Hikikomori and gaming disorder tendency: A case-control online survey for nonworking adults

Virtual reality as a novel therapeutic tool in psychiatry: will virtual reality intervention for families rescue hikikomori?

PURPOSE OF REVIEW

Digital technology is beginning to revolutionize psychiatry. Virtual reality (VR) allows users to experience a virtual space through their three primary senses. In psychiatry, social skills training (SST), including role-play, has been introduced in occupational therapy to improve patients' social abilities. In face-to-face SST, the therapist's leadership skills and the patient's ability to deal with situations are necessary. VR could resolve such limitations. Herein, we introduce recent advances in VR for psychiatry.

RECENT FINDINGS

The introduction of VR has improved the social skills of patients with schizophrenia, social anxiety, and autism spectrum disorder. We have introduced VR not only for psychiatric patients themselves but also for their family members to improve their skills in intervening with the patients, especially hard-to-reach patients such as hikikomori (social withdrawal). A pilot trial was conducted involving several family cases living with people with hikikomori, and this approach showed promising effectiveness.

SUMMARY

VR has the potential to overcome the problems of conventional treatments by enabling experiential learning. In the future, VR is expected to support not only patients with mental disorders but also to improve the skills of therapists and caregivers, including family members. Empirical research through industry-academia collaboration is desirable for spreading VR-based interventions in psychiatry.

On Your Own: An Explorative Study on the Psychopathological and Psychosocial Correlates of Hikikomori Symptoms in Dutch Adolescents and Young Adults

Hikikomori is an extreme form of social withdrawal that has been originally described in Japan but that is emergent in many other developed and industrialized countries. The present exploratory study was conducted in The Netherlands and aimed to examine psychopathological and psychosocial correlates of hikikomori symptoms as measured with the Hikikomori Questionnaire-25 (HQ-25) in a convenience population of 122 non-clinical adolescents and young adults and 24 clinically referred young people who were suspected to suffer from autism spectrum disorder (ASD; of which 75% eventually received this DSM-5 diagnosis). The results indicated that higher levels of hikikomori symptoms were associated with higher levels of psychopathological risk factors, higher levels of loneliness as well as a more positive attitude towards being alone, and higher levels of problematic internet use. Furthermore, it was found that hikikomori symptoms were significantly higher in clinically referred participants with suspect ASD than in non-clinical participants. It can be concluded that hikikomori symptoms were present in this sample of young Dutch participants and showed theoretically meaningful relations with other psychological constructs.

Exploring the relationship among hikikomori tendencies, autistic traits, computer game use and eating disorder symptoms

OBJECTIVE

The hikikomori phenomenon has recently gained growing global interest, and evidences of its association with other psychopathological dimensions are slowly but steadily emerging. We aimed to evaluate the presence and correlates of hikikomori tendencies in an Italian University population, focusing on its relationships with autism spectrum, pathological computer gaming, and eating disorders. In particular, to our knowledge, no study has yet systematically evaluated the latter association, using psychometric instruments tailored to assess eating disorder symptoms.

METHODS

2574 students were recruited via an online survey. All participants were assessed with the Hikikomori Questionnaire-25 (HQ-25), the Adult Autism Subthreshold Spectrum Questionnaire (AdAS Spectrum), the Eating Attitude test-26 (EAT-26), and the Assessment of Internet and Computer Game Addiction (AICA-S).

RESULTS

The results outlined how hikikomori risk was significantly correlated to autistic dimensions, altered eating behaviors, and videogame addiction. The closest relationship was detected with the autism spectrum. Interestingly, pathological computer gaming, most autistic dimensions, and EAT-26 oral control emerged as significant predictors of a greater risk for hikikomori, while the proneness to inflexibility and adherence to routine emerged as negative predictors.

CONCLUSIONS

Our findings support the association among hikikomori, autism spectrum, pathological computer game use, and eating disorder symptoms.

Shifting the paradigm of social withdrawal: a new era of coexisting pathological and non-pathological hikikomori

PURPOSE OF REVIEW

Social withdrawal syndrome, known as "hikikomori," has been highlighted since the late 1990 s in Japan. Hikikomori is more common in urban areas, and often comorbid with mental disorders, and now spreading throughout the world. In the post-COVID-19 era, not outing is no longer considered pathological in itself as the "new normal," and a novel concept of hikikomori is needed. This review summarizes the concept of hikikomori, and presents the latest methods for identification of hikikomori.

RECENT FINDINGS

The novel definition can distinguish between pathological and non-pathological hikikomori using the scale of "Hikikomori Diagnostic Evaluation (HiDE)," which has been developed in the hikikomori research lab at Kyushu University. An online survey among non-working adults has revealed that persons who have become pathological hikikomori for less than three months showed a particularly strong tendency toward gaming disorder and depression.

SUMMARY

Now, physical isolation itself is not pathological, but when dysfunction and distress are present, rapid mental health support should be provided. In the novel urban society, the establishment of a checkup system to assess whether persons who stay home are happy or suffering is important for prevention against mental disorders triggered by social isolation.