Painful and provocative events: Determining which events are associated with increased odds of attempting suicide

The present study sought to determine which painful and provocative events differentiated those with suicidal ideation from those who attempted suicide. Additionally, it presents a novel way of utilizing the Painful and Provocative Scale (PPES) by looking at items dichotomously as experienced or not experienced, instead of the frequency at which they are experienced.

Participants (N = 666) were recruited as part of a large online study seeking to understand suicide risk across multiple high-risk groups (i.e., veterinarians, military service members, transgender individuals, and gun owners) for suicide. Participants in the present study were predominately white, female, and heterosexual.

First, the PPES was examined as a dichotomous measure and results indicate that experiencing physical or sexual abuse, tying a noose, using intravenous drugs, or having injuries that required medical attention were associated with greater odds of attempting suicide; shooting a gun was associated with decreased odds. Next, the PPES was examined as a scale measure and findings indicate that increased exposure to rock climbing, experiencing physical or sexual abuse, or using intravenous drug were associated with increased odds of attempting suicide; while increased exposure to shooting a gun was associated with decreased odds.

The present study adds to the literature on the ideation-to-action framework and provides evidence considering the frequency of experiences using the Painful and Provocative Event Scale may not provide substantial information beyond dichotomous scoring.