A model to explain suicide by self-immolation among Iranian women: A grounded theory study

• We present a grounded theory study exploring suicide by self-immolation in Iran.
• A conceptual model explains relations among motives for self-immolation attempts.
• Family conflicts are pivotal risk factors and should be addressed in interventions.
• Mental health influences the self-immolation process at multiple levels.

IntroductionSelf-immolation is a common method of suicide among Iranian women. There are several contributing motives for attempting self-immolation, and exploration of the process of self-immolation incidents will help interventionists and clinicians develop prevention programs.MethodsA grounded theory study using face-to-face, recorded interviews was conducted with surviving self-immolated patients (n = 14), their close relatives (n = 5), and medical staff (n = 8) in Kermanshah, Iran. Data were analyzed using constant comparison in open, axial, and selective coding stages.ResultsA conceptual model was developed to explain the relationships among the main categories extracted through the grounded theory study. Family conflicts emerged as the core category. Cultural context of self-immolated patients offered a contextual condition. Other important categories linked to the core category were mental health problems, distinct characteristics of the suicidal method, and self-immolation as a threat. The role of mental health problems as a causal condition was detected in different levels of the self-immolation process. Finally, adverse consequences of self-immolation emerged as having important impact.ConclusionThe conceptual model, derived through grounded theory study, can guide design of prevention programs. The pivotal role of family conflicts should be emphasized in mental health interventions. The impact of adverse consequences of self-immolation on further suicidal processes necessitates post-suicide prevention programs. Further research to design specific interventions is recommended.