{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T01:31:40Z","timestamp":1785288700704,"version":"3.55.0"},"reference-count":35,"publisher":"Oxford University Press (OUP)","issue":"3-4","license":[{"start":{"date-parts":[[2025,9,15]],"date-time":"2025-09-15T00:00:00Z","timestamp":1757894400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Kindbridge Research Institute","award":["GR15685"],"award-info":[{"award-number":["GR15685"]}]},{"name":"Problem Gambling Network of Ohio"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,3,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Veterans are at an elevated risk for suicide, with notably high suicide rates over recent years. Additionally, veterans are also at elevated risk for a variety of psychiatric and mental health comorbidities, one of them being gambling disorder (GD). However, limited research has examined the relationship between GD and suicidality among veteran populations. The present study links suicidality with GD including comorbid diagnoses, gambling preferences, gambling severity, and impulsivity in a sample of military veterans with GD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>This study was an archival analysis of data from 603 United States veterans who received inpatient treatment for GD at a Veterans Affairs Hospital between the years of 2010 and 2024. Gambling disorder and comorbid diagnoses were determined at intake through clinician interviews and assessment. The South Oaks Gambling Screen (SOGS) and the Urgency, Premeditation, Perseverance, Sensation Seeking, and Positive Urgency Scale (UPPS-P) assessed gambling severity and impulsivity. Chi-squares, independent t-tests, and logistical regressions were conducted. Additional tests were conducted on a subset of 157 veterans for which suicide attempt reason was reported.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Suicide attempt history is extremely common in veterans receiving treatment for gambling disorder, with over 40% reporting such a history. Veterans who reported a past suicide attempt were more likely to be nonstrategic gamblers, to have a current psychiatric diagnosis, and to report greater levels of impulsivity. Women veterans were especially likely to report a suicide attempt history (60% of women in our sample). Lastly, veterans who reported their suicide attempt was related to gambling were more likely to be a strategic gambler, have greater gambling severity, and impulsivity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Veterans with GD are particularly vulnerable to increased risk for suicidality and its associations. Our findings point to the importance of customizing treatment for veterans with GD to target these potential risk profiles (e.g., gambling preferences, heightened impulsivity facets, and comorbidities) and therefore decrease the risks of suicidality.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/milmed\/usaf441","type":"journal-article","created":{"date-parts":[[2025,8,22]],"date-time":"2025-08-22T11:43:41Z","timestamp":1755863021000},"page":"e729-e736","source":"Crossref","is-referenced-by-count":4,"title":["Suicide Attempt History in Veterans Receiving Treatment for Gambling Disorder: Demographic and Psychiatric Associates"],"prefix":"10.1093","volume":"191","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-3192-6019","authenticated-orcid":false,"given":"Karen A","family":"Valle Frias","sequence":"first","affiliation":[{"name":"Department of Psychology, University of Nevada , Las Vegas, NV 89154,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2642-1351","authenticated-orcid":false,"given":"Joshua B","family":"Grubbs","sequence":"additional","affiliation":[{"name":"Center on Alcohol, Substance use, And Addictions, University of New Mexico, Albuquerque, NM 87106,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5819-2824","authenticated-orcid":false,"given":"Heather","family":"Chapman","sequence":"additional","affiliation":[{"name":"Gambling Treatment Program, VA Northeast Ohio Healthcare System , Cleveland, Ohio 44106,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0404-9480","authenticated-orcid":false,"given":"Shane W","family":"Kraus","sequence":"additional","affiliation":[{"name":"Department of Psychology, University of Nevada , Las Vegas, NV 89154,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,9,15]]},"reference":[{"key":"2026031018433400300_usaf441-B1","volume-title":"2023 National Veteran Suicide Prevention Annual Report","author":"Department of Veterans Affairs","year":"2023"},{"key":"2026031018433400300_usaf441-B2","doi-asserted-by":"crossref","first-page":"853","DOI":"10.15288\/jsad.2018.79.853","article-title":"Substance use disorders among veterans in a nationally representative sample: prevalence and associated functioning and treatment utilization","volume":"79","author":"Boden","year":"2018","journal-title":"J Stud Alcohol Drugs"},{"key":"2026031018433400300_usaf441-B3","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1016\/j.jpsychires.2024.06.044","article-title":"Substance use disorders among armed forces veterans with gambling disorder: insights from an inpatient treatment sample","volume":"177","author":"Grubbs","year":"2024","journal-title":"J Psychiatr Res"},{"key":"2026031018433400300_usaf441-B4","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1111\/sltb.12822","article-title":"Risk factors for suicide attempts among U.S. military veterans: a 7-year population-based, longitudinal cohort study","volume":"52","author":"Nichter","year":"2022","journal-title":"Suicide Life Threat Behav"},{"key":"2026031018433400300_usaf441-B5","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1037\/adb0000348","article-title":"The burden of co-occurring alcohol use disorder and PTSD in U.S. military veterans: comorbidities, functioning, and suicidality","volume":"32","author":"Norman","year":"2018","journal-title":"Psychol Addict Behav"},{"key":"2026031018433400300_usaf441-B6","doi-asserted-by":"crossref","first-page":"752","DOI":"10.1002\/da.20583","article-title":"Comorbid anxiety as a suicide risk factor among depressed veterans","volume":"26","author":"Pfeiffer","year":"2009","journal-title":"Depress Anxiety"},{"key":"2026031018433400300_usaf441-B7","doi-asserted-by":"crossref","first-page":"1031","DOI":"10.4088\/JCP.v64n0908","article-title":"Suicide attempts among veterans seeking treatment for pathological gambling","volume":"64","author":"Kausch","year":"2003","journal-title":"J Clin Psychiatry"},{"key":"2026031018433400300_usaf441-B8","doi-asserted-by":"crossref","DOI":"10.1176\/appi.books.9780890425787","volume-title":"Diagnostic and Statistical Manual of Mental Disorders","author":"American Psychiatric Association","year":"2022","edition":"5th ed"},{"key":"2026031018433400300_usaf441-B9","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1007\/s40429-020-00310-2","article-title":"Gambling problems in U.S. military veterans","volume":"7","author":"Etuk","year":"2020","journal-title":"Curr Addict Rep"},{"key":"2026031018433400300_usaf441-B10","doi-asserted-by":"crossref","first-page":"1205","DOI":"10.1007\/s10899-018-9749-z","article-title":"Gambling disorder in veterans: a review of the literature and implications for future research","volume":"34","author":"Levy","year":"2018","journal-title":"J Gambl Stud"},{"key":"2026031018433400300_usaf441-B11","first-page":"14","article-title":"Pathological gambling in combat veterans","volume":"27","author":"Hierholzer","year":"2010","journal-title":"Fed Pract"},{"key":"2026031018433400300_usaf441-B12","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1556\/2006.7.2018.25","article-title":"Gambling problems and the impact of family in UK armed forces veterans","volume":"7","author":"Dighton","year":"2018","journal-title":"J Behav Addict"},{"key":"2026031018433400300_usaf441-B13","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1111\/j.1521-0391.2012.12011.x","article-title":"Pathological and problem gambling among veterans in clinical care: prevalence, demography, and clinical correlates","volume":"22","author":"Westermeyer","year":"2013","journal-title":"Am J Addict"},{"key":"2026031018433400300_usaf441-B14","doi-asserted-by":"crossref","first-page":"107840","DOI":"10.1016\/j.addbeh.2023.107840","article-title":"Comorbid psychiatric diagnoses and gaming preferences in U.S. armed forces veterans receiving inpatient treatment for gambling disorder","volume":"147","author":"Grubbs","year":"2023","journal-title":"Addict Behav"},{"key":"2026031018433400300_usaf441-B15","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1016\/j.cobeha.2019.09.001","article-title":"Comparison of gambling profiles based on strategic versus non-strategic preferences","volume":"31","author":"Jim\u00e9nez-Murcia","year":"2020","journal-title":"Curr Opin Behav Sci"},{"key":"2026031018433400300_usaf441-B16","doi-asserted-by":"crossref","first-page":"107176","DOI":"10.1016\/j.addbeh.2021.107176","article-title":"Do emotion regulation and impulsivity differ according to gambling preferences in clinical samples of gamblers?","volume":"126","author":"Vintr\u00f3-Alcaraz","year":"2022","journal-title":"Addict Behav"},{"key":"2026031018433400300_usaf441-B17","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1111\/dar.12132","article-title":"Impulsivity as a predictor of treatment outcome in substance use disorders: review and synthesis","volume":"34","author":"Loree","year":"2015","journal-title":"Drug Alcohol Rev"},{"key":"2026031018433400300_usaf441-B18","doi-asserted-by":"crossref","first-page":"108058","DOI":"10.1016\/j.addbeh.2024.108058","article-title":"Impulsivity and diverse forms of sports wagering in the U.S.: an examination of the UPPS-P model","volume":"156","author":"Grubbs","year":"2024","journal-title":"Addict Behav"},{"key":"2026031018433400300_usaf441-B19","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1016\/j.comppsych.2016.10.005","article-title":"Is gambling disorder associated with impulsivity traits measured by the UPPS-P and is this association moderated by sex and age?","volume":"72","author":"Savvidou","year":"2017","journal-title":"Compr Psychiatry"},{"key":"2026031018433400300_usaf441-B20","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1016\/j.genhosppsych.2018.08.002","article-title":"Are suicide attempters more impulsive than suicide ideators?","volume":"63","author":"Millner","year":"2020","journal-title":"Gen Hosp Psychiatry"},{"key":"2026031018433400300_usaf441-B21","doi-asserted-by":"crossref","first-page":"357","DOI":"10.7205\/MILMED-D-13-00241","article-title":"Risk-taking behaviors and impulsivity among veterans with and without PTSD and mild TBI","volume":"179","author":"James","year":"2014","journal-title":"Mil Med"},{"key":"2026031018433400300_usaf441-B22","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1037\/bul0000411","article-title":"Suicidality among individuals with gambling problems: a meta-analytic literature review","volume":"150","author":"Kristensen","year":"2024","journal-title":"Psychol Bull"},{"key":"2026031018433400300_usaf441-B23","doi-asserted-by":"crossref","first-page":"101127","DOI":"10.1016\/j.lanepe.2024.101127","article-title":"Association between gambling disorder and suicide mortality: a comparative cohort study using Norwegian health registry data","volume":"48","author":"Kristensen","year":"2025","journal-title":"Lancet Reg Health Eur"},{"key":"2026031018433400300_usaf441-B24","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1016\/j.jpsychires.2021.09.027","article-title":"Suicidal behavior in patients with gambling disorder and their response to psychological treatment: the roles of gender and gambling preference","volume":"143","author":"Valenciano-Mendoza","year":"2021","journal-title":"J Psychiatr Res"},{"key":"2026031018433400300_usaf441-B25","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1111\/ajad.12197","article-title":"Suicidal ideation and suicide attempts in five groups with different severities of gambling: findings from the National Epidemiologic Survey on Alcohol and Related Conditions","volume":"24","author":"Moghaddam","year":"2015","journal-title":"Am J Addict"},{"key":"2026031018433400300_usaf441-B26","doi-asserted-by":"crossref","first-page":"88","DOI":"10.30773\/pi.2020.0035","article-title":"Gambling disorder symptoms, suicidal ideation, and suicide attempts","volume":"18","author":"Lee","year":"2021","journal-title":"Psychiatry Investig"},{"key":"2026031018433400300_usaf441-B27","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1177\/0891988703261999","article-title":"Pathological gambling among elderly veterans","volume":"17","author":"Kausch","year":"2004","journal-title":"J Geriatr Psychiatry Neurol"},{"key":"2026031018433400300_usaf441-B28","doi-asserted-by":"crossref","first-page":"100038","DOI":"10.1016\/j.anzjph.2023.100038","article-title":"Gambling problems predict suicidality in recently transitioned military veterans","volume":"47","author":"Metcalf","year":"2023","journal-title":"Aust N Z J Public Health"},{"key":"2026031018433400300_usaf441-B29","doi-asserted-by":"crossref","first-page":"1099","DOI":"10.1007\/s10899-017-9678-2","article-title":"Gambling in a national U.S. veteran population: prevalence, socio-demographics, and psychiatric comorbidities","volume":"33","author":"Stefanovics","year":"2017","journal-title":"J Gambl Stud"},{"key":"2026031018433400300_usaf441-B30","doi-asserted-by":"crossref","first-page":"1184","DOI":"10.1176\/ajp.144.9.1184","article-title":"The South Oaks Gambling Screen (SOGS): a new instrument for the identification of pathological gamblers","volume":"144","author":"Lesieur","year":"1987","journal-title":"Am J Psychiatry"},{"key":"2026031018433400300_usaf441-B31","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1037\/1064-1297.11.3.210","article-title":"Understanding the role of impulsivity and externalizing psychopathology in alcohol abuse: application of the UPPS impulsive behavior scale","volume":"11","author":"Whiteside","year":"2003","journal-title":"Exp Clin Psychopharmacol"},{"key":"2026031018433400300_usaf441-B32","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1521\/pedi.2022.36.3.339","article-title":"Prevalence of personality disorders across veteran samples: a meta-analysis","volume":"36","author":"Edwards","year":"2022","journal-title":"J Pers Disord"},{"key":"2026031018433400300_usaf441-B33","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1016\/j.jad.2010.08.006","article-title":"Examining the role of emotion in suicidality: negative urgency as an amplifier of the relationship between components of the interpersonal-psychological theory of suicidal behavior and lifetime number of suicide attempts","volume":"129","author":"Anestis","year":"2011","journal-title":"J Affect Disord"},{"key":"2026031018433400300_usaf441-B34","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1177\/104012371102300204","article-title":"Strategic vs nonstrategic gambling: characteristics of pathological gamblers based on gambling preference","volume":"23","author":"Odlaug","year":"2011","journal-title":"Ann Clin Psychiatry"},{"key":"2026031018433400300_usaf441-B35","doi-asserted-by":"crossref","first-page":"8986","DOI":"10.3390\/ijerph17238986","article-title":"Sensation seeking and gambling behavior in adolescence: can externalizing problems moderate this relationship?","volume":"17","author":"Tani","year":"2020","journal-title":"Int J Environ Res Public Health"}],"container-title":["Military Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/milmed\/article-pdf\/191\/3-4\/e729\/64345764\/usaf441.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/milmed\/article-pdf\/191\/3-4\/e729\/64345764\/usaf441.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T22:43:43Z","timestamp":1773182623000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/milmed\/article\/191\/3-4\/e729\/8261516"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,15]]},"references-count":35,"journal-issue":{"issue":"3-4","published-online":{"date-parts":[[2025,9,15]]},"published-print":{"date-parts":[[2026,3,1]]}},"URL":"https:\/\/doi.org\/10.1093\/milmed\/usaf441","relation":{},"ISSN":["0026-4075","1930-613X"],"issn-type":[{"value":"0026-4075","type":"print"},{"value":"1930-613X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,3]]},"published":{"date-parts":[[2025,9,15]]}}}