{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T16:37:54Z","timestamp":1790095074289,"version":"4.0.1"},"reference-count":48,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2023,6,16]],"date-time":"2023-06-16T00:00:00Z","timestamp":1686873600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Hikikomori is a severe form of social withdrawal increasing among the young Italian population. Hikikomori has been connected to psychological problems and high environmental sensitivity. Nevertheless, only a few studies have been carried out in the Italian context, and they did not analyze several aspects strictly related to the hikikomori phenomenon, such as the role of attachment and sensitivity. We aimed to investigate the relationship between attachment, sensitivity, and psychological problems in a sample of Italian hikikomori. Our sample comprised 72 Italian adolescents and young adults (49 males and 23 females), meanly aged 22.5 years, recruited through online forums and clinical centers for the hikikomori phenomenon. Our participants fulfilled the Highly Sensitive Person Scale (HSPS), the Attachment Style Questionnaire (ASQ), and the Hopkins Symptom Checklist (SCL-90-R). The results showed high psychological issues (i.e., depression and anxiety), environmental sensitivity, and insecure attachment orientations. Moreover, we discovered a significant relationship between attachment dimensions, environmental sensitivity, and psychopathology. Our study sheds light on a novel research path and could help both the researchers and the clinicians who work with people suffering from social withdrawal.<\/jats:p>","DOI":"10.3390\/ijerph20126148","type":"journal-article","created":{"date-parts":[[2023,6,16]],"date-time":"2023-06-16T02:54:33Z","timestamp":1686884073000},"page":"6148","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Sensitivity and Attachment in an Italian Sample of Hikikomori Adolescents and Young Adults"],"prefix":"10.3390","volume":"20","author":[{"given":"Alessandra","family":"Santona","sequence":"first","affiliation":[{"name":"Department of Psychology, University of Milano-Bicocca, 20126 Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Lionetti","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Imagine and Clinical Sciences, University of G. D\u2019Annunzio Chieti-Pescara, 66100 Chieti, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6108-4645","authenticated-orcid":false,"given":"Giacomo","family":"Tognasso","sequence":"additional","affiliation":[{"name":"Department of Psychology, University of Milano-Bicocca, 20126 Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Fusco","sequence":"additional","affiliation":[{"name":"Department of Psychology, University of Milano-Bicocca, 20126 Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Graziana","family":"Maccagnano","sequence":"additional","affiliation":[{"name":"Department of Psychology, University of Milano-Bicocca, 20126 Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danila","family":"Barreca","sequence":"additional","affiliation":[{"name":"Department of Psychology, University of Milano-Bicocca, 20126 Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5939-3134","authenticated-orcid":false,"given":"Laura","family":"Gorla","sequence":"additional","affiliation":[{"name":"Department of Psychology, University of Milano-Bicocca, 20126 Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,6,16]]},"reference":[{"key":"ref_1","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":"Kato","year":"2019","journal-title":"Psychiatry Clin. Neurosci."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1010","DOI":"10.1177\/00207640221099408","article-title":"Hikikomori and Modern-Type Depression in Italy: A New Phenotypical Trans-Cultural Characterization?","volume":"68","author":"Orsolini","year":"2022","journal-title":"Int. J. Soc. Psychiatry"},{"key":"ref_3","unstructured":"Saito, T. (1998). Social Withdrawal (Shakaiteki Hikikomori), PHP Shinsho. (In Japanese)."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"e03011","DOI":"10.1016\/j.heliyon.2019.e03011","article-title":"Development of 5-Day Hikikomori Intervention Program for Family Members: A Single-Arm Pilot Trial","volume":"6","author":"Kubo","year":"2020","journal-title":"Heliyon"},{"key":"ref_5","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":"Teo","year":"2010","journal-title":"Int. J. Soc. Psychiatry"},{"key":"ref_6","first-page":"21","article-title":"Hikikomori: Clinical and Psychopathological Issues","volume":"2","author":"Sarchione","year":"2015","journal-title":"Res. Av. Psychiatry"},{"key":"ref_7","first-page":"191","article-title":"The Phenomenon of \u201cHikikomori\u201d (Social Withdrawal) and the Socio-Cultural Situation in Japan Today","volume":"19","author":"Suwa","year":"2013","journal-title":"J. Psychopathol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"558","DOI":"10.3389\/fpsyt.2019.00558","article-title":"Similar but Different: Psychological and Psychopathological Features of Primary and Secondary Hikikomori","volume":"10","author":"Frankova","year":"2019","journal-title":"Front. Psychiatry"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"595","DOI":"10.1177\/0004867415581179","article-title":"Youth Social Withdrawal Behavior (Hikikomori): A Systematic Review of Qualitative and Quantitative Studies","volume":"49","author":"Li","year":"2015","journal-title":"Aust. N. Z. J. Psychiatry"},{"key":"ref_10","first-page":"157","article-title":"Il Fenomeno Dell\u2019hikikomori: Cultural Bound o Quadro Psicopatologico Emergente?","volume":"16","author":"Aguglia","year":"2010","journal-title":"Petralia Giorn Ital Psicopat"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"286","DOI":"10.1016\/j.jpeds.2020.06.089","article-title":"The Hikikomori Phenomenon of Social Withdrawal: An Emerging Condition Involving Youth\u2019s Mental Health and Social Participation","volume":"225","author":"Ferrara","year":"2020","journal-title":"J. Pediatr."},{"key":"ref_12","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":"Bowker","year":"2019","journal-title":"J. Genet. Psychol."},{"key":"ref_13","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 Adult: Social Isolation and Social Network","volume":"10","author":"Tateno","year":"2019","journal-title":"Front. Psychiatry"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"e025213","DOI":"10.1136\/bmjopen-2018-025213","article-title":"The Hikikomori\u2019 Syndrome: Worldwide Prevalence and Co-Occurring Major Psychiatric Disorders: A Systematic Review and Meta-Analysis Protocol","volume":"9","author":"Pozza","year":"2019","journal-title":"BMJ Open"},{"key":"ref_15","unstructured":"Lancini, M. (2019). Il Ritiro Sociale Negli Adolescenti, Raffaello Cortina."},{"key":"ref_16","unstructured":"Crepaldi, M. (2019). Hikikomori: I Giovani Che Non Escono Di Casa, Alpes Italia."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"989","DOI":"10.1037\/dev0000471","article-title":"Secure Base Script and Psychological Dysfunction in Japanese Young Adults in the 21st Century: Using the Attachment Script Assessment","volume":"54","author":"Umemura","year":"2018","journal-title":"Dev. Psychol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1177\/0020764011423182","article-title":"Attachment and Hikikomori: A Psychosocial Developmental Model","volume":"59","author":"Krieg","year":"2013","journal-title":"Int. J. Soc. Psychiatry"},{"key":"ref_19","unstructured":"Bowlby, J. (1969). Attachment and Loss: Volume I: Attachment, Basic Books."},{"key":"ref_20","unstructured":"Feeney, J.A., Noller, P., and Hanrahan, M. (1994). Attachment in Adults: Clinical and Developmental Perspectives. BT\u2014Attachment in Adults: Clinical and Developmental Perspectives, Guilford Press."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1135","DOI":"10.1111\/j.1467-6494.2010.00645.x","article-title":"Adult Attachment, Dependence, Self-Criticism, and Depressive Symptoms: A Test of a Mediational Model","volume":"78","author":"Cantazaro","year":"2010","journal-title":"J. Pers."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Mikulincer, M., and Shaver, P.R. (2013). The Role of Attachment Security in Adolescent and Adult Close Relationships, Oxford University Press.","DOI":"10.1093\/oxfordhb\/9780195398694.013.0004"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1016\/j.wpsyc.2012.01.003","article-title":"An Attachment Perspective on Psychopathology","volume":"11","author":"Mikulincer","year":"2012","journal-title":"World Psychiatry"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1300\/J189v04n03_01","article-title":"Social Withdrawal in Japanese Youth","volume":"4","author":"Hattori","year":"2006","journal-title":"J. Trauma Pract."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1007\/s10615-007-0110-8","article-title":"What Is Adult Attachment?","volume":"36","author":"Sable","year":"2008","journal-title":"Clin. Soc. Work J."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"511","DOI":"10.1037\/0022-3514.52.3.511","article-title":"Romantic Love Conceptualized as an Attachment Process","volume":"52","author":"Hazan","year":"1987","journal-title":"J. Pers. Soc. Psychol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1037\/1089-2680.4.2.132","article-title":"Adult Romantic Attachment: Theoretical Developments, Emerging Controversies, and Unanswered Questions","volume":"4","author":"Fraley","year":"2000","journal-title":"Rev. Gen. Psychol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"346","DOI":"10.1177\/0165025415587726","article-title":"The Relationships between Shyness and Unsociability and Peer Difficulties: The Moderating Role of Insecure Attachment","volume":"40","author":"Chen","year":"2016","journal-title":"Int. J. Behav. Dev."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1038\/s41398-017-0090-6","article-title":"Dandelions, Tulips and Orchids: Evidence for the Existence of Low-Sensitive, Medium-Sensitive and High-Sensitive Individuals","volume":"8","author":"Lionetti","year":"2018","journal-title":"Transl. Psychiatry"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1016\/j.paid.2015.03.045","article-title":"Trait Sensory-Processing Sensitivity and Subjective Well-Being: Distinctive Associations for Different Aspects of Sensitivity","volume":"83","author":"Sobocko","year":"2015","journal-title":"Pers. Individ. Differ."},{"key":"ref_31","unstructured":"Acevedo, B.P. (2020). The Highly Sensitive Brain, Academic Press."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1016\/j.neubiorev.2019.01.009","article-title":"Sensory Processing Sensitivity in the Context of Environmental Sensitivity: A Critical Review and Development of Research Agenda","volume":"98","author":"Greven","year":"2019","journal-title":"Neurosci. Biobehav. Rev."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1037\/dev0000406","article-title":"Environmental Sensitivity in Children: Development of the Highly Sensitive Child Scale and Identification of Sensitivity Groups","volume":"54","author":"Pluess","year":"2018","journal-title":"Dev. Psychol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1177\/0020764011423184","article-title":"Comorbid Social Withdrawal (Hikikomori) in Outpatients with Social Anxiety Disorder: Clinical Characteristics and Treatment Response in a Case Series","volume":"59","author":"Nagata","year":"2013","journal-title":"Int. J. Soc. Psychiatry"},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Kubo, H., Katsuki, R., Horie, K., Yamakawa, I., Tateno, M., Shinfuku, N., Sartorius, N., Sakamoto, S., and Kato, T.A. (2022). Risk Factors of Hikikomori among Office Workers during the COVID-19 Pandemic: A Prospective Online Survey. Curr. Psychol., 1\u201319.","DOI":"10.1007\/s12144-022-03446-8"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1111\/pcn.13354","article-title":"Hikikomori: Social Withdrawal a Risk Factor for Depression","volume":"76","author":"Lee","year":"2022","journal-title":"Psychiatry Clin. Neurosci."},{"key":"ref_37","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":"Yong","year":"2019","journal-title":"Front. Psychiatry"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1039","DOI":"10.1016\/j.psychres.2018.03.060","article-title":"A 12-Month Study of the Hikikomori Syndrome of Social Withdrawal: Clinical Characterization and Different Subtypes Proposal","volume":"270","author":"Teo","year":"2018","journal-title":"Psychiatry Res."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"97","DOI":"10.4081\/hpr.2020.9068","article-title":"Hikikomori: A Systemic-Relational Analysis","volume":"8","author":"Maglia","year":"2020","journal-title":"Health Psychol. Res."},{"key":"ref_40","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":"Hamasaki","year":"2021","journal-title":"Child Psychiatry Hum. Dev."},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Hall, J.A., and Bernieri, F.J. (2001). Interpersonal Sensitivity Theory and Measurement, Lawrence Erlbaum Associates Publishers.","DOI":"10.4324\/9781410600424"},{"key":"ref_42","first-page":"106","article-title":"Hikikomori, Problematic Internet Use and Psychopathology: Correlates in Non-Clinical and Clinical Samples of Young Adults in Italy","volume":"27","author":"Amendola","year":"2021","journal-title":"J. Psychopathol."},{"key":"ref_43","first-page":"55","article-title":"On the Dimensionality of the Attachment Style Questionnaire in Italian Clinical and Nonclinical Participants","volume":"20","author":"Fossati","year":"2003","journal-title":"J. Soc. Pers. Relatsh."},{"key":"ref_44","unstructured":"Sarno, I., Preti, E., Prunas, A., and Madeddu, F. (2011). SCL-90-R Symptom Checklist-90-R Adattamento Italiano 2011, Giunti, Organizzazioni Speciali."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1176\/ajp.111.5.343","article-title":"Comfort, Effectiveness, and Self-Awareness as Criteria of Improvement in Psychotherapy","volume":"111","author":"Parloff","year":"1954","journal-title":"Am. J. Psychiatry"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1037\/0022-3514.73.2.345","article-title":"Sensory-Processing Sensitivity and Its Relation to Introversion and Emotionality","volume":"73","author":"Aron","year":"1997","journal-title":"J. Pers. Soc. Psychol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"374","DOI":"10.1002\/cpp.667","article-title":"Attachment and Symptoms of Psychopathology: Early Maladaptive Schemas as a Cognitive Link?","volume":"17","author":"Bosmans","year":"2010","journal-title":"Clin. Psychol. Psychother."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"1429","DOI":"10.1016\/j.paid.2005.05.007","article-title":"Sensory Processing Sensitivity and Its Relation to Parental Bonding, Anxiety, and Depression","volume":"39","author":"Liss","year":"2005","journal-title":"Pers. Individ. Differ."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/20\/12\/6148\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T19:56:15Z","timestamp":1760126175000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/20\/12\/6148"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,6,16]]},"references-count":48,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2023,6]]}},"alternative-id":["ijerph20126148"],"URL":"https:\/\/doi.org\/10.3390\/ijerph20126148","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,6,16]]}}}