Abstract
This study aimed to assess using tree-based models the impact of different dimensions of religion and other risk factors on suicide attempts in the Islamic Republic of Iran. Three hundred patients who attempted suicide and 300 age- and sex-matched patient attendants with other types of disease who referred to Kerman Afzalipour Hospital were recruited for this study following a convenience sampling. Religiosity was assessed by the Duke University Religion Index. A tree-based model was constructed using the Gini Index as the homogeneity criterion. A complementary discrimination analysis was also applied. Variables contributing to the construction of the tree were stressful life events, mental disorder, family support, and religious belief. Strong religious belief was a protective factor for those with a low number of stressful life events and those with a high mental disorder score; 72 % of those who formed these two groups had not attempted suicide. Moreover, 63 % of those with a high number of stressful life events, strong family support, strong problem-solving skills, and a low mental disorder score were less likely to attempt suicide. The significance of four other variables, GHQ, problem-coping skills, friend support, and neuroticism, was revealed in the discrimination analysis. Religious beliefs seem to be an independent factor that can predict risk for suicidal behavior. Based on the decision tree, religious beliefs among people with a high number of stressful life events might not be a dissuading factor. Such subjects need more family support and problem-solving skills.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Akbari, M., Haghdoost, A. A., Nakhaee, N., Bahramnejad, A., Baneshi, M. R., & Zolala, F. (2015). Risk and protective factor for suicide attempt in Iran: A matched case–control study. Archives of Iranian Medicine, 18(11), 747–752.
Asadi, H., Hosseini, S., & Jalili, P. (2013). Prediction of suicide in students based on religious beliefs, social support, coping strategies, and public health. Journal of Applied Psychology, 6(4), 87–101.
Bakhshipour, A., & Bagharian, K. (2006). Psychometric properties of eysenck personality questionnaire-revised(epq) short scale. Contemporary Psychology, 1(2), 3–12. (in Persian).
Beghi, M., Rosenbaum, J. F., Cerri, C., & Cornaggia, C. M. (2013). Risk factors for fatal and nonfatal repetition of suicide attempts: a literature review. Neuropsychiatric Disease and Treatment, 9, 17–25.
Bryan, C. J., & Rudd, M. D. (2012). Life stressors, emotional distress, and trauma-related thoughts occurring in the 24th preceding active duty US Soldiers’ suicide attempts. Journal of Psychiatric Research, 46(7), 843–848.
Christiansen, E., Larsen, K. J., Agerbo, E., Bilenberg, N., & Stenager, E. (2013). Incidence and risk factors for suicide attempts in a general population of young people: A Danish register-based study. Australian and New Zealand Journal of Psychiatry, 47(3), 259–270.
Diaconu, G., & Turecki, G. (2009). Family history of suicidal behavior predicts impulsive-aggressive behavior levels in psychiatric outpatients. Journal of Affective Disorders, 113(1–2), 172–178.
Ebrahimi, A., Molavi, G., Bornamanesh, A., & Yaghoubi, M. (2007). Psychometric properties and factor structure of General Health Questionnaire 28 (GHQ-28) in Iranian psychiatric patients. Journal Research Behavior Sciences, 5(1), 5–12. (in Persian).
Gartner, J., Larson, D. B., & Allen, G. D. (1991). Religious commitment and mental health: A review of the empirical literature. Journal of Psychology and Theology, 19(1), 6–25.
Ghanizadeh, A., Nouri, S., & Nabr, S. (2012). Psychiatric problems and suicidal behaviour in incarcerated adolescents in the Islamic Republic of Iran. Eastern Mediterranean Health Journal, 18(4), 311–317.
Hawton, K., Harriss, L., Hodder, K., Simkin, S., & Gunnell, D. (2001). The influence of the economic and social environment on deliberate self-harm and suicide: An ecological and person-based study. Psychological Medicine, 31(05), 827–836.
Joshanlo, M., Rostami, R., & Nosratabadi, M. (2006). Investigate the gender differences in predictors of social welfare. Journal Psychology Sciences, 5(1), 166–184. (in Persian).
Kaslow, N. J., Thompson, M. P., Okun, A., Price, A., Young, S., Bender, M., et al. (2002). Risk and protective factors for suicidal behavior in abused African American women. Journal of Consulting and Clinical Psychology, 70(2), 311–319.
Koenig, H. G., & Bussing, A. (2010). The duke university religion index (DUREL): A five-item measure for use in epidemological studies. Religions, 1(1), 78–85.
Levi, F., La Vecchia, C., Lucchini, F., Negri, E., Saxena, S., Maulik, P. K., et al. (2003). Trends in mortality from suicide, 1965–99. Acta Psychiatrica Scand., 108(5), 341–349.
Marco, S., & Paola, Z. (2012). A bias correction algorithm for the Gini variable importance measure in classification trees. Journal of Computational and Graphical Statistics, 17(3), 611–628.
Miret, M., Ayuso-Mateos, J. L., Sanchez-Moreno, J., & Vieta, E. (2013). Depressive disorders and suicide: Epidemiology, risk factors, and burden. Neuroscience and Biobehavioral Reviews, 37(10), 2372–2374.
Molock, S. D., Puri, R., Matlin, S., & Barksdale, C. (2006). Relationship between religious coping and suicidal behaviors among African American adolescents. Journal of Black Psychology, 32(3), 366–389.
Neuner, T., Schmid, R., Wolfersdorf, M., & Spieأںl, H. (2008). Predicting inpatient suicides and suicide attempts by using clinical routine data? General Hospital Psychiatry, 30(4), 324–330.
Noori, A., Shokoohi, M., Baneshi, M. R., Naderi, N., Bakhshandeh, H., & Haghdoost, A. A. (2014). Impact of socio-economic status on the hospital readmission of Congestive Heart Failure patients: A prospective cohort study. International Journal of Health Policy and Management, 3(5), 251–257.
Organization, W. H. (2012). Suicide prevention (SUPRE), 2012. Retrieved on 6.
Peduzzi, P., Concato, J., Feinstein, A. R., & Holford, T. R. (1995). Importance of events per independent variable in proportional hazards regression analysis II. Accuracy and precision of regression estimates. Journal of Clinical Epidemiology, 48(12), 1503–1510.
Pilowsky, D. J., Wu, L.-T., & Anthony, J. C. (2014). Panic attacks and suicide attempts in mid-adolescence. The American Journal of Psychiatry, 156(10), 1545–1549.
Podgorelec, V., Kokol, P., Stiglic, B., & Rozman, I. (2002). Decision trees: An overview and their use in medicine. Journal of Medical Systems, 26(5), 445–463.
Pour Shahbaz, A. (1993). The relation between stressful life events and personality type in patients with leukemia. Clinical psychology Senior Thesis, Iran, 1993 (in Persian).
Rogers, J. R. (2001). Psychological research into suicide: Past, present and future. In D. Lester (Ed.), Suicide: Resources for the new millennium (pp. 31–44). Philadelphia: Brunner/Routledge Publishers.
Rosenberg, M. L., Davidson, L. E., Smith, J. C., Berman, A. L., Buzbee, H., Gantner, G., et al. (1988). Operational criteria for the determination of suicide. Journal of Forensic Sciences, 33(6), 1445–1456.
Saberi-Zafaghandi, M., Hajebi, A., Eskandarieh, S., & Ahmadzad Asl, M. (2012). Epidemiology of suicide and attempted suicide derived from the health system database in the Islamic Republic of Iran: 2001–2007. Eastern Mediterranean Health Journal, 18(8), 836–841.
Saffari, M., Koenig, H. G., Ghanizadeh, G., Pakpour, A. H., & Baldacchino, D. R. (2014). Psychometric properties of the Persian spiritual coping strategies scale in hemodialysis patients. Journal of Religion and Health, 53(4), 1025–1035.
Shakeri, J., Parvizifard, A. A., Sadeghi, K., & Moradi, R. (2006). Personality traits, stress, coping and religious attitudes among individuals attempting suicide. Iranian Journal of Psychiatry and Clinical Psychology, 12(3), 244–250. (in Persian).
Su, C. T., Chen, K. H., Chen, L. F., Wang, P. C., & Hsiao, Y. H. (2012). Prediagnosis of obstructive sleep apnea via multiclass MTS. Computational and Mathematical Methods in Medicine, 2012(2012), 1–8.
Walker, R. L., & Bishop, S. (2005). Examining a model of the relation between religiosity and suicidal ideation in a sample of African American and White college students. Suicide and Life-Threatening Behavior, 35(6), 630–639.
Acknowledgments
The authors would like to acknowledge and thank all those who participated in this study. This article was the result of an MSc thesis (Project Number: 92/21).
Author Contributions
A.A.H., M.A., and F.Z. conceptualized and designed the experiments for this manuscript. M.A. and R.T. performed experiments. M.A., M.R.B., and A.A.H. analyzed the data. M.A., M.J., and R.T. contributed the reagents/materials/analysis tools. M.A., M.R.B., A.A.H., and M.J. composed the manuscript.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflicts of interest
None to declare.
Rights and permissions
About this article
Cite this article
Baneshi, M.R., Haghdoost, A.A., Zolala, F. et al. Can Religious Beliefs be a Protective Factor for Suicidal Behavior? A Decision Tree Analysis in a Mid-Sized City in Iran, 2013. J Relig Health 56, 428–436 (2017). https://doi.org/10.1007/s10943-016-0215-x
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10943-016-0215-x