The relationship of spiritual understanding and self-esteem with suicidal thoughts

Introduction: Spirituality, as with the knowledge of the whole universe, is a force beyond the material aspects of life. Self-esteem is generally a component of evaluation of selfconcept and the suicidal thoughts is a condition that implies on the occurrence of any selfdestructing thoughts. Materials and methods: Methodology of the present study was descriptive and correlational. The study population included all graduate students of Azad University of Ilam from which 235 persons (138 men and 97 women) were selected through stratified random sampling. The measuring tools of data were as follow: Kings spiritual understanding questionnaire, Eysenck self-esteem questionnaire and Beck suicidal ideation scale. The data was analyzed with using the statistical software SPSS the statistical methods, Pearson correlation coefficient, analysis of variance, multiple regression analysis and structural equations. Results: Spiritual understanding and self-esteem reversely and significantly predicted the thoughts of suicide with the coefficients -0.194 and -0.077, respectively. Conclusion: Individual factors such as spiritual perception and self-esteem are important and effective on the mental aspects of students. By increasing the impact of these factors, it could be expected to reduce the number of suicides.


Introduction
Spirituality as the knowledge of universe or as a force beyond the material aspects of life makes a profound sense of oneness or unity with the cosmos. Positive thoughts and hardiness are two components of spirituality and have relation with health and resistance against stress. Spiritual backrest can act as a deterrent against stress. The results of some studies have shown that there is a positive significant relationship between mental health, physical health, life satisfaction and welfare (1). Emmons believes that spirituality can be considered as a kind of intelligence, because it predicts performance and compatibility of individual (for example more health) and has raise capabilities that enable persons to solve their problems and access to their goals. Gardner criticized Emmons and believes that those aspects of spirituality that are related to the experiences of cognitive stability (like experience of sacred or transcendent states) must be separated from the aspects of rational, problem-solving and information processing (2). Can be attributed the cause opposition from some researchers, such as Gardner, about the problem, that spiritual intelligence involves motivation, willingness, morality and character is to look of their practical knowledge of intelligence (3). Emmons et al. defines the spiritual understanding of framework for identifying, organizing skills and capabilities that require the use of adaptive spirituality (2). Spiritual understanding, that can be knows one of the practical aspects of spirituality and it is use of abilities and spiritual resources. Such that person can adopt significant decisions about issue of the existence to think deeply and also for solving their everyday problems efforts. Therefore understanding the spiritual, mental aspects and intangible spirituality with actions and issues of person in the world concrete and tangible will composition. Individuals who have high spiritual understanding, they can be better understand the meaning of life and through discovery of the meaning of life decreases their anxiety and as a result increases their psychological health (3). On the other side, self-esteem usually is of assessment component of self-concept and that includes aspects of cognitive, behavioral and also emotional. However these structures often used to refer to a general sense of personal value, delicate concepts such as self-confidence, implicitly as a concept of self-esteem in more specific areas will be used. Also broadly assumes that self-esteem acts as an adjective, that's mean self-esteem, over time in person is fixed. Nevertheless this term is a common structures that with different areas of psychology, including personality (shyness), behavioral (task performance), cognitive (orientation documents), and Clinical Implications (anxiety and depression) is connected, in particular a few scholars are emphasized on functions of adaptive and selfsupporting of self-esteem (4). The theory of self-concept states that general and specific self-esteem are not same and cannot deduced one from the other. For example general self-esteem, emotional component and with psychological well being is associated and dedicated selfesteem a cognitive component and is associated with behavioral outcomes (5).
To narrow sense, self-esteem include amount of value that individuals for themselves are allowed. The high level of self esteem is represents a positive assessment of its own and vice versa. In other words, self esteem is a perception not a reality. Nevertheless, self esteem may be have intimately related with the cultures of other communities (6). Self esteem is attitude towards (7). Suicidal thoughts, implies a condition in which on the occurrence of any idea of declining. These thoughts, is encompass spectrum of obscure ideas, about the possibility of ending life, until complete suicide. Suicidal thoughts has a close relationship with abnormal reactions such as alcohol consumption and drug use, conflict with parents, running away from home, pessimism about the future, lack of social support and lack of communication with others. In other words, suicidal thoughts, itself is considered a risk factor for suicide (8). In explaining mental health as one of the important factors in the incidence of suicidal thoughts Berkmen et al. effective social support in mental health and consequently, reducing suicidal thoughts in person. Including the personality traits connected who somehow, with the emergence of suicidal ideation realistic can be named something such as low selfesteem, external locus of control, distress, impulsivity, aggression and extraversion (9). Mirzaee et al. has done a research to evaluate the effectiveness of the training component of spiritual intelligence on the health of students. Their results showed that the education component of spiritual intelligence on general health students has a positive effect (10). Research results of Yaghoubi et al. showed that there is a significant relationship between spiritual understanding and mental health of students, in the sense that those students who had higher understanding of extent of greater mental health (11). Extensive researches suggest that there is a relationship between self esteem, emotions, coping and health. This research suggests is experience that person with low self-esteem, than those with high selfesteem, more negative emotions (12). Greenberg et al. found that is protection self esteem, human, against anxiety, to improve coping strategies and increase physical health (13). However about suicide can be said that suicide is mental health problem. According to official 1996 World Health Organization each year at least 500 thousand person in the world with suicide end their life. Studies related to suicide investigate three important phenomenon that includes suicidal ideation, suicide attempt and suicide (14). In view of the above and given the extent, different individual factors and social in suicide in this study we have tried and to be addressed among individual factors, factors such as spiritual understanding and self-esteem and assessment the effects of these variables on extent of suicidal thoughts. The research conceptual framework: In view of the aforementioned subjects, it can be deduced that with increasing the variables, spiritual understanding and selfesteem, among students the suicidal thoughts could be reduced. Therefore, the conceptual model as follows would be designed ( Figure 1):

Materials and methods
The present research method was descriptive kind of correlational study. The study population included all students graduate, Azad University of Ilam is that were selected of them 250 students stratified random sampling. In this way the different disciplines of the humanities were divided either to a class and then were distributed the number of completed surveys randomly students that eventually were considered the number of 235 questionnaires to analyze the data. The research tools included the spiritual understanding questionnaire, Self-esteem Eysenck Scale and Suicidal thoughts Beck scale.
Spiritual understanding questionnaire has 43 questions with 5 options as "Likert scoring". Validity and content questions through a surveys of 19 person of experts examined and reliability as well as through implementation on 40 of students, the method of "reliability" and the distance 5 weeks 0.71 Calculated. Selfesteem Eysenck Scale questionnaire has 30 questions. Subjects for every question shall try as much as possible to answer yes or no. While it is not possible for him to be take the middle option and the question mark and select it. Scoring in this questionnaire is as follows: to stand back that measure self-esteem, the feeling of inferiority in consequence a score awarded while to stand in front of it did not be scored and the candidates, question mark in practice been graded 1/5. Suicidal thoughts Beck scale is a self-evaluation tool of 19 questions. This questionnaire has been prepared for the detection and measurement of the intensity of attitudes, behaviors and planned to commit suicide last week. This Scale based on grade point 3 been set. Overall score based on the total score is calculated. Questions of scale such as death, suicidal tendencies both active and inactive, duration and frequency of suicidal thoughts, feelings of self-control barriers, suicide and the willingness to commit suicide and examined the catalog is used. The data using statistical software in both descriptive (mean, standard deviation) and inferential statistics (ANOVA and multiple regression and SEM) using the statistical software SPSS and Amos were analyzed.

Results
Results are shown in the following tables: In  Table  3, there was a positive, strong and significant relationship between spiritual attitudes and intellectual ability with a correlation coefficient of 0.987, as well as between spiritual attitudes and self-esteem with a correlation coefficient of 0.840.
Also, there was a significantly inverse relationship between spiritual attitudes and suicide with a coefficient of -0.942. According to the results of Table 4, the F values 1771.19 and 904.77 for the models (1) and (2) were respectively obtained and given the positive significant levels, they are reliable.
According to the results presented in Table  5, t values obtained in the model (1) by a Coefficient of 42.085 is more than of amount obtained in the model (2). Based on the obtained β coefficients (Table 6), there was a significant and inverse correlation between self-esteem and suicidal thoughts.    Table 6. Regression analysis of the variables. P Value C.R (t-value) Deviation error Estimate (β) Direction 1.00 Spiritual understanding <---Spiritual attitude -88.24 0.009 0.77 Spiritual understanding <---Spiritual ability 0.045 -2.00 0.039 -0.08 Self-esteem <---thoughts suicide --21.03 0.009 -0.19 Spiritual understanding <---suicidal thoughts

Discussion
After reviewing the questionnaires, totally 235 questionnaires were analyzed and descriptive statistics of the data have been shown in Table 2. The results of correlation matrix research variables in Table 3 indicate that between spiritual understanding, self-esteem and suicidal thoughts there is a negative (inverse) and significantly relationship. So that the highest correlation the spiritual vision, the dimensions of spiritual understanding (-0.942) and lowest correlation related to self-esteem (-0.818). So between spiritual understanding (the Spiritual aspects and Spiritual ability), self-esteem and suicidal thoughts there was a significant and inverse relationship. Regression analysis variables of spiritual understanding and self-esteem, suicidal thoughts students indicates, that the above-mentioned variables can to predict in students with suicidal thoughts and can significantly the rate of suicidal thoughts between students. Unstandardized regression coefficients spiritual understanding and self-esteem, suicidal thoughts respectively (-0.215) and (-0.089) is in other words with an increase of one unit variables spiritual understanding and self-esteem, suicidal thoughts variable respectively is reduced to (-0.215) and (-0.089). Therefore hypothesis of the research are approved. The beta coefficient obtained for the self-esteem and suicide (-0.077) stating that between self-esteem and suicidal is inverse relationship with the intensity of (-0.077) and established in other words with increase of one unit on self-esteem, decline with the intensity of (-0.077) will be suicidal thoughts that value of (P value) significance of this relationship agrees because resulting amount (0.045) smaller than assumed error (0.05). On other hand beta coefficient obtained for the spiritual understanding and suicide (-0.194) stating that between spiritual understanding and committed suicide with the intensity (-0.194) there is inverse relationship in other words with an increase of one unit in spiritual understanding, decline with intensity (-0.194) will be the suicidal thoughts that value of (P value) the significance of this relationship confirms that as the value obtained (0.000) smaller than the assumed error (0.05). As is known the coefficient obtained for the variable spiritual understanding greater self-esteem and this namely the correlation spiritual understanding with thoughts of suicide is far more than self-esteem. Also the structural model the fit is acceptable so results of estimation model, is reliable. The findings is consistent with the researchers, Mirzaee (11), Yaghoubi (12) and Greenberg et al. (13). To illustrate it can be said that the high level of spiritual understanding makes that people can adopt significant decisions about the theme think deeply and also attempts to solve their daily problems and not to surrender and not in terms of their failure, which led to the development of damaging their thoughts.

Conclusion
According to the survey conducted on the psychological aspects (especially cognitive one) in this research that included spiritual understanding and self-esteem, the results show that the high level of spiritual understanding and self-esteem leads to declined suicidal thoughts as well as suicide attempts in the subjects. Also, the self-positive assessment of people (based on the definitions of self-esteem) prevents the people to conceive their value lower than the problems of life and in this way protects to hurt their life. Therefore, since the suicide is a death in which the person consciously and deliberately destruct his/her life and occurs among all age groups, suicidal ideation is precursor of suicide attempt, and several factors including physical, psychological, social, family and career can be the cause of suicidal thoughts.