The Impact of Higher Levels of Autistic Traits on Risk of Hikikomori (pathological Social Withdrawal) in Young Adults

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2023 Feb 22

PMID 36809281

Authors

Mark Brosnan

Jeff Gavin

Affiliations

Soon will be listed here.

Abstract

Background: Hikikomori is an extreme state of social withdrawal, originally identified in Japan but more recently recognised internationally. Many countries imposed restrictions during the COVID-19 pandemic which may have had a detrimental impact on those at risk of hikikomori, specifically young adults and those with high levels of autistic traits.

Aims: To explore whether levels of autistic traits mediate the relationship between psychological wellbeing and hikikomori risk. We also looked at whether autistic traits mediated between lockdown experiences (e.g. not leaving the house) and hikikomori risk.

Methods: 646 young people (aged 16-24) from a wide range of countries completed an online questionnaire assessing psychological wellbeing, autistic traits and experiences of lockdown for this cross-sectional study.

Results: Autistic traits mediated the relationship between both psychological wellbeing and hikikomori risk, as well as frequency of leaving the house during lockdown and hikikomori risk. Greater hikikomori risk was associated with poor psychological wellbeing, higher autistic traits and leaving the house less frequently during the COVID-19 pandemic.

Conclusions: These findings suggest similarities with Japanese hikikomori research and are consistent with suggestions that psychological wellbeing and COVID-19 restrictions are associated with increased hikikomori risk in young adults, and both associations are mediated by higher levels of autistic traits.

Citing Articles

Assessing Autistic Traits, Hikikomori Tendencies, Pathological Videogaming, and Eating Disorders in University Students: Are Pathological Videogaming and Eating Disorders Gender-Specific Manifestations of the Autism Spectrum?.

Carpita B, Nardi B, Giovannoni F, Parri F, Cerofolini G, Bonelli C Brain Sci. 2024; 14(7).

PMID: 39061460 PMC: 11274810. DOI: 10.3390/brainsci14070720.

Case report: hikikomori syndrome in Italy and its link with autistic traits and internet gaming disorder.

Carpita B, Bonelli C, Giovannoni F, Parri F, Gambini M, Nardi B Front Psychiatry. 2024; 15:1378572.

PMID: 38863612 PMC: 11165146. DOI: 10.3389/fpsyt.2024.1378572.

Internet Gaming Disorder in Children and Adolescents with Autism Spectrum Disorder and Attention Deficit Hyperactivity Disorder.

Simonelli V, Narzisi A, Sesso G, Salvati A, Milone A, Viglione V Brain Sci. 2024; 14(2).

PMID: 38391728 PMC: 10887068. DOI: 10.3390/brainsci14020154.

Autism Spectrum, Hikikomori Syndrome and Internet Gaming Disorder: Is There a Link?.

DellOsso L, Amatori G, Muti D, Giovannoni F, Parri F, Violi M Brain Sci. 2023; 13(7).

PMID: 37509046 PMC: 10377367. DOI: 10.3390/brainsci13071116.

References

Roza T, Spritzer D, Gadelha A, Passos I . Hikikomori and the COVID-19 pandemic: not leaving behind the socially withdrawn. Braz J Psychiatry. 2020; 43(1):114-116. PMC: 7861179. DOI: 10.1590/1516-4446-2020-1145. View

McKay M, Andretta J . Evidence for the Psychometric Validity, Internal Consistency and Measurement Invariance of Warwick Edinburgh Mental Well-being Scale Scores in Scottish and Irish Adolescents. Psychiatry Res. 2017; 255:382-386. DOI: 10.1016/j.psychres.2017.06.071. View

Huang Q, Cao S, Zhou S, Punia D, Zhu X, Luo Y . How anxiety predicts interpersonal curiosity during the COVID-19 pandemic: The mediation effect of interpersonal distancing and autistic tendency. Pers Individ Dif. 2021; 180:110973. PMC: 8487302. DOI: 10.1016/j.paid.2021.110973. View

Eysenbach G . Improving the quality of Web surveys: the Checklist for Reporting Results of Internet E-Surveys (CHERRIES). J Med Internet Res. 2004; 6(3):e34. PMC: 1550605. DOI: 10.2196/jmir.6.3.e34. View

Teo A, Gaw A . Hikikomori, a Japanese culture-bound syndrome of social withdrawal?: A proposal for DSM-5. J Nerv Ment Dis. 2010; 198(6):444-9. PMC: 4912003. DOI: 10.1097/NMD.0b013e3181e086b1. View

Uchida Y, Norasakkunkit V . The NEET and Hikikomori spectrum: Assessing the risks and consequences of becoming culturally marginalized. Front Psychol. 2015; 6:1117. PMC: 4540084. DOI: 10.3389/fpsyg.2015.01117. View

Funakoshi A, Saito M, Yong R, Suzuki M . Home visiting support for people with hikikomori (social withdrawal) provided by experienced and effective workers. Int J Soc Psychiatry. 2021; 68(4):836-843. DOI: 10.1177/00207640211009266. View

Zhao X, Zhao B, Li W, Cai Y, Shi W, Li C . Autistic traits and gender modulate emotion changes before and during the COVID-19 pandemic. Curr Psychol. 2021; 41(11):8181-8191. PMC: 8346342. DOI: 10.1007/s12144-021-02170-z. View

Gray N, OConnor C, Knowles J, Pink J, Simkiss N, Williams S . The Influence of the COVID-19 Pandemic on Mental Well-Being and Psychological Distress: Impact Upon a Single Country. Front Psychiatry. 2020; 11:594115. PMC: 7686842. DOI: 10.3389/fpsyt.2020.594115. View

10.

Kato T, Teo A, Tateno M, Watabe M, Kubo H, Kanba S . Can Pokémon GO rescue shut-ins (hikikomori) from their isolated world?. Psychiatry Clin Neurosci. 2016; 71(1):75-76. DOI: 10.1111/pcn.12481. View

11.

Quittkat H, Dusing R, Holtmann F, Buhlmann U, Svaldi J, Vocks S . Perceived Impact of Covid-19 Across Different Mental Disorders: A Study on Disorder-Specific Symptoms, Psychosocial Stress and Behavior. Front Psychol. 2020; 11:586246. PMC: 7705217. DOI: 10.3389/fpsyg.2020.586246. View

12.

Booth T, Murray A, McKenzie K, Kuenssberg R, ODonnell M, Burnett H . Brief report: an evaluation of the AQ-10 as a brief screening instrument for ASD in adults. J Autism Dev Disord. 2013; 43(12):2997-3000. DOI: 10.1007/s10803-013-1844-5. View

13.

Katsuki R, Tateno M, Kubo H, Kurahara K, Hayakawa K, Kuwano N . Autism spectrum conditions in hikikomori: A pilot case-control study. Psychiatry Clin Neurosci. 2020; 74(12):652-658. PMC: 7756345. DOI: 10.1111/pcn.13154. View

14.

Brosnan M . An Exploratory Study of a Dimensional Assessment of the Diagnostic Criteria for Autism. J Autism Dev Disord. 2020; 50(11):4158-4164. PMC: 7557478. DOI: 10.1007/s10803-020-04474-8. View

15.

Ruzich E, Allison C, Smith P, Watson P, Auyeung B, Ring H . Measuring autistic traits in the general population: a systematic review of the Autism-Spectrum Quotient (AQ) in a nonclinical population sample of 6,900 typical adult males and females. Mol Autism. 2015; 6:2. PMC: 4396128. DOI: 10.1186/2040-2392-6-2. View

16.

Kato T, Kanba S, Teo A . Hikikomori : Multidimensional understanding, assessment, and future international perspectives. Psychiatry Clin Neurosci. 2019; 73(8):427-440. DOI: 10.1111/pcn.12895. View

17.

Concerto C, Rodolico A, Avanzato C, Fusar-Poli L, Signorelli M, Battaglia F . Autistic Traits and Attention-Deficit Hyperactivity Disorder Symptoms Predict the Severity of Internet Gaming Disorder in an Italian Adult Population. Brain Sci. 2021; 11(6). PMC: 8230698. DOI: 10.3390/brainsci11060774. View

18.

Mboera L, Akipede G, Banerjee A, Cuevas L, Czypionka T, Khan M . Mitigating lockdown challenges in response to COVID-19 in Sub-Saharan Africa. Int J Infect Dis. 2020; 96:308-310. PMC: 7211664. DOI: 10.1016/j.ijid.2020.05.018. View

19.

Kwong A, Pearson R, Adams M, Northstone K, Tilling K, Smith D . Mental health before and during the COVID-19 pandemic in two longitudinal UK population cohorts. Br J Psychiatry. 2020; 218(6):334-343. PMC: 7844173. DOI: 10.1192/bjp.2020.242. View

20.

Teo A, Fetters M, Stufflebam K, Tateno M, Balhara Y, Choi T . Identification of the hikikomori syndrome of social withdrawal: Psychosocial features and treatment preferences in four countries. Int J Soc Psychiatry. 2014; 61(1):64-72. PMC: 5573567. DOI: 10.1177/0020764014535758. View