Introduction

Suicidal ideation, also referred to as suicidal thoughts, is characterized by an individual’s desire to end their own life, as defined by ^{Saseem and Munaf (2017}). Suicidal ideation is the most critical risk factor for suicide in the general population (^{Ibrahim et al., 2017}), which is the second leading cause of death worldwide for individuals aged 15-29 (^{World Health Organization [WHO], 2016}). Sadly, every year, 800.000 people die from suicide. The risk factors for suicidal ideation can emerge from psychological, sociological, physiological, familial, and economic factors, according to a study conducted by ^{Al-Shawashereh (2015}). Mental disorders, hopelessness, impulsivity, and non-suicidal self-injury are among the known causes of suicidal ideation, according to a previous study (^{Klonsky et al., 2016}). In addition, academic stress has been identified as a risk factor for suicidal ideation (^{Al-Shawashereh, 2015}).

According to the American College Health Association (ACHA), suicide is currently the second leading cause of death among college students (^{Rosiek et al., 2016}; ^{Reynolds, 2015}). In Iran, the national rate of suicide is 5.7 for males and 3.1 for females per 100,000, according to the Iranian Forensic Medicine Bureau (^{Ziaei et al., 2017}). Suicidal ideation is becoming a growing problem among college students, as academic stress, increased responsibilities, and feelings of hopelessness can lead to stress and depression (Al-Shereh, 2015; ^{Klonsky et al., 2016}). Unfortunately, there have been few studies in our community that have focused on suicidal thoughts by gender. Moreover, the lack of data, statistics, and research on this topic in our community limits our understanding and knowledge about suicidal thoughts among university students. These research gaps create uncertainty in our understanding of suicidal thoughts and their prevalence among college students.Understanding gender differences in suicidal thoughts is a crucial area of study. Previous research has shown that while males are more likely to commit suicide, females are more likely to attempt it (^{Be Friends Worldwide, 2016}). The present study aims to increase awareness of suicidal ideation among university students, focusing on gender differences.

Previous studies have explored the association between gender and suicidal ideation. ^{Ibrahim et al. (2017}) conducted a study among Malaysian students to compare the psychological factors associated with suicidal ideation in males and females. Their results showed that male participants had higher mean scores for suicidal ideation than female participants. Similarly, Al-Shereh (2015) found that suicidal ideation was more common among male university students than female students. However, a study conducted in Poland (^{Park, 2014}; ^{Rosiek et al., 2016}) showed that female medical students had higher levels of suicidal thinking than male students. Additionally, studies have shown that suicidal ideation and attempts are more common among female teenagers than males (McMahon et al., 2014).

The present study aims to determine the statistically significant differences in suicidal thoughts between male and female Koya University students. By understanding these sex differences, we can better identify those at risk and provide targeted interventions to prevent suicide.

Methods

This study collected data from 209 Koya University students in Kurdistan, Iraq. The sample included 104 females and 105 males, and a convenience sampling technique was used to select participants. The questionnaires were distributed across different locations on campus, including the faculty of science and health, faculty of engineering, faculty of education, faculty of social and humanistic science, and dormitories. Although convenience sampling has limitations, it was chosen due to its practicality and accessibility in obtaining a sample of participants. Despite the non-random selection of participants, the study aims to provide insights into suicidal ideation among Koya University students and its association with gender.

The present study utilized a quantitative research approach with a survey design questionnaire and distributed it among students. The study used the Scale for Suicidal Ideation (SSI), developed by ^{Beck, et al. (1979}). This scale consists of 19 items that quantify suicidal ideation. Each item includes three alternative statements graded in intensity from 0 to 2. The developers evaluated the SSI’s internal consistency on a sample of 90 participants and found to be high at .89. The internal reliability coefficient of the SSI was also evaluated on a sample of 25 participants among the 90 participants and found to be .83. The developers validated the scale for concurrent, discriminative, and constructive validity.

The researcher adapted the scale in the present study; first, she conducted linguistic validation to create the Kurdish version of the scale for suicidal ideation. Previously the scale was translated by two doctors at Sulymaniyah University. Then, the researcher worked on the face validity of the scale. Three experts (a doctorate literature in clinical psychology and two bachelor’s degree in clinical psychology) at Koya University checked face validity for the scale, and some note adds to the scale that notes about how to design the scale. All items accepted. Next, we worked on content validity for (SSI) with seven experts (three bachelor’s degrees in clinical psychology, two doctorate degrees in literature in clinical psychology, and two master’s degrees in literature in clinical psychology) at Koya University, then worked on Content validity ratio (CVR) for each item till know which item is important or deleted, and all item accepted by experts. After, the researcher took 50 students (25 were males and 25 were females) for a pilot study to find the reliability by the SPSS program. In Cronbach alpha reliability (CAR) was, four items deleted to increase (CAR). These items were (2, 3, 14, and 16). Cronbach alpha reliability for the scale of suicidal ideation (SSI) was .89.

Results

The study aimed to determine the statistically significant difference between males and females among Koya University students regarding suicidal ideation. The results show that female students (M = 6.69, SD = 6.1) have significantly higher levels of suicidal ideation than male students (M = 5.05, SD = 5.1), with a significant difference of (t(207) = -2, p = .05), d-Cohen= .292. This indicates a statistically significant difference between males and females based on suicidal thoughts (Table 1).

Table 1: The Result Of The Independent Sample T-test for Gender Differences in Suicidal Thought. 

Discussion

The present study found a statistically significant difference between males and females in the incidence of suicidal thoughts. According to previous research, support result in this research (^{Al-Shawashereh, 2015}: ^{Hallfors et al., 2004}; ^{Ibrahim et al., 2017}; ^{Kim & Lee, 2018}). Some of the previous research findings are contradictory. The finding in the research of Lin et al. (2017) e ^{Al-Shereh (2015}) showed no statistically significant difference between males and females in the occurrence of suicidal thoughts. Another study by Obrahim et al. (2017) with sample students found a higher frequency of suicidal thoughts among females when compared to males. Previous research showed that suicidal thoughts among males are more frequent than females (^{Ibrahim et al., 2017}). Similar results were presented by ^{Al-Shereh (2015}). However, the majority of the studies corroborate with the findings of our study, showing that suicidal ideation among females occurs more frequently than among males (Listenbee et al., 2014; McMahon, et al., 2014; ^{Park, 2014}; ^{Rosiek et al., 2016}). Because females tend to present higher levels of academic stress, daily stress, and a higher prevalence of depression and other mental disorders than males (^{Park, 2014}). Regarding the sample of our study, we argue that, due to cultural beliefs, males are perceived as more robust than females when responding to the problems they face daily (^{Noh et al., 2017}).

It is crucial to consider the risk factors associated with suicidal thoughts when interpreting these results. Research has consistently shown that females are likelier to experience interpersonal stressors and internalizing symptoms such as anxiety and depression. At the same time, males are more likely to experience externalizing symptoms such as aggression and substance use (^{Canetto & Sakinofsky, 1998}). Therefore, these gender-based differences in risk factors may contribute to the higher incidence of suicidal thoughts among female students found in our study.

Our findings raise important questions about the resources and support available to university students struggling with suicidal thoughts. For instance, do universities provide mental health screening programs and counseling services to needy students? What preventive measures are in place to combat the stigmatization of mental health issues and encourage individuals to seek help? Addressing these questions is crucial in promoting university students’ mental health and well-being.

The higher prevalence of suicidal ideation among female students may be attributed to several factors, such as higher levels of academic stress, daily stress, and a higher prevalence of depression and other mental disorders than males (Park, 2014). Additionally, cultural beliefs may contribute to the perception that males are more resilient when facing daily problems (^{Noh et al., 2017}). When interpreting these results, it is important to consider other risk factors for suicidal thoughts, such as interpersonal stressors and internalizing symptoms, which are more common among females. At the same time, males are more likely to experience externalizing symptoms, such as aggression (^{Canetto & Sakinofsky, 1998}).

Despite the study’s contributions, some limitations should be acknowledged. The topic’s sensitivity may have caused some students to be hesitant to share their thoughts on suicide. Additionally, the lack of data and statistics on suicidal thoughts in our country and the small sample size may affect the generalizability of the results. Future studies may consider more extensive sample size and the inclusion of qualitative data to understand better the underlying factors contributing to suicidal ideation among university students in Kurdistan - Iraq.

As with any cross-sectional study, the present study has benefits but has critical limitations. The results do not allow us to establish causation; they only reflect what could be identified at a particular time. Therefore, following participants to capture variable changes over time is important. Additionally, the sample studied does not represent the population of interest, limiting the study findings’ generalizability. Finally, cross-sectional studies could be more extensive in controlling confounding variables and presenting firm conclusions regarding the relationships between variables.

Conclusion

These findings provide important insights into the issue of suicide among university students in the Kurdistan Region of Iraq, showing differences between men and women, with the latest presenting higher levels of suicidal thoughts. It is essential to implement mental health screening programs and provide counseling services to students struggling with suicidal thoughts in universities. Preventive measures that combat the stigmatization of mental health must be taken to encourage people to seek help. More studies are needed to address Central Asia and Middle Eastern mental health issues.