Reviewer’s report
Title: 
“It was like nobody cared about what I said?” Iranian women committed
self- immolation: A qualitative study
Version: 
1 
Date: 
20 Aug 2020
Reviewer's report:
The manuscript is 
improved from the previous version and outline the
background and methods more clearly described. However I found that the
analysis is still lacking depth. The authors have attempted to use 
the IMV model
to interpret their findings as suggested but have not understood fully the
dimensions of this model. Of crucial importance in this study is to use the
interviews to understand why such a distinct method is selected and what aspects
within the pre-motivational and motivational phase lead the participants to
consider such a method. It is in this depth of interrogation of the findings that we
can attempt to understand possible modifications in the pathway. Without a more
substantial analysis and coherent presentation of the results and discussion i
cannot recommend for publication.
Major Revisions
The results section reveals the weakness of the analysis. As the themes are not
clear, the quotes not always related and the lack of depth makes it difficult to
trust the results.
Theme 1: The authors describe a range of background factors and stressors but
there is no discussion of any triggering factors. 
Theme 2: The theme is poorly analysed. The sub themes are not well represented
by the quotes. P14 showed some ambivalence and lack of knowledge of the
method. This seems like the important aspect of understanding the volitional
moderators. P10 talks about choosing the method as she believed it would "kill
her faster". This aspect is not picked up by the authors as important to
understand the choice of method.
Theme 3: The two sub-themes appear to be very indistinct and again the quotes
do not really address the sub-themes that were highlighted. It is unclear if the
authors are making reference to the defeat and humiliation of the IMV which is
in the motivational phase.
Theme 4: 
This theme is the most well developed although could easily be
combined with theme 3.
Discussion
The authors made revisions to the text to discuss the IMV model but its
application does not always seem appropriate. For example the revision line 299
"The final act of self-immolation supports phase one motivational phase:
emergence of suicidal ideation, and phase 3 volitional phase of the IMV model
from suicidal ideation to suicide attempts/suicide." The choice of method comes
in the later phases of the model and so the authors do not appear to be applying
the theory in a consistent way.
Other minor issues
Line 45 : It is recommended not to use the term commit suicide rather "died by
suicide".
Paragraph beginning line 59 This is a very confused paragraph and does identify
the gaps in the literature that forms the basis of this study.
Line 133 - This appears to be a very important factor that is largely ignored in
the analysis
Line 140- should read to protect their identity
Discussion - Should be limited to main findings. First paragraph discusses mean
age of participants when this is not a main finding.
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Is the study design appropriate to answer the research question (including the use
of appropriate controls), and are the conclusions supported by the evidence
presented?
Yes
Are the methods sufficiently described to allow the study to be repeated?
Yes
Is the use of statistics and treatment of uncertainties appropriate?
Yes
Is the presentation of the work clear?
No
Are the images in this manuscript (including electrophoretic gels and blots) free
from apparent manipulation?
Yes