Gender in the Suicidal Experience: A Qualitative Study among Adolescents.

BACKGROUND: Teenaged boys die more often than girls by suicide, although they report fewer suicide attempts and seek less care. The aim of this work is to explore the subjective experience of adolescent suicidal behavior to determine the aspects that are common to adolescent girls and boys and those that are specific to one gender. METHOD: The study included 22 adolescents receiving care for suicidal behavior. The semi-structured interviews were analyzed according to the methods of Interpretative Phenomenological Analysis. RESULTS: Three themes of experience emerged: the experience of suffering, connection to others, and courage. The individual and interpersonal dimensions highlight feelings that they are not understood by others and are isolated. Young boys experience relationship difficulties more as rejection, and young girls describe a fear of being abandoned, for which they feel responsible. Boys and girls have different definitions of courage: boys sometimes appear to value the courage to risk death, while girls perceived risk-and therefore courage-in seeking help. DISCUSSION: Specific prevention programs must focus on the perception of care and its representations. By positioning the experience of adolescents as expertise, these programs would thus better respond to the expectations and the reluctance of this audience. Gender attitudes that are harmful to the use of care can be addressed and worked on. By separating the reception of care from the demeaning representation common among teens, these can be linked to a notion of shared vulnerability and interdependence and enable earlier recourse to treatment.

Preliminary study of the social withdrawal (hikikomori) spectrum in French adolescents: focusing on the differences in pathology and related factors compared with Japanese adolescents.

BACKGROUND: Social withdrawal (hikikomori) has become an internationally recognized phenomenon, but its pathology and related factors are not yet fully known. We previously conducted a statistical case-control study on adolescent patients with hikikomori in Japan, which revealed the non-specificity of pathology in patients with hikikomori. Further, environmental factors, such as the lack of communication between parents and Internet overuse, were found to be significant predictors of hikikomori severity. Here, we aimed to conduct a similar preliminary case-control study in France and to compare the results with those from the study conducted in Japan. METHODS: Parents of middle school students who underwent psychiatric outpatient treatment for hikikomori (n = 10) and control group parents (n = 115) completed the Child Behavior Checklist to evaluate their child's psychopathological characteristics and the Parental Assessment of Environment and Hikikomori Severity Scales, as in our previous study in Japan. We compared the descriptive statistics and intergroup differences in France with those from the previous study conducted in Japan. In the multiple regression analysis to find predictors of hikikomori severity in French and also Japanese subjects, the same dependent and independent variables were chosen for the present study (both differed from the previous study). These were used in order to make accurate intercountry comparisons. RESULTS: The comparisons revealed no differences in the pathology of hikikomori between Japan and France. Specifically, both studies found similarly increased scores for all symptom scales, with no specific bias. However, the statistical predictors of hikikomori severity in France (lack of communication between parents and child and lack of communication with the community) differed from those in Japan (lack of communication between parents). CONCLUSION: Hikikomori in Japan and France could be considered essentially the same phenomenon; moreover, our findings demonstrated the universal non-specificity and unbiasedness of the hikikomori pathology. This suggests that hikikomori is not a single clinical category with a specific psychopathology; instead, it is a common phenotype with various underlying pathologies. However, different strategies may be required in each country to prevent the onset and progression of hikikomori.

Identifying Social Withdrawal (Hikikomori) Factors in Adolescents: Understanding the Hikikomori Spectrum.

Hikikomori is a Japanese term for social withdrawal, ranging from complete inability to venture outdoors to preferring to stay inside. The prevalence of hikikomori is high, up to 1.2% of the Japanese population, but only few studies have examined its emergence in adolescents. Therefore, we sought to identify environmental and psycho-behavioral characteristics related to hikikomori during adolescence. Parents of middle school students who underwent psychiatric outpatient treatment for hikikomori (n = 20) and control group parents (n = 88) completed the Child Behavior Checklist to evaluate their child's psycho-behavioral characteristics and novel scales to evaluate environmental characteristics and hikikomori severity. Scores for all eight Child Behavior Checklist subscales were significantly higher in the experimental group. Multiple regression analysis revealed that "anxious/depressed," "somatic complaints," "lack of communication between parents" and "overuse of the Internet" were significant predictors of hikikomori severity. These findings can help identify individuals who are at risk of developing hikikomori.

[Pathology seen in French "Hikikomori"].

Young people who meet the definition of "Hikikomori" have come to be seen in France since around 2008. However, simply "fitting the definition" does not necessarily mean that they are the same as "Hikikomori" in Japan. Rather, it is important to ask what kind of young people "fit the definition of Hikikomori in France" and what kind of pathology they have. With these questions, our Japanese-French joint research team comprising specialists in various fields conducted a survey of "Hikikomori" in French youth, with support from a Grant-in-Aid for Scientific Research B (overseas research), and started a comparative joint study on "Hikikomori" in Japan and "Hikikomori" in France. In that study it was found that whereas one aspect of "Hikikomori" in Japan is described by the word déraillement (coming off the "rails"), "Hikikomori" in France is a state closer to dropping out and is accompanied by a type of "sense of insufficiency". This "sense of insufficiency" is above all related to something in the society and culture of France, and an investigation of how it is linked to "Hikikomori" is an issue for the future.