{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T06:08:59Z","timestamp":1785391739799,"version":"3.55.0"},"reference-count":66,"publisher":"Public Library of Science (PLoS)","issue":"2","license":[{"start":{"date-parts":[[2023,2,21]],"date-time":"2023-02-21T00:00:00Z","timestamp":1676937600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\"><jats:title>Background<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec><jats:sec id=\"sec002\"><jats:title>Aims<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec><jats:sec id=\"sec003\"><jats:title>Methods<\/jats:title><jats:p>646 young people (aged 16\u201324) from a wide range of countries completed an online questionnaire assessing psychological wellbeing, autistic traits and experiences of lockdown for this cross-sectional study.<\/jats:p><\/jats:sec><jats:sec id=\"sec004\"><jats:title>Results<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec><jats:sec id=\"sec005\"><jats:title>Conclusions<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec>","DOI":"10.1371\/journal.pone.0281833","type":"journal-article","created":{"date-parts":[[2023,2,21]],"date-time":"2023-02-21T18:38:40Z","timestamp":1677004720000},"page":"e0281833","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":20,"title":["The impact of higher levels of autistic traits on risk of hikikomori (pathological social withdrawal) in young adults"],"prefix":"10.1371","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0683-1492","authenticated-orcid":true,"given":"Mark","family":"Brosnan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeff","family":"Gavin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2023,2,21]]},"reference":[{"issue":"8","key":"pone.0281833.ref001","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1111\/pcn.12895","article-title":"Hikikomori: Multidimensional understanding, assessment, and future international perspectives","volume":"73","author":"T. A. Kato","year":"2019","journal-title":"Psychiatry and Clinical Neurosciences"},{"issue":"1","key":"pone.0281833.ref002","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1002\/wps.20705","article-title":"Defining pathological social withdrawal: proposed diagnostic criteria for hikikomori","volume":"19","author":"T. A. Kato","year":"2020","journal-title":"World Psychiatry"},{"key":"pone.0281833.ref003","doi-asserted-by":"crossref","unstructured":"Tan, M. P., Lee, W., & Kato, T. A. (2020). International experience of hikikomori (prolonged social withdrawal) and its relevance to psychiatric research. BJPsych International, 1\u20133.","DOI":"10.1192\/bji.2020.20"},{"issue":"2","key":"pone.0281833.ref004","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1177\/0020764008100629","article-title":"A new form of social withdrawal in Japan: a review of hikikomori","volume":"56","author":"A. R. Teo","year":"2010","journal-title":"International Journal of Social Psychiatry"},{"key":"pone.0281833.ref005","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1016\/j.psychres.2008.10.019","article-title":"Lifetime prevalence, psychiatric comorbidity and demographic correlates of \u201chikikomori\u201d in a community population in Japan","volume":"176","author":"A. Koyama","year":"2010","journal-title":"Psychiatry Research"},{"key":"pone.0281833.ref006","doi-asserted-by":"crossref","first-page":"247","DOI":"10.3389\/fpsyt.2019.00247","article-title":"Hikikomori is most associated with interpersonal relationships, followed by suicide risks: a secondary analysis of a national cross-sectional study","volume":"10","author":"R. Yong","year":"2019","journal-title":"Frontiers in Psychiatry"},{"key":"pone.0281833.ref007","doi-asserted-by":"crossref","first-page":"918","DOI":"10.1521\/jscp.2014.33.10.918","article-title":"To conform or to maintain self-consistency? Hikikomori risk in Japan and the deviation from seeking harmony","volume":"33","author":"N. Norasakkunkit","year":"2014","journal-title":"Journal of Social and Clinical Psychology"},{"issue":"1","key":"pone.0281833.ref008","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1002\/wps.20497","article-title":"Hikikomori: experience in Japan and international relevance","volume":"17","author":"T. A. Kato","year":"2018","journal-title":"World Psychiatry"},{"issue":"9796","key":"pone.0281833.ref009","doi-asserted-by":"crossref","first-page":"1070","DOI":"10.1016\/S0140-6736(11)61475-X","article-title":"Are Japan\u2019s hikikomori and depression in young people spreading abroad?","volume":"378","author":"T. A. Kato","year":"2011","journal-title":"The Lancet"},{"key":"pone.0281833.ref010","doi-asserted-by":"crossref","first-page":"1117","DOI":"10.3389\/fpsyg.2015.01117","article-title":"The NEET and Hikikomori spectrum: Assessing the risks and consequences of becoming culturally marginalized","volume":"6","author":"Y. Uchida","year":"2015","journal-title":"Frontiers in Psychology"},{"issue":"7","key":"pone.0281833.ref011","doi-asserted-by":"crossref","first-page":"1061","DOI":"10.1007\/s00127-011-0411-7","article-title":"Does the \u2018hikikomori\u2019 syndrome of social withdrawal exist outside Japan? A preliminary international investigation","volume":"47","author":"T. A. Kato","year":"2012","journal-title":"Social Psychiatry and Psychiatric Epidemiology"},{"issue":"1","key":"pone.0281833.ref012","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1177\/0020764014535758","article-title":"Identification of the hikikomori syndrome of social withdrawal: psychosocial features and treatment preferences in four countries","volume":"61","author":"A. R. Teo","year":"2015","journal-title":"International Journal of Social Psychiatry"},{"issue":"4\u20135","key":"pone.0281833.ref013","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1080\/00221325.2019.1633618","article-title":"Severe social withdrawal: Cultural variation in past hikikomori experiences of university students in Nigeria, Singapore, and the United States","volume":"180","author":"J. C. Bowker","year":"2019","journal-title":"The Journal of Genetic Psychology"},{"issue":"5","key":"pone.0281833.ref014","doi-asserted-by":"crossref","first-page":"808","DOI":"10.1007\/s10578-020-01064-8","article-title":"Identifying social withdrawal (hikikomori) factors in adolescents: understanding the hikikomori spectrum","volume":"52","author":"Y. Hamasaki","year":"2021","journal-title":"Child Psychiatry and Human Development"},{"key":"pone.0281833.ref015","doi-asserted-by":"crossref","unstructured":"Ralston, K., Everington, D., Feng, Z., & Dibben, C. (2021). Economic inactivity, not in employment, education or training (NEET) and scarring: the importance of NEET as a marker of long-term disadvantage. Work, Employment and Society, 0950017020973882.","DOI":"10.1177\/0950017020973882"},{"key":"pone.0281833.ref016","article-title":"Forced social isolation due to COVID\u201019 and consequent mental health problems: Lessons from hikikomori","author":"T. A. Kato","year":"2020b","journal-title":"Psychiatry and Clinical Neurosciences"},{"issue":"1","key":"pone.0281833.ref017","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1016\/j.psychres.2015.04.033","article-title":"Psychopathology associated with social withdrawal: Idiopathic and comorbid presentations","volume":"228","author":"A. R. Teo","year":"2015","journal-title":"Psychiatry Research"},{"key":"pone.0281833.ref018","first-page":"433","volume-title":"Cultural sociology of mental illness: An A-to-Z guide","author":"V. Norasakkunkit","year":"2014"},{"key":"pone.0281833.ref019","doi-asserted-by":"crossref","first-page":"455","DOI":"10.3389\/fpsyt.2019.00455","article-title":"Internet addiction, smartphone addiction, and Hikikomori trait in Japanese young adults: social isolation and social network","volume":"10","author":"M. Tateno","year":"2019","journal-title":"Frontiers in Psychiatry"},{"issue":"6","key":"pone.0281833.ref020","doi-asserted-by":"crossref","first-page":"444","DOI":"10.1097\/NMD.0b013e3181e086b1","article-title":"Hikikomori, a Japanese culture-bound syndrome of social withdrawal? A proposal for DSM-V","volume":"198","author":"A. R. Teo","year":"2010","journal-title":"The Journal of Nervous and Mental Disease"},{"key":"pone.0281833.ref021","first-page":"191","article-title":"The phenomenon of \u201chikikomori\u201d(social withdrawal) and the socio-cultural situation in Japan today","volume":"19","author":"M. Suwa","year":"2013","journal-title":"Journal of Psychopathology"},{"issue":"1","key":"pone.0281833.ref022","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/1471-244X-12-169","article-title":"Hikikomori as a possible clinical term in psychiatry: a questionnaire survey","volume":"12","author":"M. Tateno","year":"2012","journal-title":"BMC Psychiatry"},{"key":"pone.0281833.ref023","doi-asserted-by":"crossref","unstructured":"American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https:\/\/doi.org\/10.1176\/appi.books.9780890425596.","DOI":"10.1176\/appi.books.9780890425596"},{"key":"pone.0281833.ref024","unstructured":"World Health Organization. (2018). ICD-11: International classification of diseases (11th revision). https:\/\/icd.who.int\/."},{"issue":"12","key":"pone.0281833.ref025","doi-asserted-by":"crossref","first-page":"652","DOI":"10.1111\/pcn.13154","article-title":"Autism spectrum conditions in hikikomori: a pilot case\u2013control study","volume":"74","author":"R. Katsuki","year":"2020","journal-title":"Psychiatry and Clinical Neurosciences"},{"issue":"2","key":"pone.0281833.ref026","doi-asserted-by":"crossref","first-page":"202","DOI":"10.1016\/j.jaac.2011.11.003","article-title":"Toward brief \u201cred flags\u201d for autism screening: the short autism spectrum quotient and the short quantitative checklist in 1,000 cases and 3,000 controls","volume":"51","author":"C. Allison","year":"2012","journal-title":"Journal of the American Academy of Child & Adolescent Psychiatry"},{"issue":"1","key":"pone.0281833.ref027","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1023\/A:1005653411471","article-title":"The autism-spectrum quotient (AQ): Evidence from asperger syndrome\/high-functioning autism, males and females, scientists and mathematicians","volume":"31","author":"S. Baron-Cohen","year":"2001","journal-title":"Journal of Autism and Developmental Disorders"},{"issue":"11","key":"pone.0281833.ref028","doi-asserted-by":"crossref","first-page":"4158","DOI":"10.1007\/s10803-020-04474-8","article-title":"An exploratory study of a dimensional assessment of the diagnostic criteria for autism","volume":"50","author":"M. Brosnan","year":"2020","journal-title":"Journal of Autism and Developmental Disorders"},{"issue":"6","key":"pone.0281833.ref029","doi-asserted-by":"crossref","first-page":"655","DOI":"10.1016\/j.biopsych.2004.12.014","article-title":"Intergenerational transmission of subthreshold autistic traits in the general population","volume":"57","author":"J. N. Constantino","year":"2005","journal-title":"Biological Psychiatry"},{"issue":"1","key":"pone.0281833.ref030","first-page":"1","article-title":"Measuring autistic traits in the general population: a systematic review of the Autism-Spectrum Quotient (AQ) in a nonclinical population sample of 6,900 typical adult males and females","volume":"6","author":"E. Ruzich","year":"2015","journal-title":"Molecular Autism"},{"key":"pone.0281833.ref031","first-page":"1","article-title":"Longitudinal association between autistic traits and affinity for hikikomori in Japanese university students","author":"Y. Shimono","year":"2021","journal-title":"Current Psychology"},{"issue":"10","key":"pone.0281833.ref032","doi-asserted-by":"crossref","first-page":"e003319","DOI":"10.1136\/bmjgh-2020-003319","article-title":"Lockdown measures in response to COVID-19 in nine sub-Saharan African countries","volume":"5","author":"N. Haider","year":"2020","journal-title":"BMJ Global Health"},{"key":"pone.0281833.ref033","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1016\/j.ijid.2020.05.018","article-title":"Mitigating lockdown challenges in response to COVID-19 in Sub-Saharan Africa","volume":"96","author":"L. E. Mboera","year":"2020","journal-title":"International Journal of Infectious Diseases"},{"issue":"3","key":"pone.0281833.ref034","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1002\/wps.20804","article-title":"Hikikomori: a hidden mental health need following the COVID\u201019 pandemic","volume":"19","author":"M. Rooksby","year":"2020","journal-title":"World Psychiatry"},{"key":"pone.0281833.ref035","doi-asserted-by":"crossref","first-page":"102288","DOI":"10.1016\/j.ajp.2020.102288","article-title":"Potential changes to the hikikomori phenomenon in the wake of the Covid-19 pandemic","volume":"54","author":"P. W. Wong","year":"2020","journal-title":"Asian Journal of Psychiatry"},{"key":"pone.0281833.ref036","doi-asserted-by":"crossref","first-page":"559951","DOI":"10.3389\/fpsyg.2020.559951","article-title":"Adolescents in quarantine during COVID-19 pandemic in Italy: perceived health risk, beliefs, psychological experiences and expectations for the future","volume":"11","author":"E. Commodari","year":"2020","journal-title":"Frontiers in Psychology"},{"issue":"2","key":"pone.0281833.ref037","article-title":"The psychological impact of the lockdown on Italian university students during the first wave of COVID-19 pandemic: psychological experiences, health risk perceptions, distance learning, and future perspectives","volume":"9","author":"E. Commodari","year":"2021","journal-title":"Mediterranean Journal of Clinical Psychology"},{"issue":"23","key":"pone.0281833.ref038","doi-asserted-by":"crossref","first-page":"15814","DOI":"10.3390\/ijerph192315814","article-title":"Flourishing or Languishing? Predictors of Positive Mental Health in Medical Students during the COVID-19 Pandemic","volume":"19","author":"C. Concerto","year":"2022","journal-title":"International Journal of Environmental Research and Public Health"},{"issue":"1","key":"pone.0281833.ref039","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1038\/s41598-020-79850-6","article-title":"Depressive symptoms in response to COVID-19 and lockdown: a cross-sectional study on the Italian population","volume":"10","author":"M. Delmastro","year":"2020","journal-title":"Scientific Reports"},{"key":"pone.0281833.ref040","doi-asserted-by":"crossref","first-page":"586246","DOI":"10.3389\/fpsyg.2020.586246","article-title":"Perceived impact of Covid-19 across different mental disorders: a study on disorder-specific symptoms, psychosocial stress and behavior","volume":"11","author":"H. L. Quittkat","year":"2020","journal-title":"Frontiers in Psychology"},{"key":"pone.0281833.ref041","doi-asserted-by":"crossref","first-page":"113918","DOI":"10.1016\/j.psychres.2021.113918","article-title":"Autistic traits and negative emotions in the general population during COVID-19: mediating roles of the behavioural immune system and COVID-19 risk perception","volume":"300","author":"X. Zhao","year":"2021","journal-title":"Psychiatry Research"},{"key":"pone.0281833.ref042","doi-asserted-by":"crossref","first-page":"110973","DOI":"10.1016\/j.paid.2021.110973","article-title":"How anxiety predicts interpersonal curiosity during the COVID-19 pandemic: the mediation effect of interpersonal distancing and autistic tendency","volume":"180","author":"Q. Huang","year":"2021","journal-title":"Personality and Individual Differences"},{"issue":"6","key":"pone.0281833.ref043","doi-asserted-by":"crossref","first-page":"334","DOI":"10.1192\/bjp.2020.242","article-title":"Mental health before and during the COVID-19 pandemic in two longitudinal UK population cohorts","volume":"218","author":"A. S. Kwong","year":"2021","journal-title":"The British Journal of Psychiatry"},{"issue":"1","key":"pone.0281833.ref044","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1590\/1516-4446-2020-1145","article-title":"Hikikomori and the COVID-19 pandemic: not leaving behind the socially withdrawn","volume":"43","author":"T. H. Roza","year":"2021","journal-title":"Brazilian Journal of Psychiatry"},{"key":"pone.0281833.ref045","article-title":"The influence of the COVID-19 pandemic on mental well-being and psychological distress: impact upon a single country","volume":"11","author":"N. S. Gray","year":"2020","journal-title":"Frontiers in Psychiatry"},{"issue":"6","key":"pone.0281833.ref046","doi-asserted-by":"crossref","first-page":"326","DOI":"10.1192\/bjp.2020.212","article-title":"Mental health and well-being during the COVID-19 pandemic: longitudinal analyses of adults in the UK COVID-19 Mental Health & Wellbeing study","volume":"218","author":"R. C. O\u2019Connor","year":"2021","journal-title":"The British Journal of Psychiatry"},{"issue":"3","key":"pone.0281833.ref047","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1089\/cyber.2021.0171","article-title":"The relationship between hikikomori risk and internet Use during COVID-19 restrictions","volume":"25","author":"J. Gavin","year":"2022","journal-title":"Cyberpsychology, Behavior, and Social Networking"},{"key":"pone.0281833.ref048","unstructured":"Hofstede-insights.com https:\/\/www.hofstede-insights.com\/ last accessed 05\/01\/2023."},{"key":"pone.0281833.ref049","unstructured":"Hofstede, G. (1980), Culture\u2019s Consequences: International Differences in Work-Related Values. Sage, Beverly Hills, CA."},{"key":"pone.0281833.ref050","unstructured":"Hofstede, G. (2001), Culture\u2019s Consequences: Comparing Values, Behaviors, Institutions, and Organizations Across Nations, 2nd ed., Sage, Thousand Oaks, CA."},{"key":"pone.0281833.ref051","doi-asserted-by":"crossref","first-page":"382","DOI":"10.1016\/j.psychres.2017.06.071","article-title":"Evidence for the Psychometric Validity, Internal consistency and measurement invariance of Warwick Edinburgh Mental Wellbeing Scale Scores in Scottish and Irish Adolescents","volume":"255","author":"MT McKay","year":"2017","journal-title":"Psychiatry Research"},{"key":"pone.0281833.ref052","doi-asserted-by":"crossref","first-page":"718","DOI":"10.1177\/1403494817735391","article-title":"Validation of two versions of the Warwick-Edinburgh Mental Well-Being Scale among Norwegian adolescents","volume":"46","author":"R. Ringdal","year":"2018","journal-title":"Scandinavian Journal of Public Health"},{"key":"pone.0281833.ref053","doi-asserted-by":"crossref","first-page":"2997","DOI":"10.1007\/s10803-013-1844-5","article-title":"Brief report: An evaluation of the AQ-10 as a brief screening instrument for ASD in Adults","volume":"43","author":"T. Booth","year":"2013","journal-title":"Journal of Autism and Developmental Disorders"},{"key":"pone.0281833.ref054","doi-asserted-by":"crossref","first-page":"773","DOI":"10.1007\/s10803-018-3749-9","article-title":"Measuring autism traits in the adult general population with the brief autism-spectrum quotient, AQ-10: findings from the Stockholm Public Health Cohort","volume":"49","author":"A. Lundin","year":"2019","journal-title":"Journal of Autism and Developmental Disorders"},{"issue":"3","key":"pone.0281833.ref055","doi-asserted-by":"crossref","first-page":"e132","DOI":"10.2196\/jmir.6.3.e34","article-title":"Improving the quality of Web surveys: the Checklist for Reporting Results of Internet E-Surveys (CHERRIES)","volume":"6","author":"G. Eysenbach","year":"2004","journal-title":"Journal of medical Internet research"},{"issue":"1","key":"pone.0281833.ref056","doi-asserted-by":"crossref","first-page":"e2042","DOI":"10.2196\/jmir.2042","article-title":"Correction: improving the Quality of web surveys: the Checklist for Reporting results of internet E-Surveys (CHERRIES)","volume":"14","author":"G. Eysenbach","year":"2012","journal-title":"Journal of medical Internet research"},{"key":"pone.0281833.ref057","first-page":"1","article-title":"Autistic traits and gender modulate emotion changes before and during the COVID-19 pandemic","author":"X. Zhao","year":"2021b","journal-title":"Current Psychology"},{"key":"pone.0281833.ref058","unstructured":"Hayes, A.F. (2022). Introduction to mediation, moderation, and conditional process analysis: a regression-based approach. Guildford Press."},{"issue":"4","key":"pone.0281833.ref059","first-page":"237","article-title":"Characteristics of and gender difference factors of hikikomori among the working-age population: a cross-sectional population study in rural Japan","volume":"67","author":"R. K. Yong","year":"2020","journal-title":"Japanese Journal of Public Health"},{"issue":"10","key":"pone.0281833.ref060","doi-asserted-by":"crossref","first-page":"4159","DOI":"10.1007\/s10803-019-04119-5","article-title":"Is there a relationship between cyber-dependent crime, autistic-like traits and autism?","volume":"49","author":"K. L. Payne","year":"2019","journal-title":"Journal of Autism and Developmental Disorders"},{"issue":"1","key":"pone.0281833.ref061","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1111\/pcn.12481","article-title":"Can Pok\u00e9mon GO rescue shut-ins (hikikomori) from their isolated world","volume":"71","author":"T. A. Kato","year":"2017","journal-title":"Psychiatry and Clinical Neurosciences"},{"key":"pone.0281833.ref062","doi-asserted-by":"crossref","first-page":"848","DOI":"10.1016\/j.psychres.2016.10.038","article-title":"New game software (Pok\u00e9mon Go) may help youth with severe social withdrawal, hikikomori","volume":"246","author":"M. Tateno","year":"2016","journal-title":"Psychiatry Research"},{"issue":"4","key":"pone.0281833.ref063","doi-asserted-by":"crossref","first-page":"836","DOI":"10.1177\/00207640211009266","article-title":"Home visiting support for people with hikikomori (social withdrawal) provided by experienced and effective workers","volume":"68","author":"A. Funakoshi","year":"2022","journal-title":"International Journal Social Psychiatry"},{"issue":"11","key":"pone.0281833.ref064","doi-asserted-by":"crossref","first-page":"1560","DOI":"10.7326\/M22-1507","article-title":"The Impact of the COVID-19 Pandemic and Associated Control Measures on the Mental Health of the General Population: A Systematic Review and Dose\u2013Response Meta-analysis","volume":"175","author":"G. Salanti","year":"2022","journal-title":"Annals of Internal Medicine"},{"issue":"6","key":"pone.0281833.ref065","doi-asserted-by":"crossref","first-page":"774","DOI":"10.3390\/brainsci11060774","article-title":"Autistic traits and attention-deficit hyperactivity disorder symptoms predict the severity of internet gaming disorder in an italian adult population","volume":"11","author":"C. Concerto","year":"2021","journal-title":"Brain Sciences"},{"issue":"3","key":"pone.0281833.ref066","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1097\/YCO.0000000000000601","article-title":"Internet society, internet addiction, and pathological social withdrawal: the chicken and egg dilemma for internet addiction and hikikomori","volume":"33","author":"T. A. Kato","year":"2020","journal-title":"Current Opinion in Psychiatry"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0281833","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,7]],"date-time":"2023-12-07T09:46:43Z","timestamp":1701942403000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0281833"}},"subtitle":[],"editor":[{"given":"Carmen","family":"Concerto","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2023,2,21]]},"references-count":66,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2023,2,21]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0281833","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,2,21]]}}}