Exploring Hikikomori-like idiom of distress a year into the SARS-CoV-2 pandemic in Oman: Factorial validity of the 25-item Hikikomori Questionnaire, prevalence and associated factors

Abstract

Background Existing literature that examines the Hikikomori-like idiom of distress (HLID) initially labelled this phenomenon as a culture-bound syndrome. However, the increasing number of reports from other parts of the world suggest that HLID could instead be a culture-reactive idiom of distress, originating from biopsychosocial disequilibrium and cultural upheaval. The impact of imposed social withdrawal due to the Coronavirus 2 severe acute respiratory syndrome (SARS-CoV-2) pandemic on the growing prevalence of HLID has not yet been adequately explored. Aims: The first objective is to examine the factorial validity of the 25-item Hikikomori Questionnaire (HQ-25) in Oman. Second, we aimed to investigate the prevalence of HLID following the lifting of SARS-COV-2 restrictions in the Arabian Gulf country of Oman. The third related objective is to examine factors associated with the variation of HLID. Methods This cross-sectional online survey was widely distributed across the diverse socio-demographic population residing in Oman. After the validation of the questionnaire and the factorial validity, the Arabic version of HQ-25 was used to explore the prevalence and factors associated with HLID. Results A total of 1529 participants were included in the study (response rate = 76.5%), of whom 44% (n = 673) expressed HLID. We randomly split it into half, one for exploratory factor analysis (EFA) (n = 764) and the other half for confirmatory factor analysis (CFA) (n = 765). From the EFA results, a three-factor model was found for the Omani version of HQ-25, which represented 52.87% of the variance with good internal reliability (Overall Cronbach’s: 0.92; Socialisation: 0.92; Isolation: 0.84; Emotional support: 0.73). The CFA results report acceptable goodness-of-fit indices (χ2/df = 17.92, p < .001; CFI = 0.90; TLI = 0.95; RMSEA = 0.04, 95% CI 0.02–0.07; SRMR = 0.05) of the three-factor model of the collected samples. All 1529 data were used in the respondents. The results of the logistic regression showed that married marital status (OR = 1.51, 95% CI: 1.12–2.03, p = 0.007), older age (OR = 0.97, 95% CI: 0.95–0.99, p = 0.008), living in an urban area (OR = 0.71, 95% CI: 0.56–0.91, p = 0.006), unemployed occupational status (OR = 1.72, 95% CI: 1.30–2.88, p < .001), screen time (7+ hours vs. <4 hours: OR = 4.50, 95% CI: 3.16–6.41, p < .001; 4–7 hours vs. <4 hours: OR = 2.10, 95% CI: 1.61–2.70, p < .001), history of mental illness (OR = 3.70, 95% CI: 2.29–5.91, p < .001), and adverse childhood experiences (OR = 2.60, 95% CI: 2.03–3.20, p < .001) were significant risk factors for HLID. Conclusion The factorial validity of the HQ-25 performed in this study appears to mirror the previously reported 3-factor structures. Some of the associated factors appear to support and, conversely, dissent from the findings of previous studies. These are discussed in terms of the attributions of the SARS-COV-2 pandemic, demographic trends in Oman, and sociocultural factors specific to the region of interest.

Validation of the German version of the 25‐item hikikomori questionnaire 25

“…university degree(Al-Sibani et al, 2023). The former study partly attributed their high prevalence to the characteristics of their sample and recruiting individuals online (which may be associated a bit with social anxiety disorder); The possibly low threshold value (HQ-25-G: 42) could also be of significance here.…”

“…Initially viewed as a phenomenon primarily linked to Japanese culture, researchers (Teo & Gaw, 2010 ) have called for further exploration into whether hikikomori might represent a psychological disorder in a broader sense. Indeed, the phenomenon of hikikomori has been observed globally (Al‐Sibani et al., 2023 ; Fino et al., 2023 ; Je et al., 2022 ; Kaya et al., 2023 ; Lyakina et al., 2023 ; Yinan et al., 2023 ). A very recent bibliometric analysis also stressed the marked rise in research output regarding the topic of hikikomori (Wan Hussain, 2023 ).…”

“…Indeed, the phenomenon of hikikomori has been observed globally (Al-Sibani et al, 2023;Fino et al, 2023;Je et al, 2022;Kaya et al, 2023;Lyakina et al, 2023;Yinan et al, 2023). A very recent bibliometric analysis also stressed the marked rise in research output regarding the topic of hikikomori (Wan Hussain, 2023).…”

Cluster analysis of hikikomori-like idiom of distress in Oman

“…The HQ-25 has a total score range of 0-100; a cutoff score of 42þ was defined as Hikikomori disorder (Teo et al, 2018). In our previous work, the Arabic version conducted in Oman showed good reliability and validity results (Al-Sibani et al, 2023).…”

“…The survey was anonymous, with no personal data collected, and information confidentiality was assured. The survey approached 2,000 potential participants, and 1,529 replied to the online survey (response rate = 76.5%) (Al-Sibani et al , 2023). Among 1529, 673 subjects (prevalence rate = 44.0%) were identified with HLID according to the HQ-25 with a total score cutoff of 42+ (Teo et al , 2018).…”