Hikikomori and the false positives challenge: Comment on Amendola's “Clarifying the position of hikikomori in mental health

Amendola's review raises the question of whether some variants of hikikomori-type social withdrawal are not mental disorders but rather psychologically normal-range attempts to cope with a changing social environment that is unlike the one for which human beings were biologically designed. To place this question in context, I survey issues regarding the prevention of false-positive diagnoses of problematic non-disordered conditions as disorders. I offer a series of examples of other categories in which such errors have occurred and sometimes been corrected, drawing parallels to and implications for the consideration of hikikomori. I argue that hikikomori offers an opportunity for reflection on how novel problematic behaviors can be assessed for disordered versus non-disordered variants.