Comparing perceived reasons for initiating and maintaining hikikomori (prolonged social withdrawal): Quantitative text analysis

Identifying the reasons for initiation and maintaining hikikomori-prolonged social withdrawal-and their differences is important for preventive and personalized treatment. Quantitative text analysis and chi-squared tests were conducted using word frequencies to explore the reasons. Multiple regression analysis was used to describe the association between the reasons and psycho-behavioral characteristics, with each coded reason and psycho-behavioral variable as the independent and dependent variables, respectively. Seventy participants currently in hikikomori (48.6% men, mean age 44.8 years) completed four instruments: a free-text description of the reasons, the Adaptive Behaviors Scale for Hikikomori, Japanese version of the Patient Health Questionnaire, and Quality of Life Scale for Hikikomori. Chi-squared tests showed that reasons related to relief and despair/desire were more frequent in maintaining hikikomori compared to initiating. The weighted Kappa statistics was low overall and ranged from -0.08-0.62. Regression analysis revealed that no models for reasons for initiating hikikomori were significant. In contrast, the models for maintaining hikikomori were all significant. Poor health reason was positively associated with depression. Poor health and despair/desire reasons were negatively associated with social interaction and quality of life. These findings indicate that the reasons should be assessed independently. Furthermore, a focus on reasons for maintaining may be useful in mental health treatment.