Modeling of structural relationships between suicide risk factors based on Three-Step Theory (3ST) among people with emotional disorders

Introduction: Suicide is one of the major public health concerns worldwide which has numerous negative consequences for individual and society. Aim: This study aimed to model the structural equations of suicide risk factors based on the three-step theory of suicide in individuals with the emotional disorders. Method: This was a descriptive study using structural equation modeling. The statistical population included all people with emotional disorders referring to psychiatric outpatient clinics of Razi Educational and Medical Center of Tabriz in 2020. 205 patients with emotional disorders were selected by purposive sampling method and, they answered the questionnaires of Suicide Ideation (STS), Suicide Attempt (SAS), Suicide Capacity (SCS), and Suicide Motivation Questionnaire (IMSA). Data were analyzed using Pearson SPSS correlation test version 23 and structural equation modeling. Results: The correlation coefficient results showed a significant relationship between pain, hopelessness, sense of connectedness, and suicide capacity with suicidal ideation and suicide attempt (P<0.05). The results of structural equation modeling showed that the indirect effect of hopelessness (0.234) and low connectedness (0.048) on suicide ideation via suicide capacity was significant. The results showed that the indirect effect of frustration (0.586) and low belonging (0.121) on suicide attempts via suicidal capacity was significant. Conclusion: Using a three-step model can be useful in rapid diagnosis and action to distinguish people with only suicide ideation or who are prone to suicide.