Pathological and non-pathological hikikomori: social media use, digital engagement, and therapeutic implications

Abstract

Introduction: Hikikomori 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]). Method: A 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). Results: Pathological hikikomori used significantly more social media platforms than non-pathological hikikomori (4.16 vs 3.84: F(1,1224)=20.05, p