Investigating the Relationship between Tolerance for Ambiguity, Hardiness , And Trauma with Suicidal Tendencies Mediated by Attitudes Toward Death in Young People

Relationship between Tolerance for Ambiguity, Hardiness , And Trauma with Suicidal Tendencies Mediated by Attitudes Toward Death

Authors

  • Mohammad Ali Karimi M.A. student in Clinical Psychology, Islamic Azad University, Zanjan Branch, Zanjan, Iran
  • Nafiseh Ayatelahi M.A. in Educational Psychology, Central Tehran Branch, Islamic Azad University, Tehran, Iran.
  • Paria Sadat Hoseini Parachan M.A. in General Psychology, Islamic Azad University, North Tehran Branch, Tehran, Iran.
  • Mohammad Bigdeli M.A in Islamic Positive Psychology, Abhar Branch, Islamic Azad University, Zanjan, Iran.
  • Mitra Zeynolabedini M.A in Educational Psychology, Azad University Central Tehran, Tehran, Iran.
  • Mohsen Bayat PhD in Psychology, Faculty of Educational Sciences and Psychology, Mohaghegh Ardabili University, Ardabil, Iran

DOI:

https://doi.org/10.63053/ijhes.126

Keywords:

Tolerance of ambiguity, psychological hardiness, trauma, suicidal tendency, attitude towards death

Abstract

This study aimed to investigate the relationship between tolerance for ambiguity, psychological hardiness, and trauma with suicidal tendencies and the mediating role of attitudes toward death in medical students in Zanjan in 2024. The statistical population of this study included medical students and sampling was conducted using the convenience method. Data were collected from 324 participants using standardized tolerance for ambiguity (DTS), psychological hardiness (PHQ), trauma (IES-R), suicidal tendencies (BSSI), and attitudes toward death (DAP) questionnaires and analyzed with SPSS 25 and AMOS 24 software. The findings showed that tolerance for ambiguity had a strong positive effect on psychological hardness (β=0.58) and a negative impact on suicidal tendencies (β=-0.32), while trauma was associated with a decrease in psychological hardness (β=-0.41) and an increase in suicidal tendencies (β=0.47). Attitudes towards death also significantly increased suicidal tendencies (β=0.54). Indirect effects showed that tolerance for ambiguity, by enhancing psychological hardiness, reduced suicidal tendencies by 0.21 points, while trauma, by weakening psychological hardiness, increased this risk by 0.18 points. The model fit indices (CFI=0.96, RMSEA=0.03, χ²/ df =1.8) and coefficients of determination (R²=0.48 to 0.62) emphasized the favorable fit of the model to the data. These results indicate that tolerance for ambiguity and psychological hardiness reduce the risk of suicidal tendencies by moderating attitudes toward death, while trauma increases this risk by intensifying negative attitudes toward death. These findings highlight the need to design psychotherapy interventions to enhance tolerance for ambiguity and psychological resilience and reduce the effects of trauma on medical students .

Author Biographies

Mohammad Ali Karimi, M.A. student in Clinical Psychology, Islamic Azad University, Zanjan Branch, Zanjan, Iran

M.A. student in Clinical Psychology, Islamic Azad University, Zanjan Branch, Zanjan, Iran

Nafiseh Ayatelahi, M.A. in Educational Psychology, Central Tehran Branch, Islamic Azad University, Tehran, Iran.

M.A. in Educational Psychology, Central Tehran Branch, Islamic Azad University, Tehran, Iran.

Paria Sadat Hoseini Parachan, M.A. in General Psychology, Islamic Azad University, North Tehran Branch, Tehran, Iran.

M.A. in General Psychology, Islamic Azad University, North Tehran Branch, Tehran, Iran.

Mohammad Bigdeli, M.A in Islamic Positive Psychology, Abhar Branch, Islamic Azad University, Zanjan, Iran.

M.A in Islamic Positive Psychology, Abhar Branch, Islamic Azad University, Zanjan, Iran.

Mohsen Bayat, PhD in Psychology, Faculty of Educational Sciences and Psychology, Mohaghegh Ardabili University, Ardabil, Iran

PhD in Psychology, Faculty of Educational Sciences and Psychology, Mohaghegh Ardabili University, Ardabil, Iran

References

– Abootalebi , Z., Hidaji , MB, & Rafezi , Z. (2025). Prediction of Self-Harming Behaviors Based on the Emotion Regulation Difficulty and Intolerance of Uncertainty in Students. International Journal of New Findings in Health and Educational Sciences (IJHES), 3(1), 1-10 .

– Adeyemi, AE (2025). Mental toughness, emotion expressivity and psychological well-being (Doctoral dissertation, Manchester Metropolitan University) .

– Barnett, MD, Reed, CM, & Adams, CM (2021). Death attitudes, palliative care self-efficacy, and attitudes toward care of the dying among hospice nurses. Journal of clinical psychology in medical settings, 28, 295-300

– Bridge, JA, Ruch, DA, Sheftall , AH, Hahm , HC, O'Keefe, VM, Fontanella , CA, ... & Horowitz, LM (2023). Youth suicide during the first year of the COVID-19 pandemic. Pediatrics, 151(3), e2022058375 .

– Chua, JYX, & Shorey , S. (2021). Effectiveness of end-of-life educational interventions at improving nurses' and nursing students' attitude toward death and care of dying patients: A systematic review and meta-analysis. Nurse Education Today, 101, 104892

– Curtis, Y. (2023). Elite Mental Toughness™: A Military Unit-Based Group Suicidal Ideation Risk Management Program (Doctoral dissertation, Alaska Pacific University) .

– Dev, AS, Davison, T., Broos, HC, Johnson, SL, & Timpano, KR (2025). Emotion-related impulsivity factors and intolerance of uncertainty are uniquely associated with interpersonal-psychological risk factors for suicide. British Journal of Clinical Psychology

– Genuchi , MC (2024). Broadening the perspective on the dynamics of men's suicide: thought suppression as a mediator between men's self-reliance and suicidality. Archives of suicide research, 28(1), 324-341

– Gorse, M. (2022). Risk and protective factors to LGBTQ+ youth suicide: A review of the literature. Child and Adolescent Social Work Journal, 39(1), 17-28

– Kelek , Ş., Uçar , MS, Yıldırım , NH, & Düşünceli , B. (2022). Mediating role of coronavirus anxiety in the relationship between intolerance of uncertainty and suicide probability during the COVID-19 pandemic. Sakarya University Journal of Education, 12(3), 522-544

– Malik, TH (2023). Institutionally Manifested Mortalities: Religiosity Mitigates Suicides; Uncertainty Intolerance Eclipses. In The Palgrave handbook of global social change (pp. 1-27). Cham: Springer International Publishing

– Posamentier , J., Seibel, K., & DyTang , N. (2023). Preventing youth suicide: A review of school-based practices and how social-emotional learning fits into comprehensive efforts. Trauma, Violence, & Abuse, 24(2), 746-759

– Quinton, AM, Ali, D., Danese , A., Happe , F., & Rumball, F. (2024). The assessment and treatment of post-traumatic stress disorder in autistic people: a systematic review. Review Journal of Autism and Developmental Disorders, 1-35

– Sallnow , L., Smith, R., Ahmedzai , SH, Bhadelia, A., Chamberlain, C., Cong, Y., ... & Wyatt, K. (2022). Report of the Lancet Commission on the Value of Death: bringing death back into life. The Lancet, 399(10327), 837-884

– Shahram, SZ, Smith, ML, Ben-David, S., Feddersen , M., Kemp, TE, & Plamondon , K. (2021). Promoting "zest for life": A systematic literature review of resiliency factors to prevent youth suicide. Journal of research on adolescence, 31(1), 4-24

– Shneidman , ES (2023). Orientations towards death: A vital aspect of the study of lives. In The study of lives (pp. 200-227). Routledge .

– Singh, RN, & Bhardwaj, SS (2022). Effects of Mental Toughness on Suicidal Ideation among Adolescent Students. International Journal of Recent Advances in Psychology, 9(1 and 2), 19-28

– Zaretsky , TG, Jagodnik , KM, Barsic , R., Antonio, JH, Bonanno , PA, MacLeod, C., ... & Yehuda, R. (2024). The psychedelic future of post-traumatic stress disorder treatment. Current neuropharmacology, 22(4), 636-735

Published

2025-04-26

How to Cite

Karimi, M. A., Ayatelahi, N., Hoseini Parachan, P. S., Bigdeli, M., Zeynolabedini, M., & Bayat, M. (2025). Investigating the Relationship between Tolerance for Ambiguity, Hardiness , And Trauma with Suicidal Tendencies Mediated by Attitudes Toward Death in Young People: Relationship between Tolerance for Ambiguity, Hardiness , And Trauma with Suicidal Tendencies Mediated by Attitudes Toward Death. International Journal of New Findings in Health and Educational Sciences (IJHES), 3(2), 18–30. https://doi.org/10.63053/ijhes.126

Issue

Section

Articles

Similar Articles

1 2 3 4 > >> 

You may also start an advanced similarity search for this article.