Clinical cross-sectional study finds resilience and depression traits link to social withdrawal in adolescents, suggesting new intervention strategies.
This clinical cross-sectional study investigated psychosocial factors associated with social withdrawal (hikikomori) in 417 adolescent psychiatric outpatients (aged 13–19 years). Participants were assessed during their initial visit using the 25-item Hikikomori Questionnaire (HQ-25), the Quick Inventory of Depressive Symptomatology, Tarumi’s Modern-Type Depression Trait Scale (TACS-22), and the Bidimensional Resilience Scale. Hierarchical multiple regression analyses revealed that higher social withdrawal severity was significantly associated with greater depressive symptoms, lower resilience, and higher modern-type depression (MTD) traits. Notably, lower resilience exhibited the strongest independent association with social withdrawal across all models (β = −40, p < .001), while suicidal ideation was not an independent associated factor. These findings suggest that social withdrawal in clinical adolescents primarily reflects a depletion of psychological resources and maladaptive coping rather than depressive severity alone. Clinical interventions should prioritize transdiagnostic, resilience-focused strategies that address internal psychosocial disengagement beyond traditional symptom-based diagnoses or behavioral markers like school attendance.
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Nakane et al. (2026) studied this question.
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