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Accepted for/Published in: JMIR Research Protocols

Date Submitted: Jul 27, 2025
Open Peer Review Period: Jul 29, 2025 - Sep 23, 2025
Date Accepted: Dec 12, 2025
(closed for review but you can still tweet)

The final, peer-reviewed published version of this preprint can be found here:

Exploring the Cognitive and Behavioral Risks and Maintenance Factors of Hikikomori: Protocol for an Ecological Momentary Assessment Study

MacLellan A, Takano K

Exploring the Cognitive and Behavioral Risks and Maintenance Factors of Hikikomori: Protocol for an Ecological Momentary Assessment Study

JMIR Res Protoc 2026;15:e81384

DOI: 10.2196/81384

PMID: 41701933

PMCID: 12912654

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

  • Alexander MacLellan; 
  • Keisuke Takano

ABSTRACT

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regulation, familial support and internet behaviours are proposed to contribute to the onset and maintenance of a withdrawn state, though they have not been explored longitudinally.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.


 Citation

Please cite as:

MacLellan A, Takano K

Exploring the Cognitive and Behavioral Risks and Maintenance Factors of Hikikomori: Protocol for an Ecological Momentary Assessment Study

JMIR Res Protoc 2026;15:e81384

DOI: 10.2196/81384

PMID: 41701933

PMCID: 12912654

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