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Journal Article


Heidari M, Haghdoost A, Khanjani N. Med. J. Islam. Repub. Iran 2019; 33: e138.


Neurology Research Center, Kerman University of Medical Sciences, Kerman, Iran.


(Copyright © 2019, Tehran University of Medical Sciences)








Background: 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. Methods: 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. Results: 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. Conclusion: 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.

© 2019 Iran University of Medical Sciences.

Language: en


Causal layered analysis (CLA); Etiology; Iran; Metaphor; Suicide; World view


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