Autism and attention deficit hyperactivity disorder (ADHD) are neurodevelopmental conditions associated with social communication differences and distinctive patterns of online engagement. Both conditions have been linked to increased risk of social withdrawal, yet little research has examined hikikomori vulnerability-a continuum of withdrawal-related tendencies-within a transdiagnostic digital context. This study investigated hikikomori vulnerability among UK-based young adults with autism or ADHD and examined how active and passive social media use and online gaming relate to withdrawal vulnerability. A total of 101 participants aged 18-24 with self-reported diagnoses of autism (n = 52) or ADHD (n = 49) completed the Hikikomori Questionnaire (HQ-25M) alongside self-estimates of active and passive online engagement. Although total online time did not differ between groups, autistic participants reported significantly higher overall hikikomori vulnerability than those with ADHD, driven by greater socialization difficulties and physical isolation. Differences in patterns of online engagement were observed at the level of effect sizes, with autistic participants tending toward greater passive social media use and less gaming with others. Across the full sample, passive social media use was positively associated with overall hikikomori vulnerability, particularly the Isolation and Emotional Support dimensions, whereas active social media use showed no such associations. Isolation was additionally correlated with gaming with others. These findings support a transdiagnostic, coping-motivated model of digital engagement, suggesting that passive online behaviors are associated with withdrawal vulnerability across neurodevelopmental conditions. The results extend motivational frameworks of Internet use to hikikomori vulnerability and highlight the importance of balanced and more active forms of digital engagement in relation to withdrawal-related experiences among neurodivergent young adults.

BACKGROUND:Self-harm is highly prevalent among young people yet remains misunderstood and stigmatised in schools and among pupils. Schools are positioned to first detect self-harm but are ill-equipped to respond or support. Despite these concerns, studies exploring the management of self-harm in schools from staff perspectives are limited. METHODS:Therefore, the current study explored experiences of secondary school staff when addressing self-harm in schools through a Thematic Analysis of semi-structured focus groups. RESULTS:Analysis revealed an overarching theme-addressing self-harm in schools is a systemic issue that requires governmental, institutional, and interpersonal support. Two main themes and five subthemes were identified within this overarching theme. CONCLUSIONS:Lack of standardised guidelines and stigmatisation around self-harm are key barriers that prevent staff from effectively addressing self-harm. Training is crucial for school staff to respond safely to self-harm and avoid fearful or avoidant responses, alongside increased access to clinically trained professionals. These findings are discussed in relation to school-based interventions targeted towards self-harm.

IntroductionHikikomori is traditionally defined as a form of pathological social withdrawal marked by extreme social isolation in one’s home, leading to significant functional impairment or distress. However, shifts in working and study habits since COVID-19 have introduced the concept of ‘non-pathological hikikomori’ to describe individuals who are isolated in their homes but do not experience functional impairment or distress. Hikikomori are frequent users of the internet and social media, which raises interesting questions regarding the relationship between social withdrawal and physical withdrawal. This study examined whether social media use differs by hikikomori status (pathological vs. non-pathological) and phase (early [<3 months], pre- [3–6 months], full [6+ months]).MethodA cross-sectional study recruited 1,420 self-identified frequent internet users (aged 18-25) via Prolific, who completed a questionnaire on their social media activity (time spent; type of communication), hikikomori status (pathological/non-pathological), and phase (early/pre/full). Of these, 1,235 identified as hikikomori (Mage = 21.5, SD = 2.2; females = 661, males = 572, undisclosed = 2). Within this group, 455 were classified as pathological hikikomori (early = 113, pre = 151, full = 191), while 780 were non-pathological (early = 179, pre = 201, full = 400).ResultsPathological hikikomori used significantly more social media platforms than non-pathological hikikomori (4.16 vs 3.84: F(1,1224)=20.05, p<.001, ηp²=.016). In terms of phase, full hikikomori (3.82) used fewer social media platforms than early (4.01) and pre (4.13) hikikomori, (F(2,1224)=7.19, p<.001, ηp²=.012: early and pre hikikomori did not differ from each other). The interaction between pathological status and phase was not significant [F(2,1224)=1.28, p=.278, ηp²=.002]. Social media platforms were not used for more time by pathological compared to non-pathological hikikomori, but there were differences in how the social media platforms were used. Regarding communication style, across all phases, pathological hikikomori consistently engaged with others via TikTok and YouTube significantly more than non-pathological hikikomori. Using TikTok and YouTube, Pathological hikikomori sent more messages [F(1,958)=8.77, p=.003, ηp²=.009; F(1,1161)=21.50, p<.001, ηp²=.018; respectively] and received more messages [F(1,958)=13.15, p<.001, ηp²=.014; F(1,1161)=21.37, p<.001, ηp²=.018; respectively], had more targeted messages [F(1,958)=8.49, p=.004, ηp²=.009; F(1,1161)=20.77, p<.001, ηp²=.018; respectively], had more stylised messages [F(1,958)=13.60, p<.001, ηp²=.014; F(1,1161)=24.13, p<.001, ηp²=.020; respectively] and had more broadcast messages [F(1,958)=7.58, p=.006, ηp²=.008; F(1,1161)=13.22, p<.001, ηp²=.011; respectively] than non-pathological hikikomori.ConclusionThese findings suggest a complex relationship between social media use and social withdrawal. Future research should explore whether communication through YouTube and TikTok is linked to social isolation and whether these platforms could serve as intervention tools to support pathological hikikomori. Importantly, as the sample consisted of self-identified frequent internet users, generalizability to the broader population of hikikomori should be treated with caution.

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.

People living with Type 1 and Type 2 diabetes (T1DM &T2DM) report that media - including journalism, health promotion, and popular culture - are a primary source of stigmatic representations of diabetes, and that this compromises their physical and mental health. This view of diabetes as stigmatised is not shared by many health professionals and nor the wider public. We used an existing representation of diabetes on Instagram, #DiabetesOnAPlate, to examine how stigmatic representations of diabetes are (re)produced, discussed, and contested. Our analysis found that, consistent with the notion of diabetes as stigmatised, use of the hashtag #DiabetesOnAPlate on Instagram is associated with public health discourses of indulgent eating and with posts that signal recognition of this as a moral transgression. A subsequent on-line survey found that participants who did not have diabetes did not recognise a prototypical #DiabetesOnAPlate post as stigmatic. Whilst some with T1DM and T2DM did perceive and contest the stigma, T1DM participants did so for their group (but not for T2DM); and there was evidence that some T2DM participants internalised the stigma. These findings support concerns about the everyday, divisive nature of stigmatic representations of diabetes on social network sites, which on the one hand reflect public health discourse and on the other may compromise health policy objectives and exacerbate health inequalities.

This mixed method study explores importance of and influences on men’s grooming behaviors and appearance concerns. Survey data from 83 men based in the United Kingdom showed high social media users engaged in significantly more grooming behaviors than low users. Gay men viewed grooming as significantly more important and implemented more grooming habits than straight men. Qualitative responses yielded themes relating to standards set by traditional media and the blurring of boundaries between traditional and new forms of (social) media. Themes reflected the freedom and constraints of sexuality in relation to grooming as well as the management of attraction and status. More research is needed to consider the impact grooming pressures and influences might have on men in the future.

This study explores the phenomenon of hikikomori, or extreme social isolation, which for the past 20 years has been associated with a range of negative outcomes, including psychological, financial, and social. As hikikomori is associated with marked social withdrawal in one's home and increased Internet use, it has been suggested that the social and technological changes brought about by COVID-19 restrictions may exacerbate the risk of hikikomori in young adults. This study, therefore, sought to identify the relationship between hikikomori risk and changes in Internet use for young people aged 16-24 years during COVID-19 restrictions. An international sample of 826 participants completed an online survey consisting of questions about demographics, experience of lockdown restrictions in the previous 12 months, changes to Internet use in the previous 12 months and a hikikomori risk scale. Higher hikikomori risk was associated with being male, greater time spent in lockdown, and leaving the house less frequently. An increase in Internet use during lockdown was associated with reduced risk of hikikomori. Findings are discussed in relation to gender differences in the type of Internet use engaged in by males and females. It is concluded that online social interaction may be a means of mitigating hikikomori risk in post-COVID-19 societies.

Background: Restricted and Repetitive Behaviours (RRB) are a core characteristic of autism, though little is known about autistic people's lived experience of these phenomena. Research has defined RRB in terms of: 1) a distinction between higher-order and lower-order RRB; as well as 2) a perceived lack of function and 3) a perceived lack of voluntary control. Method: Twelve autistic adults without intellectual disability were interviewed to elucidate an understanding of these three issues from their lived experience. Results: Thematic analysis identified four key themes regarding RRB: Self-regulation; positive impacts; negative impacts and suppression. The distinction between higher-order and lower-order RRB was not reflected in the adults' lived experience. In addition to having both positive and negative impacts, the expression of RRB for some behaviours in certain contexts was largely, though not wholly, under voluntary control. Perceived negative evaluations from others can result in strategies to minimise the expression of RRB to observers, although suppressing RRB can be stressful with a cost to the individual. Conclusions: These findings provide insight into the important functions of RRB and both its positive and negative impacts. It indicates that future research should look to help maximise the positive impacts and minimize the negative, and consider the impact suppression of RRB has on mental health and functioning.

Those seeking romantic relations are increasingly using online dating sites, including young men on the autism spectrum. This study presented dating profiles with and without an explicit label of autism and positive or negative wording to 306 ‘females seeking a male partner’. Participants assessed the men’s dating profiles in terms of perceived attractiveness, trustworthiness and desire-to-date. They also completed a questionnaire on their level of stigmatisation of, and familiarity with, autism. An explicit autism label and positive wording positively impacted perceived attractiveness. With positively worded profiles, those with highly stigmatising views reported decreased desire-to-date when an explicit label of autism was present; those with low levels of stigmatising reported increased desire-to-date when an explicit autism label was present.

In this chapter, we pose the question: if it is not possible to have a set of ethical rules that can deal with all situations, how, then, as researchers, do we uphold the essence of our ethical principles when conducting research in and on the online world? We set out to answer this question by structuring our response around three universal principles that underpin the notion of "do no harm" with respect to how we go about conducting ethical research:  respect for the autonomy, privacy, and dignity of individuals and communities;  scientific integrity;  maximizing benefits and minimizing harm We share examples of good and bad practice and conclude that how the principles are applied and how unexpected happenings are dealt with will rely on the researchers' and ethics committees' ability to act carefully with due diligence with the information they have at that time.

Studies concerned with perceptions of stalking have demonstrated that the prior relationship between the stalker and the victim biases decision making in both individual and mock jury situations. These biases tend to benefit ex-partners over strangers yet the reality of stalking is that it is ex-partners who cause more concern and are more dangerous. Previous research demonstrates that one way to overcome this bias during individual decision making is to provide information describing the reasons for the previous relationship breaking down. The current mixed-method study examines the influence of this information on small groups randomly assigned to one of five conditions where the relationship information provided differed and individual and group decisions regarding vignettes of stalking situations were examined. Group decisions and analysis of the deliberations indicated that in small group settings, as with the previous findings for individual decisions, relationship information plays a role in overcoming the ex-partner bias.

Purpose Revenge pornography is a growing risk among adolescents and young adults. Often stemming from sexting, some victims of revenge pornography report experiencing victim-blame similar to that accompanying the reporting of rape. The purpose of this paper is to explore the assumptions that underlie attributions of victim-blame, with a focus on perpetrator and victim responsibility, as well as gendered assumptions surrounding sexting. Design/methodology/approach A total of 222 UK university students (111 male, 111 females) read one of two versions of a hypothetical revenge pornography scenario, one involving a male victim of a female perpetrator, the other a female victim of a male perpetrator. They then responded to an open-ended question regarding responsibility. Findings Qualitative content analysis of these responses identified three inter-related themes: the victim’s behaviour, mitigating victim responsibility and minimising the behaviour. Social implications The majority of participants in this study attributed at least some responsibility to the victims of revenge pornography depicted in the scenarios. Sex of the victim played a less important role than assumptions around sexting. Originality/value The study suggests that victim-blame is linked to the consent implied by sharing intimate images with a partner, but is also mitigated by the normative nature of this relationship practice. There was some evidence that the experience of male victims of revenge pornography is trivialised. These findings have implications for e-safety and victim support.

Little is known about how recovery from self-harm is understood by individuals with personal experience of self-harm. YouTube is an important online venue for posting and discussion of user-generated self-harm videos. Drawing on this material, this study explores how self-harm recovery is presented on YouTube. The 30 most highly-viewed videos about recovery from self-harm were thematically analysed. Three themes were identified: 1) a desire for change, 2) control over change, 3) implementing change. This study identifies multiple understandings of self-harm, which in turn shape individuals' understandings of self-harm recovery. This has implications for self-harm advice or support.

A lack of success through traditional, face-to-face dating has led some autistic adults to pursue relationships through online dating. Creating an online dating profile, however, is a process that requires a range of complex social skills, the ability to balance a number of social demands, and self- and other-awareness - all of which can be challenging for autistic people. This paper presents two studies investigating the perceived attractiveness, trustworthiness and desirability of autistic males' online dating profiles by females from the general population. In Study 1, 111 heterosexual females rated the autistic attributes and interests in an online dating profile as comparably attractive, trustworthy and desirable to date as an online dating profile comprising typical attributes and interests, but online dating profiles that mixed typical attributes with autistic interests were perceived to be less desirable to date. Study 2 investigated the impact of the wording of autistic characteristics and an explicit statement of a diagnosis of autism in 127 heterosexual females. Positive wording and an explicit statement of a diagnosis of autism enhanced perceived attractiveness and trustworthiness, but not desirability to date. The implications for the construction of autistic males’ online dating profiles are discussed.

Background: Seeking and sharing information are the primary uses of the internet and social media. It is therefore vital to understand the processes individuals go through when engaging with information on these diverse platforms, especially in areas such as health- and risk-related information. One important element of such engagement is evaluating and attributing expertise to others. Objective: This study aimed to explore how meanings around expertise in relation to food allergy and intolerance (food hypersensitivity) were constructed by 2 groups of social media users: (1) those who use platforms for reasons relating to food hypersensitivity and (2) those seen as experts by this community. Methods: Survey participants were asked open-ended questions to identify potential experts in food hypersensitivity issues on social media and to discuss their reasoning for their choices (n=143). Subsequently, 8 adult social media users with experience of managing food hypersensitivity and 5 participants designated as experts by those users took part in email interviews. Survey and interview data were analyzed thematically using Braun and Clarke's approach. Results: Judging expertise on social media is a complex and multifaceted process. Users might be judged as experts through their professional background or their experience living with food hypersensitivities. How users behave on social media and the traces of their Web-based activity can influence how others will see them. Such considerations are both measured and moderated through the social media community itself. Findings highlighted how social media often act as a supportive information tool following a diagnosis, but this also raised concerns regarding the scenario of patients not being able to access suitable vetted information. Conclusions: This work has implications for understanding how users perceive expertise on social media in relation to a health concern and how information assessments are made during the management of risks. Findings provide practical insights to both medical and organizational stakeholders involved in the support of those living with life-changing conditions, such as food hypersensitivities.

Dating involves a range of complex social skills that autistic adults can often find challenging. Many autistic adults have turned to online dating, which in theory may ameliorate these social difficulties. The aim of this study was to explore, for the first time, how autistic males describe themselves in online dating profiles. The online dating profiles of 52 self-identified autistic males were analyzed using a combination of frequency and thematic analyses. A common pattern of self-description was identified, involving a combination of both desirable and undesirable characteristics. Themes included interests, negative descriptions of personality, ideal match, and autism. Findings are discussed in terms of desirability, the norms of online dating, and the benefits and costs of computer-mediated communication for autistic male online daters.

People living with Complex Regional Pain Syndrome (CRPS) experience frustration with the lack of knowledge and understanding of CRPS as a pain condition. In this case study, we explain how we worked with a group of people living with CRPS with the intention of helping them create a Wikipedia page about CRPS written by them, for people like them. We share what happened when our participants did not engage. We show you how we found a solution and in so doing, show how you can be creative when facing research challenges, yet still meet the essence of the original goal of the research.