Investigating prolonged social withdrawal behaviour as a risk factor for self-harm and suicidal behaviours

Abstract

Background Self-harm and suicidal behaviour are recognised as public health concerns. Prolonged social withdrawal behaviour, or hikikomori, is reported as a risk factor for suicidal behaviour. Aims To examine the occurrence and additional risk of prolonged social withdrawal behaviour on self-harm and suicidal behaviour among Chinese university students. Method A cross-sectional online survey was conducted with three universities in southern China. A two-stage random sampling was adopted for recruitment, with students in different years of study, in different departments of each participating university. Hierarchical logistic regression analyses were conducted to investigate the sociodemographic and psychological correlates of self-harm and suicidal behaviours among male and female participants with hikikomori status. Results Of the students who completed the online survey, 1735 (72.23%) were included in the analysis; 11.5% (n = 200) reported self-harm behaviour and 11.8% (n = 204) reported suicidal behaviours in the past 12 months. Men showed a higher prevalence rate of self-harm than women (14.7% v. 10.8%, P = 0.048), but a similar rate of suicidal behaviours (11.9% v. 11.3%, P = 0.78). The overall prevalence rate of social withdrawal behaviour was 3.2% (7.0% for men and 2.3% for women, P < 0.001). Prolonged social withdrawal behaviour status was significantly associated with self-harm (odds ratio 2.00, 95% CI 1.22–3.29) and suicidal behaviour (odds ratio 2.35, 95% CI 1.45–3.81). However, the associations became statistically insignificant after adjustment for psychological factors in the final models in the logistic regression analyses. Conclusions Prolonged social withdrawal behaviour appears to be associated with self-harm and suicidal behaviour, but psychological factors have stronger links with suicidality.

Psychometric properties of the Purpose In Life‐Short Form in the Spanish population

“…The PIL‐SF showed acceptable internal consistency, an appropriate value for short‐form measures (Streiner et al, 2015). This result is similar to the obtained in other studies carried out with the PIL‐SF (Schulenberg et al, 2011; Xiao et al, 2021), lower than the obtained by Peter et al (2014), Schulenberg et al (2016) and Zhu et al (2021), and higher than the obtained by Pacak‐Vedel et al (2021) and Schnetzer et al (2013).…”

“…Thus, studies carried out with adolescents (Schulenberg et al, 2016), adults (Drescher et al, 2012), and spinal cord injury people (Peter et al, 2014) have only reported data related to the reliability of the scale (internal consistency) and its construct validity. Xiao et al (2021) and Zhu et al (2021) in their respective studies with students, only offered results on the internal consistency of the scale.…”

Contemporary Hermits: A Developmental Psychopathology Account of Extreme Social Withdrawal (Hikikomori) in Young People

“…The results showed that these secluded individuals displayed high levels of loneliness, had weakly developed social networks, and showed considerable levels of disability. Moreover, there is evidence indicating that individuals displaying ESW are at increased risk for committing suicide (Yong & Nomura, 2019 ; Zhu et al, 2021 ). All this suggests that at least on a group level, ESW is associated with substantial psychosocial impairment and disability.…”

Reaching hidden youth in Singapore through the Hidden Youth Intervention Program: A biopsychosocial approach integrating mental health and social work interventions

“…Youth who experience extensive social isolation are more likely to have poorer physical health ( 7 ), conflictual family relationships ( 8 ), increased risk of suicidal behaviors ( 9 ), and poorer psychological outcomes ( 10 ). Though mental illness is not the primary cause of social withdrawal ( 11 ), hidden youth are at a higher risk of presenting with co-morbid psychiatric disorders such as social anxiety and depression ( 12 ).…”