ArticlePCN reports : psychiatry and clinical neurosciences2026
Hikikomori as a culturally situated expression of neurodivergence: A two-stage international analysis.
Article in PCN reports : psychiatry and clinical neurosciences, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Aim: Hikikomori is a behavior characterized by prolonged social withdrawal, identified in 1990s Japan, and with increasing global recognition. Over two decades of research, the phenomenon remains clinically ambiguous; debate persists over whether hikikomori represents a psychiatric disorder, a behavioral response, or an adaptive coping strategy. This review examines the intersection between hikikomori and neurodivergent traits, focusing on autism spectrum characteristics, and ecological and cultural contexts that shape presentation. Methods: Two-stage literature review. Stage 1 comprised a scoping review of diagnostic criteria for autism and behavioral features of hikikomori, identifying overlapping social communication differences, sensory sensitivities, and restricted interests. Stage 2 employed a targeted Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) approach, synthesizing international literature across quantitative, qualitative, and mixed-method studies. Findings followed three research questions: overlap between autism and hikikomori; Japanese environmental and societal triggers; and whether hikikomori can be understood as an adaptive response. Results: Results indicate nuanced convergence between autistic traits and hikikomori behaviors. Social communication difficulties, engagement in repetitive activities, and sensory sensitivities appear in both populations. Developmental trajectories differ; hikikomori emerge in adolescence/early adulthood. Environmental pressures, including academic expectations, family dynamics, and cultural norms around conformity, exacerbate withdrawal behaviors. Adaptive perspectives suggest that withdrawal is a protective mechanism, facilitating sensory regulation, psychological coping, and engagement in preferred activities. Pathological outcomes arise when isolation is prolonged/unsupported. Conclusion: This review underscores important ecological and neurodiversity-informed frameworks in understanding hikikomori. Implications for practice include flexible support strategies, culturally sensitive assessment, and recognizing potential adaptive functions of withdrawal. Future research should be longitudinal, first-person experiences, and interaction between neurodivergence and environmental stressors across cultures.
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