Investigation of Risk and Protective Factors in Women Attempting Suicide: A Phenomenological Approach

Document Type : Research Paper

Authors

1 Ph.D. Student, Department of Psychology, Faculty of Educational Science and Psychology, University of Isfahan, Isfahan, Iran.

2 Department of Psychology, Faculty of Educational Science and Psychology, University of Isfahan, Isfahan, Iran

3 Department of psychiatry, School of Medicine, Behavioral Sciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

The aim of this study was to investigate the lived experiences of women attempting suicide regarding risk factors and protective factors. The study method was qualitative and the phenomenological approach. Sampling was purposeful and after semi-structured interviews with 15 women who attempted suicide, saturation was achieved. Seven-step Colaizzi method was used for analysis. The reliability of the findings was confirmed based on Lincoln and Guba criteria. Identified four themes and eight subthemes for risk factors: Tensions in family relationships (subthemes: Argument and conflict, emotional indifference, Lack of marital loyalty), Failed relationships (self-blame, loss), Mental suffering (Living in sorrow and despair, Sense of being a burden, Perception of inefficiency) and theme of poverty and unemployment. Four themes were also extracted regarding protective factors: emotional attachment to a family member, sense of responsibility towards children, religious beliefs, and perceived social support. The results of this study indicate the importance of family and emotional relationships as well as untreated depression as the main factors identified as effective. Outcomes and key implications of this study were mainly related to improving the treatment experiences of women surviving suicide and other high-risk populations through the development of preventive interventions commensurate with the findings.

Keywords

References

شیخی، م. ت.، جمیلی کهنه‌شهری، ف.، و رضایی‌نسب، ز. (1396). بررسی تجارب زیستۀ اقدام به خودکشی زنان شهر ایلام با رویکرد روشی نظریه‌مبنایی. مجلۀ جامعه‌شناسی ایران. 18(4)، 107-82.‌
References
Abalos, E. E., Rivera, R. Y., Locsin, R. C., Florida, F., & Schoenhofer, S. O. (2016). Husserlian phenomenology and Colaizzi’s method of data analysis: Exemplar in qualitative nursing inquiry using as caring theory. International Journal for Human Caring, 20(1), 19–23.
Anestis, M., Bryan, C., Cornette, M., & Joiner, T. (2009). Understanding suicidal behavior in the military: An evaluation of Joiner's interpersonal-psychological theory of suicidal behavior in two case studies of active duty post-deployers. Journal of Mental Health Counseling, 31(1), 60-75.
Azizpour, M., Taghizadeh, Z., Mohammadi, N., & Vedadhir, A. (2019). Being at the center of attention: Iranian women's experience after suicide attempts. Perspectives in Psychiatric Care, 55(3), 445-452.
Bell, C. M., Ridley, J. A., Overholser, J. C., Young, K., Athey, A., Lehmann, J., & Phillips, K. (2018). The role of perceived burden and social support in suicide and depression. Suicide and Life Threatening Behavior, 48(1), 87-94.
Creswell, J. W., & Báez, J. C. (2020). 30 essential skills for the qualitative researcher. London, UK: Sage Publications.
Cook, L.C., & Borrill, J. (2015), Identifying suicide risk in a metropolitan probation trust: Risk factors and staff decision making. Leg Crim Psychol, 20(2), 255-266.
Dadpour, B., Madani Sani, F., Rahimi Doab, M., Gerami, A., Rajaei, P., Talebi, M. (2015). Factors Related in Suicide Attempts in Admitted Poisoned Patients. Journal of Patient Safety & Quality Improvement, 3(3), 247-251.
Daruwala, S. E., LaCroix, J. M., Perera, K. U., Tucker, J., Colborn, V., Weaver, J., Soumoff, A., & Ghahramanlou-Holloway, M. (2018). Suicide ideation and self-efficacy to avoid suicidal action among psychiatrically hospitalized military personnel. Psychiatry Research, 270, 1131–1136.
Denneson, L. M., Hoffmire, C. A., Blosnich, J. R., Dichter, M. E., Fitelson, E., Holliday, R., Monteith, L. L., Smolenski, D. J., & Yano, E. M. (2021). Advancing Knowledge of Suicide Risk and Prevention Among Women: Introduction to the Supplement. Medical Care, 59(2), 1-3.
Edgcomb, J. B., Thiruvalluru, R., Pathak, J., & Brooks, J. O. (2021). Machine learning to differentiate risk of suicide attempt and self-harm after general medical hospitalization of women with mental illness. Medical Care, 59(2), 58-64.
Ernst, M., Kallenbach-Kaminski, L., Kaufhold, J., Negele, A., Bahrke, U., Hautzinger, M., Beutel, M. E., & Leuzinger-Bohleber, M. (2020). Suicide attempts in chronically depressed individuals: What are the risk factors? Psychiatry Research, 287, 112481.
Farzaneh, E., Amani, F., Sadeghi-Movahhed, F., & Mataei, K. (2020). Factors Affecting Unsuccessful Suicide Among Women Referred to Emergency Room of Ardabil City Hospital, Ardabil, Iran. International Journal of Medical Toxicology and Forensic Medicine, 10(2), 27412.
Ghaderi, S., Morovat, B., Masoumirad, R., Noori, R., Saeedi Moghaddam, S., Moazen, B., & Shokoohi, M. (2020). Shining light on darkness: suicidal ideation and suicide attempt among Iranian women who do and do not use drugs. Drugs: Education, Prevention and Policy, 28(4), 349-356.
Hatkevich, C., Penner, F., & Sharp, C. (2019). Difficulties in emotion regulation and suicide ideation and attempt in adolescent inpatients. Psychiatry Research, 271, 230-238.
Hoffmann, W. A., Myburgh, C., & Poggenpoel, M. (2010). The lived experiences of late-adolescent female suicide survivors:‘A part of me died’. Health SA Gesondheid, 15(1), 1-9.
Hunter, C. (2020). Living with Suicide: Collective Narrative Practice with People Experiencing Ongoing Suicidality. PhD dissertation in psychology, University of East London School of psychology.
Joiner, T. E. (2005). Why people die by suicide. Harvard University Press.
Joiner, T. E., Jr., Hollar, D., & Van Orden, K. A. (2006). On Buckeyes, Gators, Super Bowl Sunday, and the Miracle on Ice: “Pulling Together” is associated with lower suicide rates. Journal of Social and Clinical Psychology, 25(2), 180−196.
Joiner, T. E., Van Orden, K. A., Witte, T. K., Selby, E. A., Ribeiro, J. D., Lewis, R., & Rudd, M. D. (2009). Acquired capability for suicidal behavior and its interaction with burdensomeness and belongingness to predict suicide attempts. Journal of Abnormal Psychology, 118(3), 634−646.
Karamouzian, M., & Rostami, M. (2019). Suicide statistics in Iran: let’s get specific. American Journal of Men’s Health, 13(1), 1557988318807079.
Khankeh, H. R., Hosseini, S. A., Rezaie, L., Shakeri, J., & Schwebel, D. C. (2015). A model to explain suicide by self-immolation among Iranian women: a grounded theory study. Burns, 41(7), 1562-1571.
Keyvanara, M., Mousavi, S. G., Khayyer, Z., & Ngaosuvan, L. (2020). A qualitative exploration of motives of suicide attempts among Iranian women. Australian journal of psychology, 72(2), 133-144.
Korkmaz, S., Keleş, D. D., Kazgan, A., Baykara, S., Gürok, M. G., Demir, C. F., & Atmaca, M. (2020). Emotional intelligence and problem solving skills in individuals who attempted suicide. Journal of Clinical Neuroscience, 74, 120-123.
Krychiw, J. K., & Ward-Ciesielski, E. F. (2019). Factors related to suicide's unpredictability: a qualitative study of adults with lived experience of suicide attempts. International Journal of Qualitative Studies on Health and Well-Being, 14(1), 565-585.
Lew, B., Huen, J., Yu, P., Yuan, L., Wang, D. F., Ping, F., Abu Talib, M., Lester, D., & Jia, C. X. (2019). Associations between depression, anxiety, stress, hopelessness, subjective well-being, coping styles and suicide in Chinese university students. PloS one, 14(7), e0217372.
Lincoln, Y. S., & Guba, E. G. (1985). Establishing trustworthiness. Naturalistic Inquiry, 289(331), 289-327.
Lin, J., Su, Y., Lv, X., Liu, Q., Wang, G., Wei, J., Zhu, G., Chen, Q., Tian, H., Zhang, K., Wang, X., Zhang, N., Wang, Y., Yu, X., & Si, T. (2020). Perceived stressfulness mediates the effects of subjective social support and negative coping style on suicide risk in Chinese patients with major depressive disorder. Journal of Affective Disorders, 265, 32–38.
Ljusic, D., Ravanic, D., Filipovic Danic, S., Soldatovic, I., Cvetkovic, J., & Stojanovic Tasic, M. (2016). Contemporary principles of suicide prevention. Medicinski Pregled, 69(11-12), 367–371.
Luhaäär, K., & Sisask, M. (2018). Pathways to Attempted Suicide as Reflected in the Narratives of People with Lived Experience. Religions, 9(4), 137.
Vijayakumar, L. (2018). Challenges and opportunities in suicide prevention in South-East Asia. WHO South-East Asia Journal of Public Health, 6(1), 30-33.
Mohebbi, A., & Boushehri, B. (2006). Stressor factors effects in intentionally committing suicide by chemical materials: Review of four hundred cases. The Journal Of Urmia University of Medical Sciences, 17(3), 219-25.
Montgomery, A. E., Dichter, M. E., & Blosnich, J. R. (2021). Gender Differences in the predictors of suicide-related morbidity among veterans reporting current housing instability. Medical Care, 59(2), 36-41.
Mosharraf, Sh., Mousavi, Gh., Rouhafza, H. R., Reyhani, M. & Shoushtarizadeh, Sh. (2013). Investigating the relationship between the stresses of the past year and suicide attempt in Falavarjan County in 2011-2012. Behavioral Science Research, 11(5), 411-422.
Nelson, G., Hanna, R., Houri, A., & Klimes-Dougan, B. (2012). Protective functions of religious traditions for suicide risk. Suicidology Online, 3(1), 59-71.
O'Connor, R. C., Armitage, C. J., & Gray, L. (2006). The role of clinical and social cognitive variables in parasuicide. The British Journal of Clinical Psychology, 45, 465–481.
O’Connor, R. C. (2011). Towards an integrated motivational–volitional model of suicidal behaviour. International handbook of suicide prevention: Research, Policy and Practice, 1, 181-198.
O’Brien, R. W., & Tomoyasu, N. (2021). Women and suicide: Moving forward on a troubling problem. Medical Care, 59(2), 4- 5.
Olfson, M., Wall, M., Wang, S., Crystal, S., Bridge, J. A., Liu, S.-M., & Blanco, C. (2018). Suicide after deliberate self-harm in adolescents and young adults. Pediatrics, 141(4), e20173517.
Pettit, J. W., Lam, A. G., Voelz, Z. R., Walker, R. L., Perez, M., Joiner, T. E., Jr., Lester, D., & He, Z.-X. (2002). Perceived burdensomeness and lethality of suicide method among suicide completers in the People's Republic of China. Omega: Journal of Death and Dying, 45(1), 57−67.
Polit, D. F., & Beck, C. T. (2017). Nursing research: generating and assessing evidence for nursing practice (10th Ed.). Philadelphia, Wolters Kluwer Health.
Reiners, G. M. (2012). Understanding the differences between Husserl’s (descriptive) and Heidegger’s (interpretive) phenomenological research. Journal of Nursing & Care, 1(5), 1-3.
Rezaie, L., Hosseini, S. A., Rassafiani, M., Najafi, F., Shakeri, J., & Khankeh, H. (2014). Why self-immolation? A qualitative exploration of the motives for attempting suicide by self-immolation. Burns: Journal of the International Society for Burn Injuries, 40(2), 319–327.
Rezaei, M., Khodabakhshi-Koolaee, A., Falsafinejad, M. R., & Sanagoo, A. (2020). Identifying the psychological challenges of mothers with a chronically ill child: A phenomenological study. Journal of Qualitative Research in Health Sciences, 9(1), 18-27.
Sadri Damirchi, E., Zakibakhsh Mohammadi, N., & Amir, M. B. (2019). The role of thwarted belongingness, perceived burdensomeness, self-efficacy and ego strength in predicting suicidal ideation of nurses. Health in Emergencies and Disasters, 4(2), 85-92.
Shaw, J. L., Beans, J. A., Comtois, K. A., & Hiratsuka, V. Y. (2019). Lived experiences of suicide risk and resilience among Alaska Native and American Indian people. International Journal of Environmental Research and Public Health, 16(20), 39-53.
Shamsaei, F., Yaghmaei, S., & Haghighi, M. (2020). Exploring the lived experiences of the suicide attempt survivors: a phenomenological approach. International Journal of Qualitative Studies on Health and Well-Being, 15(1), 1745478.
Shneidman, E. S. (1993). Some controversies in suicidology: Toward a mentalistic discipline. Suicide and Life‐Threatening Behavior, 23(4), 292-298.
Stajkovic, A. D., Bandura, A., Locke, E. A., Lee, D., & Sergent, K. (2018). Test of three conceptual models of influence of the big five personality traits and self-efficacy on academic performance: A meta-analytic path-analysis. Personality and Individual Differences, 120(2018), 238-245.
Steele, I. H., Thrower, N., Noroian, P., & Saleh, F. M. (2018). Understanding suicide across the lifespan: a United States perspective of suicide risk factors, assessment & management. Journal of Forensic Sciences, 63(1), 162-171.
Till, B., Tran, U. S., & Niederkrotenthaler, T. (2017). Relationship Satisfaction and Risk Factors for Suicide. Crisis, 38(1), 7–16.
Vijayakumar, L. (2018). Challenges and opportunities in suicide prevention in South-East Asia. WHO South-East Asia Journal of Public Health, 6(1), 30-33.
Wasserman, D. (2016). Suicide: An Unnecessary Death. London. Oxford University Press, pp. 27–37.
Wetherall, K., Robb, K. A., & O'Connor, R. C. (2019). Social rank theory of depression: A systematic review of self-perceptions of social rank and their relationship with depressive symptoms and suicide risk. Journal of Affective Disorders, 246, 300–319.
World Health Organization. (2012). Public health action for the prevention of suicide-A framework. Retrieved from http://apps.who.int/ iris/bitstream/10665/75166/1/9789241503570 eng.pdf?ua=1.
World Health Organization. (2019). Suicide worldwide in 2019. https://www.who.int/publications/i/item/9789240026643
Zhang, J., Liu, X. & Fang, L. (2019). Combined effects of depression and anxiety on suicide: A ‌case-control psychological autopsy study in rural China. Psychiatry Research, 271, 370-373.‌
Journal of Applied Psychological Research
Volume 13, Issue 3
December 2022
Pages 19-38

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History

  • Receive Date: 17 June 2021
  • Revise Date: 12 August 2021
  • Accept Date: 22 November 2022
  • First Publish Date: 22 November 2022
  • Publish Date: 22 November 2022

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