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Correia Lopes F, Pinto da Costa M, Fernandez-Lazaro CI, Lara-Abelenda FJ, Pereira-Sanchez V, Teo AR, Alvarez-Mon MA. Analysis of the hikikomori phenomenon - an international infodemiology study of Twitter data in Portuguese. BMC Public Health 2024; 24:518. [PMID: 38373925 PMCID: PMC10875796 DOI: 10.1186/s12889-023-17617-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 12/29/2023] [Indexed: 02/21/2024] Open
Abstract
BACKGROUND Hikikomori refers to the extreme isolation of individuals in their own homes, lasting at least six months. In recent years social isolation has become an important clinical, social, and public health problem, with increased awareness of hikikomori around the globe. Portuguese is one of the six most spoken languages in the world, but no studies have analysed the content regarding this phenomenon expressed in Portuguese. OBJECTIVE To explore the hikikomori phenomenon on Twitter in Portuguese, utilising a mixed-methods approach encompassing content analysis, emotional analysis, and correlation analysis. METHODS A mixed methods analysis of all publicly available tweets in the Portuguese language using a specific keyword (hikikomori) between 1st January 2008 and 19th October 2022. The content analysis involved categorising tweets based on tone, content, and user types, while correlation analysis was used to investigate user engagement and geographical distribution. Statistical analysis and artificial intelligence were employed to classify and interpret the tweet data. RESULTS Among the total of 13,915 tweets generated, in terms of tone 10,731 were classified as "negative", and 3184 as "positive". Regarding content, "curiosities" was the most posted, as well as the most retweeted and liked topic. Worldwide, most of the hikikomori related tweets in Portuguese were posted in Europe, while "individuals with hikikomori" were the users most active posting. Regarding emotion analysis, the majority of tweets were "neutral". CONCLUSIONS These findings show the global prevalence of the discourse on hikikomori phenomenon among Portuguese speakers. It also indicates an increase in the number of tweets on this topic in certain continents over the years. These findings can contribute to developing specific interventions, support networks, and awareness-raising campaigns for affected individuals.
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Affiliation(s)
| | - Mariana Pinto da Costa
- Institute of Biomedical Sciences Abel Salazar, University of Porto, Porto, Portugal.
- Institute of Psychiatry Psychology & Neuroscience, King´s College London, London, UK.
| | - Cesar I Fernandez-Lazaro
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Francisco J Lara-Abelenda
- Department of Signal Theory and Communications and Telematic Systems and Computing, School of Telecommunications Engineering, Rey Juan Carlos University, 28942, Madrid, Spain
| | | | - Alan R Teo
- Health Services Research & Development Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, OR, USA
- Department of Psychiatry, Oregon Health & Science University, Portland, OR, USA
| | - Miguel Angel Alvarez-Mon
- Department of Medicine and Medical Specialties, Faculty of Medicine and Health Sciences, University of Alcala, Alcala de Henares, Spain
- Department of Psychiatry and Mental Health, University Hospital Infanta Leonor, Madrid, Spain
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), Madrid, Spain
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Khiatani S, Liu D, Yeo BSS, Wong JCM. Reaching hidden youth in Singapore through the Hidden Youth Intervention Program: A biopsychosocial approach integrating mental health and social work interventions. Front Psychiatry 2023; 14:1133659. [PMID: 37009115 PMCID: PMC10061831 DOI: 10.3389/fpsyt.2023.1133659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 02/20/2023] [Indexed: 03/18/2023] Open
Abstract
Hidden youth are youth who withdraw from society for at least 6 months, physically isolating within their homes or rooms. There has been a steady rise in this phenomenon across many developed countries, and this trend is expected to continue. As hidden youths often present with complex psychopathology and psychosocial issues, multi-factorial intervention approaches are recommended. To reach this isolated population and address gaps in services, a community mental health service and a youth social work team collaborated to develop the first specialized intervention for hidden youth in Singapore. This pilot intervention combines components from Hikikomori treatment models from Japan and Hong Kong, and a treatment program for isolated individuals diagnosed with Internet Gaming Disorder. This paper describes the development of the pilot intervention model- a four-stage biopsychosocial intervention targeting the complex needs of hidden youth and their families- and illustrates its implementation and challenges faced through a case study. Based on 2 years of service delivery to 25 youths, good practices such as utilizing novel outreach strategies and the importance of involving and caring for caregivers are also highlighted. Preliminary outcomes of this ongoing pilot intervention indicate reductions in social withdrawal behavior and increased engagement in school or work, especially for youth at the final stage of intervention. Strengths of the program include its multi-disciplinary and flexible nature, and the whole-family approach. Limitations of this program included a lack of information on Singaporean hidden youth and the lack of quantitative outcome data of this pilot program. In future, we aim to further enhance program elements through collaboration with international and local partners, and to develop an evaluative framework to determine program effectiveness.
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Affiliation(s)
- Sonia Khiatani
- Department of Psychological Medicine, National University Hospital, Singapore, Singapore
- *Correspondence: Sonia Khiatani
| | - Denise Liu
- Strategic Planning and Research Department, Fei Yue Community Services, Singapore, Singapore
| | | | - John Chee Meng Wong
- Department of Psychological Medicine, National University Hospital, Singapore, Singapore
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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Vilardell-Dávila A, Martínez-Andrade G, Klünder-Klünder M, Miranda-Lora AL, Mendoza E, Flores-Huerta S, Vargas-González JE, Duque X, Vilchis-Gil J. A Multi-Component Educational Intervention for Addressing Levels of Physical Activity and Sedentary Behaviors of Schoolchildren. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3003. [PMID: 36833697 PMCID: PMC9966386 DOI: 10.3390/ijerph20043003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 01/16/2023] [Accepted: 02/03/2023] [Indexed: 06/18/2023]
Abstract
Physical inactivity and a sedentary lifestyle are risk factors for excess weight and obesity in childhood. It is, therefore, necessary to adopt strategies which can modify these behaviors during childhood, the age at which habits are formed. This study aimed to evaluate the impact of an educational intervention using digital media and face-to-face activities involving children, parents, and the school community on the level of physical activity and sedentary behavior among schoolchildren. This was a secondary analysis of data obtained from a community trial in which students from four primary schools in Mexico City participated. Two schools were assigned to the intervention group (IG) and two to the control group (CG). The intervention lasted 12 months and included a face-to-face component, which involved sessions and workshops for parents and children, as well as visual material for children and a distance component utilizing electronic means (web portal and text messages to mobile phones) for parents. Anthropometric measurements were taken and information was collected on moderate to vigorous physical activity performed by the children and on the time that the schoolchildren spent in front of screens at the beginning of the study and at 6 and 12 months. Information on 201 children from the IG and 167 children from the CG was included in the analysis. At 12 months, the IG showed a mean decrease of 33.4 min/d [95% CI: -53.5 to -13.3] in screen time, while the CG showed an increase of 12.5 min/d [CI 95%: -10.5 to 35.6], p = 0.003. After 12 months of follow-up, applying this educational intervention reduced the time that schoolchildren spent in front of screens. Educational intervention is a feasible and accessible strategy for promoting changes in sedentary behaviors in the school-age population.
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Affiliation(s)
- Ana Vilardell-Dávila
- Epidemiological Research Unit in Endocrinology and Nutrition, Hospital Infantil de México Federico Gómez, Ministry of Health (SSA), Mexico City 06720, Mexico
| | - Gloria Martínez-Andrade
- Mexican Academic Area of Nutrition, Institute of Health Sciences, Autonomous University of the State of Hidalgo, Pachuca 42039, Mexico
| | - Miguel Klünder-Klünder
- Deputy Director of Research, Mexico Children’s Hospital Federico Gómez, Mexico City 06720, Mexico
| | - América Liliana Miranda-Lora
- Epidemiological Research Unit in Endocrinology and Nutrition, Hospital Infantil de México Federico Gómez, Ministry of Health (SSA), Mexico City 06720, Mexico
| | - Eugenia Mendoza
- Unit of Medical Research in Infectious and Parasitic Diseases, Mexican Institute of Social Security (IMSS), Mexico City 06720, Mexico
| | - Samuel Flores-Huerta
- Epidemiological Research Unit in Endocrinology and Nutrition, Hospital Infantil de México Federico Gómez, Ministry of Health (SSA), Mexico City 06720, Mexico
| | - Jorge Eduardo Vargas-González
- Epidemiological Research Unit in Endocrinology and Nutrition, Hospital Infantil de México Federico Gómez, Ministry of Health (SSA), Mexico City 06720, Mexico
| | - Ximena Duque
- Unit of Medical Research in Infectious and Parasitic Diseases, Mexican Institute of Social Security (IMSS), Mexico City 06720, Mexico
| | - Jenny Vilchis-Gil
- Epidemiological Research Unit in Endocrinology and Nutrition, Hospital Infantil de México Federico Gómez, Ministry of Health (SSA), Mexico City 06720, Mexico
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Yokoyama K, Furuhashi T, Yamamoto Y, Rooksby M, McLeod HJ. An examination of the potential benefits of expert guided physical activity for supporting recovery from extreme social withdrawal: Two case reports focused on the treatment of Hikikomori. Front Psychiatry 2023; 14:1084384. [PMID: 37032932 PMCID: PMC10076732 DOI: 10.3389/fpsyt.2023.1084384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Accepted: 02/28/2023] [Indexed: 04/11/2023] Open
Abstract
Extreme and long-term social withdrawal, first described in Japan as Hikikomori, has now become a globally recognized mental health problem. Intervention studies severely lag behind epidemiological and phenomenological research. We present two descriptive case reports of Japanese university students with Hikikomori who participated in an early phase test of a structured intervention involving physical activities that was developed and facilitated by clinicians and physical education specialists-Human Movement Consultation (HMC). The two recipients (19- and 29-years old at the start of treatment) completed approximately 40 consultation sessions delivered over 3 years consisting of a combination of outdoor workouts (i.e., walking, running, and cycling) and interpersonal sports (e.g., table tennis, badminton, and tennis). Changes in social withdrawal behavior were independently rated from clinical health records using a structured scale (the Glasgow Hikikomori Scale; GHS). Behavioral observations and scale data for both cases indicated improvements from pre-treatment levels of social withdrawal. At the end of the intervention, both had returned to normative levels of functioning. Case A returned to university and Case B secured a new job upon the completion of HMC. To help advance our understanding of treatment options, these case descriptions analyze potential change mechanisms in order to understand how HMC can support recovery from extreme social withdrawal. One key observation is that both outdoor workouts and interpersonal sports offer a non-threatening method of enabling Hikikomori to engage in interpersonal interactions. Such connections via structured activities may allow the reinstatement of social skills in a graded manner. In addition, an initial focus on physical experiences may help promote psychological and social connectedness without triggering the social fears and challenges that underlie the Hikikomori state. The findings from these two cases offer a framework to guide further research and the development of exercise-based interventions for this hidden and often neglected group.
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Affiliation(s)
- Keiko Yokoyama
- Research Center of Health, Physical Fitness and Sports, Nagoya University, Nagoya, Japan
- *Correspondence: Keiko Yokoyama
| | - Tadaaki Furuhashi
- Department of Psychopathology and Psychotherapy, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yuji Yamamoto
- Research Center of Health, Physical Fitness and Sports, Nagoya University, Nagoya, Japan
| | - Maki Rooksby
- School of Neuroscience and Psychology, University of Glasgow, Glasgow, United Kingdom
| | - Hamish J. McLeod
- School of Health and Wellbeing, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
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Nonaka S, Takeda T, Sakai M. Who are hikikomori? Demographic and clinical features of hikikomori (prolonged social withdrawal): A systematic review. Aust N Z J Psychiatry 2022; 56:1542-1554. [PMID: 35332798 DOI: 10.1177/00048674221085917] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE This review, which was registered with PROSPERO (CRD42021237988), aimed to systematically extract common elements in the hikikomori definition or criteria applied by researchers and examine cultural differences and chronological changes in the demographic characteristics of hikikomori individuals such as age, gender and hikikomori duration. METHOD For inclusion in the review, the hikikomori criteria, age and gender of the hikikomori individuals had to be specified, and the article had to be peer-reviewed and written in Japanese or English, focusing on hikikomori individuals or their families. Case studies, reviews and qualitative studies were excluded. RESULTS The total sample size for the 52 studies included in the review was 4744. Over 80% of the studies included the elements 'not working or attending school', 'not socializing outside one's home' and 'duration of hikikomori' in their hikikomori criteria, and many studies included the element 'staying at home on most days except solitary outings'. A cross-temporal meta-analysis showed the possibility that the age of hikikomori individuals increased chronologically (β = 0.44, B = 0.50, 95% confidence interval = [0.16, 0.84]). Comparisons weighted by sample size between Japan and other countries showed the possibility that the age of hikikomori individuals was higher (d = 0.32), the percentage of males was lower (d = 0.91) and the hikikomori duration was shorter (d = 2.06) in studies conducted in countries other than Japan. However, many of the included studies had a high risk of selection bias, and this bias may have influenced the results obtained. Thus, the results of this study may represent the researcher's perception of hikikomori rather than accurately representing the actual condition of hikikomori. CONCLUSION Researchers should specifically identify similarities and differences in the clinical picture of hikikomori and compare the studies to organize the findings derived from studies focusing on hikikomori.
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Affiliation(s)
- Shunsuke Nonaka
- School of Child Psychology, Tokyo Future University, Tokyo, Japan
| | - Tomoya Takeda
- Department of Psychology, Fukuyama University, Hiroshima, Japan
| | - Motohiro Sakai
- Faculty of Education, University of Miyazaki, Miyazaki, Japan
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Nonaka S, Sakai M. Measuring the Quality of Life for Individuals With Prolonged Social Withdrawal (Hikikomori). Psychiatry Investig 2022; 19:341-347. [PMID: 35505459 PMCID: PMC9136523 DOI: 10.30773/pi.2021.0348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 02/21/2022] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE This 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. METHODS The 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. RESULTS Good 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. CONCLUSION This study suggests that QOL-H can be an appropriate measure of QOL for individuals with hikikomori.
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Affiliation(s)
- Shunsuke Nonaka
- School of Child Psychology, Tokyo Future University, Tokyo, Japan
| | - Motohiro Sakai
- Faculty of Education, University of Miyazaki, Miyazaki, Japan
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Lin PKF, Andrew, Koh AHQ, Liew K. The relationship between Hikikomori risk factors and social withdrawal tendencies among emerging adults-An exploratory study of Hikikomori in Singapore. Front Psychiatry 2022; 13:1065304. [PMID: 36620652 PMCID: PMC9812485 DOI: 10.3389/fpsyt.2022.1065304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Accepted: 12/05/2022] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION Once a localized Japanese phenomenon, Hikikomori-type social withdrawal has since been observed globally in increasing numbers. However, there is a lack of research about Hikikomori in Singapore. Consequently, local variations of Hikikomori may differ from past research in Japan. Drawing on associations found in international and Japanese Hikikomori research, we explored some variables relevant and generalizable to the Singaporean context. Specifically, we examined the relationships between (1) Hikikomori risk factors, (2) social withdrawal tendencies, (3) depression and anxiety, (4) connections with family and friends, and (5) employment status. METHODS In a cross-sectional survey study (N = 416; M age = 24.90, SD age = 4.79; females = 236, males = 177, undisclosed = 3), participants were provided a Qualtrics link and asked to complete a questionnaire comprising the NHR scale, LSNS-6, DASS-21, ERQ, and HQ-25. RESULTS We found that (a) Hikikomori risk factors positively correlated with social withdrawal tendencies and depression and anxiety but negatively correlated with support from family and friends, (b) high Hikikomori risk factors predicted high social withdrawal tendencies, (c) support from friends (one of the psychosocial factors) predicted social withdrawal tendencies together with the Hikikomori risk factors, and (d) social withdrawal tendencies moderated the relationship between Hikikomori risk factors and depression among the emerging adults in Singapore. CONCLUSION The current research findings serve as a basis for future Hikikomori research in Singapore.
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Affiliation(s)
- Patrick K F Lin
- School of Social and Health Sciences, James Cook University, Singapore, Singapore
| | - Andrew
- School of Social and Health Sciences, James Cook University, Singapore, Singapore
| | - Alethea H Q Koh
- Institute for the Future of Human Society, Kyoto University, Kyoto, Japan
| | - Kongmeng Liew
- Graduate School of Science and Technology, Nara Institute of Science and Technology, Ikoma, Japan
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Yung JYK, Wong V, Ho GWK, Molassiotis A. Understanding the experiences of hikikomori through the lens of the CHIME framework: connectedness, hope and optimism, identity, meaning in life, and empowerment; systematic review. BMC Psychol 2021; 9:104. [PMID: 34246318 PMCID: PMC8272358 DOI: 10.1186/s40359-021-00605-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 06/24/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Hikikomori is a phenomenon describing people who exhibit behaviors of self-secluding themselves at home for long durations of time and usually only having face-to-face social interactions with none other than family. Existing interventions for hikikomori are inconclusive and the majority are absent in using a theoretical framework to guide its components. Therefore, applicability of the psychosocial recovery framework of Connectedness, Hope and Optimism, Identity, Meaning in Life, and Empowerment (CHIME) towards hikikomori care was reviewed. METHOD Five databases were searched in April 2020 with the search formula from a published systematic review on hikikomori combined with search terms specific to domains of the CHIME framework. Articles included in the review were of the English language, of all publication years, peer-reviewed, quantitative or qualitative research studies and case studies, included study designs that were observational or interventional in nature, and involved populations of socially withdrawn youth. RESULTS CHIME's comprehensive structure and organized approach could guide researchers or service providers in determining areas needing assessments, measurement, and areas of focus. It is suggested that the CHIME framework is applicable after modifying a specific dimension-'meaning of mental illness experiences' into 'meaning of the hikikomori experience'. Thematic overlap occurred between the domains of connectedness, identity, and meaning. Yet, additional dimensions or domains such as trust building, non-linearity, and spatiality can be included for addressing specific limitations in this application, which would help towards catering services to help hikikomori in recovery or in increasing quality-of-life of those individuals' while entrapped in this withdrawn lifestyle. CONCLUSION CHIME framework could be applicable towards hikikomori care after applying the suggested modifications. Additionally, many knowledge gaps were found in literature during this review that warrants further investigation to improve hikikomori care.
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Affiliation(s)
- Jolene Y K Yung
- A130, School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, HKSAR, China.
| | - Victor Wong
- AAB1028, Department of Social Work, Hong Kong Baptist University, Kowloon Tong, Kowloon, HKSAR, China
| | - Grace W K Ho
- PQ426, School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, HKSAR, China
| | - Alex Molassiotis
- GH507, School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, HKSAR, China
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Nonaka S, Sakai M. A correlational study of socioeconomic factors and the prevalence of hikikomori in Japan from 2010 to 2019. Compr Psychiatry 2021; 108:152251. [PMID: 34044327 DOI: 10.1016/j.comppsych.2021.152251] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 04/23/2021] [Accepted: 04/27/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Although several surveys have suggested that socioeconomic factors function as background variables for the incidence of hikikomori (prolonged social withdrawal), no research has directly examined whether socioeconomic indicators increase the incidence of hikikomori. This study aimed to examine the relationship between socioeconomic factors and the incidence of hikikomori using data from eight cross-sectional studies conducted by our group between 2010 and 2019. METHODS We used socio-economic data from national surveys and collected the demographic data of members of a multi-branch Japanese association for family members of hikikomori patients for the period of 2010-2019. RESULTS The results of the partial correlation analysis showed that the incidence probability of hikikomori increased in tandem with unemployment rates and household income. Further, the associations were positively strong in the 2010-2015 research period; however, they were absent, weak, or medium in the 2016-2019 research period. CONCLUSIONS The findings suggest that socioeconomic factors relate to the increase in hikikomori, and that these factors should be considered when identifying the individual or cultural factors that cause hikikomori.
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Affiliation(s)
- Shunsuke Nonaka
- School of Child Psychology, Tokyo Future University, 34-12 Senju Akebono-cho, Adachi-ku, Tokyo TK 120-0023, Japan.
| | - Motohiro Sakai
- Faculty of Education, University of Miyazaki, 1-1 Gakuen Kibanadai Nishi, Miyazaki MZ 889-2192, Japan.
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Nonaka S, Sakai M. Psychological Factors Associated with Social Withdrawal (Hikikomori). Psychiatry Investig 2021; 18:463-470. [PMID: 34053211 PMCID: PMC8169334 DOI: 10.30773/pi.2021.0050] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 03/08/2021] [Indexed: 12/04/2022] Open
Abstract
OBJECTIVE Cases 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. METHODS Two 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. RESULTS Hierarchical 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. CONCLUSION The 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.
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Affiliation(s)
- Shunsuke Nonaka
- School of Child Psychology, Tokyo Future University, Tokyo, Japan
| | - Motohiro Sakai
- Faculty of Education, University of Miyazaki, Miyazaki, Japan
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Abstract
The incidence of prehypertension (blood pressure 120-139 and/or 80-89 mm Hg) in young adults worldwide ranges from ~37.5% to 77.1%. Identifying high-risk groups of prehypertension in young adults is helpful for early and effective interventions and treatments to reduce the occurrence of future hypertension and organ damage. This review summarized the epidemiological characteristics, disease intervention measures, and disease progression characteristics of prehypertension to provide a basis for the development of targeted intervention measures for young adults with prehypertension.
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Affiliation(s)
- Ma Jun
- Xiangya Nursing School, Central South University, Changsha, China. E-mail.
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Pereira-Sanchez V, Alvarez-Mon MA, Asunsolo Del Barco A, Alvarez-Mon M, Teo A. Exploring the Extent of the Hikikomori Phenomenon on Twitter: Mixed Methods Study of Western Language Tweets. J Med Internet Res 2019; 21:e14167. [PMID: 31144665 PMCID: PMC6658314 DOI: 10.2196/14167] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 04/28/2019] [Accepted: 04/29/2019] [Indexed: 01/22/2023] Open
Abstract
Background Hikikomori is a severe form of social withdrawal, originally described in Japan but recently reported in other countries. Debate exists as to what extent hikikomori is viewed as a problem outside of the Japanese context. Objective We aimed to explore perceptions about hikikomori outside Japan by analyzing Western language content from the popular social media platform, Twitter. Methods We conducted a mixed methods analysis of all publicly available tweets using the hashtag #hikikomori between February 1 and August 16, 2018, in 5 Western languages (Catalan, English, French, Italian, and Spanish). Tweets were first classified as to whether they described hikikomori as a problem or a nonproblematic phenomenon. Tweets regarding hikikomori as a problem were then subclassified in terms of the type of problem (medical, social, or anecdotal) they referred to, and we marked if they referenced scientific publications or the presence of hikikomori in countries other than Japan. We also examined measures of interest in content related to hikikomori, including retweets, likes, and associated hashtags. Results A total of 1042 tweets used #hikikomori, and 656 (62.3%) were included in the content analysis. Most of the included tweets were written in English (44.20%) and Italian (34.16%), and a majority (56.70%) discussed hikikomori as a problem. Tweets referencing scientific publications (3.96%) and hikikomori as present in countries other than Japan (13.57%) were less common. Tweets mentioning hikikomori outside Japan were statistically more likely to be retweeted (P=.01) and liked (P=.01) than those not mentioning it, whereas tweets with explicit scientific references were statistically more retweeted (P=.01) but not liked (P=.10) than those without that reference. Retweet and like figures were not statistically significantly different among other categories and subcategories. The most associated hashtags included references to Japan, mental health, and the youth. Conclusions Hikikomori is a repeated word in non-Japanese Western languages on Twitter, suggesting the presence of hikikomori in countries outside Japan. Most tweets treat hikikomori as a problem, but the ways they post about it are highly heterogeneous.
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Affiliation(s)
| | | | - Angel Asunsolo Del Barco
- Department of Surgery, Medical and Social Sciences, University of Alcala, Madrid, Spain.,Instituto Ramon y Cajal de Investigaciones Sanitarias, Madrid, Spain.,Department of Epidemiology & Biostatistics, Graduate School of Public Health and Health Policy, University of New York, New York, NY, United States
| | - Melchor Alvarez-Mon
- Instituto Ramon y Cajal de Investigaciones Sanitarias, Madrid, Spain.,Department of Medicine and Medical Specialities, University of Alcala, Madrid, Spain.,Service of Internal Medicine, Autoimmune Diseases and Rheumatology, Hospital Universitario Principe de Asturias, Madrid, Spain
| | - Alan Teo
- Department of Psychiatry, Oregon Health & Science University, Portland, OR, United States.,School of Public Health, Oregon Health & Science University and Portland State University, Portland, OR, United States.,Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Department of Veterans Affairs (VA), Portland, OR, United States
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13
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Yuen JWM, Wong VCW, Tam WWS, So KW, Chien WT. A One-Year Prospective Follow-Up Study on the Health Profile of Hikikomori Living in Hong Kong. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16040546. [PMID: 30769783 PMCID: PMC6406688 DOI: 10.3390/ijerph16040546] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Revised: 02/10/2019] [Accepted: 02/12/2019] [Indexed: 01/28/2023]
Abstract
Background: A prospective cohort study was conducted to follow-up on 104 participants on their changes of social, psychological and physical health as exposed to the hikikomori lifestyle. Methods: Participants were interviewed at baseline, 6 months and 12 months by administering a set of questionnaires and anthropometric measurements. Results: All three health domains of hikikomori were significantly improved over the follow-up period as evidenced by: (1) increased social network scores from 2.79 ± 1.80 to 3.09 ± 1.87, (2) decreased perceived stress scores from 21.18 ± 5.87 to 20.11 ± 5.79, and (3) reduced blood pressure levels from 118/75 to 115/71 and waist-to-hip ratios. Almost half of the participants have recovered from hikikomori by returning to the workforce in society; however, the health improvements were dominant in those that remained as hikikomori and were associated with the gradual swapping of exercise practices from light to moderate level strength. Conclusions: With intended exposure to social worker engagement, physical assessments of the cohort study triggered the social workers to encourage participants to do more exercises, which in turn enhanced their awareness of health modification towards a better health. Engagement of social workers could be considered as part of the intended exposure for all participants, which suggested social work intervention was effective in helping hikikomori recovery.
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Affiliation(s)
- John W M Yuen
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong.
| | - Victor C W Wong
- Department of Social Work, Hong Kong Baptist University, Kowloon Tong, Kowloon, Hong Kong.
| | - Wilson W S Tam
- Alice Lee Centre for Nursing Studies, National University of Singapore, Singapore 119077, Singapore.
| | - Ka Wing So
- Withdrawal Youth Service, Hong Kong Christian Service, Tsim Sha Tsui, Kowloon, Hong Kong.
| | - Wai Tong Chien
- Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong.
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14
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Nonaka S, Shimada H, Sakai M. Family Behavioral Repertoires and Family Interaction Influence the Adaptive Behaviors of Individuals With Hikikomori. Front Psychiatry 2019; 10:977. [PMID: 32009999 PMCID: PMC6976530 DOI: 10.3389/fpsyt.2019.00977] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2018] [Accepted: 12/09/2019] [Indexed: 11/13/2022] Open
Abstract
Background: Family support is key in the initial stages of psychological support for individuals with hikikomori. However, it remains necessary to confirm the relationship between families' cognitive behavioral factors and the severity of hikikomori to understand ways of improving hikikomori. We examined the influences of family behavioral repertoires for coping with hikikomori and family interaction on the adaptive behaviors of individuals with hikikomori. We employed a control group to examine whether the influence of these adaptive behaviors was unique to families of individuals with hikikomori. Methods: We asked 185 parents of individuals with hikikomori (hikikomori group) and 460 parents of individuals with no experience of hikikomori (control group) to complete the Family Behavioral Repertoire Scale for coping with hikikomori (FBS-H), the Family Interaction Scale for Hikikomori (FIS-H), and the Adaptive Behaviors Scale for Hikikomori (ABS-H). Using the subscales of the ABS-H as the dependent variables, we conducted hierarchical multiple regression analyses wherein family behavioral repertoire was added in Step 1, experience frequency and cognition of contingency were added in Step 2 as control values, family interaction was added in Step 3, and the interaction terms were added in Step 4. Results: The ABS-H total and subscale scores were significantly lower in the hikikomori group than in the control group. The social participation subscale showed the largest difference, while the family subscale showed the smallest. In the hikikomori group, we observed a significant adjusted R 2 for the family and value subscales (Step 1). The ΔR 2 in Step 3 was significant for the interaction and family subscales of the ABS-H. In the control group, significant adjusted R 2 values were found for all ABS-H subscales in Step 1, but the ΔR 2 in Step 3 was not significant for any subscales. Conclusion: Family-related cognitive behavioral factors, such as family behavioral repertoire and family interaction, appear to relate to improvement in hikikomori. Of course, these findings warrant further investigation because we did not examine the longitudinal, causal relations between these variables. In the future, we might also test the effect of family support interventions that target families' behavioral repertoire and family interaction.
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Affiliation(s)
- Shunsuke Nonaka
- School of Child Psychology, Tokyo Future University, Tokyo, Japan
| | | | - Motohiro Sakai
- Faculty of Education, University of Miyazaki, Miyazaki, Japan
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15
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Wong JCM, Wan MJS, Kroneman L, Kato TA, Lo TW, Wong PWC, Chan GH. Hikikomori Phenomenon in East Asia: Regional Perspectives, Challenges, and Opportunities for Social Health Agencies. Front Psychiatry 2019; 10:512. [PMID: 31396114 PMCID: PMC6663978 DOI: 10.3389/fpsyt.2019.00512] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Accepted: 06/28/2019] [Indexed: 12/27/2022] Open
Abstract
Hikikomori, which originated in Japan, refers to the condition where youths withdraw into the home and do not participate in society for an extended period of time. Recent updates on hikikomori presentation within the region were exchanged at a Hikikomori Round Table and Regional Symposium (HRTRS) discussion late 2017, leading to this perspective paper. Hikikomori presents as an overall homogeneous construct, while diversity in clinical presentation exists across East Asian countries. We examined the various presentations, risk factors, theoretical frameworks, and classification issues about hikikomori. In particular, specific risk factors have emerged to some degree across the region, while some are more locale specific. We propose that hikikomori youths have differential onset and developmental patterns, potentially resulting in heterogeneous presentation. We briefly summarized existing interventions in the East Asian region. Intervention strategies need to be tailored to different subtypes. A multicomponent approach would address complexity, multifactorial onset, and development of the condition. The HRTRS presented to participating countries the opportunity to collectively work toward a more universal definition of the hikikomori condition and explored innovative ways to shape existing service structures. Opportunities for participating countries described pertain to early detection of cases, adoption of assessment tools, and improved intervention services.
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Affiliation(s)
- John Chee Meng Wong
- Department of Psychological Medicine, National University Health Systems, Singapore, Singapore
| | - Michelle Jing Si Wan
- NUS Mind-Science Centre, Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Leoniek Kroneman
- NUS Mind-Science Centre, Department of Psychological Medicine, Yong Loo Lin School of Medicine National University of Singapore, Singapore, Singapore
| | - Takahiro A Kato
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - T Wing Lo
- Department of Applied Social Sciences, City University of Hong Kong, Kowloon, Hong Kong
| | - Paul Wai-Ching Wong
- Department of Social Work and Social Administration, Faculty of Social Sciences, The University of Hong Kong, Hong Kong, Hong Kong
| | - Gloria Hongyee Chan
- Department of Social and Behavioural Sciences, Caritas Institute of Higher Education, Kowloon, Hong Kong
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