چکیده فارسی: یکی از بحرانهای مورد توجه در سطح جهانی، خودکشی و پیامدهای ناشی از آن میباشد. به نظر میرسد خودکشی بالاخص با افزایش سن، روند صعودی پیدا کرده و در جمعیت سالمندان به شدت افزایش یافته است. بنابراین پژوهش حاضر با هدف بررسی رابطه مقایسه اجتماعی و افکار خودکشی با نقش میانجیگری سبکهای تصمیمگیری سالمندان انجام شد. پژوهش حاضر همبستگی از نوع مدل یابی معادلات ساختاری بود. جامعه آماری شامل سالمندان بالای 65 سال شهر شیراز بود که از میان آنها نمونه 265 نفری به روش نمونهگیری در دسترس، و با توجه به معیارهای ورود انتخاب شدند. شرکت کنندگان به پرسشنامههای افکار خودکشی بک، سبکهای تصمیمگیری اسکات و بروس و پرسشنامه مقایسه اجتماعی گیبونز و بانک پاسخ دادند. اطلاعات جمعآوری شده با روش مدل معادلات ساختاری و در نرمافزارهای SPSS26 و LISREL8.8 مورد تجزیه و تحلیل قرار گرفت. نتایج پژوهش حاضر نشان داد مدل مفروض از برازش خوبی برخوردار است. همچنین نتایج نشان داد مقایسه اجتماعی از طریق سبکهای تصمیمگیری با افکار خودکشی ارتباط دارد. بدین صورت که سبکهای تصمیمگیری منطقی و شهودی با افکار خودکشی رابطه منفی و معنادار و با سبک تصمیمگیری اجتنابی، وابسته و آنی رابطه مثبت و معنادار دارد. با توجه به نتایج پژوهش حاضر به روانشناسان و متخصصین توصیه میشود برای حل مشکل خودکشی به عنوان یک معضل جهانی و رو به افزایش، به افراد کمک کنند تا بر ویژگیهای مثبت زندگی خویش متمرکز شوند و از مقایسه سطحی بپرهیزند. همچنین با آموزش مهارتهای تصمیمگیری در کاهش میزان خودکشی در سالمندان گام بردارند.
The Relationship Between Social Comparisons and Suicidal Ideation in Older Adults: The Mediating Role of Decision-Making Styles
English Abstract: One of the most important crises in the world seems to be suicide and its consequences. It seems that suicide, especially with increasing age, has an upward trend and has greatly increased in older population. Therefore, the present study was to investigate the relationship between social comparisons and suicidal thoughts with the mediating role of decision-making styles in older adults. This was a correlational study, of structural equation modeling (SEM) type. The statistical population included older adults over 65 years old living in Shiraz, Iran, among whom 265 were selected using convenience sampling method and according to the inclusion criteria. Participants filled out Beck scale for suicidal ideation (BSS), Scott and Bruce’s decision-making styles questionnaire, and Gibbons and Buunk’s social comparison questionnaire. The collected information was analyzed using SEM in SPSS-26 and Lisrel-8.8 software. The results of the present study indicate that the hypothesized model demonstrates a good fit. Furthermore, the findings suggest that social comparison is related to suicidal ideation through the mediating role of decision-making styles. Specifically, logical and intuitive decision-making styles were significantly and negatively associated with suicidal ideation, while the avoidant, dependent, and immediate decision-making styles were positively and significantly related to suicidal ideation. Based on the findings of this research, psychologists and experts are advised to address suicide ideation as a global and escalating issue by assisting individuals in shifting their focus towards the positive aspects of their lives and refraining from making superficial comparisons. Furthermore, reducing suicide ideation can be achieved by imparting decision-making skills to older adults. EXTENDED ABSTRACT Introduction Various studies have shown that suicide probability increases with age, and accordingly the growing attention has been paid to suicide phenomena in adults, particularly older adults. Suicide behavior is multifaceted and complex, making it challenging to predict. Among numerous factors, suicidal ideation appears to be the most significant predictor of suicidal behavior. Although the research literature has explored various variables related to suicidal ideation in older adults, less attention has been given to social factors. One significant factor that can contribute to suicidal ideation is social comparison. Studies have demonstrated that individuals tend to engage in upward social comparisons, and when individuals perceive themselves as having lesser capabilities, these comparisons can be detrimental. Given that older individuals may experience declining abilities in various domains, social comparisons can have more severe consequences. While some studies have examined the relationship between social comparison and suicidal ideation, none have investigated the mechanisms underlying this relationship. Research in this area has highlighted decision-making styles as a variable, and exploring this variable in the older adults can help interpret the relationship between suicidal ideation and social comparisons. Therefore, due to the lack of studies in this domain, the aim of the present study was to investigate the relationship between suicidal ideation and social comparison through the mediating role of decision-making styles. Method The present research employed a correlational design, of structural equation modeling (SEM) type. The statistical population consisted of all older adults aged 65 and above residing in Shiraz, Iran, among whom 265 participants (130 males and 135 females) were selected using convenience sampling as the research sample. Inclusion criteria comprised (1) being aged 65 or above, (2) absence of physical and mental disabilities, (3) literacy, and (4) willingness to participate in the study and complete the questionnaires, while exclusion criteria included (1) consumption of psychotropic drugs and (2) physical and mental disabilities. Participants completed Beck scale for suicidal ideation (BSS), Scott and Bruce’s decision-making styles questionnaire, and Gibbons and Buunk’s social comparison questionnaire. The questionnaires were administered to eligible older adults, and necessary guidance for completing them was provided. Finally, the data obtained from the questionnaires were analyzed using Pearson’s correlation coefficient and SEM in SPSS-21 and Lisrel-1.9 software. Results Before conducting data analysis, it was determined that the distribution of scores for all variables was normal, and the results indicated no correlation between errors and no collinearity between variables. To evaluate the proposed model, SEM was utilized. The results of Pearson’s correlation tests revealed significant positive correlations between suicidal ideation with social comparison, intuitive, avoidant, dependent and immediate decision-making styles. Moreover, there was significant negative correlations between suicidal ideation with rational decision-making styles. The final model of the study can be seen in Figure 1. The fit indices for the obtained model were as follows: X2/df = 2/31, CFI = 0.92, TLI = 0.91, NFI = 0.94, AGFI = 0.94, and RMSEA = 0.06, indicating an adequate fit of the model. The results of the Sobel test indicated that rational decision-making style in the relationship between social comparison and suicidal ideation (Z = 57.3, p < 0.01), intuitive decision-making style in the relationship between social comparison and suicidal ideation (Z = 97.2, p < 0.01), avoidant decision-making style in the relationship between social comparison and suicidal ideation (Z = 5.3, p < 0.01), dependent decision-making style in the relationship between social comparison and suicidal ideation (Z = 32.2, p < 0.01), and immediate decision-making style in the relationship between social comparison and suicidal ideation (Z = 42.2, p < 0.01) played a significant mediating role. Conclusion According to the studies, individuals tend to engage in social comparisons with those perceived as better than themselves. This tendency can lead to feelings of inadequacy, negative emotional experiences, and even suicidal ideation. When individuals engage in social comparisons, these judgments are often unrealistic, and they hold a superficial attitude towards the well-being and capabilities of others. Examining information derived from social judgments can influence subsequent decision-making processes. Cognitive psychologists believe that rational or intuitive decision-making styles lead to better decision outcomes in life, while avoidant, dependent, and impulsive decision-making styles have negative effects on decision-making processes. Decision-making deficits can impair individuals’ problem-solving abilities, leading to an accumulation of stressors that may exacerbate distress and provide a basis for suicidal ideations, ultimately leading to risky behaviors such as self-harm and suicide. Individuals with a rational decision-making style carefully evaluate all possible options and choose the best and most desirable one. Individuals with an intuitive decision-making style have clear insights into the outcome of their decisions and select an appropriate option. These two styles, with the help of logic and insight, can reduce suicidal ideations. Individuals with a dependent decision-making style lack intellectual independence and constantly seek support from others, which becomes more challenging in old age as social support becomes scarcer, with few close ones to rely on. Avoidant decision-making involves avoiding decision-making and problem-solving efforts, which can create a crisis situation and increase conflicts due to the inability to choose from available options. Based on the above, the dependent and avoidant decision-making styles can create a basis for negative emotions. In impulsive decision-making, individuals aim to quickly select their desired option in the shortest possible time and seek relief from pain and distress, which significantly increases suicidal ideations. Ethical Consideration Ethical Code To comply with ethical standards in the research, the study was pre-registered at Payame Noor University, Tehran. Financial Support This study had no financial support Authors’ Contributions A.M: Conceptualization, methodology, Software, validation, formal analysis, data curation, resources, Writing- Original draft, writingreview & editing. Conflict of Interest The author had no conflicts of interest. Acknowledgments Respectful appreciation is extended to the esteemed older participants for their cooperation and assistance in completing the questionnaires. References Abubakar, A. M., Elrehail, H., Alatailat, M. A., & Elçi, A. (2019). Knowledge management, decision-making style and organizational performance. Journal of Innovation & Knowledge, 4(2), 104-114. https://doi.org/10.1016/j.jik.2017.07.003 Ahmadi Ghozlojeh, A., & Mehdizadeh Tavasani, A. (2019). Factorial structure and psychometric properties of persian version of social comparisons orientation scale (SCOS). Rooyesh, 8 (6) 209-216. [Persian]. http://frooyesh.ir/article-1- 1140 -fa.html Alizadeh Damieh, T. (2022). Prediction of suicide rate based on decision-making styles and religious coping strategies of male students. The 7th international conference on management, psychology and humanities with a sustainable development approach. [Persian] AlShra'ah, A. E. (2015). The Impact of decision-making style son organizational learning: An Empirical study on the public manufacturing companies in Jordan. International Journal of Business and Social Science, 6(4) 34-40. Andersen, S. M., & Chen, S. (2002). The relational self: An interpersonal social-cognitive theory. Psychological Review, 109(4), 619–645. https://doi.org/10.1037/0033-295X.109.4.619 Ennis, J., Fathi-Ashtiani, A., Soltaninejad, A., & Amiri, M. (2006). Prevalence of suicidal thoughts and associated factors among the soldiers. Journal of Military Medicine, 2(8), 7-11. [Persian] Barber, J. G. (2001). Relative misery and youth suicide. Australian & New Zealand. Journal of Psychiatry, 35(1), 49-57. https://doi.org/10.1046/j.1440-1614.2001.00854.x Barusch, A. S. (2013). The aging tsunami: Time for a new metaphor? Journal of Gerontological Social work, 56(3), 181-184. https://doi.org/10.1080/01634372.2013.787348 Barzilay, S., & Apter, A. (2014). Psychological models of suicide. Archives of Suicide Research, 18(4), 295-312. https://doi.org/10.1080/13811118.2013.824825 Beck, A. T., Steer, R. A., & Brown, G. (1996). Beck depression inventory–II. Psychological Assessment, 4, 561-571. https://doi.org/10.1037/t00742-000 Beghi, M., Butera, E., Cerri, C. G., Cornaggia, C. M., Febbo, F., Mollica, A., Berardino, G., Piscitelli, D., Resta, R., Logroscino, G., Daniele, A., Altamura, M., Bellomo, A., Panza, F., & Lozupone, M. (2021). Suicidal behaviour in older age: A systematic review of risk factors associated to suicide attempts and completed suicides. Neuroscience & Biobehavioral Reviews, 127, 193-211. https://doi.org/10.1016/j.neubiorev.2021.04.011 Bridge, J. A., McBee-Strayer, S. M., Cannon, E. A., Sheftall, A. H., Reynolds, B., Campo, J. V., Pajer, K. A., Barbe, R. P., Brent, D. A., & Brent, D. A. (2012). Impaired decision making in adolescent suicide attempters. Journal of the American Academy of Child & Adolescent Psychiatry, 51(4), 394-403. https://doi.org/10.1016/j.jaac.2012.01.002 Brousseau, K. R., Driver, M. J., Hourihan, G., & Larsson, R. (2006). The seasoned executive's decision-making style. Harvard Business Review, 84(2), 110-21. Buunk, A. P., Groothof, H. A., & Siero, F. W. (2007). Social comparison and satisfaction with one's social life. Journal of Social and Personal Relationships, 24(2), 197-205. https://doi.org/10.1177/0265407507075410 Buunk, A. P., & Gibbons, F. X. (2006). Social comparison orientation: A new perspective on those who do and those who don't compare with others. In S. Guimond (Ed.), Social comparison and social psychology: Understanding cognition, intergroup relations, and culture (pp. 15–32). Cambridge University Press. Chan, A. S. W., Lo, I. P. Y., & Yan, E. (2022). Health and social inclusion: The impact of psychological well-being and suicide attempts among older men who have sex with men. American Journal of Men's Health, 16(5), 15579883221120985 Article.https://doi.org/10.1177/15579883221120985 Choi, N.G., DiNitto, D.M., Marti, C.N., Kaplan, M.S., Conwell, Y. )2017(. Suicide means among decedents aged 50+ years, 2005-2014: trends and associations with sociodemographic and precipitating factors. The American Journal of Geriatric Psychiatry, 25 (12), 1404–1414. https://doi.org/10.1016/j.jagp.2017.06.001. Cheung, F., & Lucas, R. E. (2016). Income inequality is associated with stronger social comparison effects: The effect of relative income on life satisfaction. Journal of Personality and Social Psychology, 110(2), 332–341. https://doi.org/10.1037/pspp0000059 Curşeu, P. L., & Schruijer, S. G. (2012). Decision styles and rationality: An analysis of the predictive validity of the General Decision-Making Style Inventory. Educational and Psychological Measurement, 72(6), 1053-1062. https://doi.org/10.1177/0013164412448066 De Leo, D. E., Bille-Brahe, U. E., Kerkhof, A. E., & Schmidtke, A. E. (2004). Suicidal behaviour: Theories and research findings. Hogrefe & Huber Publishers. 17–39. Dennis, M. S., & Owens, D. W. (2012). Self-harm in older people: a clear need for specialist assessment and care. The British Journal of Psychiatry, 200(5), 356-358. https://doi.org/10.1192/ bjp.bp.111.104109. Festinger, L. (1954). A theory of social comparison processes. Human Relations, 7(2), 117–140. https://doi.org/10.1177/001872675400700202 Ebrahimi, A., Taher, M., & Nouhi, S. (2023). The relationship between mental health and physical health of elderly living in nursing homes: The mediating role of feelings of guilt and loneliness. Aging Psychology, 9(1), 31-19. [Persian] Fischer, S., Soyez, K., & Gurtner, S. (2015). Adapting Scott and Bruce’s general decision-making style inventory to patient decision making in provider choice. Medical Decision Making, 35(4), 525-532. https://doi.org/10.1177/0272989X15575518 Franklin, J. C., Ribeiro, J. D., Fox, K. R., Bentley, K. H., Kleiman, E. M., Huang, X., Musacchio, K. M., Jaroszewski, A. C., Chang, B. P., & Nock, M. K. (2017). Risk factors for suicidal thoughts and behaviors: A meta-analysis of 50 years of research. Psychological bulletin, 143(2), 187-232. https://doi.org/10.1037/bul0000084 GBD, 2017. Causes of Death Collaborators, 2018. Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980- 2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet 392 (10159), 1736–1788. https://doi.org/10.1016/S0140-6736(18)32203-7. Gerber, J. P., Wheeler, L., & Suls, J. (2018). A social comparison theory meta-analysis 60+ years on. Psychological Bulletin, 144(2), 177-197. https://doi.org/10.1037/bul0000127 Gvion, Y., Levi-Belz, Y., Hadlaczky, G., & Apter, A. (2015). On the role of impulsivity and decision-making in suicidal behavior. World Journal of Psychiatry, 5(3), 255-259. https://doi. 10.5498/wjp.v5.i3.255 Lynch, J. W., Smith, G. D., Kaplan, G. A., & House, J. S. (2000). Income inequality and mortality: Importance to health of individual income, psychosocial environment, or material conditions. British Medica Journal, 320(7243), 1200-1204. https://doi.org/10.1136/bmj.320.7243.1200 Istituto Nazionale di Statistica (2020). Nazionale diStatistica.https://www.istat.it. Last accessed: December 31st. James, G., Witten, D., Hastie, T., & Tibshirani, R. (2013). An introduction to statistical learning (Vol. 112, p. 18). New York: springer. http://hdl.handle.net/1/9528 Jollant, F., Guillaume, S., Jaussent, I., Castelnau, D., Malafosse, A., & Courtet, P. (2007). Impaired decision-making in suicide attempters may increase the risk of problems in affective relationships. Journal of Affective Disorders, 99(1-3), 59-62. https://doi.org/10.1176/appi.ajp.162.2.304 Kingsbury, M., Reme, B. A., Skogen, J. C., Sivertsen, B., Øverland, S., Cantor, N., Hysing, M., Petrie, K., & Colman, I. (2021). Differential associations between types of social media use and university students' non-suicidal self-injury and suicidal behavior. Computers in Human Behavior, 115, 106614. https://doi.org/10.1016/j.chb.2020.106614 Kleiman, E. M., & Nock, M. K. (2018). Real-time assessment of suicidal thoughts and behaviors. Current Opinion in Psychology, 22, 33-37. https://doi.org/10.1016/j.copsyc.2017.07.026 Kline, R. B. (2015). Principles and practice of structural equation modeling: Guilford publications. Principles and practice of structural equation modeling: Guilford publications. Li, X., Hou, Z. J., & Jia, Y. (2015). The influence of social comparison on career decision-making: Vocational identity as a moderator and regret as a mediator. Journal of Vocational Behavior, 86, 10-19. https://doi.org/10.1016/j.jvb.2014.10.003 Markman, A. B. (2020). Approaches to comparison and their influence on social comparison. In J. Suls, R. L. Collins, & L. Wheeler (Eds.), Social comparison, judgment, and behavior (pp. 430–442). Oxford University Press. https://doi.org/10.1093/oso/9780190629113.003.0015 Momeni, Kh., Amani, R., Janjani, P., Majzoobi, M. R., & Hadian Hamedani, K. (2021). The Relationship between attachment styles with positive and negative affect in the elderly: The Mediating role of reminiscence styles. Aging Psychology, 7(4), 407-422. [Persian] Morelli, M., Casagrande, M., & Forte, G. (2022). Decision making: A theoretical review. Integrative Psychological and Behavioral Science, 56(3), 609-629. https://doi.org/10.1093/fampra/19.6.617 Nikanjam, G., Azadyekta, M., & Nasrollahi, B. (2022). The effectiveness of reality therapy on the life expectancy and psychological well-being of the elderly living in nursing homes. Aging Psychology, 8(4), 389-400. [Persian] Qiu, T., & Klonsky, E. D. (2021). Deciding to die: the relations of decision-making styles to suicide ideation and attempts. International Journal of Cognitive Therapy, 14, 341-361. Richard-Devantoy, S., Olie, E., Guillaume, S., & Courtet, P. (2016). Decision-making in unipolar or bipolar suicide attempters. Journal of Affective Disorders, 190, 128-136. https://doi.org/10.1016/j.jad.2015.10.001 Rosenberg, M. L., Murray, D., Jobes, D., Davidson, L. E., O'Carroll, P. W., Smith, J. C., & Mills, D. H. (1988). Operational criteria for the determination of suicide. Journal of Forensic Sciences, 33(6), 1445-1456. https:// doi.10.1520/JFS12589J Scott, S. G., & Bruce, R. A. (1995). Decision-making style: The development and assessment of a new measure. Educational and Psychological Measurement, 55(5), 818–831. https://doi.org/10.1177/0013164495055005017 Sisask, M., Värnik, A., Kolves, K., Konstabel, K., & Wasserman, D. (2008). Subjective psychological well-being (WHO-5) in assessment of the severity of suicide attempt. Nordic Journal of Psychiatry, 62(6), 431-435. http://doi.org/10.1080/08039480801959273 Suls, J., Collins, R. L., & Wheeler, L. (Eds.). (2019). Social comparison, judgment, and behavior. Oxford University Press, USA. Suls, J., & Wheeler, L. (2017). The Trail of Social Comparison. The Oxford handbook of social influence, 71-86. https://doi.org/10.1093/oxfordhb/9780199859870.013.13 Tabesh F., & Zare, H. (2011). The effect of emotional intelligence training on logical, intuitive, avoidance, dependent and spontaneous styles. International Journal of Behavioral Sciences, 6(4), 9-323. [Persian] Taylor, P. J., McDonald, J., Smith, M., Nicholson, H., & Forrester, R. (2019). Distinguishing people with current, past, and no history of non-suicidal self-injury: Shame, social comparison, and self-concept integration. Journal of Affective Disorders, 246, 182-188. https://doi.org/10.1016/j.jad.2018.12.033 Turecki, G., Brent, D. A., Gunnell, D., O’Connor, R. C., Oquendo, M. A., Pirkis, J., & Stanley, B. H. (2019). Suicide and suicide risk. Nature Reviews Disease Primers, 74(5), 1-22. https://doi.org/10.1038/ s41572-019-0121-0 Edoka, A. (2022). Decision Making Styles and Resilience as Correlates of Suicidal Ideation Among Undergraduates. Practicum Psychologia, 12(1),1-16. https://journals.aphriapub.com/index.php/PP/article/view/2056 Värnik, P. (2012). Suicide in the world. International Journal of Environmental Research and Public Health, 9(3), 760-771. https://doi.org/10.3390/ijerph9030760 Wetherall, K., Robb, K. A., & O'Connor, R. C. (2019). An examination of social comparison and suicide ideation through the lens of the integrated motivational–volitional model of suicidal behavior. Suicide and Life‐Threatening Behavior, 49(1), 167-182. https://doi.org/10.1111/sltb.12434 Wheeler, L., & Miyake, K. (1992). Social comparison in everyday life. Journal of Personality and Social Psychology, 62(5), 760. https://doi.org/10.1037/0022-3514.62.5.760 Willard, D. F. X., & Markman, A. B. (2017). Anchoring on self and others during social interactions. Topics in Cognitive Science, 9, 819–841.https://doi.org/10.1111/tops.12275 World Health Organization. (2016). Available at: ealth/prevention/suicide. Last accessed: January 30, 2021.