title: Youth social withdrawal behavior (hikikomori): A systematic review of qualitative and quantitative studies.
abstract: OBJECTIVE
  Acute and/or severe social withdrawal behavior among youth was seen as a culture-bound psychiatric syndrome in Japan, but more youth social withdrawal cases in different countries have been discovered recently. However, due to the lack of a formal definition and diagnostic tool for youth social withdrawal, cross-cultural observational and intervention studies are limited. We aimed to consolidate existing knowledge in order to understand youth social withdrawal from diverse perspectives and suggest different interventions for different trajectories of youth social withdrawal.
  
  
  METHODS
  This review examined the current available scientific information on youth social withdrawal in the academic databases: ProQuest, ScienceDirect, Web of Science and PubMed. We included quantitative and qualitative studies of socially withdrawn youths published in English and academic peer-reviewed journals.
  
  
  RESULTS
  We synthesized the information into the following categories: (1) definitions of youth social withdrawal, (2) developmental theories, (3) factors associated with youth social withdrawal and (4) interventions for socially withdrawn youths. Accordingly, there are diverse and controversial definitions for youth social withdrawal. Studies of youth social withdrawal are based on models that lead to quite different conclusions. Researchers with an attachment perspective view youth social withdrawal as a negative phenomenon, whereas those who adopt Erikson's developmental theory view it more positively as a process of seeking self-knowledge. Different interventions for socially withdrawn youths have been developed, mainly in Japan, but evidence-based practice is almost non-existent.
  
  
  CONCLUSIONS
  We propose a theoretical framework that views youth social withdrawal as resulting from the interplay between psychological, social and behavioral factors. Future validation of the framework will help drive forward advances in theory and interventions for youth social withdrawal as an emerging issue in developed countries.
authors: Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China.
authors: Tim M H
authors: TM
authors: Li
authors: Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China paulw@hku.hk.
authors: Paul W C
authors: PW
authors: Wong
mesh_terms: D006801:Humans; D008960:Models, Psychological; D012920:Social Behavior Disorders / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy; D012934:Social Isolation / Q000523:psychology*
keywords: Youth social withdrawal; attachment; contemporary youth issue; hikikomori; psychosocial development