Document Type : Research Article
Authors
1
PhD Student, Department of Psychology, Islamic Azad University, Arsanjan Branch, Arsanjan, Iran
2
Assistant Professor, Department of Psychology, Islamic Azad University, Arsanjan Branch, Arsanjan, Iran
10.22055/psy.2025.50346.3471
Abstract
Introduction
Over the past two decades, suicide has become a major public health concern, with a global increase of approximately 36%. This alarming trend results in over 700,000 deaths annually, particularly affecting adolescents. Meanwhile, suicidal behavior is influenced by a variety of predisposing and activating factors that heighten the risk of suicide and self-harm. Therefore, this study aimed to phenomenologically explore the underlying and activating factors of suicide through the lived experiences of adolescents.
Method
This qualitative study employed a phenomenological approach and focused on adolescents aged 12 to 20 who had a history of suicide attempts in the northern counties of Fars province, specifically Khorrambid, Bavanat, Eqlid, and Abadeh during the years 2023-2024. A total of 22 participants were selected through purposive sampling until saturation was reached. Data collection involved conducting in-depth, semi-structured interviews with participants in the field. The reliability of the interview data was assessed based on four criteria: acceptability (reliability), trustworthiness (validity), generalizability (transferability), and confirmability. The interview data were analyzed using the qualitative statistics software MAXQDA-10 and the thematic analysis method. Additionally, an interpretive strategy was employed to understand and interpret the semantic codes related to the phenomenon of suicide.
Results
Qualitative content analysis of semi-structured in-depth interviews with participants revealed that contextual factors influencing suicide among attempters can be categorized into five main themes: demographic, social, economic, policy, and cultural factors. The results indicated that "demographic factors" affecting suicide fall into three categories: age (with subcategories of mid-adolescence and late adolescence), biological sex (subcategories of girls and boys), and education (subcategories of academic motivation and academic performance). In the "social factors" theme, two primary categories were identified: witnessing violence (subcategories of domestic violence and social violence) and peer influence (subcategory of role modeling), both of which significantly affect the experiences of suicide attempters. Regarding "economic factors," two main categories emerged: poverty (with subcategories of financial difficulties in meeting expenses and experiences of discrimination and inequality) and unemployment (subcategory of lack of a job or income for the head of the family). The "policy factors" theme highlighted the impact of inadequate forward-looking policymaking, which includes subcategories focused on envisioning a possible future and designing policies to leverage the potential of young people. Also, the theme of "cultural factors" revealed three main categories affecting suicide: the conflict between tradition and modernity (with a subcategory addressing social development), the weakening of social ties (subcategories of diminishing family connections and reduced intergroup relationships), and identity failure (with subcategories of confusion, self-doubt, and cultural despair) experienced by those attempting suicide. In addition, this study identified and categorized suicidal activators into two main themes. The first theme, "external activators" encompasses two primary categories: stressful events, which include subcategories such as domestic violence, social violence, life changes, and specific negative experiences; and interpersonal relationship failures, covering family interactions, peer group dynamics, and romantic relationships. The second theme, "internal activators" consists of three main categories: thoughts and beliefs, which include subcategories like automatic thoughts, distorted cognitive patterns, core beliefs, and attributive beliefs; emotional manifestations, which encompass psychological pain and complex emotions; and behavioral manifestations, including impulsive behaviors, avoidance of social situations, and the use of nicotine, alcohol, and drugs.
Discussion
These findings emphasize the influence of various underlying and activating risk factors on suicide. Therefore, it is essential for healthcare systems at local, national, and global levels to integrate these factors into their strategies. Consequently, this research offers valuable insights for enhancing prevention, treatment, and support services within mental health programs, particularly for crisis intervention and community-based professionals who work with individuals at risk of suicide. Additionally, the study underscores the need to identify, prioritize, and quantify these risk factors in future research, as this could assist mental health policymakers in making informed decisions to lower suicide risks and rates.
Keywords
Subjects