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Nagata, T., Yamada, H., Teo, A.R., Yoshimura, C., Nakajima, T. and van Vliet, I. (2013) Comorbid Social Withdrawal (Hikikomori) in Outpatients with Social Anxiety Disorder: Clinical Characteristics and Treatment Response in a Case Series. International Journal of Social Psychiatry, 59, 73-78.
http://dx.doi.org/10.1177/0020764011423184
http://isp.sagepub.com/cgi/pmidlookup?view=long&pmid=21997765

has been cited by the following article:

  • TITLE: Hikikomori, a Phenomenon of Social Withdrawal and Isolation in Young Adults Marked by an Anomic Response to Coping Difficulties: A Qualitative Study Exploring Individual Experiences from First- and Second-Person Perspectives

    AUTHORS: Roseline Kim Fong Yong, Yoshihiro Kaneko

    KEYWORDS: Hikikomori, Social Withdraw, Social Isolation, Individual Experiences, Qualitative Study, Coping Difficulties, Mental Health

    JOURNAL NAME: Open Journal of Preventive Medicine, Vol.6 No.1, January 15, 2016

    ABSTRACT: Hikikomori is a recent phenomenon among young adults in which they isolate themselves from social contacts and responsibility for more than 6 months. This problem has assumed epidemic proportions in Japan and has been widely discussed across disciplines. Previous studies have associated hikikomori with a maladaptation to structural change, an emergent mental problem that needs new diagnosis, or an under-diagnosed schizophrenic disorder. Most previous work has adopted a clinical perspective, and there have been no qualitative studies exploring the individual feelings of people suffering from the syndrome. We adopted a qualitative method using a grounded theory approach. Data collection and analysis took place between September 2006 and August 2008. Theoretical sampling included eight informants from snowball sampling and an online observation consisting of 160 online participants. Analysis focused on informants’ first- and second-person experiences of hikikomori. Data analysis revealed one overriding theme: coping difficulties consisting of the two categories stasis and expression. As a result of conflicting demands and reduced autonomy, respondents experienced stasis, which prevented them from moving forward; “hiding” or “avoiding” heightened the expression of their behaviors. This is the first study to explore the in-depth experience of individuals suffering from hikikomori syndrome in a non-clinical setting. We argue that hikikomoriis not a result of asocial behavior, but rather an anomic response to a situation that informants felt powerless to change and from which they could see no way out. We also observed that feelings of hopelessness and relationship fatigue might be overcome by introducing a relaxed social environment that people can control during rehabilitation.