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征集新故事:探索伊朗自杀的病因(因果分层分析)。

Call for new stories: Exploring the etiology of suicide in Iran (Causal layered analysis).

作者信息

Heidari Mohammad, Haghdoost Aliakbar, Khanjani Narges

机构信息

Modeling in Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.

Department of Epidemiology and Biostatistics, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran.

出版信息

Med J Islam Repub Iran. 2019 Dec 17;33:138. doi: 10.34171/mjiri.33.138. eCollection 2019.

DOI:10.34171/mjiri.33.138
PMID:32280644
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7137879/
Abstract

Despite many studies on suicide, the causation remains ambiguous, and there is a necessity for new all-inclusive methodology. Causal layer analysis (CLA) is a relatively new technique to deeply explore the etiologies of suicide in Iran. Causal layered analysis (CLA) combines empirical, interpretative, critical, and action research methods in comprehensive hierarchical layers of causality, like an iceberg. Layers begin from the first observable layer called litany to the deeper underneath layers, including systemic, worldview, and metaphor. In the litany layer, the general appearance of suicide in Iran was extracted through published evidence. In the systemic layer, observed quantitative results of litany was interpreted based on the short-term historical facts by conducting 30 semi-structured interviews with experts. In the worldview layer, 40 deep interviews with suicide attempt cases, 10 focus-groups among adolescents, and 20 semi-structured interviews with nurses and experts were conducted. In the myth and metaphor layer, the Persian poetry of the last century was studied and suicide notes and stories were reviewed. Three causal models of CLA 1 (self-burning of women as an objection to the closed society), CLA 2 (duality of parent's addiction- divorce), CLA 3 (suicide as a reaction to the identity crisis) were extracted. Macrohistorical changes such as war, urbanization, and modernity have confronted the new the new generation with distinctive and unexpected realities in life, which are not similar to their dreams and old stories. Suicide is a reaction to this silent inner battle between old metaphors and new realities.

摘要

尽管对自杀进行了许多研究,但其成因仍不明确,因此有必要采用新的综合方法。因果层分析(CLA)是一种相对较新的技术,用于深入探究伊朗自杀的病因。因果层分析(CLA)在因果关系的综合层次结构中结合了实证、解释性、批判性和行动研究方法,就像一座冰山。这些层次从第一个可观察到的层面即连祷开始,到更深层次,包括系统层面、世界观层面和隐喻层面。在连祷层面,通过已发表的证据提取了伊朗自杀的总体情况。在系统层面,通过对专家进行30次半结构化访谈,根据短期历史事实对连祷层面观察到的定量结果进行了解释。在世界观层面,对自杀未遂案例进行了40次深度访谈,对青少年进行了10次焦点小组访谈,并对护士和专家进行了20次半结构化访谈。在神话和隐喻层面,研究了上世纪的波斯诗歌,并对自杀遗书和故事进行了回顾。提取了因果层分析的三个因果模型:CLA 1(女性自焚作为对封闭社会的抗议)、CLA 2(父母成瘾与离婚的双重性)、CLA 3(自杀作为对身份危机的反应)。战争、城市化和现代性等宏观历史变化使新一代面临生活中独特且意想不到的现实,这些现实与他们的梦想和旧故事不同。自杀是对旧隐喻与新现实之间这场无声内心斗争的一种反应。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/17bb/7137879/aec7847520fe/mjiri-33-138-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/17bb/7137879/aec7847520fe/mjiri-33-138-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/17bb/7137879/aec7847520fe/mjiri-33-138-g001.jpg

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本文引用的文献

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The prevention strategies for the geographical belt of self-immolation.自焚地理带的预防策略。
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A cohort study of regional migration and the risks of attempted suicide and violent assault injury.一项关于地区迁移与自杀未遂及暴力袭击伤害风险的队列研究。
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Social constraints, loss-related factors, depression, and posttraumatic stress in a treatment-seeking suicide bereaved sample.寻求治疗的自杀丧亲样本中的社会限制、与丧失相关的因素、抑郁和创伤后应激。
Psychol Trauma. 2016 Nov;8(6):657-660. doi: 10.1037/tra0000128. Epub 2016 Mar 7.
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Can Religious Beliefs be a Protective Factor for Suicidal Behavior? A Decision Tree Analysis in a Mid-Sized City in Iran, 2013.宗教信仰能否成为自杀行为的保护因素?2013年伊朗某中等城市的决策树分析
J Relig Health. 2017 Apr;56(2):428-436. doi: 10.1007/s10943-016-0215-x.
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Religion and Completed Suicide: a Meta-Analysis.宗教与自杀既遂:一项荟萃分析
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Economic crisis and mortality by suicide: two concepts hard to link.经济危机与自杀死亡率:两个难以关联的概念。
Eur J Public Health. 2015 Oct;25(5):900. doi: 10.1093/eurpub/ckv080. Epub 2015 May 11.
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BMJ Open. 2015 Mar 25;5(3):e007295. doi: 10.1136/bmjopen-2014-007295.
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