Papers - SAKAI Motohiro
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Shunsuke Nonaka, Hiroaki Kubo, Tomoya Takeda, Motohiro Sakai
International Journal of Social Psychiatry 207640241310189 2025
Language：English Publishing type：Research paper (scientific journal) Publisher：SAGE Publications
Background:
Currently, paradoxical findings exist regarding the level of functioning in individuals with Hikikomori (prolonged social withdrawal).
Aims:
This systematic review aimed to clarify the functioning, disability, and health of individuals with Hikikomori and their families in comparison to those without Hikikomori.
Method:
Relevant studies were searched from April 22 to 25, 2022, using MEDLINE, PsycINFO, Scopus, and two Japanese databases. Functions were categorized into ‘body functions”; “structure”; and “activity and participation’, which were further classified into subcategories.
Results:
Of the 8,181 studies screened, 24 studies with 1,769 individuals with Hikikomori were included. Twelve, three, and four indicators from six studies on depression and anxiety, three on addiction, and two on thought problem symptoms, respectively, were higher in the Hikikomori group than in the comparison group, with at least moderate effect sizes. Three indicators from three studies on interpersonal relationships were worse in the Hikikomori group, with at least moderate effect sizes. The meta-analyses showed that internalizing symptoms, externalizing symptoms, and thought disorders were significantly higher in the Hikikomori group than those in the comparison group with moderate-to-high effect sizes. Contrastingly, communication/interpersonal interactions were significantly lower in the Hikikomori group than those in the comparison group. No significant differences were observed in daily life/social life and the families’ communication/interpersonal interactions and relationship.
Conclusions:
The study limitations include a high risk of bias and heterogeneity. Overall, individuals with Hikikomori often have impaired mental and interpersonal interaction functions; thus, comorbidities of this condition should be carefully assessed. PROSPERO: CRD42022320592.DOI： 10.1177/00207640241310189
Other Link： https://journals.sagepub.com/doi/full-xml/10.1177/00207640241310189
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Sakai M., Yoshinaga N., Thew G.R., Clark D.M.
Frontiers in Psychiatry 15 1368722 2024.5
Authorship：Lead author Language：English Publishing type：Research paper (scientific journal) Publisher：Frontiers in Psychiatry
Hikikomori (prolonged social withdrawal) has been discussed as a hidden worldwide epidemic and a significant social and healthcare issue. Social anxiety disorder is the most common psychiatric disorder preceding the onset of Hikikomori. Although studies exist suggesting the effectiveness of family-support interventions, little is known about psychotherapeutic approaches for Hikikomori individuals. Here, we present a case of Hikikomori wherein an internet-delivered cognitive therapy for social anxiety disorder (iCT-SAD) worked effectively in improving the client’s social anxiety symptoms and social interaction behaviors. This case study demonstrates the principle that evidence-based psychological interventions focusing on social anxiety can be effective for clients with Hikikomori. Furthermore, the online mode of treatment delivery, along with a variety of relevant modules, may facilitate clients’ engagement with treatment at home. The findings suggest that iCT-SAD might be a promising option for Hikikomori clients who have social anxiety problems, within the recommended stepped-intervention approach.
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小学校における学級崩壊 ─ 小学校教員への半構造化面接から ─
立元 真, 境 泉洋, 尾之上 高哉
宮崎大学教育学部紀要 ( 103 ) 102 - 113 2024.3
Language：Japanese Publishing type：Research paper (bulletin of university, research institution)
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幼児期の集団社会的スキルトレーニングが学齢期の社会的適応に与える影響
髙橋 京子, 境 泉洋, 松原 耕平
宮崎大学教育学部紀要 ( 102 ) 127 - 139 2024.3
Authorship：Last author Language：Japanese Publishing type：Research paper (bulletin of university, research institution)
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メンタルヘルス予防教育プログラムを加えた集団SST の効果
髙橋 京子, 境 泉洋, 松原 耕平, 石川 信一
宮崎大学教育学部紀要 ( 102 ) 140 - 151 2024.3
Authorship：Last author Language：Japanese Publishing type：Research paper (bulletin of university, research institution)
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幼稚園において保育者が行うペアレント・トレーニングの効果
玉城 美千子、松原 耕平、立元 真、境 泉洋
宮崎大学教育学部紀要 ( 101 ) 151 - 169 2023.8
Authorship：Last author Language：Japanese Publishing type：Research paper (bulletin of university, research institution)
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Nonaka S., Sakai M.
International Journal of Mental Health 2023.7
Publishing type：Research paper (scientific journal) Publisher：International Journal of Mental Health
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.
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ひきこもり状態にある人の家族が認識する家族会の機能 Reviewed
野中 俊介・境 泉洋・加藤 隆弘
カウンセリング研究 55 17 - 26 2023.7
Language：Japanese Publishing type：Research paper (scientific journal)
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コロナ禍におけるひきこもり状態にある人の課題と支援 Invited Reviewed
野中 俊介・境 泉洋
臨床発達心理実践研究 18 18 - 23 2023.7
Language：Japanese Publishing type：Research paper (scientific journal)
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The suitability of outing frequency as a definition of hikikomori (prolonged social withdrawal). Reviewed
Nonaka S, Sakai M
Frontiers in psychiatry 14 1027498 2023.5
Language：English Publishing type：Research paper (scientific journal)
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ひきこもりの生きづらさと叡智 Invited
境 泉洋
こころの科学 増刊 114 - 122 2023.3
Authorship：Lead author Language：Japanese Publishing type：Research paper (scientific journal)
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Kubo H., Urata H., Sakai M., Nonaka S., Kishimoto J., Saito K., Tateno M., Kobara K., Fujisawa D., Hashimoto N., Suzuki Y., Honda Y., Nakao T., Otsuka K., Kanba S., Kuroki T., Kato T.A.
Frontiers in Psychiatry 13 1029653 2023.1
Language：Japanese Publishing type：Research paper (scientific journal) Publisher：Frontiers in Psychiatry
Backgrounds: Hikikomori, pathological social withdrawal, is becoming a crucial mental health issue in Japan and worldwide. We have developed a 3-day family intervention program for hikikomori sufferers based on Mental Health First Aid (MHFA) and Community Reinforcement and Family Training (CRAFT). This study aims to confirm the effectiveness of the 3-day program by a randomized controlled trial. Methods: This study was registered on the UMIN Clinical Trials Registry (UMIN000037289). Fifteen parents were assigned to the treat as usual (TAU) group (TAU only; Age Mean, 65.6; SD, 7.8), and 14 to the Program group (program + TAU; Age Mean, 67.9; SD, 8.6). This study was discontinued due to the COVID-19 pandemic; the recruitment rate was 36.3% of our target sample size of 80. Results: Perceived skills improved temporally and stigma temporally worsened in the TAU group. Confidence decreased and attitude showed no change in both groups. Aggressive behaviors of hikikomori sufferers were significantly worsened in the Program group; however, no serious domestic violence was reported. In the TAU group, Avoidance and irregular life patterns were improved. Activity levels were worsened in both groups. Two participants (16.7%) in the Program group and one participant (7.7%) in the TAU group reported actual behavioral changes (e.g., utilizing support). Conclusion: We could not draw general conclusions on the effectiveness of the program due to the study discontinuation. Nevertheless, this study indicates the necessity for revision of the program to improve family members’ confidence in engaging with hikikomori sufferers, with safer approaching by families.
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Nonaka S., Takeda T., Sakai M.
Australian and New Zealand Journal of Psychiatry 56 ( 12 ) 1542 - 1554 2022.12
Language：English Publishing type：Research paper (scientific journal) Publisher：Australian and New Zealand Journal of Psychiatry
Objective: This review, which was registered with PROSPERO (CRD42021237988), aimed to systematically extract common elements in the hikikomori definition or criteria applied by researchers and examine cultural differences and chronological changes in the demographic characteristics of hikikomori individuals such as age, gender and hikikomori duration. Method: For inclusion in the review, the hikikomori criteria, age and gender of the hikikomori individuals had to be specified, and the article had to be peer-reviewed and written in Japanese or English, focusing on hikikomori individuals or their families. Case studies, reviews and qualitative studies were excluded. Results: The total sample size for the 52 studies included in the review was 4744. Over 80% of the studies included the elements ‘not working or attending school’, ‘not socializing outside one’s home’ and ‘duration of hikikomori’ in their hikikomori criteria, and many studies included the element ‘staying at home on most days except solitary outings’. A cross-temporal meta-analysis showed the possibility that the age of hikikomori individuals increased chronologically (β = 0.44, B = 0.50, 95% confidence interval = [0.16, 0.84]). Comparisons weighted by sample size between Japan and other countries showed the possibility that the age of hikikomori individuals was higher (d = 0.32), the percentage of males was lower (d = 0.91) and the hikikomori duration was shorter (d = 2.06) in studies conducted in countries other than Japan. However, many of the included studies had a high risk of selection bias, and this bias may have influenced the results obtained. Thus, the results of this study may represent the researcher’s perception of hikikomori rather than accurately representing the actual condition of hikikomori. Conclusion: Researchers should specifically identify similarities and differences in the clinical picture of hikikomori and compare the studies to organize the findings derived from studies focusing on hikikomori.
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特集 ひきこもりの理解と支援 中高年代のひきこもりの家族支援 Invited
境 泉洋
精神医学 64 ( 11 ) 1509 - 1514 2022.11
Publishing type：Research paper (scientific journal) Publisher：株式会社医学書院
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Measuring the Quality of Life for Individuals With Prolonged Social Withdrawal (Hikikomori). Reviewed
Nonaka S, Sakai M
Psychiatry investigation 19 ( 5 ) 341 - 347 2022.5
Language：English Publishing type：Research paper (scientific journal) Publisher：Psychiatry Investigation
Objective This study aimed to develop a quality of life scale for hikikomori (QOL-H), measuring the subjective quality of life (QOL) of individuals with hikikomori, and confirming its reliability and validity. Methods The characteristics of the scale were examined using item response theory. Data were collected from 99 people with hikikomori, 100 people who had experienced hikikomori in the past, and 198 people who had not experienced hikikomori, to develop the scale, examine its reliability, validity, and characteristics. For convergent validity, the correlation coefficients between QOL-H and social interaction behaviors, hikikomori characteristics, depressive symptoms, subjective happiness, and difficulty in social participation were calculated. Results Good internal consistency, test-retest reliability, and convergent validity were confirmed for the QOL-H. Furthermore, significant differences in scores among all groups confirmed adequate criterion-related validity. Total information function indicated a high measurement accuracy when QOL was average or slightly high. Conclusion This study suggests that QOL-H can be an appropriate measure of QOL for individuals with hikikomori.
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新たな人生の始まりにする「ひきこもり」 Invited
境 泉洋
臨床心理学 22 ( 2 ) 183 - 187 2022.2
Authorship：Lead author Language：Japanese Publishing type：Research paper (scientific journal)
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特集 〈心〉の病名を問う : 臨床における効用と限界 ; さまざまな臨床現場における〈心〉の病名を問う Invited
境 泉洋
臨床心理学 22 ( 1 ) 25 - 29 2022.1
Authorship：Lead author Language：Japanese Publishing type：Research paper (scientific journal)
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Individuals with hikikomori and their families’ cognitive behavioral factors: A prospective study Reviewed
Nonaka S., Shimada H., Sakai M.
Current Psychology 2022
Language：Japanese Publishing type：Research paper (scientific journal) Publisher：Current Psychology
The cognitive behavioral variables of a family that influence the improvement of prolonged social withdrawal (hikikomori) remain unclear. This study prospectively and experimentally examined the effects of family behavioral repertoire and family interaction on hikikomori recovery. The participants were selected from family associations and support centers in the Kanto region of Japan; the study was performed from May 2017 to March 2018. Overall, seven family members (four mothers and three fathers, aged 55–73) of hikikomori individuals (five males and two females, aged 20–47) participated in four 90-min individual sessions targeting cognitive behavioral variables (family behavioral repertoire, cognition of contingency, family interaction, and target behaviors); the intervention sessions were customized according to family characteristics, and participants were followed up at one, three, and six months after the intervention. Of these, three participants demonstrated improvements in up to two cognitive-behavioral variables after the intervention; furthermore, in all three cases, the social interactions of the hikikomori individuals increased later than the changes in their families. The time differences in these alterations suggest a causal relationship between family cognitive behavioral variables and recovery from hikikomori. However, Spearman’s correlation coefficients using the difference values from the pre-assessment were not significant for the hikikomori individuals’ social interactions and the families’ cognitive behavioral variables. These correlation analyses were preliminary because of the small sample size. Further studies with larger sample sizes and robust study designs are needed to confirm these findings.
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特集 社会につながれない 隠されたひきこもり-8050問題 長期化するひきこもり本人と共に生きる家族の相談支援 Reviewed
境 泉洋
公衆衛生 85 ( 10 ) 655 - 660 2021.10
Publishing type：Research paper (scientific journal) Publisher：株式会社医学書院
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スクールカウンセリングとアサーション Invited
境 泉洋
精神療法 増刊 ( 8号 ) 155 - 160 2021.9
Authorship：Lead author Language：Japanese Publishing type：Research paper (scientific journal)