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Background: Hikikomori (acute social withdrawal) is a social issue in Japan that affects both the society and the lives of the individual sufferers.

Aims: This study aims to connect attachment theory and hikikomori by using a culturally sensitive psychosocial developmental model that outlines the various stages of attachment throughout the developmental years.

Method: Twenty–four hikikomori sufferers and 60 comparison group participants were given questionnaires assessing parent and peer relationships, temperament and school experiences.

Results: We found the hikikomori participants had a higher incidence of ambivalent attachment, reported more parental and peer rejection and bullying, and expressed greater temperamental shyness. Path analysis supported our developmental model. We found that shy temperament and parental rejection predicted ambivalent attachment, which when coupled with peer rejection predicted hikikomori. Our model implies that treatment and prevention may require attention to attachment insecurities in early childhood, peer rejection in middle childhood and/or early adolescence.

Conclusion: We believe it is helpful in understanding hikikomori to first understand how the attachment system balances security with exploration and the anxiety associated with novelty and challenge. Finally, we examine implications of the model for intervention, treatment and future research.

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