Examining Tweet Content and Engagement of Users With Tweets About Hikikomori in Japanese: Mixed Methods Study of Social Withdrawal

Abstract

Background Hikikomori is a form of severe social withdrawal that is particularly prevalent in Japan. Social media posts offer insight into public perceptions of mental health conditions and may also inform strategies to identify, engage, and support hard-to-reach patient populations such as individuals affected by hikikomori. Objective In this study, we seek to identify the types of content on Twitter related to hikikomori in the Japanese language and to assess Twitter users’ engagement with that content. Methods We conducted a mixed methods analysis of a random sample of 4940 Japanese tweets from February to August 2018 using a hashtag (#hikikomori). Qualitative content analysis included examination of the text of each tweet, development of a codebook, and categorization of tweets into relevant codes. For quantitative analysis (n=4859 tweets), we used bivariate and multivariate logistic regression models, adjusted for multiple comparisons, and estimated the predicted probabilities of tweets receiving engagement (likes or retweets). Results Our content analysis identified 9 codes relevant to tweets about hikikomori: personal anecdotes, social support, marketing, advice, stigma, educational opportunities, refuge (ibasho), employment opportunities, and medicine and science. Tweets about personal anecdotes were the most common (present in 2747/4859, 56.53% of the tweets), followed by social support (902/4859, 18.56%) and marketing (624/4859, 12.84%). In the adjusted models, tweets coded as stigma had a lower predicted probability of likes (−33 percentage points, 95% CI −42 to −23 percentage points; P<.001) and retweets (−11 percentage points, 95% CI −18 to −4 percentage points; P<.001), personal anecdotes had a lower predicted probability of retweets (−8 percentage points, 95% CI −14 to −3 percentage points; P=.002), marketing had a lower predicted probability of likes (−13 percentage points, 95% CI −21 to −6 percentage points; P<.001), and social support had a higher predicted probability of retweets (+15 percentage points, 95% CI 6-24 percentage points; P=.001), compared with all tweets without each of these codes. Conclusions Japanese tweets about hikikomori reflect a unique array of topics, many of which have not been identified in prior research and vary in their likelihood of receiving engagement. Tweets often contain personal stories of hikikomori, suggesting the potential to identify individuals with hikikomori through Twitter.

Analysis of the hikikomori phenomenon – an international infodemiology study of Twitter data in Portuguese

“…Two previous studies [ 7 , 8 ] have additionally shown that the majority of tweets have reported hikikomori as a problem, which corroborates in the findings of our study, suggesting widespread awareness of the seriousness of the phenomenon.…”

“…The interest of users in a specific topic can be assessed by analysing the number of retweets and likes that each tweet generates [ 48 ]. A study [ 8 ] that explored this phenomenon by analysing tweets had more likes than retweets, similar to our study. This could be attributed to the fact that people are more comfortable to show their interest in the subject, but less inclined to actively share the tweets for wider dissemination.…”

“…While a previous study [ 8 ] of tweets about hikikomori in Japanese showed that personal stories were the most posted content, in our study, curiosities about hikikomori were predominant, suggesting that the hikikomori phenomenon has generated more interest among people since the users who posted the tweets know some curiosities about this phenomenon.…”

“…Whilst the internet is increasingly present in our lives, and therefore, people are more digitally connected, this may sometimes lead to isolation and increased loneliness [ 8 ]. There may be different situations why people isolate themselves on the internet, from online gaming to social networking, as well as family problems and difficulties of inclusion in the school of young people [ 9 , 10 ].…”

“…Twitter is a helpful tool to investigate the hikikomori phenomenon since those affected often use social media as an online ‘refuge’ [ 1 , 25 ]. Previous studies of hikikomori using infodemiology explored contents and perceptions related to hikikomori on Twitter in Japanese and some Western languages, finding personal stories as the most posted content, and several mentions of hikikomori in non-Japanese Western languages [ 7 , 8 ]. Understanding the content of tweets related to the hikikomori phenomenon provides valuable information on how this social issue is perceived and discussed among different people.…”