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Identifying Social Withdrawal (Hikikomori) Factors in Adolescents: Understanding the Hikikomori Spectrum.

ABSTRACT: Hikikomori is a Japanese term for social withdrawal, ranging from complete inability to venture outdoors to preferring to stay inside. The prevalence of hikikomori is high, up to 1.2% of the Japanese population, but only few studies have examined its emergence in adolescents. Therefore, we sought to identify environmental and psycho-behavioral characteristics related to hikikomori during adolescence. Parents of middle school students who underwent psychiatric outpatient treatment for hikikomori (n = 20) and control group parents (n = 88) completed the Child Behavior Checklist to evaluate their child's psycho-behavioral characteristics and novel scales to evaluate environmental characteristics and hikikomori severity. Scores for all eight Child Behavior Checklist subscales were significantly higher in the experimental group. Multiple regression analysis revealed that "anxious/depressed," "somatic complaints," "lack of communication between parents" and "overuse of the Internet" were significant predictors of hikikomori severity. These findings can help identify individuals who are at risk of developing hikikomori.

SUBMITTER: Hamasaki Y

PROVIDER: S-EPMC8405474 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Psychological Factors Associated with Social Withdrawal (Hikikomori).

Project description:ObjectiveCases of prolonged social withdrawal (hikikomori) have recently been reported in several countries. This study examined the impact of cognitive-behavioral and emotional factors on hikikomori behavior to identify intervention targets. Identifying such targets could facilitate the development of techniques to address hikikomori characteristics.MethodsTwo hundred Japanese individuals (mean age=38.73, SD=6.85) completed the Adaptive Behaviors Scale for Hikikomori and Stress Response Scale-18, along with the Japanese versions of the Self-Compassion Scale (Short Form), Acceptance and Action Questionnaire-II, and Brief Coping Orientation to Problems Experienced Inventory. Participants were divided into two groups: individuals with no experience of social withdrawal, and those with experience of social withdrawal.ResultsHierarchical multiple regression analysis showed that the use of instrumental support, behavioral disengagement stress coping skills, self-compassion, and psychological stress were associated with hikikomori behaviors. Furthermore, higher instrumental support levels, associated with a decrease in hikikomori behaviors, were found in the hikikomori group.ConclusionThe use of instrumental support, behavioral disengagement stress coping skills, self-compassion, and psychological stress should be targeted in hikikomori prevention interventions. Moreover, encouragement for the use of instrumental support is needed for improving hikikomori.

| S-EPMC8169334 | biostudies-literature

Blood metabolic signatures of hikikomori, pathological social withdrawal.

Project description:BackgroundA severe form of pathological social withdrawal, 'hikikomori,' has been acknowledged in Japan, spreading worldwide, and becoming a global health issue. The pathophysiology of hikikomori has not been clarified, and its biological traits remain unexplored.MethodsDrug-free patients with hikikomori (n = 42) and healthy controls (n = 41) were recruited. Psychological assessments for the severity of hikikomori and depression were conducted. Blood biochemical tests and plasma metabolome analysis were performed. Based on the integrated information, machine-learning models were created to discriminate cases of hikikomori from healthy controls, predict hikikomori severity, stratify the cases, and identify metabolic signatures that contribute to each model.ResultsLong-chain acylcarnitine levels were remarkably higher in patients with hikikomori; bilirubin, arginine, ornithine, and serum arginase were significantly different in male patients with hikikomori. The discriminative random forest model was highly performant, exhibiting an area under the ROC curve of 0.854 (confidential interval = 0.648-1.000). To predict hikikomori severity, a partial least squares PLS-regression model was successfully created with high linearity and practical accuracy. In addition, blood serum uric acid and plasma cholesterol esters contributed to the stratification of cases.ConclusionsThese findings reveal the blood metabolic signatures of hikikomori, which are key to elucidating the pathophysiology of hikikomori and also useful as an index for monitoring the treatment course for rehabilitation.

| S-EPMC9286746 | biostudies-literature

Blood biomarkers of Hikikomori, a severe social withdrawal syndrome.

Project description:Hikikomori, a severe form of social withdrawal syndrome, is a growing social issue in Japan and internationally. The pathophysiology of hikikomori has not yet been elucidated and an effective treatment remains to be established. Recently, we revealed that avoidant personality disorder is the most common comorbidity of hikikomori. Thus, we have postulated that avoidant personality is the personality underpinning hikikomori. First, we herein show relationships between avoidant personality traits, blood biomarkers, hikikomori-related psychological features, and behavioural characteristics assessed by a trust game in non-hikikomori volunteers. Avoidant personality traits were negatively associated with high-density lipoprotein cholesterol (HDL-C) and uric acid (UA) in men, and positively associated with fibrin degeneration products (FDP) and high sensitivity C-reactive protein (hsCRP) in women. Next, we recruited actual individuals with hikikomori, and compared avoidant personality traits, blood biomarkers, and psychological features between individuals with hikikomori and age-matched healthy controls. Individuals with hikikomori had higher avoidant personality scores in both sexes, and showed lower serum UA levels in men and lower HDL-C levels in women compared with healthy controls. This is the first report showing possible blood biomarkers for hikikomori, and opens the door to clarify the underlying biological pathophysiology of hikikomori.

| S-EPMC5811600 | biostudies-literature

Measuring the Quality of Life for Individuals With Prolonged Social Withdrawal (Hikikomori).

Project description:ObjectiveThis study aimed to develop a quality of life scale for hikikomori (QOL-H), measuring the subjective quality of life (QOL) of individuals with hikikomori, and confirming its reliability and validity.MethodsThe characteristics of the scale were examined using item response theory. Data were collected from 99 people with hikikomori, 100 people who had experienced hikikomori in the past, and 198 people who had not experienced hikikomori, to develop the scale, examine its reliability, validity, and characteristics. For convergent validity, the correlation coefficients between QOL-H and social interaction behaviors, hikikomori characteristics, depressive symptoms, subjective happiness, and difficulty in social participation were calculated.ResultsGood internal consistency, test-retest reliability, and convergent validity were confirmed for the QOL-H. Furthermore, significant differences in scores among all groups confirmed adequate criterion-related validity. Total information function indicated a high measurement accuracy when QOL was average or slightly high.ConclusionThis study suggests that QOL-H can be an appropriate measure of QOL for individuals with hikikomori.

| S-EPMC9136523 | biostudies-literature

International experience of hikikomori (prolonged social withdrawal) and its relevance to psychiatric research.

Project description:When prolonged social withdrawal was first described in Japan as 'hikikomori', many studies examining its etiology suggested it to be related to factors unique to Japan and thus a culture-bound syndrome. However, existing research has suffered from a lack of standardised definitions, impeding comparability between studies. We summarise existing research and discuss its relevance to psychiatric practice today.

| S-EPMC8274427 | biostudies-literature

The suitability of outing frequency as a definition of hikikomori (prolonged social withdrawal)

Project description:Recent research has employed outing frequency, referred to in this study as one’s frequency of going out of the home, as a condition to define and determine the severity of hikikomori (prolonged social withdrawal). However, there is little definitive evidence on this topic. Furthermore, compared to the previous definition, it is unclear how the scope of hikikomori included in the proposed condition differs. This study aimed to clarify the relationship between hikikomori tendencies and the frequency and quality of outings to bridge this gap in research. Methods Data included 397 self-rated online samples, 72 self-rated offline samples, and 784 parent-rated samples. Quantitative and qualitative indicators of outings and subjective social functioning impairment were used in the analysis. Results The cut-off points supported the criteria for the number of days outside the home proposed in previous studies. The results revealed that the outing frequency condition excluded about 14.5–20.6% of those previously considered to have hikikomori. Logistic regression analysis showed that low outings with interpersonal interaction, low frequency of outings, and high subjective social functioning impairment consistently predicted hikikomori. However, outings without interpersonal interaction did not predict hikikomori. Conclusion These results indicate that outing frequency tends to be suitable as one of the conditions for hikikomori. However, they indicate that we should also focus on the quality of outings, that is, outings with or without interpersonal interaction, to evaluate hikikomori consistently with previous findings. Further research is needed to clarify the appropriate frequency of outings to define hikikomori and determine its severity.

| S-EPMC10061135 | biostudies-literature

Identification of the hikikomori syndrome of social withdrawal: Psychosocial features and treatment preferences in four countries.

Project description:Hikikomori, a form of social withdrawal first reported in Japan, may exist globally but cross-national studies of cases of hikikomori are lacking.To identify individuals with hikikomori in multiple countries and describe features of the condition.Participants were recruited from sites in India, Japan, Korea and the United States. Hikikomori was defined as a 6-month or longer period of spending almost all time at home and avoiding social situations and social relationships, associated with significant distress/impairment. Additional measures included the University of California, Los Angeles (UCLA) Loneliness Scale, Lubben Social Network Scale (LSNS-6), Sheehan Disability Scale (SDS) and modified Cornell Treatment Preferences Index.A total of 36 participants with hikikomori were identified, with cases detected in all four countries. These individuals had high levels of loneliness (UCLA Loneliness Scale M = 55.4, SD = 10.5), limited social networks (LSNS-6 M = 9.7, SD = 5.5) and moderate functional impairment (SDS M = 16.5, SD = 7.9). Of them 28 (78%) desired treatment for their social withdrawal, with a significantly higher preference for psychotherapy over pharmacotherapy, in-person over telepsychiatry treatment and mental health specialists over primary care providers. Across countries, participants with hikikomori had similar generally treatment preferences and psychosocial features.Hikikomori exists cross-nationally and can be assessed with a standardized assessment tool. Individuals with hikikomori have substantial psychosocial impairment and disability, and some may desire treatment.

| S-EPMC5573567 | biostudies-other

The impact of higher levels of autistic traits on risk of hikikomori (pathological social withdrawal) in young adults.

Project description:BackgroundHikikomori is an extreme state of social withdrawal, originally identified in Japan but more recently recognised internationally. Many countries imposed restrictions during the COVID-19 pandemic which may have had a detrimental impact on those at risk of hikikomori, specifically young adults and those with high levels of autistic traits.AimsTo explore whether levels of autistic traits mediate the relationship between psychological wellbeing and hikikomori risk. We also looked at whether autistic traits mediated between lockdown experiences (e.g. not leaving the house) and hikikomori risk.Methods646 young people (aged 16-24) from a wide range of countries completed an online questionnaire assessing psychological wellbeing, autistic traits and experiences of lockdown for this cross-sectional study.ResultsAutistic traits mediated the relationship between both psychological wellbeing and hikikomori risk, as well as frequency of leaving the house during lockdown and hikikomori risk. Greater hikikomori risk was associated with poor psychological wellbeing, higher autistic traits and leaving the house less frequently during the COVID-19 pandemic.ConclusionsThese findings suggest similarities with Japanese hikikomori research and are consistent with suggestions that psychological wellbeing and COVID-19 restrictions are associated with increased hikikomori risk in young adults, and both associations are mediated by higher levels of autistic traits.

| S-EPMC9942989 | biostudies-literature

Can an Universal School-Based Social Emotional Learning Program Reduce Adolescents' Social Withdrawal and Social Anxiety?

Project description:There is a lack of studies analyzing if universal school-based Social and Emotional Learning programs can reduce social withdrawal and social anxiety. This study analyzed the effectiveness of one such program on those variables, and the role of individual school climate perceptions. In this nationwide study, 704 seventh to eighth-grade Portuguese students (Mage = 12.96, SD = 1.09, 48% girls), of which 215 (30.6%) in the comparison group, were assessed at pretest, post-test, and follow-up seven months later. Analyses showed positive intervention results in self- and teacher-reported social withdrawal and social anxiety. Regarding school climate, intervention group students with more positive teacher-student relationships benefitted more from program participation in social anxiety. These results support the program's effectiveness for addressing social withdrawal and social anxiety.

| S-EPMC10495480 | biostudies-literature

Use of a public film event to promote understanding and help seeking for social withdrawal.

Project description:This study aimed to implement a public film event about mental health aspects of social withdrawal. Secondary aims were to assess participants' knowledge, attitudes, and intended behaviors related to social withdrawal.The event, held at three U.S. sites, consisted of a film screening, question-and-answer session, and lecture. Participants completed a post-event survey.Of the 163 participants, 115 (70.6%) completed surveys. Most of the sample deemed social withdrawal a significant mental health issue. Regarding post-event intended behaviors, 90.2% reported intent to get more information, 48.0% to being vigilant for social withdrawal in others, and 19.6% to talking with a health care professional about concerns for social withdrawal in themselves or someone they knew. Asian participants were significantly more likely than non-Asians to intend to encourage help-seeking for social withdrawal (p = .001).A public film event may be a creative way to improve mental health awareness and treatment-seeking.

| S-EPMC5573568 | biostudies-other

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