Early Adolescents in Social Withdrawal: Elements for the Assessment of Hikikomori Sindrome

Abstract

IntroductionClinical psychologists and psychiatrists consider the social withdrawal and the loss of interest in the human environment as potential signals of distress and mental illness. A particular form of social withdrawal is the hikikomori sindrome, identified in Japan (Saito, 1998). The hikikomori are called “family heremits” or “bedroom heremits”.Objectives and AimsThe UFSMIA Arezzo has received during last years a number of requests to take care of hikikomori adolescents. The research collects clinical data useful to the assessment.MethodsThe research analyzed a number of clinical cases focusing the interest on five early adolescents in treatment. The researchers compared the different anamnesis, the symptomatology, likeness and difference in the teenagers life style.ResultsThe work identifies some aspects in common from the five subjects of the study. These characteristics can be used as signals of the hikikomori sindrome among early adolescents in a Italian cultural context. The hikikomori’s life style is centered on the own home; he/she presents an extreme withdrawal from peer group and a refusal of school; there is not a diagnosis of other significant psychiatric disorders; it is always present a distortion of the sleep-wake cycle and a conflict with parents.ConclusionsThe phenomenon of hikikomory sindrome appears also with the beginning of adolescence. The signs of disease are in large part similar to the Japanese descriptions, although if the researchers noticed some aspects tipical of the italian cultural context.

Hikikomori: debating a XXI century phenomenon from a clinical point of view

“…On the basis of its own clinical experience, the UFSMIA of Arezzo has articulated an approach based on several interventions, fine-tuned for each case and each individual moment. No rigid protocol was defined, rather therapeutic programs are organized following a careful assessment of the degree and the typology of social withdrawal, its comorbidity with other clinical conditions, the existence of withdrawal-based psychopathological symptoms, and the personal and family resources that can be activated (49,50). The actions of different professionals (child neuropsychiatrists, psychologists, teachers, social, and community workers) must be combined and arranged according to the concept of modularity (51), which should aim each single intervention at welldefined and specific objectives within a wide-ranging clinical project.…”

Therapeutic comparison in psychological capital

“…Regarding family issues, it is described that hikikomori have the typical experiences of having mothers who impose great academic expectations on them to attain the desired goals of entering prestigious schools and pursing distinguished career paths (3,7), or emotionally neglectful parents, which results in the youth adapting by suppressing their "original identities and authentic feelings" [(4), p. 182]. Regarding school experiences, inability to fit into the education system, inability to adapt to the peer group, and bullying are events related to social withdrawal (20,21). Regarding career experiences, "negative appraisals and thinking" toward the career life and future and seeing themselves as "unable to secure a job" is a negative experience for hikikomori (6,22).…”