Background: This controlled prospective study examines psychophysiological reactions in employees during their first and second year abroad to identify individual as well as work-related factors predictive of positive adjustment. Methods: Employees (n = 47) relocating from Sweden to a foreign country on a work-related assignment were followed. The subjects completed a questionnaire before relocation and after 1 and 2 years abroad. Blood samples were collected for determination of the stressor-related hormones prolactin, cortisol and testosterone. A matched non-moving reference group of employees (n = 35) responded to the questionnaire at similar time periods, and also provided blood samples. Results: During the years abroad, the expatriate employees experienced increased psychosocial stress as well as negative adjustment as reflected in circulating levels of prolactin and testosterone, worse mental well-being and worsening subjective work environment, as compared with the non-moving group. The greatest change occurred during the first year. Individual factors such as social support, internal locus of control, self-esteem and sense of coherence modified the stress response and predicted employees' ability to adjust to foreign assignments. Negative changes in the psychosocial work environment explained to a large degree the decrease in work adjustment during the first year and these findings were also reflected in physiological stress indicators. Conclusions: The study emphasises the importance for multinational organisations to look at these individual characteristics before sending employees abroad. They also need to get more involved in supporting employees to manage stressors characteristic of the first year of foreign work.
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