater than .1,
multicollinearity was not violated.
To run the last multiple regression comparing the regression equations for each gender’s
well-being scores, the SPSS file was split according to gender and rechecked for normality and
outliers. The assumption of normality was fulfilled, but one additional outlier for the females
was identified beyond the χ2 criteria (χ2(2) = 13.82, p < .001). No additional outliers were
identified for males. Due to the earlier violations of the assumption of normality, this regression
analysis was only performed on the psychological well-being scores.
13 General Well-Being
Standard multiple regression was conducted to determine the accuracy of the independent
variables (gender, attending a high school reentry program, and number of countries lived in)
predicting psychological well-being scores. Regression results indicate that the overall model
significantly predicts psychological well-being, R2 = .17, R2adj = .15, F(3, 161) = 10.71, p < .001.
This model accounts for 16.6% of the variance in psychological well-being scores. A summary
of regression coefficients is presented in Table 4 and indicates that only gender significantly
contributed to this model.
Table 4
Coefficients for Model Variables
Variable
Gender
High school reentry program
Number of countries lived in
B
-1.19
-.07
-.08
β
-.40
-.02
-.05
t
-5.51
-.31
-.69
p
.000
.76
.49
Bivariate r Partial r
-.06
-.02
-.06
-.02
-.08
-.05
Depression
Forward logistic regression was conducted to determine which independent variables
(gender, number of countries lived in, attendance at a high school MK reentry program) are
predictors of depression (normal or elevated). Regression results indicated that the overall model
fit of one predictor (gender) was fair (-2 Log Likelihood = 211.711) and was statistically reliable
in distinguishing between normal and elevated depression, χ2(1) = 15.48, p < .001. The model
correctly classified 64.5% of the cases. Regression coefficients are presented in Table 5. Wald
statistics indicated that gender significantly predicts depression. Odds ratios for these variables
are fairly promising.
Table 5
Regression Coefficients—Depression
14 Variable
Gender
B
1.28
Wald
14.59
Df
1
p
.000
Odds ratio
3.58
Anxiety
Forward logistic regression was conducted to determine which independent variables
(gender, number of countries lived in, attendance at a high school MK reentry program) are
predictors of anxiety (normal or elevated). Regression results indicated no statistically
significant model could be identified among the predictor variables.
Stress
Forward logistic regression was conducted to determine which independent variables
(gender, number of countries lived in, attendance at a high school MK reentry program) are
predictors of stress (normal or elevated). Regression results indicated that the overall model fit
of one predictors (gender) was fair (-2 Log Likelihood = 186.75) and was statistically reliable in
distinguishing between normal and elevated depression, χ2(1) = 12.91, p < .001. The model
correctly classified 71.1% of the cases. Regression coefficients are presented in Table 6. Wald
statistics indicated that gender significantly predicts depression. Odds ratios for these variables
are fairly promising as well.
Table 6
Regression Coefficients—Stress
Variable
Gender
B
1.30
Wald
11.67
Df
1
p
.001
Odds ratio
3.68
Overall DASS-21 Scores
Forward logistic regression was conducted to determine which independent variables
(gender, number of countries lived in, attendance at a high school MK reentry program) are
predictors of overall DASS scores (normal or elevated). Regression results indicated that the
15 overall model fit of one predictors (gender) was fair (-2 Log Likelihood = 167.09) and was
statistically reliable in distinguishing between normal and elevated DASS-21 scores, χ2(1) =
20.69, p < .001. The model correctly classified 74.7% of the cases. Regression coefficients are
presented in Table 7. Wald statistics indicated that gender significantly predicts overall DASS21 scores. Odds ratios for these variables are fairly promising as well.
Table 7
Regression Coefficients—Overall DASS-21 Scores
Variable
Gender
B
1.73
Wald
17.93
Df
1
p
.000
Odds ratio
5.61
Regression Equations for Each Gender
Standard multiple regression was conducted to determine the accuracy of the independent
variables (attending a high school reentry program, and number of countries lived in) predicting
male psychological well-being scores. The previously transformed PGWBI scores were utilized.
Regression results indicate that the overall model does not significantly predict psychological
well-being, R2 = .06, R2adj = .04, F(2, 73) = 2.44, p = n.s. Standard multiple regression was also
conducted to determine the accuracy of the independent variables (attending a high school
reentry program, and number of countries lived in) predicting female psychological well-being
scores. The previously transformed PGWBI scores were utilized. Regression results indicate
that the overall model does not significantly predict psychological well-being, R2 = .01, R2adj = .008, F(2, 85) = .64, p = n.s.
Interpretation of Results
Gender was identified as a significant predictor of psychological well-being, depression,
stress, and overall DASS-21 scores among college-aged MKs repatriating to the United States. It
is notable that females have been previously identified as obtaining significantly higher scores
16 than males on the depression scale of the DASS-21 (Crawford & Henry, 2003, p. 117; Henry &
Crawford, 2005). The gender difference in both depression and well-being scores has been
observed by other researchers as well among both MKs and non-MKs (Stevenson & Wolfers,
2009; Weissman & Klerman, 1977).
However, gender was not found to predict anxiety scores in the current study,
contradicting the patterns found in the normative data regarding the DASS-21, which indicated
that gender significantly correlates to both the anxiety and depression scales (Crawford & Henry,
2003, p. 117; Henry & Crawford, 2005). Previous researchers have noted that anxiety is a
common feature of MKs experiencing reentry (Koteskey, 2008); this discrepancy may be
explained with further examination of the factor structure of stress and anxiety as defined by the
DASS-21. Test items identified in the factor structure for anxiety included primarily physical
symptoms (breathing, dry mouth, trembling, changes in heart rate), whereas items related to
stress were primarily psychological or emotional in nature (being touchy, nervous, agitated,
having difficulty winding down or relaxing; Henry & Crawford, 2005, p. 235). Perhaps prior
studies identifying anxiety during reentry were more accurately describing what the DASS-21
would classify as stress. Stress scores did differ significantly between genders, which would
seem to support the idea that MKs are reacting more emotionally or psychologically than
physiologically to their reentry. Prior research has also validated that repatriating MKs report
higher levels of stress than anxiety on the DASS-21 (Selby, Braunack-Mayer, et al., 2009),
which supports the results of the current study.
Neither attendance at a high school transition program nor the number of countries lived
in were significant predictors or psychological well-being, stress, depression, anxiety, or overall
DASS scores. Overall, the results of the current study seem to echo previous findings indicating
17 that gender is the variable most likely to predict one’s reentry experience (Brabant, Palmer, &
Gramling, 1990, p. 397).
When participants were separated by gender, neither the number of countries lived in nor
attending a high school reentry program significantly predicted female psychological well-being.
Implications for MKs, Mission Agencies, and Missionary Families
Since gender may be a significant factor in the reentry process, it may be beneficial for
reentry programs to allow males and females opportunities to develop same-gender support
during reentry. Prior to and during reentry, it is crucial for parents, counselors, mission agencies,
and other support systems to educate MKs that some symptoms of depression and stress are
normal during their repatriation, and that females may struggle more (or differently) than males.
However, MKs also need to be provided with information regarding signs and symptoms
indicating a need for professional help. Parents, school counselors, and other involved adults
need to watch carefully and have conversations with repatriating MKs to prepare them for these
symptoms, provide them with education regarding coping skills, and assure them that these
symptoms are normal among repatriating MKs.
It appears that high school reentry programs do not significantly affect participant
depression, stress, anxiety, or psychological well-being. While this does not imply that such
programs should be discontinued, it does suggest that reentry programs provided by high schools
may need to reexamine their curriculum in order to improve their outcomes. The effectiveness
of such programs might be limited simply because they are taking place outside of the United
States; it is difficult to immerse students in the realities of American culture when they are still
abroad.
18 Counselors working with MKs should be aware that the genders may present with
different level of stress, psychological well-being, and depression during reentry. Some authors
have suggested that reentry programs can significantly improve overall adjustment for
repatriating MKs (Davis et al., 2010). It is unknown what aspects of the reentry programs result
in these improved scores; however, it is possible that simply being around other MKs with
similar experiences contributes to this. As such, counselors should consider helping MKs
develop informal supports with others who have similar experiences, using resources such as the
TCK network or Mu Kappa (a MK fraternity present on some Christian college campuses).
Cross-cultural transitions constitute a significant disruption for MKs; as such, these MKs
may exhibit some psychiatric symptomatology during the transition period. Counselors working
with MKs would do well to educate themselves to the realities of MK life in order to better
understand the unique experiences of these individuals. The significance of grief and adjustment
difficulties moving from one country to another cannot be underestimated by the practicing
counselor.
Strengths of this study include the diversity and number of participants included. One
distinction of this study is that the measurements were obtained while the MKs were early in the
process of repatriation; previous studies have primarily relied on retrospective data. Likewise,
data for this study were collected over a 3-year period, permitting a more longitudinal view and a
larger sample size than if data had only been collected during 1 year. The present study
contributes significantly to existing MK literature by providing additional evidence that male and
female MKs may experience repatriation differently, whether the difference in their experience is
genetic, cultural, or conditioned. Such knowledge may contribute to more focused MK research
in the future.
19 Several limitations are notable. First, the largest mission-sending agency in the world,
the International Mission Board of the Southern Baptist Convention, only had one participant
involved in this study, which would seem to reflect that while the study is quite diverse, it may
still not fully represent the entire MK population. Also, this study only examined MKs who
were attending a reentry program: it is unknown whether MKs who did not attend reentry would
exhibit similar characteristics or responses.
Another limitation occurred related to the study design. Since the data did not fit the
assumption of normality, a logistic regression was used, which is less powerful than the multiple
regression originally planned for this study. Rather than being able to examine the full range of
participant DASS-21 scores, scores could only be compared if they were clinically elevated or
within normal range. Likewise, of the five independent variables originally identified for use in
the study, two had to be reduced due to collinearity issues. It is unknown if the independent
variables that were eliminated might have produced different results than the variables that were
used in the statistical analysis.
This study is predicated on the assumption that reentry adjustment may result in differing
levels of anxiety, stress, depression, and/or psychological well-being. However, the literature
would seem to indicate that more than any of these symptoms, reentrants simply experience
grief, a construct which was not measured in this study. In other words, this study measured
demonstrations of grief rather than measuring grief itself. Likewise, this study did not explore
sociocultural adaptation, which may be a mediating factor in MK adjustment (Klemens & Bikos,
2009). The absence of both of these constructs in the design of the study may have limited the
study’s results.
Recommendations for Future Research
20 Many questions are yet to be answered regarding MK adjustment and repatriation, some
of which have been raised by the present study. While there is evidence that the differing
adjustment processes between genders call for further exploration, additional questions exist
which should first be answered. The present study measured outcomes of grief and sociocultural
adjustment rather than measuring levels these constructs themselves. Tools to assess grief may
need to be developed or modified since present tools are not designed to measure grief related to
the loss of an entire culture and lifestyle. Likewise, this study did not assess levels of parental
support or participant adjustment patterns, both of which may influence the repatriative process
as well (Selby, Braunack-Mayer, et al., 2009).
The present study calls into question whether reentrants experience anxiety or stress, a
question whose answer depends on the definition of these constructs. However, this speaks to
the importance of using a common language between researchers or at least defining constructs
in such a way as to eliminate confusion. Similarly, it is not known whether reentrants in this
study experienced increased depression as an expression of their grief or whether this was simply
an outcome of the entire transition process. It is somewhat difficult to discern any differences
between genders using instruments that are known to identify differences between males and
females within their normative test sample. Using such instruments, it is not possible to discern
whether observed differences between genders reflect true differences or merely reflect the
differences observed by the test developers.
These findings have significance to the larger missionary community by calling for
recognition that male and female MKs may have different needs during the repatriation process
and by also reexamining the effectiveness of high school reentry programs. Future research
should continue to examine both the qualitative and quantitative experience of repatriating MKs,
21 particularly taking note of their unique experience and perhaps developing measurement scales
specific to their needs. Ultimately, such insights may provide both preventive and supportive
interventions that could improve the reentry experience for MKs, lessen the stress experienced
by missionary parents, and lengthen the tenure of missionaries on the field.
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