Hikikomori-Like Social Withdrawal Mediates the Relationship Between Autistic Traits and Pathological Video Game Use Among University Students

Background: With the rise of immersive digital entertainment, concerns have grown around Video Gaming addiction (VGA) and its potential link to severe social withdrawal, such as hikikomori, especially in individuals with high autistic traits (ATs). While the association between these dimension has been widely described, there are still few studies on its correlation and, so far, no study has yet investigated the three simultaneously. Aims: Our study aims to explore the presence and interplay between ATs, hikikomori tendencies and VGA, particularly in the context of university students. Methods: 2,168 university students were assessed with the Assessment of Internet and Computer Game Addiction (AICA-S), the Adult Autism Subthreshold Spectrum (AdAS Spectrum), and the Hikikomori Questionnaire-25 (HQ-25) and classified in non-pathological, excessive and pathological gamers, based on the AICA-S scores. Results: Pathological gamers reported greater autistic traits and hikikomori tendencies, moreover AdAS Spectrum and HQ-25 total scores, as well as some of their domains, emerged as significant positive predictors of AICA-S total score, of a greater number of hours spent playing video games and of the presence of school-related issues attributed to video games. A mediation analysis demonstrated significant direct and indirect effect through the HQ-25, of the AdAS Spectrum total score on the AICA-S total score. Conclusions: Our findings support the association between pathological use of video games and both autistic traits and hikikomori tendencies.