Sex-differences in hikikomori traits as predictors of problematic internet use in Italian university students

Assessing Autistic Traits, Hikikomori Tendencies, Pathological Videogaming, and Eating Disorders in University Students: Are Pathological Videogaming and Eating Disorders Gender-Specific Manifestations of the Autism Spectrum?

In the previous literature, specific attention has been paid to investigate autism spectrum symptoms and traits in university students. In this framework, we aimed to evaluate the presence and correlates of autistic traits, hikikomori tendencies, altered eating behaviors, and pathological videogaming in a sample of Italian university students enrolled in bachelor's degree courses. A total of 1192 students were recruited via an online survey and assessed with the Hikikomori Questionnaire-25, the Adult Autism Subthreshold Spectrum Questionnaire, the Eating Attitude test-26, and the Assessment of Internet and Computer Game Addiction. Our results highlighted significant differences in the prevalence of autistic traits, social withdrawal tendencies, altered eating habits, and pathological videogame use in university students based on gender, age, parents' level of instruction, and field of study. A significant effect of the presence of autistic traits and gender on the scores obtained with the other questionnaires was reported. Our results not only support the role of autistic traits as a vulnerability factor for the development of a set of psychopathological conditions but also suggest that gender could modulate this vulnerability, supporting the hypothesis of gender-specific phenotypes in the autism spectrum.

Predominant affective temperaments in depressive patients with severe social withdrawal

BACKGROUND

Hikikomori (HK) is characterized by self-isolation and social refusal, being more likely also associated with affective disorders, including depression. This case-control study primarily aimed at identifying (if any) predominant affective temperaments are associated with HK in depressed versus not-depressed individuals. Secondary objectives comprise assessing which other psychopathological dimensions (e.g., boredom, anxiety) are associated with the HK specifier in depressed individuals.

METHODS

From the larger SWATCH study, 687 Italian young people were screened for depression, as measured by 9 items-Patient Health Questionnaire (PHQ-9) and HK-like social withdrawal, through the Hikikomori Questionnaire-25 (HQ-25). All subjects were administered a brief-Temperament Evaluation of Memphis, Pisa, Paris and San Diego (TEMPS-M), the 7 items-Generalized Anxiety Disorder (GAD-7) and the Multidimensional State Boredom Scale (MSBS).

RESULTS

Males reported significantly higher scores at HQ-25 total score than females (p = 0.026). In the total sample, HK social withdrawal is positively predicted by MSBS low arousal, disengagement, depressive levels, depressive and irritable affective temperaments, while negatively by anxiety (F(6, 680) = 82.336, p < 0.001, R2 = 0.421). By selecting only depressed sample, HQ-25 is positively predicted by MSBS total score, low arousal and depressive affective temperament, while negatively by MSBS high arousal (F(4, 383) = 48.544, p < 0.001, R2 = 0.336). The logistic regression model found that the likelihood of developing depression with the HK specifier is significantly predicted by depressive and cyclothymic affective temperaments.

CONCLUSIONS

These preliminary findings could help in clinically characterizing the relationship between specific affective temperamental profiles among individuals with depression with/without HK specifier, in order to provide a more tailored and personalized therapeutic approach. Our Italian study should be extensively replicated in larger, longitudinal and multicentric pan-European studies, by specifically assessing the impact of these findings on depression clinical course, prognosis and treatment outcomes.

Depression and stress are associated with latent profiles of problematic social media use among college students

Background

The previous literature has demonstrated that depression, anxiety, and stress are significant predictors of problematic social media use. However, the manifestation of problematic social media use varies, and the predictive relationship between depression, anxiety, and stress with different subgroups of problematic social media use remains unclear. The aim of this research was to evaluate latent subgroups of problematic social media use among college students and to investigate the impact of depression, anxiety, and stress on these latent subgroups.

Methods

A survey was carried out among college students in China using a cross-sectional approach. A total of 955 participants were included, with a mean age of 19.50 ± 1.22 years. Participants completed questionnaires containing the Bergen Social Media Addiction Scale (BSMAS) and the Depression, Anxiety, and Stress Scale-21 (DASS-21). The study employed latent profile analysis (LPA) to investigate latent subgroups of Chinese college students with problematic social media use, and a robust three-step approach was used to develop predictive regression mixed models of depression, anxiety, and stress on latent subgroups.

Results

Problematic social media use of Chinese college students can be categorized into four latent subgroups, namely, the high-risk group, the moderate-risk with pleasure group, the moderate-risk with compulsion group, and the low-risk group. The regression model showed that there was a significant difference between the high-risk group and the low-risk group on the stress scale. There was a significant difference between the moderate-risk with pleasure group and the moderate-risk with compulsion group on the depression scale.

Conclusion

Problematic social media use is heterogeneous, with depression and stress being potentially key factors influencing problematic social media use. Depression would make college students more likely to be moderate-risk with compulsion problematic social media users than moderate-risk with pleasure problematic social media users, and stress would make college students more likely to be high-risk problematic social media users than low-risk problematic social media users.

Mediating effect of self-concealment between non-suicidal self-injury and internet addiction in college students: a cross-sectional study

BACKGROUND

Internet addiction, defined as uncontrolled behaviour resulting from the use of the Internet without the influence of addictive substances, which can seriously impair academic, occupational and social functioning. Non-suicidal self-injury, defined as self-injurious behaviour without the intent to die, and its addictive characteristics are similar to those of Internet addiction. Currently, there is a lack of research on the relationship between non-suicidal self-injury and Internet addiction. The purpose of this study was to examine the relationship between non-suicidal self-injury and internet addiction among college students and the role of self-concealment in this relationship.

METHODS

In this study, data were collected online between December 2022 and January 2023 from 600 university students in Chengdu, Sichuan Province, China, using purposive sampling. The questionnaires included the Non-Suicidal Self-Injury Inventory (NSSI), the Self-Concealment Scale (SCS) and the Internet Addiction Test (IAT).

RESULTS

A total of 573 valid questionnaires were recovered, with a valid recovery rate of 95.50%.

CONCLUTION

The results suggest that self-concealment plays a partial mediating role between non-suicidal self-injury and internet addiction among college students. The authors emphasized the importance of internet addiction. In order to reduce the occurrence of internet addiction, schools should provide targeted interventions to promote the psychological health of college students' internet addictive behaviours.

Hikikomori (Severe Social Withdrawal) in Italian Adolescents: Clinical Features and Follow-Up

Severe social withdrawal, including staying alone in one's bedroom, non-attendance at school or work, and minimal or absent social contacts, sometimes only through electronic devices, can be found in several psychiatric disorders, or in a 'primary' form, firstly defined in Japan as 'Hikikomori'. The distinction between primary and secondary forms is questionable, as it prevalently depends on the quality of psychiatric assessment. To date, few studies specifically explored Hikikomori in an adolescent population outside Japan. The aim of the present study is to describe clinical features of a consecutive group of 80 referred youth (13 to 18 years, 57 males) with social isolation, of which 40 were followed up on for 4-6 months, to characterize clinical features and outcome. All the participants presented psychiatric comorbid disorders, prevalently anxiety disorders, mood disorders, and autism spectrum disorder. Suicidality (ideation and behavior) was reported in 32.5% of the participants, and 20% of the participants attempted suicide. More than half of the participants exceeded the cut-off of the Internet Addiction Test, and 42.4% met the criteria for the Internet Gaming Disorder. At the follow-up appointment, an improvement of social withdrawal was reported in 75% of the sample; 67.5% of the participants significantly improved according to the CGI-improvement scale; and 55% of the participants had an improvement of functioning according to the C-GAS. Our findings suggest that Hikikomori is a transnosographic entity, with high rates of suicidality and Internet addiction, and that can it improve when it is timely diagnosed and treated.

Relationship Between Social Withdrawal (Hikikomori), Personality, and Coping in an Adult Population

OBJECTIVE

The aim of this study was to investigate the relationships between personality dimensions, coping strategies, and Hikikomori while controlling for the presence of depression and anxiety.

METHODS

Two groups, recruited on social networks, were compared: the control group (n=101, mean age±standard deviation [SD]= 36.2±12.8 years) and the Hikikomori group (n=28, mean age±SD=30.1±9.1 years). Participants of both groups completed the Big Five Inventory, the Brief Coping Orientation to Problems Experienced, and the Hospital Anxiety and Depression Scale.

RESULTS

The Hikikomori group had higher depression, anxiety, neuroticism, and dysfunctional coping dimension (self-blame and behavioral disengagement) scores than the control group. Being alone and depression were positively associated with Hikikomori while extraversion and instrumental support were negatively associated with Hikikomori.

CONCLUSION

These findings contribute to a better understanding of the psychological functioning of Hikikomori as well as to treatment elaboration and confirm that some psychological characteristics are transcultural.

The Mediatory Role of the Boredom and Loneliness Dimensions in the Development of Problematic Internet Use

In recent years, there has been a gradual digitalization of our society, resulting in intensified technology use for daily life activities, including the emergence of problematic Internet use (PIU). Few studies specifically addressed the boredom and loneliness dimensions in mediating the association between depression, anxiety, and stress levels and the onset of PIU. A nationwide population-based cross-sectional case-control study was carried out by recruiting a sample of Italian young people (aged 18-35). Only 1643 participants were selected for the analyses based on the age and the presence versus absence of PIU. Participants were mainly females (68.7%), with a mean age of 21.8 (SD = 1.7). Non-PIU individuals had significantly stable relationships (p = 0.012), siblings (p = 0.044) and lived with their family (p = 0.010), compared to PIU. PIU individuals displayed significantly higher depression, anxiety, and stress, as well as higher loneliness and boredom levels (all p < 0.001), compared to non-PIU. Depressive symptomatology predicted PIU and that their interaction is positively double mediated by boredom and loneliness (ß = 0.3829 (0.0245), 95%CI = 0.3349-0.4309). Our findings suggested that boredom and loneliness dimensions could act as mediators in the association between depressive symptomatology and the likelihood of PIU onset and maintenance.

Is internet gaming disorder associated with suicidal behaviors among the younger generation? Multiple logistic regressions on a large-scale purposive sampling survey

The ubiquity of Internet gaming as part of the younger generation's (11-35 year-olds) lifestyle to-day warrants a deeper understanding of its impact on their mental health. In particular, there has been scant research investigating the link between Internet Gaming Disorder (IGD) and suicidal behaviors in this demographic group, even though several mental health symptoms of the former are known risk factors for the latter. This paper aims to establish the presence or absence of association between IGD and each of suicidal ideation, self-harm, and suicide attempt among the younger generation. A large-scale online survey on Internet gamers in Hong Kong was conducted in February 2019. 3430 respondents were recruited through purposive sampling. Study samples were stratified into distinct age groups and multiple logistic regression was conducted for each measured suicidal behavior in each age group. After controlling for sociodemographics, Internet usage, self-reported bullying perpetration and bullying victimization, social withdrawal, and self-reported psychiatric diagnoses such as depression and psychosis, analyses revealed that adolescent (11-17 year-old) gamers with IGD were more likely than their peers who had no IGD to have had suicidal ideation, self-harm, and suicide attempt in their lifetime. These associations did not hold for 18-35 year-old gamers. Findings suggest that it may be prudent to recognize IGD as a growing public mental health priority for the young populace, particularly adolescents. Existing suicide prevention efforts can be complemented through screening adolescents for IGD, and could be expanded to online gaming platforms to reach more hidden at-risk individuals.

Examining the relationship between social withdrawal motivations and symptoms of hikikomori

Objective: This study aimed to examine the association between social withdrawal motivations (peer isolation, shyness, unsociability, low mood, and avoidance) and symptoms of hikikomori using both variable- and person-oriented analyses.Method: Adolescents (N = 212) participated in this cross-sectional study. Data were collected using the Social Withdrawal Motivations Scale and the Avoidance subscale of the Child Social Preference Scale-Revised, the 25-item Hikikomori Questionnaire, the Personality Inventory for the DSM-5 Brief Form, and the Interpersonal sensitivity subscale of the Brief Symptom Inventory.Results: Path analysis revealed that peer isolation, shyness, unsociability, and avoidance were associated with symptoms of hikikomori while covarying for age, sex, maladaptive personality, and interpersonal sensitivity. Cluster analysis based on social withdrawal motivations identified four subtypes of adolescents. The group with high social withdrawal motivations showed the highest level of overall personality dysfunction and interpersonal sensitivity. Additionally, the group with high social withdrawal motivations and the group with high avoidance demonstrated higher symptoms of hikikomori compared to the other two groups, after accounting for the effects of the covariates.Conclusions: The findings highlight that the evaluation of co-occurrent social withdrawal motivations may improve the ability to identify those adolescents most in need of support.