Establishing the psychometric properties and construct validity of the Painful and Provocative Events Scale-Revised

Background: Engagement in painful and provocative events is central to hypotheses for how capability for suicide develops. However, the existing measure of painful and provocative events is not psychometrically sound. We developed a measure with improved psychometric properties: the Painful and Provocative Events Scale (PPES)-Revised. Method: In study 1, 447 adults (53.5% women, mean age = 35.4 years) answered 77 items describing painful and/or provocative experiences. Exploratory factor analysis (EFA) was performed. In study 2, 403 adults (55.1% women, mean age = 38.1 years) answered the retained items and confirmatory factor analysis (CFA) was performed. The scale's factorial invariance across gender was examined. Estimates of convergent and discriminant validity were obtained. Results: EFA yielded a two-factor structure, which was confirmed with CFA. The factor structure was invariant across men and women. Estimates of convergent and discriminant validity were promising. Limitations: Limitations include non-weighted items, additional need for CFA among high-risk groups, lack of assessment of person-specific painful and provocative events, and need for prospective research to establish the scale's predictive validity. Conclusions: By assessing painful and provocative events more uniformly and reliably than the existing measure, the PPES-Revised has the potential to advance the understanding of capability for suicide.