Farsi mental pain scales validated in suicidal Iranian adolescents

Psychological pain — the inner, subjective suffering that many people describe as unbearable rather than simply sad — has been identified as a driver of suicide, yet empirical studies of the construct, particularly in young people, have been limited. Two brief questionnaires designed to capture this experience, the 8-item Orbach and Mikulincer Mental Pain Scale (OMMP-8) and the Psychic Pain Scale (PPS), have now been tested in Farsi with adolescents at clinical risk. The new study, published in BMC Psychiatry, reports that both translated instruments performed well among suicidal and non-suicidal teenagers in Iran, offering researchers in Persian-speaking settings a validated way to measure a construct that has been difficult to quantify.

The research team, led by Mohammad Javad Bagian Koulemarzi with collaborators including Katie C. Lewis and Yazdan Naderi Rajeh, recruited 623 suicidal adolescents aged 13 to 18 from Lorestan province in Iran, alongside 110 non-suicidal adolescents of the same age range. The suicidal group was 53.9 percent female, while the comparison group was 72.7 percent female. Each participant completed the two pain measures along with questionnaires covering hopelessness, depression, anxiety and the severity of suicidal ideation, allowing the investigators to test how the new scales behaved relative to instruments with established psychometric credentials.

A central question in psychometric research is whether a questionnaire measures the same underlying structure when it moves into a new language and culture. The team therefore examined the factor structure of each Farsi translation — the pattern of how items cluster together statistically — and compared it with the structures reported in earlier studies of the original versions. Both scales reproduced the factor structures identified previously, an encouraging sign that the core dimensions of mental pain as conceived by the original authors translate meaningfully into Farsi and resonate with Iranian adolescents.

Reliability, the degree to which a scale yields consistent measurements, was also strong for both instruments. Internal consistency coefficients indicated that respondents answered related items in coherent ways, which matters when a scale is intended for clinical use or research screening. Convergent validity provided a second line of evidence.

Scores on both the OMMP-8 and the PPS correlated in the expected directions with measures of hopelessness, depression, anxiety and the severity of suicidal ideation. This pattern supports the theoretical claim that mental pain sits within the same clinical neighbourhood as these well-established risk constructs, consistent with the study's framing of psychological pain as relevant to near-term suicide risk. The most clinically consequential analysis involved cut-off scores — thresholds on each scale that best distinguish suicidal from non-suicidal adolescents.

The researchers identified optimal cut-points for both instruments, but these values represented a slight departure from those reported in earlier studies with other populations. The authors interpret this divergence as suggesting that the level of severity and persistence of psychological pain may predict suicide risk somewhat differently in Iranian adolescents than in individuals from other age and cultural groups, underscoring why culturally specific validation matters. Why does psychological pain attract attention in suicide research?

According to the study's framing, suicide is a global health concern frequently cited as a leading cause of death in youth and adolescents, and understanding near-term risk requires measures sensitive to age and cultural context. The study's conclusions are measured. The authors state that the Farsi translations of the OMMP-8 and PPS may be considered valid and reliable for use in Iranian adolescent populations, expanding understanding of psychological pain in youth across cultural contexts while highlighting areas that need further study.

The evidence comes from a single province, and the slight shift in optimal cut-off scores signals that severity thresholds may not generalise straightforwardly across populations. For the wider field, the findings contribute to an effort to build a cross-cultural evidence base for psychological pain as a measurable clinical construct. Replicated factor structures across languages suggest that the experience the scales probe is not an artefact of any one culture's vocabulary, while population-specific cut-offs remind researchers that the relationship between pain intensity and risk is shaped by context.

As empirical work on psychological pain in young people remains limited, validated instruments in additional languages are a practical step toward integrating this construct into suicide risk research — with the caveat, as the authors themselves note, that further study is needed before firm clinical recommendations can follow.

Subject of Research: Validation of Farsi versions of the OMMP-8 and Psychic Pain Scale in suicidal and non-suicidal Iranian adolescents

Article Title: Psychometric evaluation of the Farsi 8-item Orbach Mikulincer Mental Pain Scale and Psychic Pain Scale in suicidal adolescents

Article References: Koulemarzi, M. J. B., Lewis, K. C., Marzban, M., Rajabi, M., Soleymani Moghadam, M., & Rajeh, Y. N. (2026). Psychometric evaluation of the Farsi 8-item Orbach Mikulincer Mental Pain Scale and Psychic Pain Scale in suicidal adolescents. BMC Psychiatry. https://doi.org/10.1186/s12888-026-08749-9

Image Credits: AI Generated

DOI: 10.1186/s12888-026-08749-9

Keywords: psychological pain, suicide risk, adolescents, psychometrics, Farsi translation, OMMP-8, Psychic Pain Scale, Iran, convergent validity, cut-off scores, cross-cultural validation, BMC Psychiatry