Hikikomori, known as Social Withdrawal Syndrome, has a diagnostic criterion of individuals being unceasingly reclusive for at least 6 months with remarkable functional deterioration (Kato, Kanba, & Teo, 2020). Originated in Japan, it has become a pressing social phenomenon in modern society. With the psychological ailment significantly impacting Japan’s workforce and reflecting on the overall wellbeing of its people (Kato, Kanba, & Teo, 2018), it raises the question as to why Hikikomori seems to be typically associated with the Japanese culture and contemporary youths (Kato, Kanba, & Teo, 2019).
A total of eleven peer-reviewed journal articles were gathered predominantly from online searches using the NUS Library portal. Therefore, this review offers an overview of the notion of Hikikomori as a disorder shaped by Japanese society.
This paper will first analyze the factors that lead to HIkikomori in Japan. Thereafter, the paper will discuss the consequences of social withdrawal on an individual’s mental and physical well-being. Lastly, the paper will establish the intervention strategies and techniques that are presently available for this disorder.
An important factor when analyzing Hikikomori is to understand the determinants that compel an individual into a state of social withdrawal. Towards the biological aspect, males are identified to be particularly susceptible (Yong, & Nomura, 2019; Kato, Kanba, & Teo, 2019; Pozza, Coluccia, Kato, Gaetani, & Ferretti, 2019). In terms of social circumstance, poor interpersonal skills and proliferation of online communication are substantial contributors (Teo, et al.
, 2014; Hayakawa, et al. 2018; Yong, & Nomura, 2019; Kato, Kanba, & Teo, 2019) Furthermore, Japanese social customs can result in stress and coping difficulties which precipitates social withdrawal (Teo, et al., 2015; Berman, & Rizzo, 2018; Kato, Kanba, & Teo, 2019; Pozza, Coluccia, Kato, Gaetani, & Ferretti, 2019).
Berman, & Rizzo (2018) noted that Japan is delineated by conformity to societal expectations and values including traditional gender role beliefs and hierarchical social order whereby young people are pressurised to comply. While the advent of globalization pressures the Japanese labour industry to increase competitiveness, individuals are exploited, demeaned and oppressed by social norms (Norasakkunkit, & Uchida, 2014; Kato, Kanba, & Teo, 2019). Consequently, insecurity and maladaptations to hostile school and workplace environments abets the abnormal choice of unemployment termed as “Freeters” in Japan and social isolation (Norasakkunkit, & Uchida, 2014; Berman, & Rizzo, 2018; Yong, & Nomura, 2019). Norasakkunkit, & Uchida (2014) observed that social marginalization increases Hikikomori risk through applying the Culture Shock and Adaptation Model to the Willingness to Comply survey findings. Pertaining to the psychological component, all the authors highlighted that the syndrome is largely influenced by psychological and behavioural deficits. Kato, Kanba, & Teo (2019) assert that the Japanese psychological construct of ‘Amae’ which meant overdependence on family and ‘Haji’ which meant shame, led Hikikomori to be considered as a culturally-specific syndrome.
With disempowerment and precarity, Hikikomori individuals appear to have health ramifications ranging from mental to physical impairment (Tanabe, et al., 2017; Kato, Kanba, & Teo, 2019). Towards the mental aspect, Hikikomori could co-occur with or engender psychiatric conditions (Teo, et al., 2015; Tanabe, et al., 2017; Kato, Kanba, & Teo, 2019; Pozza, Coluccia, Kato, Gaetani, & Ferretti, 2019). For example, Teo, et al., (2015) ascertained avoidant personality disorder as highly prevailing comorbidity of Hikikomori. Regarding the physical aspect, medical comorbidities could also arise due to the abstinence from social and physical activities (Tanabe, et al., 2017; Berman, & Rizzo, 2018). For instance, Tanabe, et al., (2017) found that Wet Beriberi, a disease affecting the heart and circulatory system is linked to Hikikomori due to the adoption of an unhealthy lifestyle such as poor eating habits. Therefore, Hikikomori can be detrimental to the psychological and physical welfare of sufferers.
Pertaining to the condition, the therapeutic interventions are targeted towards supporting Hikikomori sufferers and their affected family (Teo, et al. 2014; Berman, & Rizzo, 2018; Kato, Kanba, & Teo, 2018, 2019; Yong, & Nomura 2019). All the authors have identified that there are both pharmacological and non-pharmacological approaches to treating individuals. Kato, Kanba, & Teo (2018) stated that there are more than fifty government-funded community support centres equipped with resources like psychotherapy, helping unemployed individuals to find suitable jobs, group therapy, and family assistance. Although treatment preferences have been indicated by interview responses in a study (Teo, et al., 2014), these articles have yet elucidated on the effectiveness of the interventions available. Moreover, there is a dearth of investigation on the older people who are also affected by the condition.
In conclusion, Hikikomori individuals are regarded as deviants with an anomic response to globalization in a conformist society. This literature review on Hikikomori in Japan has observed that the discussion has been chiefly pivoted on the cultural and psychosocial perspectives by the authors. With the physical and mental repercussions of Hikikomori and the current interventions discussed, it is recommended that future studies can include an evidence-based approach to the interventions for Hikikomori and to expound further on the effects of Hikikomori towards the older population.