Journal of Police Medicine

fa تجربیات دوران کودکی و نشانگان افسردگی-گرایش به خودکشی: بررسی نقش میانجی نشخوار فکری و تعلق‌پذیری خنثی Childhood Experiences and Depressive Symptoms- Suicidal tendencies: A Mediating Role of Rumination and Thwarted Belongingness طب بحران Crisis Medicine پژوهشی اصيل Original Research <div style="text-align: justify;">اهداف: تجارب نامطلوب دوران کودکی به طور مداوم با مشکلات روان‌پزشکی در کودکان و بزرگسالان در ارتباط است. با این حال اثرات طولانی مدت تجربیات کودکی بر سلامت روان در بزرگسالی مورد مطالعه قرار نگرفته است. بنابراین هدف پژوهش حاضر بررسی ارتباط تجربیات دوران کودکی و نشانگان افسردگی-گرایش به خودکشی با نقش میانجی نشخوار فکری و تعلق‌پذیری خنثی بود. مواد و روش‌ها: این مطالعه توصیفی به روش مدل‌یابی معادلات ساختاری است. جامعه آماری تمامی دانشجویان مشغول به تحصیل در دانشگاه محقق اردبیلی در سال تحصیلی 1399 بود که 650 نفر به شیوه نمونه‌گیری در دسترس انتخاب شدند. داده‌ها با استفاده از پرسش‌نامه‌های نشانگان افسردگی-گرایش به خودکشی Joiner با ضریب آلفای کرونباخ و روایی همگرا 0/91 و 0/74، تعلق‌پذیری Hill  و  Pettitبا ضریب آلفای کرونباخ و روایی همگرا 0/88 و 0/84، نشخوار فکریO’Connor  و  Williams با ضریب آلفای کرونباخ و روایی همگرا 0/79 و 0/75 و تجربیات دوران کودکی مرکز پیشگیری و کنترل بیماری‌های آمریکا و بنیاد کایزر با ضریب آلفای کرونباخ و روایی همگرا 0/91 و 0/87 استفاده شد. داده‌های حاصل با استفاده از روش معادلات ساختاری و تحلیل عاملی تأییدی و با کمک نرم‌افزار SPSS 25 و AMOS 24 تجزیه و تحلیل شدند. یافته‌ها: در نهایت داده‌های 600 شرکت‌کننده با میانگین سنی 4/44±23/09 سال بررسی شد. اثر مستقیم تجربیات کودکی بر نشخوار فکری و نشانگان افسردگی-گرایش به خودکشی مثبت معنادار بود (0/001>p). همچنین اثر مستقیم تجربیات دوران کودکی بر تعلق‌پذیری منفی معنادار بود (0/001>p). اما بین تعلق‌پذیری و نشانگان افسردگی-گرایش به خودکشی اثر مستقیم منفی و بین نشخوار فکری و نشانگان افسردگی-گرایش به خودکشی اثر مستقیم مثبت معنادار بود (0/05>p). همچنین اثر غیرمستقیم تجربیات دوران کودکی از طریق نشخوار فکری و تعلق‌پذیری بر نشانگان افسردگی-گرایش به خودکشی معنادار بود (0/001>p). نتیجه‌گیری: براساس یافته‌های این پژوهش می‌توان نتیجه گرفت که نشخوار فکری و تعلق‌پذیری بین تجربیات دوران کودکی و نشانگان افسردگی-گرایش به خودکشی دارای نقش میانجی است.</div> Introduction Suicidal behavior is one of the most important factors in behavioral health among young people and the second cause of death among this population [1]. ... [2-4]. One of the causes of students' risk of suicide is psychological factors [5]. ... [6-8]. Specific childhood experiences increases the risk of adopting health-damaging behaviors such as personality disorders [9] and antisocial behaviors and suicide attempts [10]. Rumination is associated with depression, anxiety, and suicide risk, however the mechanism of influence is unknown [11]. Rumination is set of passive thoughts repetitive and a way to deal with negative moods that involve self-centered attention. [12]. Rumination is associated with more severe and long-term depression and delayed betterment and thoughts increase of suicidal ideation, motivation and concentration decrease and also greater frustration [13]. Negative and unpleasant experiences in childhood are among the thoughts that are continued in adulthood and become as inconsistent behaviors [14] ... [15]. Thwarted belongingness is also one of the issues that has been considered in new models of suicide [16]. ... [17]. Two components of rumination and thwarted belongingness can be considered as mediating factors in relation between bad childhood experiences and suicidal ideation. .... [18]. This study is significant because many people referred to a police officer within three months before of committing suicide [19]. The suicidal ideation has also been seen in military societies such as soldiers [20]. Aim(s) The aim of this study was to investigate the relation between childhood experiences and symptoms of depression-suicidal ideation among young people by considering the mediating role of rumination and thwarted belongingness. The hypothetical research model is presented in Figure 1. Research Type This descriptive study was done via by structural equation modeling. Research Society, Place and Time The statistical population of this study was all students of Mohaghegh Ardebili University in the academic year of 2020. Sampling Method and Number 650 people were selected by available sampling method. Used Devices & Materials Data were collected using the Depression-Suicide Syndrome Questionnaire (Cronbach's alpha coefficient and convergent validity 0.91 and 0.74) .... [21, 22], Interpersonal Needs Questionnaire (Cronbach's alpha and convergent validity 0.88 and 84) / 0) .... [23, 24], Rumination Questionnaire (Cronbach's alpha coefficient and convergent validity 0.79 and 0.75) ... [25, 26] as well as Questionnaire of Adverse Childhood Experiences (Cronbach's alpha coefficient and convergent validity of 0.91 and 0.87) ... [27, 28]. Due to the corona status, data collection method was performed in two parts; the first part consisted of collecting demographic information of the samples and the second part included the questionnaires which were designed and made using Porsall online in the context of cyberspace the links of which were provided to students. Ethical Permissions The present study with the ethics code of IR.ARUMS.REC.1399.425 has been approved by the Ethics Committee of Ardabil University of Medical Sciences. Statistical Analysis The data were analyzed via structural equation modeling method in SPSS 25 software. In this subscale analysis, depression-suicidal ideation was measured as a dependent variable, rumination and belongingness as mediating variables, and childhood experiences as a predictor variable. The fitness of the research measurement model was evaluated by confirmatory factor analysis using AMOS 24 software. Finding by Text 22 questionnaires out of 650 questionnaires, were discarded due to incompleteness and the response rate was 96%. Using the distance (Mahalanobis) with a confidence level of 0.95%, 28 more questionnaires were discarded and finally 600 questionnaires were included in the statistical analysis. In the present study, 139 (23.2%) participants were male and 461 (76.8%) were female (Table 1). The mean scores of the studied indicators were examined (Table 2). The relationship between childhood experiences with rumination and symptoms of depression-suicidal ideation was statistically significant and positive. Also, the relation between childhood experiences and the mediating variable of belongingness was significant and inverse. The relationships between the mediating variables of rumination and belongingness with symptoms of depression-suicidal ideation were also respectively positive and negative, which were statistically significant (Table 3; p <0.01). Tolerance statistic and variance inflation factor (VFI) were used to examine the collinearity which was optimal for each of the predictor variables. After examining the modeling assumptions, the model test path was performed to examine the proposed model. Due to the lack of fit in some indicators of the proposed model, it was modified with the data (Table 4). In order to improve the proposed model, the next step was to correlate the errors, add paths, or delete non-significant paths for optimal model fit. The results listed in Table 4 indicated a suitable fit of the conceptual model. Standard coefficients of direct paths were obtained. According to Table 5, the path coefficient between childhood experiences and rumination as with the symptoms of depression-suicidal ideation subscale was positive (p <0.001). The path coefficient between childhood experiences and belongingness (support) was negative (p <0.001). Also, between belongingness and symptoms of depression-suicidal ideation, the path coefficient was negative (p <0.001) and the path coefficient between rumination and symptoms of depression-suicidal ideation was positive (p <0.05). Intermediate pathways were examined using the Bootstrap method. The upper and lower limits of belongingness and rumination in relation between childhood experiences and symptoms of depression-suicidal ideation subscale did not include zero, so these variables had mediating roles in the relationship between childhood experiences and symptoms of depression-suicidal ideation subscale (Table 6). Figure 2 shows the final pattern of the present study with standard coefficients. Factor loads of all markers were higher than 0.30 and all of them had the necessary power to measure the variables of the present study (Figure 2). Main Comparison to the Similar Studies The results showed that the unpleasant experiences of childhood led to the creation of a subscale of symptoms of depression-suicidal ideation in young people while rumination and belongingness played mediating roles. This finding is in line with some previous studies [13-17]. These studies have shown that suicide includes the element of innate and acquired readiness and includes the interrelation between these two elements. Accordingly, those who commit suicide develop self-abusive behaviors under the influence of factors such as a sense of thwarted belongingness and loneliness. Negative thinking patterns such as rumination also reinforce emotional disorders and ultimately increase suicidal ideation [14]. Various studies have supported the role of emotions in suicidal ideation and tendencies [11]. ... [26]. Sexual and emotional abuse, neglect and physical abuse in childhood can affect cognition and reinforce negative thoughts such as thwarted belongingness and rumination that cause depression, and this depression eventually leads to suicide [18]. According to research, people with a history of suicide also have a higher score on childhood trauma [29]. Chronic and severe dysphoric emotions include paranoid and transient experiences, impulsivity in the form of self-abusive behaviors, suicide threats, and suicide attempts [30]. Limitations The present study had some limitations, including; limitation of the study related to a thwarted belongingness scale, lack of recollection of certain events by respondents or unwillingness to reveal a problem, as well as the use of a cross-sectional research design in a sample of students. Suggestions Redoing this study in a clinical sample will help to evaluate the results of the study in diverse and at-risk populations. To determine the nature and repetition of this interaction, research is needed to determine whether these three structures interact with each other in a way that increases the symptoms of depression-suicidal ideation predicted by interpersonal theory. An important direction for future research is to elucidate how different types of risk factors and protective factors are associated with each other to develop the suicidal behaviors. One of the main areas for future research is the need to develop a comprehensive scale of childhood abuse experiences. Conclusions The results of this study support the relationship between childhood experiences and symptoms of depression-suicidal ideation mediated by a sense of thwarted belongingness and rumination. Clinical & Practical Tips in Police Medicine Identifying the causes and contexts of high-risk behaviors can be a good help to the police field. Acknowledgments We thank all the participants of the present study and those who helped us in this research. Conflict of Interest The authors state that there is no conflict of interest in the present study. Funding Sources The present study had no financial support. <div style="text-align: center;"><img alt="" src="./files/site1/images/image-20220827105626-1.png" style="width: 717px; height: 481px;" ></div> <div style="text-align: center;">Figure 1) Structural model of variables of childhood experiences and subscale of depression-suicidal ideation syndrome mediated by belonging and rumination Table 1) Descriptive statistics of research participants (600 people)</div> <div align="center" dir="ltr"> <table class="MsoTableGrid" style="border-collapse:collapse; border:none"> <tbody> <tr> <td colspan="4" style="border-bottom: 1px solid black; width: 232px; padding: 0cm 2px; height: 62px; border-top: 1px solid black; border-right: none; border-left: none; text-align: center;">Demographic features</td> <td style="border-bottom: 1px solid black; width: 65px; padding: 0cm 2px; height: 62px; border-top: 1px solid black; border-right: none; border-left: none; text-align: center;">Number</td> <td style="border-bottom: 1px solid black; width: 84px; padding: 0cm 2px; height: 62px; border-top: 1px solid black; border-right: none; border-left: none; text-align: center;">Percentage</td> </tr> <tr> <td colspan="2" rowspan="2" style="border-bottom: 1px solid black; width: 75px; padding: 0cm 2px; height: 27px; border-top: none; border-right: none; border-left: none; text-align: center;">Gender</td> <td colspan="2" style="border-width: initial; border-style: none; border-color: initial; width: 156px; padding: 0cm 2px; height: 27px; text-align: center;">Male</td> <td style="border-width: initial; border-style: none; border-color: initial; width: 65px; padding: 0cm 2px; height: 27px; text-align: center;">139</td> <td style="border-width: initial; border-style: none; border-color: initial; width: 84px; padding: 0cm 2px; height: 27px; text-align: center;">23.2</td> </tr> <tr> <td colspan="2" style="border-bottom: 1px solid black; width: 156px; padding: 0cm 2px; height: 27px; border-top: none; border-right: none; border-left: none; text-align: center;">Female</td> <td style="border-bottom: 1px solid black; width: 65px; padding: 0cm 2px; height: 27px; border-top: none; border-right: none; border-left: none; text-align: center;">461</td> <td style="border-bottom: 1px solid black; width: 84px; padding: 0cm 2px; height: 27px; border-top: none; border-right: none; border-left: none; text-align: center;">76.8</td> </tr> <tr> <td colspan="2" rowspan="8" style="border-bottom: 1px solid black; width: 75px; padding: 0cm 2px; height: 19px; border-top: none; border-right: none; border-left: none; text-align: center;">Ages</td> <td rowspan="2" style="border-width: initial; border-style: none; border-color: initial; width: 91px; padding: 0cm 2px; height: 19px; text-align: center;">Less than 20</td> <td style="border-width: initial; border-style: none; border-color: initial; width: 65px; padding: 0cm 2px; height: 19px; text-align: center;">Male</td> <td style="border-width: initial; border-style: none; border-color: initial; width: 65px; padding: 0cm 2px; height: 19px; text-align: center;">151</td> <td style="border-width: initial; border-style: none; border-color: initial; width: 84px; padding: 0cm 2px; height: 19px; text-align: center;">32.8</td> </tr> <tr> <td style="border-width: initial; border-style: none; border-color: initial; width: 65px; padding: 0cm 2px; height: 16px; text-align: center;">Female</td> <td style="border-width: initial; border-style: none; border-color: initial; width: 65px; padding: 0cm 2px; height: 16px; text-align: center;">55</td> <td style="border-width: initial; border-style: none; border-color: initial; width: 84px; padding: 0cm 2px; height: 16px; text-align: center;">39.6</td> </tr> <tr> <td rowspan="2" style="border-width: initial; border-style: none; border-color: initial; width: 91px; padding: 0cm 2px; height: 16px; text-align: center;">21 to 25</td> <td style="border-width: initial; border-style: none; border-color: initial; width: 65px; padding: 0cm 2px; height: 16px; text-align: center;">Male</td> <td style="border-width: initial; border-style: none; border-color: initial; width: 65px; padding: 0cm 2px; height: 16px; text-align: center;">208</td> <td style="border-width: initial; border-style: none; border-color: initial; width: 84px; padding: 0cm 2px; height: 16px; text-align: center;">45.1</td> </tr> <tr> <td style="border-width: initial; border-style: none; border-color: initial; width: 65px; padding: 0cm 2px; height: 16px; text-align: center;">Female</td> <td style="border-width: initial; border-style: none; border-color: initial; width: 65px; padding: 0cm 2px; height: 16px; text-align: center;">41</td> <td style="border-width: initial; border-style: none; border-color: initial; width: 84px; padding: 0cm 2px; height: 16px; text-align: center;">29.5</td> </tr> <tr> <td rowspan="2" style="border-width: initial; border-style: none; border-color: initial; width: 91px; padding: 0cm 2px; height: 24px; text-align: center;">26 to 30</td> <td style="border-width: initial; border-style: none; border-color: initial; width: 65px; padding: 0cm 2px; height: 24px; text-align: center;">Male</td> <td style="border-width: initial; border-style: none; border-color: initial; width: 65px; padding: 0cm 2px; height: 24px; text-align: center;">72</td> <td style="border-width: initial; border-style: none; border-color: initial; width: 84px; padding: 0cm 2px; height: 24px; text-align: center;">15.6</td> </tr> <tr> <td style="border-width: initial; border-style: none; border-color: initial; width: 65px; padding: 0cm 2px; height: 12px; text-align: center;">Female</td> <td style="border-width: initial; border-style: none; border-color: initial; width: 65px; padding: 0cm 2px; height: 12px; text-align: center;">17</td> <td style="border-width: initial; border-style: none; border-color: initial; width: 84px; padding: 0cm 2px; height: 12px; text-align: center;">12.02</td> </tr> <tr> <td rowspan="2" style="border-bottom: 1px solid black; width: 91px; padding: 0cm 2px; height: 17px; border-top: none; border-right: none; border-left: none; text-align: center;">Above 30</td> <td style="border-width: initial; border-style: none; border-color: initial; width: 65px; padding: 0cm 2px; height: 17px; text-align: center;">Male</td> <td style="border-width: initial; border-style: none; border-color: initial; width: 65px; padding: 0cm 2px; height: 17px; text-align: center;">30</td> <td style="border-width: initial; border-style: none; border-color: initial; width: 84px; padding: 0cm 2px; height: 17px; text-align: center;">6.5</td> </tr> <tr> <td style="border-bottom: 1px solid black; width: 65px; padding: 0cm 2px; height: 14px; border-top: none; border-right: none; border-left: none; text-align: center;">Female</td> <td style="border-bottom: 1px solid black; width: 65px; padding: 0cm 2px; height: 14px; border-top: none; border-right: none; border-left: none; text-align: center;">17</td> <td style="border-bottom: 1px solid black; width: 84px; padding: 0cm 2px; height: 14px; border-top: none; border-right: none; border-left: none; text-align: center;">17</td> </tr> <tr> <td colspan="2" rowspan="3" style="border-bottom: 1px solid black; width: 75px; padding: 0cm 2px; height: 32px; border-top: none; border-right: none; border-left: none; text-align: center;">Education</td> <td colspan="2" style="border-width: initial; border-style: none; border-color: initial; width: 156px; padding: 0cm 2px; height: 32px; text-align: center;">Bachelor</td> <td style="border-width: initial; border-style: none; border-color: initial; width: 65px; padding: 0cm 2px; height: 32px; text-align: center;">387</td> <td style="border-width: initial; border-style: none; border-color: initial; width: 84px; padding: 0cm 2px; height: 32px; text-align: center;">64.5</td> </tr> <tr> <td colspan="2" style="border-width: initial; border-style: none; border-color: initial; width: 156px; padding: 0cm 2px; height: 39px; text-align: center;">Master</td> <td style="border-width: initial; border-style: none; border-color: initial; width: 65px; padding: 0cm 2px; height: 39px; text-align: center;">191</td> <td style="border-width: initial; border-style: none; border-color: initial; width: 84px; padding: 0cm 2px; height: 39px; text-align: center;">31.8</td> </tr> <tr> <td colspan="2" style="border-bottom: 1px solid black; width: 156px; padding: 0cm 2px; height: 31px; border-top: none; border-right: none; border-left: none; text-align: center;">PHD</td> <td style="border-bottom: 1px solid black; width: 65px; padding: 0cm 2px; height: 31px; border-top: none; border-right: none; border-left: none; text-align: center;">22</td> <td style="border-bottom: 1px solid black; width: 84px; padding: 0cm 2px; height: 31px; border-top: none; border-right: none; border-left: none; text-align: center;">3.7</td> </tr> <tr> <td rowspan="4" style="border-bottom: 1px solid black; width: 75px; padding: 0cm 2px; height: 42px; border-top: none; border-right: none; border-left: none; text-align: center;">Economic situation</td> <td colspan="3" style="border-width: initial; border-style: none; border-color: initial; width: 157px; padding: 0cm 2px; height: 42px; text-align: center;">Weak</td> <td style="border-width: initial; border-style: none; border-color: initial; width: 65px; padding: 0cm 2px; height: 42px; text-align: center;">113</td> <td style="border-width: initial; border-style: none; border-color: initial; width: 84px; padding: 0cm 2px; height: 42px; text-align: center;">18.8</td> </tr> <tr> <td colspan="3" style="border-width: initial; border-style: none; border-color: initial; width: 157px; padding: 0cm 2px; height: 40px; text-align: center;">medium</td> <td style="border-width: initial; border-style: none; border-color: initial; width: 65px; padding: 0cm 2px; height: 40px; text-align: center;">308</td> <td style="border-width: initial; border-style: none; border-color: initial; width: 84px; padding: 0cm 2px; height: 40px; text-align: center;">51.3</td> </tr> <tr> <td colspan="3" style="border-width: initial; border-style: none; border-color: initial; width: 157px; padding: 0cm 2px; height: 47px; text-align: center;">Good</td> <td style="border-width: initial; border-style: none; border-color: initial; width: 65px; padding: 0cm 2px; height: 47px; text-align: center;">118</td> <td style="border-width: initial; border-style: none; border-color: initial; width: 84px; padding: 0cm 2px; height: 47px; text-align: center;">19.7</td> </tr> <tr> <td colspan="3" style="border-bottom: 1px solid black; width: 157px; padding: 0cm 2px; height: 1cm; border-top: none; border-right: none; border-left: none; text-align: center;">very good</td> <td style="border-bottom: 1px solid black; width: 65px; padding: 0cm 2px; height: 1cm; border-top: none; border-right: none; border-left: none; text-align: center;">61</td> <td style="border-bottom: 1px solid black; width: 84px; padding: 0cm 2px; height: 1cm; border-top: none; border-right: none; border-left: none; text-align: center;">10.2</td> </tr> <tr> <td style="border-width: initial; border-style: none; border-color: initial; width: 75px; text-align: center;"></td> <td style="border-width: initial; border-style: none; border-color: initial; width: 0px; text-align: center;"></td> <td style="border-width: initial; border-style: none; border-color: initial; width: 91px; text-align: center;"></td> <td style="border-width: initial; border-style: none; border-color: initial; width: 65px; text-align: center;"></td> <td style="border-width: initial; border-style: none; border-color: initial; width: 65px; text-align: center;"></td> <td style="border-width: initial; border-style: none; border-color: initial; width: 84px; text-align: center;"></td> </tr> </tbody> </table> </div> <div style="text-align: center;"> Table 2) Mean, skewness and Kurtosis of the studied indicators (600 people)</div> <div align="center" dir="ltr"> <table class="MsoTableGrid" style="border-collapse:collapse; border:none"> <tbody> <tr> <td style="border-bottom: 1px solid black; padding: 0cm 2px; border-top: 1px solid black; border-right: none; border-left: none; text-align: center;">Indicator</td> <td style="border-bottom: 1px solid black; padding: 0cm 2px; border-top: 1px solid black; border-right: none; border-left: none; text-align: center;">Mean (M±SD)</td> <td style="border-bottom: 1px solid black; padding: 0cm 2px; border-top: 1px solid black; border-right: none; border-left: none; text-align: center;">Skewness</td> <td style="border-bottom: 1px solid black; padding: 0cm 2px; border-top: 1px solid black; border-right: none; border-left: none; text-align: center;">Kurtosis</td> </tr> <tr> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; height: 74px; text-align: center;">1- symptoms of depression-suicidal ideation</td> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; height: 74px; text-align: center;">1.58±0.64</td> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; height: 74px; text-align: center;">1.73</td> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; height: 74px; text-align: center;">1.13</td> </tr> <tr> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; height: 57px; text-align: center;">2-Childhood experiences</td> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; height: 57px; text-align: center;">2.04±1.88</td> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; height: 57px; text-align: center;">1.08</td> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; height: 57px; text-align: center;">0.587</td> </tr> <tr> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; height: 48px; text-align: center;">3- Thwarted belongingness</td> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; height: 48px; text-align: center;">7.12±20.37</td> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; height: 48px; text-align: center;">0.122</td> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; height: 48px; text-align: center;">-0.006</td> </tr> <tr> <td style="border-bottom: 1px solid black; padding: 0cm 2px; height: 58px; border-top: none; border-right: none; border-left: none; text-align: center;">4-Rumination</td> <td style="border-bottom: 1px solid black; padding: 0cm 2px; height: 58px; border-top: none; border-right: none; border-left: none; text-align: center;">2.65±11.02</td> <td style="border-bottom: 1px solid black; padding: 0cm 2px; height: 58px; border-top: none; border-right: none; border-left: none; text-align: center;">-0.072</td> <td style="border-bottom: 1px solid black; padding: 0cm 2px; height: 58px; border-top: none; border-right: none; border-left: none; text-align: center;">-0.494</td> </tr> </tbody> </table> </div> <div style="text-align: center;"> Table 3) Correlation of studied indicators</div> <div align="center" dir="ltr"> <table class="MsoTableGrid" style="border-collapse:collapse; border:none"> <tbody> <tr> <td style="border-bottom: 1px solid black; padding: 0cm 2px; border-top: 1px solid black; border-right: none; border-left: none; text-align: center;">Indicators</td> <td style="border-bottom: 1px solid black; padding: 0cm 2px; border-top: 1px solid black; border-right: none; border-left: none; text-align: center;">1</td> <td style="border-bottom: 1px solid black; padding: 0cm 2px; border-top: 1px solid black; border-right: none; border-left: none; text-align: center;">2</td> <td style="border-bottom: 1px solid black; padding: 0cm 2px; border-top: 1px solid black; border-right: none; border-left: none; text-align: center;">3</td> </tr> <tr> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; text-align: center;">1- symptoms of depression-suicidal ideation</td> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; text-align: center;">-</td> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; text-align: center;">-</td> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; text-align: center;">-</td> </tr> <tr> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; text-align: center;">2- Childhood experiences</td> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; text-align: center;">0.27</td> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; text-align: center;">-</td> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; text-align: center;">-</td> </tr> <tr> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; text-align: center;">3- Thwarted belongingness</td> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; text-align: center;">-0.33</td> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; text-align: center;">-0.27</td> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; text-align: center;">-</td> </tr> <tr> <td style="border-bottom: 1px solid black; padding: 0cm 2px; border-top: none; border-right: none; border-left: none; text-align: center;">4- Intellectual rumination</td> <td style="border-bottom: 1px solid black; padding: 0cm 2px; border-top: none; border-right: none; border-left: none; text-align: center;">0.23</td> <td style="border-bottom: 1px solid black; padding: 0cm 2px; border-top: none; border-right: none; border-left: none; text-align: center;">0.22</td> <td style="border-bottom: 1px solid black; padding: 0cm 2px; border-top: none; border-right: none; border-left: none; text-align: center;">-0.28</td> </tr> </tbody> </table> </div> <div style="text-align: center;">p <0.01 Table 4) Model fit indices for the proposed structural model</div> <div align="center" dir="ltr"> <table class="MsoTableGrid" style="border-collapse:collapse; border:none"> <tbody> <tr> <td style="border-bottom: 1px solid black; padding: 0cm 2px; border-top: 1px solid black; border-right: none; border-left: none; text-align: center;">Variable fitting indices</td> <td style="border-bottom: 1px solid black; padding: 0cm 2px; border-top: 1px solid black; border-right: none; border-left: none; text-align: center;">Chi- Square</td> <td style="border-bottom: 1px solid black; padding: 0cm 2px; border-top: 1px solid black; border-right: none; border-left: none; text-align: center;">Degree of freedom</td> <td style="border-bottom: 1px solid black; padding: 0cm 2px; border-top: 1px solid black; border-right: none; border-left: none; text-align: center;">CMIN/df</td> <td style="border-bottom: 1px solid black; padding: 0cm 2px; border-top: 1px solid black; border-right: none; border-left: none; text-align: center;">GFI</td> <td style="border-bottom: 1px solid black; padding: 0cm 2px; border-top: 1px solid black; border-right: none; border-left: none; text-align: center;">AGFI</td> <td style="border-bottom: 1px solid black; padding: 0cm 2px; border-top: 1px solid black; border-right: none; border-left: none; text-align: center;">RMSEA</td> <td style="border-bottom: 1px solid black; padding: 0cm 2px; border-top: 1px solid black; border-right: none; border-left: none; text-align: center;">NFI</td> <td style="border-bottom: 1px solid black; padding: 0cm 2px; border-top: 1px solid black; border-right: none; border-left: none; text-align: center;">CFA</td> <td style="border-bottom: 1px solid black; padding: 0cm 2px; border-top: 1px solid black; border-right: none; border-left: none; text-align: center;">p</td> </tr> <tr> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; text-align: center;">Suggested pattern</td> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; text-align: center;">685-69</td> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; text-align: center;">204</td> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; text-align: center;">3.361</td> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; text-align: center;">0.89</td> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; text-align: center;">0.77</td> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; text-align: center;">0.063</td> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; text-align: center;">0.89</td> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; text-align: center;">0.78</td> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; text-align: center;">˂0.001</td> </tr> <tr> <td style="border-bottom: 1px solid black; padding: 0cm 2px; border-top: none; border-right: none; border-left: none; text-align: center;">Modified pattern</td> <td style="border-bottom: 1px solid black; padding: 0cm 2px; border-top: none; border-right: none; border-left: none; text-align: center;">410.53</td> <td style="border-bottom: 1px solid black; padding: 0cm 2px; border-top: none; border-right: none; border-left: none; text-align: center;">198</td> <td style="border-bottom: 1px solid black; padding: 0cm 2px; border-top: none; border-right: none; border-left: none; text-align: center;">2.073</td> <td style="border-bottom: 1px solid black; padding: 0cm 2px; border-top: none; border-right: none; border-left: none; text-align: center;">0.95</td> <td style="border-bottom: 1px solid black; padding: 0cm 2px; border-top: none; border-right: none; border-left: none; text-align: center;">0.97</td> <td style="border-bottom: 1px solid black; padding: 0cm 2px; border-top: none; border-right: none; border-left: none; text-align: center;">0.042</td> <td style="border-bottom: 1px solid black; padding: 0cm 2px; border-top: none; border-right: none; border-left: none; text-align: center;">0.92</td> <td style="border-bottom: 1px solid black; padding: 0cm 2px; border-top: none; border-right: none; border-left: none; text-align: center;">0.95</td> <td style="border-bottom: 1px solid black; padding: 0cm 2px; border-top: none; border-right: none; border-left: none; text-align: center;">˂0.001</td> </tr> </tbody> </table> </div> <div style="text-align: center;"> Table 5) Paths and coefficients of standard and non-standard in the model</div> <div align="center" dir="ltr"> <table class="MsoTableGrid" style="border-collapse:collapse; border:none"> <tbody> <tr> <td style="border-bottom: 1px solid black; padding: 0cm 2px; border-top: 1px solid black; border-right: none; border-left: none; text-align: center;">Variables</td> <td style="border-bottom: 1px solid black; padding: 0cm 2px; border-top: 1px solid black; border-right: none; border-left: none; text-align: center;">Non-standard beta</td> <td style="border-bottom: 1px solid black; padding: 0cm 2px; border-top: 1px solid black; border-right: none; border-left: none; text-align: center;">Standard beta</td> <td style="border-bottom: 1px solid black; padding: 0cm 2px; border-top: 1px solid black; border-right: none; border-left: none; text-align: center;">Standard deviation</td> <td style="border-bottom: 1px solid black; padding: 0cm 2px; border-top: 1px solid black; border-right: none; border-left: none; text-align: center;">CR (t) statistics</td> <td style="border-bottom: 1px solid black; padding: 0cm 2px; border-top: 1px solid black; border-right: none; border-left: none; text-align: center;">p</td> </tr> <tr> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; text-align: center;">Childhood experiences <--- belonging</td> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; text-align: center;">-2.88</td> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; text-align: center;">-0.32</td> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; text-align: center;">0.574</td> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; text-align: center;">-5.01</td> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; text-align: center;">˂0.001</td> </tr> <tr> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; text-align: center;">Childhood experiences <--- symptoms of depression-suicidal ideation</td> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; text-align: center;">0.629</td> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; text-align: center;">0.23</td> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; text-align: center;">0.163</td> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; text-align: center;">3.85</td> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; text-align: center;">˂0.001</td> </tr> <tr> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; text-align: center;">Childhood experiences <--- rumination</td> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; text-align: center;">1.33</td> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; text-align: center;">0.31</td> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; text-align: center;">0.286</td> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; text-align: center;">4.65</td> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; text-align: center;">˂0.001</td> </tr> <tr> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; text-align: center;">Rumination <--- Depression Symptoms-Suicidal tendency</td> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; text-align: center;">0.084</td> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; text-align: center;">0.28</td> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; text-align: center;">0.014</td> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; text-align: center;">5.95</td> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; text-align: center;">˂0.001</td> </tr> <tr> <td style="border-bottom: 1px solid black; padding: 0cm 2px; border-top: none; border-right: none; border-left: none; text-align: center;">Belonging <--- Depression symptoms of depression-suicidal ideation</td> <td style="border-bottom: 1px solid black; padding: 0cm 2px; border-top: none; border-right: none; border-left: none; text-align: center;">-0.077</td> <td style="border-bottom: 1px solid black; padding: 0cm 2px; border-top: none; border-right: none; border-left: none; text-align: center;">-0.12</td> <td style="border-bottom: 1px solid black; padding: 0cm 2px; border-top: none; border-right: none; border-left: none; text-align: center;">0.031</td> <td style="border-bottom: 1px solid black; padding: 0cm 2px; border-top: none; border-right: none; border-left: none; text-align: center;">-2.49</td> <td style="border-bottom: 1px solid black; padding: 0cm 2px; border-top: none; border-right: none; border-left: none; text-align: center;">0.013</td> </tr> </tbody> </table> </div> <div style="text-align: center;"> Table 6) Bootstrap test indicators for measuring indirect relationships in the model</div> <div align="center" dir="ltr"> <table class="MsoTableGrid" style="border-collapse:collapse; border:none"> <tbody> <tr> <td style="border-bottom: 1px solid black; padding: 0cm 2px; border-top: 1px solid black; border-right: none; border-left: none; text-align: center;">Variables</td> <td style="border-bottom: 1px solid black; padding: 0cm 2px; border-top: 1px solid black; border-right: none; border-left: none; text-align: center;">Non-standard beta</td> <td style="border-bottom: 1px solid black; padding: 0cm 2px; border-top: 1px solid black; border-right: none; border-left: none; text-align: center;">Standard beta</td> <td style="border-bottom: 1px solid black; padding: 0cm 2px; border-top: 1px solid black; border-right: none; border-left: none; text-align: center;">Low limit</td> <td style="border-bottom: 1px solid black; padding: 0cm 2px; border-top: 1px solid black; border-right: none; border-left: none; text-align: center;">High limit</td> <td style="border-bottom: 1px solid black; padding: 0cm 2px; border-top: 1px solid black; border-right: none; border-left: none; text-align: center;">P</td> </tr> <tr> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; text-align: center;">Childhood experiences <--- rumination <- Depressive symptoms - Suicidal tendencies</td> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; text-align: center;">0.115</td> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; text-align: center;">0.058</td> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; text-align: center;">0.029</td> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; text-align: center;">0.103</td> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; text-align: center;">˂0.001</td> </tr> <tr> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; text-align: center;">Childhood experiences <--- belonging <- depressive symptoms - suicidal tendencies</td> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; text-align: center;">0.235</td> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; text-align: center;">0.089</td> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; text-align: center;">0.054</td> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; text-align: center;">0.141</td> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; text-align: center;">˂0.001</td> </tr> <tr> <td style="border-bottom: 1px solid black; padding: 0cm 2px; border-top: none; border-right: none; border-left: none; text-align: center;">Childhood experiences <--- rumination <- belonging <- depressive symptoms-suicidal tendencies</td> <td style="border-bottom: 1px solid black; padding: 0cm 2px; border-top: none; border-right: none; border-left: none; text-align: center;">0.344</td> <td style="border-bottom: 1px solid black; padding: 0cm 2px; border-top: none; border-right: none; border-left: none; text-align: center;">0.127</td> <td style="border-bottom: 1px solid black; padding: 0cm 2px; border-top: none; border-right: none; border-left: none; text-align: center;">0.082</td> <td style="border-bottom: 1px solid black; padding: 0cm 2px; border-top: none; border-right: none; border-left: none; text-align: center;">0.192</td> <td style="border-bottom: 1px solid black; padding: 0cm 2px; border-top: none; border-right: none; border-left: none; text-align: center;">˂0.001</td> </tr> </tbody> </table> </div> <div style="text-align: center;"> <img alt="" src="./files/site1/images/image-20220827105626-2.png" style="width: 717px; height: 435px;" > Figure 2) Standardized structural model of depression-suicide subtypes</div> تجربیات دوران کودکی,افسردگی,خودکشی, Adverse Childhood Experiences,Depression,Suicide, 1 14 http://jpmed.ir/browse.php?a_code=A-10-1121-1&slc_lang=fa&sid=1 soliman ahmadboukani سلیمان احمدبوکانی arezbookani@yahoo.com 100319475328460014003 100319475328460014003 No Counselling Department, Faculty of Education & Psychology, University of Mohaghegh Ardabili, Ardabili, Iran گروه مشاوره، دانشکده علوم تربیتی و روانشناسی، دانشگاه محقق اردبیلی، اردبیل Hosein Ghamarigivi حسین قمری گیوی h_ghamari@uma.ac.ir 100319475328460014004 100319475328460014004 Yes Counselling Department, Faculty of Education & Psychology, University of Mohaghegh Ardabili, Ardabili, Iran گروه مشاوره، دانشکده علوم تربیتی و روانشناسی، دانشگاه محقق اردبیلی، اردبیل Ahmadreza Kiani احمدرضا کیانی ahmadreza_kiani@yahoo.com 100319475328460014005 100319475328460014005 No Counselling Department, Faculty of Education & Psychology, University of Mohaghegh Ardabili, Ardabili, Iran گروه مشاوره، دانشکده علوم تربیتی و روانشناسی، دانشگاه محقق اردبیلی، اردبیل Ali Rezaeisharif علی رضایی شریف rezaeisharif@uma.ac.ir 100319475328460014006 100319475328460014006 No Counselling Department, Faculty of Education & Psychology, University of Mohaghegh Ardabili, Ardabili, Iran گروه مشاوره، دانشکده علوم تربیتی و روانشناسی، دانشگاه محقق اردبیلی، اردبیل