Journal of Medical Internet Research - International Scientific Journal for Medical Research, Information and Communication on the Internet

Objective: Acute and/or severe social withdrawal behavior among youth was seen as a culture-bound psychiatric syndrome in Japan, but more youth social withdrawal cases in different countries have been discovered recently. However, due to the lack of a formal definition and diagnostic tool for youth social withdrawal, cross-cultural observational and intervention studies are limited. We aimed to consolidate existing knowledge in order to understand youth social withdrawal from diverse perspectives and suggest different interventions for different trajectories of youth social withdrawal. Method: This review examined the current available scientific information on youth social withdrawal in the academic databases: ProQuest, ScienceDirect, Web of Science and PubMed. We included quantitative and qualitative studies of socially withdrawn youths published in English and academic peer-reviewed journals. Results: We synthesized the information into the following categories: (1) definitions of youth social withdrawal, (2) developmental theories, (3) factors associated with youth social withdrawal and (4) interventions for socially withdrawn youths. Accordingly, there are diverse and controversial definitions for youth social withdrawal. Studies of youth social withdrawal are based on models that lead to quite different conclusions. Researchers with an attachment perspective view youth social withdrawal as a negative phenomenon, whereas those who adopt Erikson’s developmental theory view it more positively as a process of seeking self-knowledge. Different interventions for socially withdrawn youths have been developed, mainly in Japan, but evidence-based practice is almost non-existent. Conclusion: We propose a theoretical framework that views youth social withdrawal as resulting from the interplay between psychological, social and behavioral factors. Future validation of the framework will help drive forward advances in theory and interventions for youth social withdrawal as an emerging issue in developed countries.

Severe social withdrawal behaviors among young people have been a subject of public and clinical concerns. This study aimed to explore the prevalence of social withdrawal behaviors among young people aged 12–29 years in Hong Kong. A cross-sectional telephone-based survey was conducted with 1,010 young individuals. Social withdrawal behaviors were measured with the proposed research diagnostic criteria for hikikomori and were categorized according to the (a) international proposed duration criterion (more than 6 months), (b) local proposed criterion (less than 6 months) and (c) with withdrawal behaviors but self-perceived as non-problematic. The correlates of social withdrawal among the three groups were examined using multinomial and ordinal logistic regression analyses. The prevalence rates of more than 6 months, less than 6 months and self-perceived non-problematic social withdrawal were 1.9%, 2.5% and 2.6%, respectively. In terms of the correlates, the internationally and locally defined socially withdrawn youths are similar, while the self-perceived non-problematic group is comparable to the comparison group. The study finds that the prevalence of severe social withdrawal in Hong Kong is comparable to that in Japan. Both groups with withdrawal behaviors for more or less than 6 months share similar characteristics and are related to other contemporary youth issues, for example, compensated dating and self-injury behavior. The self-perceived non-problematic group appears to be a distinct group and the withdrawal behaviors of its members may be discretionary.

Many people face problems of emotional distress. Early detection of high-risk individuals is the key to prevent suicidal behavior. There is increasing evidence that the Internet and social media provide clues of people’s emotional distress. In particular, some people leave messages showing emotional distress or even suicide notes on the Internet. Identifying emotionally distressed people and examining their posts on the Internet are important steps for health and social work professionals to provide assistance, but the process is very time-consuming and ineffective if conducted manually using standard search engines. Following the design science approach, we present the design of a system called KAREN, which identifies individuals who blog about their emotional distress in the Chinese language, using a combination of machine learning classification and rule-based classification with rules obtained from experts. A controlled experiment and a user study were conducted to evaluate system performance in searching and analyzing blogs written by people who might be emotionally distressed. The results show that the proposed system achieved better classification performance than the benchmark methods and that professionals perceived the system to be more useful and effective for identifying bloggers with emotional distress than benchmark approaches.

Purpose of Review: Social media use (SMU) and other internet-based technologies are ubiquitous in today’s interconnected society, with young people being among the commonest users. Previous literature tends to support that SMU is associated with poor sleep and mental health issues in youth, despite some conflicting findings. In this scoping review, we summarized relevant studies published within the past 3 years, highlighted the impacts of SMU on sleep and mental health in youth, while also examined the possible underlying mechanisms involved. Future direction and intervention on rational use of SMU was discussed. Recent Findings: Both cross-sectional and longitudinal cohort studies demonstrated the negative impacts of SMU on sleep and mental health, with preliminary evidence indicating potential benefits especially during the COVID period at which social restriction was common. However, the limited longitudinal research has hindered the establishment of directionality and causality in the association among SMU, sleep, and mental health. Summary: Recent studies have made advances with a more comprehensive understanding of the impact of SMU on sleep and mental health in youth, which is of public health importance and will contribute to improving sleep and mental health outcomes while promoting rational and beneficial SMU. Future research should include the implementation of cohort studies with representative samples to investigate the directionality and causality of the complex relationships among SMU, sleep, and mental health; the use of validated questionnaires and objective measurements; and the design of randomized controlled interventional trials to reduce overall and problematic SMU that will ultimately enhance sleep and mental health outcomes in youth.

Evaluation of a Web-Based Social Network Electronic Game in Enhancing Mental Health Literacy for Young People