The impact of higher levels of autistic traits on risk of hikikomori (pathological social withdrawal) in young adults.

BACKGROUND: Hikikomori is an extreme state of social withdrawal, originally identified in Japan but more recently recognised internationally. Many countries imposed restrictions during the COVID-19 pandemic which may have had a detrimental impact on those at risk of hikikomori, specifically young adults and those with high levels of autistic traits. AIMS: To explore whether levels of autistic traits mediate the relationship between psychological wellbeing and hikikomori risk. We also looked at whether autistic traits mediated between lockdown experiences (e.g. not leaving the house) and hikikomori risk. METHODS: 646 young people (aged 16-24) from a wide range of countries completed an online questionnaire assessing psychological wellbeing, autistic traits and experiences of lockdown for this cross-sectional study. RESULTS: Autistic traits mediated the relationship between both psychological wellbeing and hikikomori risk, as well as frequency of leaving the house during lockdown and hikikomori risk. Greater hikikomori risk was associated with poor psychological wellbeing, higher autistic traits and leaving the house less frequently during the COVID-19 pandemic. CONCLUSIONS: These findings suggest similarities with Japanese hikikomori research and are consistent with suggestions that psychological wellbeing and COVID-19 restrictions are associated with increased hikikomori risk in young adults, and both associations are mediated by higher levels of autistic traits.

The Relationship Between Hikikomori Risk and Internet Use During COVID-19 Restrictions.

This study explores the phenomenon of hikikomori, or extreme social isolation, which for the past 20 years has been associated with a range of negative outcomes, including psychological, financial, and social. As hikikomori is associated with marked social withdrawal in one's home and increased Internet use, it has been suggested that the social and technological changes brought about by COVID-19 restrictions may exacerbate the risk of hikikomori in young adults. This study, therefore, sought to identify the relationship between hikikomori risk and changes in Internet use for young people aged 16-24 years during COVID-19 restrictions. An international sample of 826 participants completed an online survey consisting of questions about demographics, experience of lockdown restrictions in the previous 12 months, changes to Internet use in the previous 12 months and a hikikomori risk scale. Higher hikikomori risk was associated with being male, greater time spent in lockdown, and leaving the house less frequently. An increase in Internet use during lockdown was associated with reduced risk of hikikomori. Findings are discussed in relation to gender differences in the type of Internet use engaged in by males and females. It is concluded that online social interaction may be a means of mitigating hikikomori risk in post-COVID-19 societies.

Protocol for the methamphetamine approach-avoidance training (MAAT) trial, a randomised controlled trial of personalised approach bias modification for methamphetamine use disorder.

BACKGROUND: Globally, methamphetamine use has increased in prevalence in recent years. In Australia, there has been a dramatic increase in numbers of people seeking treatment, including residential rehabilitation, for methamphetamine use disorder (MUD). While residential rehabilitation is more effective for MUD than withdrawal treatment (i.e. "detoxification") alone, relapse rates remain high, with approximately half of rehabilitation clients using methamphetamine within 3 months of rehabilitation. "Approach bias modification" (ABM) is a computerised cognitive training approach that aims to dampen automatically triggered impulses to approach drugs and drug-related stimuli. ABM has been demonstrated to reduce alcohol relapse rates, but no randomised controlled trials of ABM for MUD have yet been conducted. We aim to test whether a novel "personalised" form of ABM, delivered during rehabilitation, reduces post-treatment methamphetamine use, relative to a sham-training control condition. Secondary outcomes will include dependence symptoms, cravings, and approach bias. METHODS: We aim to recruit 100 participants attending residential rehabilitation for MUD at 3 sites in the Melbourne metropolitan area. Participants will complete baseline measures of methamphetamine use, craving, dependence severity, and approach bias before being randomised to receiving 6 sessions of ABM or "sham" training. In the active condition, ABM will be personalised for each participant, using those methamphetamine images that they rate as most relevant to their recent methods of methamphetamine use as "avoidance" images and using positive images representing their goals or healthy sources of pleasure as "approach" images. Approach bias and craving will be re-assessed following completion of training, and methamphetamine use, dependence, and craving will be assessed 4 weeks and 3 months following discharge from residential treatment. DISCUSSION: This study is the first randomised controlled trial of ABM for MUD and also the first ABM study to test using a personalised set of both approach and avoid images for ABM training. If effective, the low cost and easy implementation of ABM means it could be widely implemented as a standard part of MUD treatment. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry ACTRN12620000072910. Registered on 30 January 2020 (prospectively registered): https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=378804&isReview=true.

Perceptions of Food Hypersensitivity Expertise on Social Media: Qualitative Study.

BACKGROUND: Seeking and sharing information are the primary uses of the internet and social media. It is therefore vital to understand the processes individuals go through when engaging with information on these diverse platforms, especially in areas such as health- and risk-related information. One important element of such engagement is evaluating and attributing expertise to others. OBJECTIVE: This study aimed to explore how meanings around expertise in relation to food allergy and intolerance (food hypersensitivity) were constructed by 2 groups of social media users: (1) those who use platforms for reasons relating to food hypersensitivity and (2) those seen as experts by this community. METHODS: Survey participants were asked open-ended questions to identify potential experts in food hypersensitivity issues on social media and to discuss their reasoning for their choices (n=143). Subsequently, 8 adult social media users with experience of managing food hypersensitivity and 5 participants designated as experts by those users took part in email interviews. Survey and interview data were analyzed thematically using Braun and Clarke's approach. RESULTS: Judging expertise on social media is a complex and multifaceted process. Users might be judged as experts through their professional background or their experience living with food hypersensitivities. How users behave on social media and the traces of their Web-based activity can influence how others will see them. Such considerations are both measured and moderated through the social media community itself. Findings highlighted how social media often act as a supportive information tool following a diagnosis, but this also raised concerns regarding the scenario of patients not being able to access suitable vetted information. CONCLUSIONS: This work has implications for understanding how users perceive expertise on social media in relation to a health concern and how information assessments are made during the management of risks. Findings provide practical insights to both medical and organizational stakeholders involved in the support of those living with life-changing conditions, such as food hypersensitivities.

Shy Geek, Likes Music, Technology, and Gaming: An Examination of Autistic Males' Online Dating Profiles.

Dating involves a range of complex social skills that autistic adults can often find challenging. Many autistic adults have turned to online dating, which in theory may ameliorate these social difficulties. The aim of this study was to explore, for the first time, how autistic males describe themselves in online dating profiles. The online dating profiles of 52 self-identified autistic males were analyzed using a combination of frequency and thematic analyses. A common pattern of self-description was identified, involving a combination of both desirable and undesirable characteristics. Themes included interests, negative descriptions of personality, ideal match, and autism. Findings are discussed in terms of desirability, the norms of online dating, and the benefits and costs of computer-mediated communication for autistic male online daters.

Co-creation of information leaflets to meet the support needs of people living with complex regional pain syndrome (CRPS) through innovative use of wiki technology.

OBJECTIVE: People living with complex regional pain syndrome (CRPS) experience frustration with the lack of knowledge and understanding of CRPS as a pain condition. We report on our attempt to address this issue. METHODS: People living with CRPS taking part in a larger study were invited to co-construct a CRPS wiki page that addressed the areas in which they had experienced the most difficulty. A blank wiki page was set up for participants to populate with issues they felt needed to be raised and addressed. RESULTS: Participants failed to engage with the wiki technology. We modified our procedure and completed an inductive analysis of a sister-forum which participants were using as part of the larger study. Six issues of importance were identified. We used the discussion forum threads to populate the themes. Due to a continued lack of engagement with the wiki technology, the team decided to create a suite of leaflets which were piloted with delegates at a CRPS patient conference. CONCLUSIONS: Future work should be mindful of the extent to which patients are able and willing to share their experiences through such technology. Striking the balance between patient-endorsed and researcher-driven co-creation of such material is imperative.

International Perceptions of Relational Stalking: The Influence of Prior Relationship, Perpetrator Sex, Target Sex, and Participant Sex.

The present study examines the influence of prior relationship on perceptions of relational stalking in the context of both opposite- and same-sex scenarios using community samples from Australia, the United States, and the United Kingdom. The study used a quasi-experimental 3 × 2 × 2 × 2 × 3 (prior relationship × perpetrator sex × target sex × participant sex × country) independent measures design. Participants comprised 2,160 members of the community, each receiving 1 of 12 versions of a hypothetical scenario and responding to scale items concerning the situation described. The findings support previous research, with scenarios involving a stranger (rather than an acquaintance or ex-partner), and scenarios involving a male perpetrator and a female target, being considered the most serious. The findings further indicate that female observers identify more closely with the role of the victim and male observers identify more closely with the role of the perpetrator, regardless of victim and perpetrator sex, and that differences in the findings across the three countries may be affected by location to a small but significant degree.

Comparing first and second generation digital natives' Internet use, Internet anxiety, and Internet identification.

The aim of the study was to compare first and second generation Digital Natives' attitudes toward and use of the Internet. The sample of first generation Digital Natives consisted of 558 students who we surveyed in 2002 and who were born after 1980. The sample of second generation Digital Natives consisted of a sample of 458 students who we surveyed in 2012 and were born after 1993. They completed a questionnaire in the first semester of their first academic year, which consisted of a measure of Internet experience, an Internet anxiety scale, and an Internet identification scale. Second generation Digital Natives had more positive attitudes toward the Internet than first generation Digital Natives. They had higher scores on the Internet identification scale and lower scores on the Internet anxiety scale compared with first generation Digital Natives. Furthermore, we found that second generation Digital Natives used the Internet more than first generation Digital Natives. E-mail was the most popular activity for both generations, although second generation Digital Natives used it significantly more than first generation Digital Natives. Social networking sites emerged as very popular for second generation Digital Natives. Both generations reported low use of Web 2.0 technologies.

Gender, internet experience, Internet identification, and internet anxiety: a ten-year followup.

In 2002, we found gender differences in the use of the Internet. Since then, however, the Internet has changed considerably. We therefore conducted a follow-up study in 2012. The study involved 501 students (389 females and 100 males, 12 participants unspecified gender) and we measured Internet use, Internet anxiety, and Internet identification. We found that males had a greater breadth of Internet use; they used the Internet more for games and entertainment than females. The differentiation between males and females in terms of Internet use is evident, and in some ways is even more distinct than 10 years ago. In our previous research we had found no gender differences in the use of the Internet for communication, whereas in the current study we have found that females use the Internet for communication than males and were using social network sites more than males. We also found, consistent with our previous study, that Internet identification and Internet anxiety were related to Internet use.

Online dating in Japan: a test of social information processing theory.

This study examines the experiences of past and present members of a popular Japanese online dating site in order to explore the extent to which Western-based theories of computer-mediated communication (CMC) and the development of online relationships are relevant to the Japanese online dating experience. Specifically, it examines whether social information processing theory (SIPT) is applicable to Japanese online dating interactions, and how and to what extent Japanese daters overcome the limitations of CMC through the use of contextual and other cues. Thirty-six current members and 27 former members of Match.com Japan completed an online survey. Using issue-based procedures for grounded theory analysis, we found strong support for SIPT. Japanese online daters adapt their efforts to present and acquire social information using the cues that the online dating platform provides, although many of these cues are specific to Japanese social context.

The presentation of "pro-anorexia" in online group interactions.

Although pro-anorexia online support forums and the narratives that occur within them are increasingly the focus of research, none, to date, focuses closely on issues of identity within this online context. Our aim in conducting this study was to examine the presentation of pro-anorexia via an interpretive phenomenological analysis of postings to a pro-anorexia ("pro-ana") online discussion forum. Analysis indicates that pro-anorexic identities are normalized and strengthened through the normalization of participants' pro-ana thoughts and behaviors, and the group bond created through sharing a secret identity. This process renders participants less likely to reveal their pro-ana identity to friends and family in the real world. The implications of our findings are discussed in relation to the theory of identity demarginalization.

I hear, I listen and I care: a qualitative investigation into the function of a self-harm message board.

This paper reports on the findings of a qualitative inquiry into the interactions on a nonprofessional self-harm message board. Individuals using the message board were very positive about the message board and appeared to feel that their needs for support, venting, and validation were being met. However, we found that negative harmful behaviors mentioned in messages posted on the board were either not acknowledged, or were legitimized and normalized by those who responded to the messages. We suggest that this process of minimizing the seriousness and/or normalizing the behaviors may actually be encouraging the maintenance of such behaviors and therefore conclude that caution should be exercised when using nonprofessional self-harm message boards.

Drawing the net: internet identification, internet use, and the image of internet users.

Theory and research suggest that Internet identification may account for some of the gender divide in Internet use. Internet identification is a type of domain identification, and is inherently bound with images of those who use the Internet, a domain traditionally conceived as masculine. Combining the "draw an Internet user" test with an Internet identification scale, this study tests two hypotheses: participants drawing gender-concordant images will (i) identify with and (ii) use the Internet more than those drawing gender-discordant images. Participants were 371 students (121 males, 250 females) from three universities in the United Kingdom and Australia. The need to challenge masculinized images of the Internet is discussed.

Internet identification and future internet use.

This paper reports a study investigating the relationship between Internet identification and future Internet use. We predict that Internet identification is stable over time and that it is predictive of future use. The participants were 216 undergraduate students (184 females and 32 males) from five universities in the United Kingdom. They completed a questionnaire concerning their use of the Internet and a measure of Internet identification at the start of the academic year and at the end of the academic year. We found that Internet identification measured at the beginning of the academic year was positively related to Internet identification measured at the end of the academic year. Furthermore, there was a positive relationship between Internet identification and future general Internet use and a positive relationship between Internet identification and future educational Internet use.

Investigating the "self" in deliberate self-harm.

In this study, the authors explored how a group of young people aged 16 to 26 years (who identified themselves as having engaged in deliberate self-harm) made sense of the self by conducting two online focus groups and four e-mail interviews. They analyzed data using interpretive phenomenological analysis. The concept of validation was the primary means of making sense of the self and concerned the desire to be considered legitimate and of worth. This desire was clearly evident across three realms of conflict: (a) the intrinsic or extrinsic self, which marked the distinction between objective fact and subjective opinion; (b) the accepted or denied self; and (c) the notion of normality. It is possible that having one's denied self validated online might lead to an exacerbation of an individual's self-harming behavior. Further work is needed to explore the effects of online discussion forums on such taboo forms of behavior.

Gender, Internet identification, and Internet anxiety: correlates of Internet use.

This paper reports a study that investigated the effects of gender, Internet anxiety, and Internet identification on use of the Internet. The study involved 608 undergraduate students (490 females and 118 males). We surveyed the students' experience with the Internet, as well as their levels of Internet anxiety and Internet identification. We found a number of gender differences in participants' use of the Internet. Males were proportionally more likely to have their own web page than were females. They used the Internet more than females; in particular, they were more likely to use game websites, to use other specialist websites, and to download material from the Internet. However, females did not use the Internet for communication more than males. There was a significant positive relationship between Internet identification and total use of the Internet, and a significant negative relationship between Internet anxiety and total use of the Internet. Controlling for Internet identification and Internet anxiety, we found a significant and negative correlation between gender and use of the Internet. In total, all three of our predictors accounted for 40% of the variance in general Internet use: with Internet identification accounting for 26%, Internet anxiety accounting for 11%, and gender accounting for 3%.