8050 Aging #hikikomori #mentalhealth @ueyamakzk

Ueyama Kazuki just told me about the expression “8050 problem” (80 years old parents, 50 years old hikikomori). I forward 3 articles he mentioned below in Japanese.




Mr Ueyama’s blog is here


Secure Base Script and Psychological Dysfunction in Japanese Young Adults (Umemura et al 2018)

Umemura, Tomotaka,Watanabe, Manami,Tazuke, Kohei,Asada-Hirano, Shintaro,Kudo, Shimpei
Developmental Psychology, Jan 25 , 2018, No Pagination Specified

The universality of secure base construct, which suggests that one’s use of an attachment figure as a secure base from which to explore the environment is an evolutionary outcome, is one of the core ideas of attachment theory. However, this universality idea has been critiqued because exploration is not as valued in Japanese culture as it is in Western cultures. Waters and Waters (2006) hypothesized that one’s experiences of secure base behaviors are stored as a script in memory, and developed a narrative assessment called the Attachment Script Assessment (ASA) to evaluate one’s secure base script. This study examined the validity of the ASA and the utility of secure base concept in Japanese culture. A sample of Japanese young adults (N = 89; M = 23.46; SD = 3.20; 57% = females) completed both the ASA and self-report questionnaires. The results revealed that the ASA score was associated with two dimensions of self-report questionnaires assessing parent–youth attachment relationships (trust and communication). The ASA score was not related to Japanese cultural values (amae acceptance, interdependent self-construal, and low independent self-construal). However, a low ASA score was related to a psychological dysfunction in the Japanese cultural context; hikikomori symptoms, which are defined as a desire to remain in his or her own room and his or her understanding of this behavior in other people. We concluded that since hikikomori can be interpreted as an extreme inhibition of exploration, the association between low secure base script and hikikomori symptoms suggests the utility of secure base construct in Japan. (PsycINFO Database Record (c) 2018 APA, all rights reserved)


A Physical Health Profile of Youths Living with a “Hikikomori” Lifestyle (Yuen et al. 2018)

A cross-sectional study was designed to understand the impacts of “hikikomori” lifestyle on physical health. A total of 104 eligible hikikomori cases were recruited from the social services network of Hong Kong with a mean age of 19.02 ± 3.62 (ranged 13–31) year-old, and had completed the set of questionnaires and a series of anthropometric and physical health measurements. Despite SF36 score of 84.0 indicated good physical functioning in general, participants were lived sedentarily with high incidence of hypertension at 15.4% and prehypertension at 31.7%. Occurrence of hypertension and prehypertension in cases living as hikikomori >6 months were 3 times and 1.5 times higher than those newly onset cases, respectively. The blood pressure levels were correlated with age and all obesity index parameters measured including waist circumference and body mass index. Results also observed a shift of body weight from underweight to overweight and obesity along the hikikomori duration. Half of the hypertensive cases involved the elevation of systolic blood pressure, which suggested higher odds of cardiovascular complications. In conclusion, the hikikomori lifestyle could be a risk behavior that may harm the younger generation physically by promoting obesity and hypertension and probably other chronic illnesses. View Full-Text

2 articles about #hikikomori in #Japan (2015 & 2017)

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.

#hikikomori in #China (Teo et al. 2017)

“The findings provide further empirical support to Li and Wong’s framework that suggests individuals with more severe social withdrawal suffer from more psychological difficulties and Kato and colleague’s hypothesis that “some common psychopathological mechanisms may exist in the act of “shutting in”

Teo, Alan R., Does hikikomori (severe social withdrawal) exist among young people in urban areas of China?. Asian Journal of Psychiatry December 2017 Volume 30, Pages 175–176 https://doi.org/10.1016/j.ajp.2017.10.026

2018.1 Insight #hikikomori @TheLancetPsych @drchrisharding

Mr X is a 40-year-old man who has spent half his life—the past 20 years—barely able to leave his room in his parents’ house. For many years aside from attending a monthly outpatient appointment he was asleep while everyone else in his household was awake. And while they slept he was up: whiling away time with computer games and online shopping—the latter at one point costing the family the equivalent of many thousands of pounds.


Psychiatrist Sekiguchi Hiroshi’s View of Hikikomori

“In Japan today, many young people are disconnecting themselves from society. They have come to be known as hikikomori (recluses), or more formally shakaiteki (social) hikikomori. Though their existence is widely recognized, their true situation is still far from being generally understood. They all have different backgrounds and circumstances and have withdrawn from society for different reasons. So, what can we say about this disparate group?

First, a definition: Hikikomori are individuals who (1) do not work or attend educational institutions, (2) are not considered to have a mental disorder, but (3) have remained at home for six months or longer without interacting personally with anyone outside their families. The third point is the most important. These people have no friends and are isolated from society, even though they may be living in the middle of a teeming city.

Some say … open access on nippon.com

Efficacy of a Multicomponent Intervention with Animal-Assisted Therapy for Socially Withdrawn Youths in Hong Kong (Wong et al. 2017)


This is an evaluation study of a pilot multicomponent program with animal-assisted therapy (AAT) for socially withdrawn youth with or without mental health problems in Hong Kong. There were fifty-six participants. Decreased level of social anxiety, and increased levels of perceived employability and self-esteem across two withdrawn groups were observed. When comparing those who did and did not receive the AAT component(s), however, AAT did not seem to have additional impacts on outcomes. The qualitative data collected through interviews with ten participants reflected that

the AAT component was attractive because the nonhuman animals made them feel respected and loved. This pilot study showed that a multicomponent program with a case management model correlated with increased levels of self-esteem and perceived employability, and a decreased level of social interaction anxiety. In addition, using nonhuman animals in a social service setting appears to be a good strategy to engage difficult-to-engage young people.


Society & animals (2017) 1-14