Extreme Social Withdrawal in Early Adolescence: Epidemiological Data On Italian Hikikomori

Abstract

IntroductionThe Japanese Saito coined the term “hikikomori” to define an extreme form of social withdrawal, particularly present in Japan (1998). In the West there is an increasing frequency of adolescents hikikomori.Objectives and AimsThe UFSMIA Arezzo has received a number of requests to take care of adolescents bearing strong similarities to hikikomori teenagers or “on the way of the social withdrawal”. These admissions have led to an epidemiological study in order to quantify these behaviors among very young teenagers in a Italian town.MethodsThe research used a questionnaire addressed to the coordinator teachers of the middle schools of Arezzo (2694 students). The questionnaire collected information on the single student absent from school for more than 40 days asking reasons for the absence.ResultsAbsents from school for more than 40 days not for an illness were 27. The average age was 14,5 years, 59,3% males, 40,7% females. The 66,6% of the students repeated one or more times a year of school. The teachers do not know the reasons for the absences for 29,6% of students but for 51,9% they indicate psychological problems as the main reason of the absences. The 40,7% of students showed difficulty waking up, leaving home, coming to school, difficulty in relating to others and low self-esteem. These signs could bring to identify hikikomori subjects.ConclusionsThe research shows that the school is not able to recognize a student hikikomori, but it can provide valuable informations to identify a teenager with social withdrawal.

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

“…A recent preliminary study has shown blood biomarkers uric acid and high-density lipoprotein cholesterol as possibly correlated with an underlying biological pathology of hikikomori [ 57 ]. Individual psychological factors including interpersonal problems [ 14 ], coping difficulties, conflicting demands, reduced autonomy [ 58 ], low self-esteem [ 34 ], and a predisposed introverted personality [ 31 ] have been shown to play some role in hikikomori propensity. However, the extent to which these underlying vulnerabilities depend on a biological foundation requires further research.…”

“…As a result of somatization, those with early hikikomori may frequently visit pediatricians about undefined complaints, which presents an opportunity for early detection. Although early screening for hikikomori may be difficult, the symptom of "school refusal" seems to be highly indicative [34][35][36]. One must also consider others on the hikikomori spectrum, who may have no problems attending school but communicate very little with people other than the members of their own families (the "hikikomori affinity group").…”

“…Compared to studies of hikikomori in adults, fewer studies have been conducted with adolescents, although a strong relationship between hikikomori and refusal to attend school has been established [ 34 – 36 ]. Adolescence is a developmental period that has a significant influence on later socio-academic achievement and often marks the onset of psychiatric symptoms [ 37 ].…”

Validation of the Italian version of the 25‐item Hikikomori Questionnaire (HQ‐25‐I)

“…We followed the International Test Commission's ( 2016 ) guidelines for adapting tests, aiming to accomplish the following tasks: (i) evaluate any linguistic, psychological, and cultural differences in the population of interest; (ii) analyze the legitimacy of hikikomori, the construct under investigation, in the target linguistic and cultural group; and (iii) verify the suitability of the adaptation design and procedure. In particular, those were fulfilled by means of a targeted review of the literature on hikikomori in the Italian context (Crepaldi, 2019 ; Hikikomori Italia, 2017 ; Poletto, 2018 ; Ranieri et al, 2015 ; Sarchione et al, 2015 ), supported by independent psychological and clinical expertise, ultimately suggesting the adaptability of the final version of the scale to the Italian context.…”

“…In light of the recent emergence of the phenomenon in several contexts, including European countries (Chauliac et al, 2017 ; Ferrara et al, 2020 ; Malagón‐Amor et al, 2015 ), and Italy, in particular (Crepaldi, 2019 ; Hikikomori Italia, 2017 ; Poletto, 2018 ; Ranieri et al, 2015 ; Sarchione et al, 2015 ), we believe that a psychometric assessment of hikikomori in European contexts and populations will provide researchers, clinicians, mental health practitioners, and policymakers with a useful tool to timely identify those at risk and facilitate the implementation of strategic prevention and intervention in both community and clinical settings.…”