Shunsuke Nonaka , Hironori Shimada & Motohiro Sakai (2017): Assessing adaptive behaviors of individuals with hikikomori (prolonged social withdrawal): development and psychometric evaluation of the parent-report scale, International Journal of Culture and Mental Health, DOI: 10.1080/17542863.2017.1367411
ABSTRACT: It is important to appropriately assess the adaptive behaviors of individuals with hikikomori (IWH) using parent reports. However, currently, there is no gold standard in the assessment of adaptive behaviors of IWH. This study aimed to: (1) develop the Adaptive Behaviors Scale for Hikikomori (ABS-H); (2) examine the factor structure of the ABS-H; and (3) examine the reliability and validity of ABS-H. A factor analysis and item response theory (IRT) analysis were conducted using data from 761 parents. Reliability and validity of ABS-H were assessed using measures of severity of hikikomori, difficulty in social participation, extent of places where IWH were active, days on which IWH went out, duration of hikikomori and happiness about relationship with one’s child. A total of 26 items were selected and item-trait was examined from the IRT results. Factor analysis identified four group factors. Cronbach’s alpha was found to be .97. Criterion-referenced, convergent and discriminant validity of the instrument were satisfactory. This study suggests that the ABS-H is a reliable measure with acceptable criterion-referenced, convergent and discriminant validity. Further research is needed to clarify the extent to which the ABS-H is sensitive in capturing the changes in the features of hikikomori.
Jogging Therapy forHikikomori Social Withdrawal and Increased Cerebral Hemodynamics: A Case Report
Masaki Nishida*, Senichiro Kikuchi, Kazuhito Fukuda and Satoshi Kato
Clinical Practice & Epidemiology in Mental Health, 2016, 12, 38-42
Abstract: Severe social withdrawal, called hikikomori, has drawn increased public attention. However, an optimal clinical approach
and strategy of treatment has not been well established. Here, we report a case of hikikomori for which an exercise intervention using jogging therapy was effective, showing cerebral hemodynamic improvement. The patient was a 20 year old Japanese male who was hospitalized in order to evaluate and treat severe social withdrawal. Although depressive and anxiety symptoms partially subsided with sertraline alone, social withdrawal persisted due to a lack of self confidence. With his consent, we implemented exercise therapy
with 30 minutes of jogging three times a week for three months. We did not change the pharmacotherapy, and his social withdrawal remarkably improved with continuous jogging exercise. Using near infrared spectroscopy to evaluate hemodynamic alteration, bilateral temporal hemodynamics considerably increased after the three-month jogging therapy. Regarding exercise therapy for mental illness, numerous studies have reported the effectiveness of exercise therapy for major depression. This case implied, however, that the applicability of exercise therapy is not limited to major depressive disorder. Jogging therapy may contribute to reinforcing self confidence associated with “resilience” in conjunction with neurophysiological modulation of neural networks.