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Suicidal Ideation Among Divorced Women in Kermanshah, Iran: The Role of Social Support and Psychological Resilience

AUTHORS

Saeed Ariapooran 1 , * , Mehdi Khezeli 2

1 Department of Psychology, Malayer University, Malayer, Iran

2 Research Center for Environmental Determinants of Health (RCEDH), Kermanshah University of Medical Sciences, Kermanshah, Iran

How to Cite: Ariapooran S, Khezeli M. Suicidal Ideation Among Divorced Women in Kermanshah, Iran: The Role of Social Support and Psychological Resilience, Iran J Psychiatry Behav Sci. Online ahead of Print ; 12(4):e3565. doi: 10.5812/ijpbs.3565.

ARTICLE INFORMATION

Iranian Journal of Psychiatry and Behavioral Sciences: 12 (4); e3565
Published Online: September 15, 2018
Article Type: Original Article
Received: July 16, 2015
Revised: May 11, 2018
Accepted: May 24, 2018
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Abstract

Objectives: Divorce is one of the main life stressors imposing a negative effect on suicidal ideation. In addition, social support and psychological resilience can have a special impact on divorce. This study aimed to determine the relationship of social support and resilience with suicidal ideation in divorced women.

Methods: The study participants consisted of 124 divorced women who were covered by the Imam Khomeini Relief Foundation of Kermanshah city (the west of Iran). Data collection tools included the multidimensional scale of perceived social support, Connor-Davidson resilience scale, and Beck scale for suicidal ideation.

Results: According to the score of Beck suicidal ideation, 16.1% of the divorced women had no suicidal ideation, 49.2% had a low risk of suicidal ideation, and 34.7% had a high risk of suicidal ideation. Social support and resilience were the most powerful variables in predicting the symptoms of suicidal ideation in divorced women, in sequence (∆R2 = 0.24, F (2, 121) = 20.44, P < 0.001).

Conclusions: The results confirm the role of social support and resilience in predicting the symptoms of suicidal ideation. Therefore, we suggest considering these variables in future studies to predict the symptoms of suicidal ideation in divorcees.

Keywords

Divorce Psychological Resilience Social Support Suicidal Ideation

Copyright © 2018, Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.

1. Background

People, who have experienced divorce, deal with various personal and interpersonal conflicts. Some of the important factors of divorce are confused identity, lack of hope, change in lifestyle, and serious problems in social and professional networks (1). Suicide and suicidal ideation are among the variables related to divorce. Suicide is an intentional human action to self-eliminate with different effort and motives (2). In addition, suicidal ideation refers to any thought and involvement towards suicidal behavior (3). Divorce is one of the major life stressors, which can have a negative impact on suicide. It has been shown that family conflict is positively associated with suicidal ideation and suicide attempts (4). Defeat in friendly relations, personal disputes with the family, and legal problems are the stressors relevant to a suicide attempt and completed suicide (5). Social support and psychological resilience are the important variables involved in the suicidal ideation of divorced women. Social support is defined as information leading the subject to believe that he/she is loved, esteemed, and is a member of a network of mutual obligation (6). Social support provides opportunities for people to discuss stress, reduce the annoyance of events, and enable people to identify their positive aspects (7). Although divorce can reduce the size of social networks, those who maintain their friendly relationships or create new social relationships can have better adaptation compared to those who are socially isolated (8). A research has shown that there is a positive relationship between low social support and suicidal ideation (9). In addition, positive social support, especially tangible support, and negative social exchanges are the predictors of suicidal behavior (10). Another concept, psychological resilience is the ability of the individual, family, and community to cope with adverse life situations or psychological stressors, which can lead to a response to future life inadaptability (11). Psychological resilience has a negative relationship with suicidal ideation and it has been shown that mental health variables such as resilience are associated with lower suicidal ideation while psychological distress is associated with high suicidal ideation (12, 13). It is suggested that individuals with psychological resilience report high levels of family cohesion, better communication, and less familial problems, but a group that has low resilience has more problems in family relationships (14).

2. Objectives

Although some researchers have focused on examining suicidal ideation among women, divorced persons, especially women, have been neglected in previous research. Therefore, the aim of the present study was to determine the relationship between social support and psychological resilience and suicidal ideation in divorced women.

3. Materials and Methods

3.1. Participants

Totally, 124 divorced women who were covered by the Imam Khomeini Relief Foundation (IKRF) of Kermanshah city (the west of Iran) participated in this study. The IKRF is an Iranian foundation that was founded in March 1979 as a charity organization to provide support for poor families in Iran and some other countries. Inclusion criteria were as follows: Having at least an elementary education, the lack of remarriage, not having severe mental and physical diseases, and lack of hospitalization for mental illness within the last month. In addition, the exclusion criteria were not having consent to participate in research and having viral illnesses such as colds and flu at the time of the study.

3.2. Procedure

In this study, the researchers referred to IKRF of Kermanshah city and in collaboration with the experts of the foundation, they provided a list of covered divorcees and through phone calls, invited them to the foundation to participate in the study. In order to meet the ethical issues, the researchers initially explained the objectives of the study for the participants and they were assured that their information would be confidential. Furthermore, the researchers obtained the written informed consent from the participants and then they completed the questionnaires in approximately 35 minutes. It should be noted that women with primary education were not involved in the research. The data were analyzed by SPSS-19 using Pearson correlation and multiple regression analysis.

3.3. Measures

3.3.1. Multidimensional Scale of Perceived Social Support (MSPSS)

This scale, which is composed of 12 items, was provided by Zimet et al. to measure three dimensions of social support including family, friends, and significant others (15). Each dimension of the scale has four items so that respondents answer to each item on a 7-point Likert scale rated from one (strongly disagree) to seven (strongly agree). Zimet et al. reported an adequate internal consistency reliability by α = 0.91, 0.87, and 0.85 for support from significant others, family, and friends, respectively (15). Bagherian and colleagues examined the psychometric properties of the Persian version of the scale in Iran. They showed that the percentage of variance explained by the three factors in the patient sample and the healthy sample was 77.87% and 78.55%, respectively. The internal consistency as assessed by Cronbach’s α was 0.83 for total MSPSS in the patients and 0.92 in the healthy group. Test-retest reliability assessed by Pearson’s correlation in the healthy group was 0.74, 0.78, and 0.84 for family, friends, and significant others, respectively (16). Another study showed that Cronbach’s alpha coefficient and the intra-class correlation coefficient (ICC) for this tool were 0.89 and 0.92, respectively (17).

3.3.2. Resilience Scale

The Connor-Davidson resilience scale (CD-RISC) comprises 25 items, each rated on a 5-point scale from not true at all (0) to true nearly all time (4), in which higher scores reflect the higher resilience. Cronbach’s alpha for the full scale was calculated as 0.89 and convergent and divergent validity were satisfactory compared to several other measuring tools. The CD-RISC has sound psychometric properties and can distinguish between those who have high and low levels of resilience (18). Mohammadi in Iran has localized this questionnaire (19). The validity of the scale was calculated from 0.41 to 0.64 (except for item 3) using the correlation of each item with the total score of coefficients (19). In addition, the reliability of the scale using the Cronbach’s alpha coefficient was satisfactory, which ranged from 0.87 to 0.91 in several studies (19, 20).

3.3.3. Beck Scale for Suicidal Ideation

Beck’s scale for suicidal ideation measures the intensity of suicidal ideation using 19 items. Each item is rated from 0 to 2. The total score on the BSS can thus range from 0 to 38, in which higher scores indicate greater levels of suicidality (21). Anisi et al. performed semantic, technical, and criterion equivalence by translating and back-translating the instrument into Persian. The concurrent validity of the scale with the General Health Questionnaire has been reported as 0.76 and reliability using Cronbach’s alpha was calculated as 0.95 (22).

4. Results

4.1. Demographic and Descriptive Statistics

Totally, 124 divorced women participated in the present study. The mean age and duration of divorce (in years) in the participants were 25.86 ± 9.47 and 5.68 ± 4.11, respectively. 62.1% of the participants were employed, 69.4% were educated under diploma, and 61.3% of the participants reported a poor economic status. Further demographic data are presented in Table 1.

Table 1. Demographic and Level of Suicidal Ideation in the Participants
Demographic CharacteristicsValues
Agea25.86 ± 9.47
Duration of divorcea5.68 ± 4.11
Education levelb
Sub diploma 86 (69.4%)
Diploma 32 (25.8%)
College 6 (4.8%)
Employmentb
Employed 47 (37.9%)
Unemployed 77 (62.1%)
Suicidal ideation (SI)b
Without SI 20 (16.1%)
Low risk of SI 61 (49.2%)
High risk of SI 43 (34.7%)

aValues are presented as mean ± SD.

bValues are presented as No. (%).

As shown in Table 1, according to the score of Beck suicidal ideation subscales, 16.1% of the divorced women lacked suicidal ideation, 49.2% had a low risk of suicidal ideation, and 34.7% had a high risk of suicidal ideation.

4.2. Correlations

Pearson correlation results indicated a negative relationship between social support from family (r = -0.318), support from friends (r = -0.366), support from significant others (r = -0.472), total social support (r = -0.455), and resilience (r = -0.410) and suicidal ideation in the divorced women (Table 2). This means that with increasing the scores of social support and resilience, the rates of suicidal ideation in the divorced women reduced.

Table 2. Correlations Between Study Variables and Other Descriptive Information
Predictors variablesMean ± SDCorrelation with Suicidal Ideation
Correlation (r)P Value
Support from family19.91 ± 7.53-0.318< 0.001
Support from friends16.43 ± 8.24-0.366< 0.001
Support from significant others19.72 ± 7.24-0.472< 0.001
Social support (total)56.06 ± 19.43-0.455< 0.001
Resilience92.50 ± 15.06-0.410< 0.001
Suicidal ideation13.46 ± 6.331-

4.3. Multiple Regressions

We conducted a multiple regression analysis to examine the relationships between suicidal ideation and various potential predictors. Table 3 summarizes the analysis results. The multiple regression model with inter-model produced ∆R2 = 0.24, F (2, 121) = 20.44, P < 0.001. According to the results, social support and resilience explained 24% of the variance of suicidal ideation. Thus, according to the Beta value and significance level, social support and resilience were the most powerful variables in predicting the symptoms of suicidal ideation in the divorced women, in sequence.

Table 3. Regression Results for Predicting Suicidal Ideation in Divorced Womena
Predicting VariablesUnstandardized CoefficientBetatP Value
BS.E
Social support-0.1640.044-0.333-3.717< 0.001
Resilience-0.1610.056-0.258-2.876< 0.005
Constant49.274.605-10.845< 0.001

aR = 0.503, R2 = 0.253, ΔR = 0.24.

5. Discussion

In the present study, based on the descriptive results, 34.7% of the divorcees had a high risk of suicidal ideation. This result is consistent with the findings of a previous study that mentioned the risk of suicide in the divorced people (23). It can also confirm the findings of another study (24), which showed that divorce and separation are associated with increased psychological distress. For the explanation of this finding, we can state that divorce is one of the main risks that threaten the Iranian family and society. Unfortunately, the life of women who are apart from their husband often is faced with uncertainties and risks such as child custody, living singly, economic difficulties, living alone with depression, and disappointment. Furthermore, the wrong attitude towards divorced women in Iran will cause problems for them in social relationships. Hence, it is likely to increase stress from divorce and consequently leads to suicidal ideation and suicide risk in such women. Pearson correlation results showed that social support from family, support from friends, support from significant others, and the total social support had a negative relationship with suicidal ideation in divorcees. Moreover, according to the regression results, the contribution of social support to the suicidal ideation was approximated by 33%. This result is consistent with previous findings, which demonstrated a positive relationship between low social support and suicidal ideation (9), as well as a negative relationship between positive social support and suicidal behavior (10). We can state that social resources enable individuals to interpret the experience of stressful events. The positive social background makes these stressful events be not interpreted as a threat by the person. On the other hand, the social support provides opportunities for people to discuss stressful events and reduce the annoyance of these events, as well as enables people to attach to the positive aspects of themselves (7). Indeed, proper social support can be effective in reducing the suicidal ideation of divorced women. In other words, social support from family, friends, and significant others can offer encouragement to divorced women to reduce the negative effects of stress after a divorce and prevent from the suicidal ideation. Although divorce can reduce the size of social networks, those who maintain their friendly relationships or create new social relationships can have a better adaptation compared to those who are socially isolated (8). In addition, the results of the Pearson correlation revealed that resilience in the divorcees has a negative relationship with suicidal ideation. In other words, increasing the resilience can reduce the suicidal ideation in divorced women. This result is consistent with the results of previous studies regarding the existence of a negative relationship between psychological resilience and suicidal ideation (12). For the explanation of this finding, we can express that since resilience is defined as a protective process that decreases the likelihood of negative consequences (25), divorced women who have resilience in facing difficulties and stresses will have a positive attitude towards preventing from the negative characteristics such as suicidal ideation. Moreover, since previous studies have shown that resilience is related with improving physical and mental health (26, 27), it can be mentioned that having this positive feature can modify the variables related to mental health such as suicidal ideation in divorced women.

One of the limitations of this study was the use of a questionnaire singly to examine variables such as suicidal ideation. Using a questionnaire as the only method to collect data can lead to incomplete information; therefore, we propose using clinical interviews in future studies in order to overcome this limitation. Another limitation of this study was the lack of a comparison group (non-divorced women). Thus, we should be cautious in generalizing the results related to the severity of suicidal ideation in divorced women. Given the above-mentioned limitations, the results indicate the role of social support and resilience in predicting suicidal ideation. Therefore, we recommend considering the role of social support and resilience in predicting the severity of suicidal ideation in divorcees, because this issue has important implications concerning psychological training to reduce women’s psychological problems.

Footnotes

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