Exploring cognitive and behavioural risk and maintenance factors of Hikikomori: Protocol for an Ecological Momentary Assessment study (Preprint)

BACKGROUND Hikikomori is a state of social withdrawal first identified in Japan gaining interest globally. Clinical case studies and cross-sectional studies suggest emotion regulation, familial support and internet behaviours are proposed to contribute to the onset and maintenance of a withdrawn state, though they have not been explored longitudinally. OBJECTIVE To investigate risk factors of hikikomori identified in previous research and explore the temporal dynamics of these relationships. METHODS A minimum of 70 participants will complete self-report measures of hikikomori, internet addiction, depression, anxiety and autism, before participating in 14 days of EMA surveys. Surveys will be delivered 5 times per day, measuring mood, internet behaviour, familial relationships, social behaviour and enjoyment, sleep quality and physical activity. RESULTS Multiple regression analyses will explore which baseline factors and grand-averaged EMA variables predict hikikomori symptoms, whilst time-lagged network analyses will explore the temporal dynamics of these relationships. Finally, time-lagged logistic regressions will explore which factors predict future social behaviour. CONCLUSIONS This study will be the first to investigate currently proposed mechanisms underlying hikikomori, whilst also investigating the time-varying relationships between affect and social behaviour. The results will have implications for hikikomori treatment, as well as open new avenues for future research into the condition.