![]() ![]() Hikikomori is associated with a range of problems at an individual level for instance, histories of trauma (Hattori, 2006), and developmental problems are common in childhood (Koyama et al., 2010). It has been estimated that there were about one million young people with this condition in Japan (Saito, 1998). Impairing patterns of long term adolescent social withdrawal and self-exclusion, including nonattendance at school or work, and minimal social contact, have been identified as a significant clinical and social problem in Japan since the late 1990s, where it is termed hikikomori (Kato et al., 2012). In this editorial perspective, we highlight how youth social withdrawal is becoming a clinical and social concern in some parts of the world and respond to the lack of research on this issue by synthesizing some of the basic research findings, and suggesting future directions for research and practice relating to this emerging youth phenomenon in middle-and-high-income countries in the hope of bringing more attention to this issue. Understanding of the issue including its causes, risks, and outcomes is very limited. Socially withdrawn youths, unfortunately, are difficult to identify and their risks can be ‘invisible’ because of their withdrawn nature and the traditional perspective of what is perceived as at-risk youth. Since its first identification, similar cases have been reported in other countries. ![]() As well clinical impairment for the withdrawn youths and burden for the families, hikikomori has brought societal and health service costs in Japan. The concept of the pathological fear of death requires further study and refinement in the area of its descriptive demarcation, psychogenesis, and clinical application.Impairing patterns of long-term adolescent social withdrawal and self-exclusion, including nonattendance at school or work, and minimal social contact, have been identified as a significant clinical and social problem in Japan since the late 1990s, where it is termed hikikomori. Finally, the article has briefly dealt with the relevance of the pathological fear of death for diagnostic assessment and psychotherapy of patients with panic disorder and hypochondriasis. ![]() A relationship between panic disorder and hypochondriasis has been examined in the light of the pathological fear of death that they often share. A role of the cognitive abnormalities in the genesis of the pathological fear of death has been examined in the panic attacks and hypochondriasis, while a developmentally determined, pervasive mistrust in the bodily functioning and bodily worth has been stressed as a factor that crucially predisposes to the pathological fear of death in hypochondriasis, and to the respective type of hypochondriasis as well. The additional contributing factors have also been taken into consideration: a defect in the defensive and symbolic representation of death, and a general collapse of defensive functioning, with regression to a state of infantile helplessness and revival of the infantile death cognitions. In an attempt to account for the origin of the pathological fear of death, most weight has been given to developmental and structural abnormalities in the regulation and control of the primary and disruptive forms of anxiety. The article has presented a concept of the pathological fear of death as a categorically defined phenomenon and outlined its distinguishing features.
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