{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T05:38:28Z","timestamp":1780465108186,"version":"3.54.1"},"reference-count":109,"publisher":"MDPI AG","issue":"21","license":[{"start":{"date-parts":[[2021,10,21]],"date-time":"2021-10-21T00:00:00Z","timestamp":1634774400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100014440","name":"Ministerio de Ciencia, Innovaci\u00f3n y Universidades","doi-asserted-by":"publisher","award":["RTI2018-101837-B-100"],"award-info":[{"award-number":["RTI2018-101837-B-100"]}],"id":[{"id":"10.13039\/100014440","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Instituto Salud Carlos III","award":["FIS PI20\/132, FIS PI17\/01167"],"award-info":[{"award-number":["FIS PI20\/132, FIS PI17\/01167"]}]},{"name":"Delegaci\u00f3n del Gobierno para el Plan Nacional sobre Drogas","award":["2017I067 and 2019I47"],"award-info":[{"award-number":["2017I067 and 2019I47"]}]},{"name":"CIBER Fisiolog\u00eda Obesidad y Nutrici\u00f3n (CIBERobn)","award":["-"],"award-info":[{"award-number":["-"]}]},{"name":"CIBER Salud Mental (CIBERSAM)","award":["-"],"award-info":[{"award-number":["-"]}]},{"name":"CERCA Programme \/ Generalitat de Catalunya","award":["-"],"award-info":[{"award-number":["-"]}]},{"name":"Fondo Europeo de Desarrollo Regional (FEDER) &quot;Una manera de hacer Europa&quot; \/ &quot;A way to build Europe&quot;","award":["-"],"award-info":[{"award-number":["-"]}]},{"name":"Research Commission of Bellvitge Campus, School of Medicine and Health Sciences, University of Barcelona","award":["-"],"award-info":[{"award-number":["-"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Addictive disorders are characterized by severe consequences, including suicidal events, but most studies investigating the association between addiction and suicidal risk have focused on substance use disorders and gambling disorder at the expense of the rest of behavioral addictions. This study examined the prevalence and the associated clinical correlates of suicidal ideation and suicide attempts in a sample of patients with a diagnosis of behavioral addiction. The total sample consisted of 4404 individuals: 4103 of these patients with gambling disorder, 99 with gaming disorder, 44 with sex addiction, and 158 with buying\u2013shopping disorder. All of them were assessed consecutively at a specialized hospital unit for the treatment of behavioral addictions. Participants attended two clinical interviews and completed self-reported questionnaires to explore clinical features of behavioral addictions, personality traits, psychopathological symptomatology, suicidal behavior, and sociodemographic variables. The highest prevalence of suicidal ideation was found in patients with gambling disorder (22.9%), followed by buying\u2013shopping disorder (18.4%), sex addiction (18.2%), and gaming disorder (6.1%). The highest prevalence of suicide attempts was registered for sex addiction (9.1%), followed by buying\u2013shopping disorder (7.6%), gambling disorder (6.7%), and gaming disorder (3.0%). Female gender and unemployment constituted two relevant sociodemographic factors associated with suicidal risk in gambling disorder, gaming disorder, and buying\u2013shopping disorder. Lack of family support appeared as a relevant risk factor, except for gaming disorder. These results pointed out that suicide is a prevalent behavior in behavioral addictions, and clinicians and researchers need to pay particular attention to the specificities of each behavioral addiction when assessing suicidal risk.<\/jats:p>","DOI":"10.3390\/ijerph182111085","type":"journal-article","created":{"date-parts":[[2021,10,22]],"date-time":"2021-10-22T00:22:02Z","timestamp":1634862122000},"page":"11085","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Prevalence of Suicidal Behavior and Associated Clinical Correlates in Patients with Behavioral Addictions"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1690-5109","authenticated-orcid":false,"given":"Eduardo","family":"Valenciano-Mendoza","sequence":"first","affiliation":[{"name":"Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, 08907 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2968-9898","authenticated-orcid":false,"given":"Fernando","family":"Fern\u00e1ndez-Aranda","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, 08907 Barcelona, Spain"},{"name":"CIBER Fisiopatolog\u00eda Obesidad y Nutrici\u00f3n (CIBERObn), Instituto de Salud Carlos III, 28029 Madrid, Spain"},{"name":"Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, 08907 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6308-3198","authenticated-orcid":false,"given":"Roser","family":"Granero","sequence":"additional","affiliation":[{"name":"CIBER Fisiopatolog\u00eda Obesidad y Nutrici\u00f3n (CIBERObn), Instituto de Salud Carlos III, 28029 Madrid, Spain"},{"name":"Department of Psychobiology and Methodology, Autonomous University of Barcelona, 08193 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M\u00f3nica","family":"G\u00f3mez-Pe\u00f1a","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, 08907 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Moragas","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, 08907 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernat","family":"Mora-Maltas","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, 08907 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5800-8975","authenticated-orcid":false,"given":"Anders","family":"H\u00e5kansson","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences Lund, Psychiatry, Faculty of Medicine, Lund University, 22 185 Lund, Sweden"},{"name":"Region Sk\u00e5ne, Malm\u00f6 Addiction Center, Gambling Disorder Unit, 205 02 Malm\u00f6, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 M.","family":"Mench\u00f3n","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, 08907 Barcelona, Spain"},{"name":"Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, 08907 Barcelona, Spain"},{"name":"CIBER Salud Mental (CIBERSAM), Instituto de Salud Carlos III, 28029 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3596-8033","authenticated-orcid":false,"given":"Susana","family":"Jim\u00e9nez-Murcia","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, 08907 Barcelona, Spain"},{"name":"CIBER Fisiopatolog\u00eda Obesidad y Nutrici\u00f3n (CIBERObn), Instituto de Salud Carlos III, 28029 Madrid, Spain"},{"name":"Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, 08907 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,10,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"233","DOI":"10.3109\/00952990.2010.491884","article-title":"Introduction to behavioral addictions","volume":"36","author":"Grant","year":"2010","journal-title":"Am. J. Drug Alcohol Abuse"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"American Psychiatric Association (APA) (2013). Diagnostic and Statistical Manual of Mental Disorders, American Psychiatric Association. [5th ed.].","DOI":"10.1176\/appi.books.9780890425596"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1097\/HRP.0000000000000051","article-title":"Gambling disorder and other behavioral addictions: Recognition and treatment","volume":"23","author":"Yau","year":"2015","journal-title":"Harv. Rev. Psychiatry"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1146\/annurev-clinpsy-032816-045120","article-title":"Behavioral Addictions as Mental Disorders: To Be or Not To Be?","volume":"14","author":"Petry","year":"2018","journal-title":"Annu. Rev. Clin. Psychol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1718","DOI":"10.1111\/add.13828","article-title":"Behavioural addiction and substance addiction should be defined by their similarities not their dissimilarities","volume":"112","author":"Griffiths","year":"2017","journal-title":"Addiction"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"2107","DOI":"10.1111\/add.13315","article-title":"Compulsive sexual behaviour as a behavioural addiction: The impact of the internet and other issues","volume":"111","author":"Griffiths","year":"2016","journal-title":"Addiction"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1556\/2006.4.2015.023","article-title":"Commentary on: Are we overpathologizing everyday life? A tenable blueprint for behavioral addiction research","volume":"4","author":"Potenza","year":"2015","journal-title":"J. Behav. Addict."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1556\/2006.4.2015.009","article-title":"Are we overpathologizing everyday life? A tenable blueprint for behavioral addiction research","volume":"4","author":"Billieux","year":"2015","journal-title":"J. Behav. Addict."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1556\/2006.4.2015.015","article-title":"Commentary on: Are we overpathologizing everyday life? A tenable blueprint for behavioral addiction research: Excessive behaviors are not necessarily addictive behaviors","volume":"4","author":"Ko","year":"2015","journal-title":"J. Behav. Addict."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"771","DOI":"10.1016\/j.neubiorev.2019.12.025","article-title":"Learning to lose control: A process-based account of behavioral addiction","volume":"108","author":"Perales","year":"2020","journal-title":"Neurosci. Biobehav. Rev."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Sassover, E., and Weinstein, A. (2020). Should compulsive sexual behavior (CSB) be considered as a behavioral addiction? A debate paper presenting the opposing view. J. Behav. Addict.","DOI":"10.1556\/2006.2020.00055"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"242","DOI":"10.3109\/00952991003721118","article-title":"Pathological Gambling and Substance use Disorders","volume":"36","author":"Wareham","year":"2010","journal-title":"Am. J. Drug Alcohol Abuse"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Ford, M., and Hakansson, A. (2020). Problem gambling, associations with comorbid health conditions, substance use, and behavioural addictions: Opportunities for pathways to treatment. PLoS ONE, 15.","DOI":"10.1371\/journal.pone.0227644"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"593533","DOI":"10.3389\/fpsyt.2020.593533","article-title":"Suicide Attempt in Patients with Gambling Disorder\u2014Associations with Comorbidity Including Substance Use Disorders","volume":"11","author":"Karlsson","year":"2020","journal-title":"Front. Psychiatry"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"114043","DOI":"10.1016\/j.psychres.2021.114043","article-title":"Internet gaming disorder and comorbidities among campus-dwelling U.S. university students","volume":"302","author":"Ohayon","year":"2021","journal-title":"Psychiatry Res."},{"key":"ref_16","unstructured":"Grant, J.E., and Potenza, M.N. (2012). Epidemiology and phenomenology of compulsive buying disorder. The Oxford Handbook of Impulse Control Disorders, Oxford University Press. [1st ed.]."},{"key":"ref_17","first-page":"14","article-title":"A review of compulsive buying disorder","volume":"6","author":"Black","year":"2007","journal-title":"World Psychiatry"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1068","DOI":"10.1556\/2006.2020.00093","article-title":"Problematic shopping and self-injurious behaviors in adolescents","volume":"9","author":"Greenberg","year":"2020","journal-title":"J. Behav. Addict."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"518","DOI":"10.1016\/j.psychres.2013.01.021","article-title":"Compulsive sexual behavior and psychopathology among treatment-seeking men in S\u00e3o Paulo, Brazil","volume":"209","author":"Ventuneac","year":"2013","journal-title":"Psychiatry Res."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Armoon, B., SoleimanvandiAzar, N., Fleury, M.J., Noroozi, A., Bayat, A.H., Mohammadi, R., Ahounbar, E., and Fattah Moghaddam, L. (2021). Prevalence, sociodemographic variables, mental health condition, and type of drug use associated with suicide behaviors among people with substance use disorders: A systematic review and meta-analysis. J. Addict. Dis., 1\u201329.","DOI":"10.1080\/10550887.2021.1912572"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1080\/16066359.2020.1784881","article-title":"Association between gambling and self-harm: A scoping review","volume":"29","author":"Gray","year":"2020","journal-title":"Addict. Res. Theory"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1007\/s40429-014-0026-7","article-title":"Clinical and Research Implications of Gambling Disorder in DSM-5","volume":"1","author":"Weinstock","year":"2014","journal-title":"Curr. Addict. Rep."},{"key":"ref_23","first-page":"1","article-title":"Gaming disorder: What doctors need to know","volume":"81","author":"George","year":"2020","journal-title":"Br. J. Hosp. Med."},{"key":"ref_24","unstructured":"World Health Organization (2019). International Statistical Classification of Diseases and Related Health Problems, World Health Organization. [11th ed.]."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"924","DOI":"10.1017\/S109285290001511X","article-title":"The neurobiology of substance and behavioral addictions","volume":"11","author":"Grant","year":"2006","journal-title":"CNS Spectr."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Heinz, A., Romanczuk-Seiferth, N., and Potenza, M.N. (2019). Gambling disorder and substance-related disorders: Similarities and differences. Gambling Disorder, Springer. [1st ed.].","DOI":"10.1007\/978-3-030-03060-5"},{"key":"ref_27","first-page":"178","article-title":"Comorbidity of Pathological Gambling: Clinical variables, personality and response to treatment","volume":"2","author":"Bueno","year":"2009","journal-title":"Rev. Psiquiatr. Salud Ment."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"255","DOI":"10.5498\/wjp.v5.i3.255","article-title":"On the role of impulsivity and decision-making in suicidal behavior","volume":"5","author":"Gvion","year":"2015","journal-title":"World J. Psychiatry"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1556\/2006.7.2018.22","article-title":"Impulsivity traits and addiction-related behaviors in youth","volume":"7","author":"Hesse","year":"2018","journal-title":"J. Behav. Addict."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1354","DOI":"10.1038\/s41386-019-0393-9","article-title":"Impulsivity in Gambling Disorder and problem gambling: A meta-analysis","volume":"44","author":"Ioannidis","year":"2019","journal-title":"Neuropsychopharmacology"},{"key":"ref_31","first-page":"1","article-title":"Dimensions of Impulsivity in Gambling Disorder","volume":"10","author":"Steward","year":"2020","journal-title":"Sci. Rep."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1016\/j.psychres.2014.11.074","article-title":"Suicidal events among pathological gamblers: The role of comorbidity of axis I and axis II disorders","volume":"225","author":"Bischof","year":"2015","journal-title":"Psychiatry Res."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1111\/ajad.12787","article-title":"Suicidality among gambling helpline callers: A consideration of the role of financial stress and conflict","volume":"27","author":"Carr","year":"2018","journal-title":"Am. J. Addict."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1016\/j.psychres.2016.04.008","article-title":"Factors associated with suicidal risk among a French cohort of problem gamblers seeking treatment","volume":"240","author":"Guilleux","year":"2016","journal-title":"Psychiatry Res."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"600","DOI":"10.1007\/s11469-014-9492-3","article-title":"Factors Associated with Suicide and Bankruptcy in Japanese Pathological Gamblers","volume":"12","author":"Komoto","year":"2014","journal-title":"Int. J. Ment. Health Addict."},{"key":"ref_36","first-page":"43","article-title":"The association between pathological gambling and suicidality in treatment-seeking pathological gamblers in South Africa","volume":"28","author":"Stein","year":"2016","journal-title":"Ann. Clin. Psychiatry"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"462","DOI":"10.1097\/00005053-200207000-00007","article-title":"Suicidal ideation and suicide attempts in treatment-seeking pathological gamblers","volume":"190","author":"Petry","year":"2002","journal-title":"J. Nerv. Ment. Dis."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1007\/s11469-006-9022-z","article-title":"Suicide ideation and behaviour in people with pathological gambling attending a treatment service","volume":"4","author":"Battersby","year":"2006","journal-title":"Int. J. Ment. Health Addict."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1112","DOI":"10.1556\/2006.7.2018.132","article-title":"Suicidal ideation and history of suicide attempts in treatment-seeking patients with gambling disorder: The role of emotion dysregulation and high trait impulsivity","volume":"7","author":"Granero","year":"2018","journal-title":"J. Behav. Addict."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s13643-020-01329-2","article-title":"Exploring the prevalence of gaming disorder and Internet gaming disorder: A rapid scoping review","volume":"9","author":"Darvesh","year":"2020","journal-title":"Syst. Rev."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"669","DOI":"10.1556\/2006.6.2017.078","article-title":"Internet gaming disorder and online gambling disorder: Clinical and personality correlates","volume":"6","author":"Granero","year":"2017","journal-title":"J. Behav. Addict."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1177\/0004867420962851","article-title":"Global prevalence of gaming disorder: A systematic review and meta-analysis","volume":"55","author":"Stevens","year":"2021","journal-title":"Aust. N. Z. J. Psychiatry"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12888-020-02870-z","article-title":"Serial multiple mediation of the association between internet gaming disorder and suicidal ideation by insomnia and depression in adolescents in Shanghai, China","volume":"20","author":"Yu","year":"2020","journal-title":"BMC Psychiatry"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1016\/j.psychres.2013.10.021","article-title":"Influence of violent video gaming on determinants of the acquired capability for suicide","volume":"215","author":"Teismann","year":"2014","journal-title":"Psychiatry Res."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1111\/pcn.12402","article-title":"Internet addiction: Prevalence and relation with mental states in adolescents","volume":"70","author":"Kawabe","year":"2016","journal-title":"Psychiatry Clin. Neurosci."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"17r11761","DOI":"10.4088\/JCP.17r11761","article-title":"Internet addiction and its relationship with suicidal behaviors: A meta-analysis of multinational observational studies","volume":"79","author":"Cheng","year":"2018","journal-title":"J. Clin. Psychiatry"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1556\/2006.6.2017.027","article-title":"Interpersonal violence, early life adversity, and suicidal behavior in hypersexual men","volume":"6","author":"Chatzittofis","year":"2017","journal-title":"J. Behav. Addict."},{"key":"ref_48","first-page":"164","article-title":"Quality of life of young adults with non-paraphilic problematic sexual behaviors: An exploratory study","volume":"8","author":"Blum","year":"2018","journal-title":"Addict. Behav. Rep."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"106647","DOI":"10.1016\/j.addbeh.2020.106647","article-title":"Predicting problematic pornography use among male returning US veterans","volume":"112","author":"Shirk","year":"2021","journal-title":"Addict. Behav."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"434","DOI":"10.12688\/f1000research.12784.1","article-title":"An overview of gambling disorder: From treatment approaches to risk factors","volume":"7","author":"Menchon","year":"2018","journal-title":"F1000Research"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"e4","DOI":"10.1016\/S2468-2667(20)30257-7","article-title":"Gambling-related suicidality: Stigma, shame, and neglect","volume":"6","author":"Livingstone","year":"2021","journal-title":"Lancet Public Health"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"603","DOI":"10.1080\/00207578.2021.1871847","article-title":"Siblings, sex, and shame: The film Shame (2011)","volume":"102","author":"Schiller","year":"2021","journal-title":"Int. J. Psychoanal."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1556\/JBA.3.2014.4.4","article-title":"Understanding the role of shame and its consequences in female hypersexual behaviours: A pilot study","volume":"3","author":"Dhuffar","year":"2014","journal-title":"J. Behav. Addict."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"458","DOI":"10.1016\/j.joep.2011.03.011","article-title":"Coping with guilt and shame in the impulse buying context","volume":"32","author":"Yi","year":"2011","journal-title":"J. Econ. Psychol."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"414","DOI":"10.1111\/bjc.12291","article-title":"Shame, guilt, and suicidal thoughts: The interaction matters","volume":"60","author":"Kealy","year":"2021","journal-title":"Br. J. Clin. Psychol."},{"key":"ref_56","doi-asserted-by":"crossref","unstructured":"Zhao, J., Chi, Y., Ju, Y., Liu, X., Wang, J., Liu, X., Lew, B., Siau, C.S., and Jia, C. (2020). Shame and suicidal ideation among undergraduates in China: The mediating effect of thwarted belongingness and perceived burdensomeness. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17072360"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"475","DOI":"10.2466\/pr0.1998.82.2.475","article-title":"Dependence on computer games by adolescents","volume":"82","author":"Griffiths","year":"1998","journal-title":"Psychol. Rep."},{"key":"ref_58","first-page":"242","article-title":"Compulsive buying: A report of 20 cases","volume":"55","author":"McElroy","year":"1994","journal-title":"J. Clin. Psychiatry"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"S16","DOI":"10.1590\/S1516-44462008005000002","article-title":"Compulsive buying disorder: A review and a Case Vignette","volume":"30","author":"Tavares","year":"2008","journal-title":"Rev. Bras. Psiquiatr."},{"key":"ref_60","unstructured":"American Psychiatric Association (APA) (2000). Diagnostic and Statistical Manual of Mental Disorders: DSM-IV-TR (Text Revision), American Psychiatric Association. [4th ed.]."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1177\/1078390303262655","article-title":"Assessing suicide ideation: Comparing self-report versus clinician report","volume":"10","author":"Yigletu","year":"2004","journal-title":"J. Am. Psychiatr. Nurses Assoc."},{"key":"ref_62","unstructured":"Derogatis, L.R. (1994). Symptom Checklist-90-Revised: Administration, Scoring and Procedures Manual, National Computer Systems, Inc. [3rd ed.]."},{"key":"ref_63","unstructured":"Gonz\u00e1lez de Rivera, J.L., de las Cuevas, C., Rodr\u00edguez Abu\u00edn, M., and Rodr\u00edguez Pulido, F. (2002). Cuestionario de 90 S\u00edntomas. Manual, TEA Ediciones."},{"key":"ref_64","doi-asserted-by":"crossref","unstructured":"Cloninger, R., Svrakic, D., and Przybeck, T. (1994). The Temperament and Character Inventory (TCI): A Guide to Its Development and Use, Washington University.","DOI":"10.1037\/t03902-000"},{"key":"ref_65","first-page":"8","article-title":"Temperament and Character Inventory-Revised (TCI-R). Standardization and normative data in a general population sample","volume":"32","author":"Montserrat","year":"2004","journal-title":"Actas Espa\u00f1olas Psiquiatria"},{"key":"ref_66","unstructured":"Hollingshead, A.B. (2011). Four Factor Index of Social Status, Yale University."},{"key":"ref_67","unstructured":"Stata-Corp (2019). Stata Statistical Software: Release 16, StataCorp LLC."},{"key":"ref_68","doi-asserted-by":"crossref","unstructured":"Olivier, J., and Bell, M.L. (2013). Effect Sizes for 2 \u00d7 2 Contingency Tables. PLoS ONE, 8.","DOI":"10.1371\/journal.pone.0058777"},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"920","DOI":"10.1080\/01621459.1993.10476358","article-title":"On a monotonicity problem in step-down multiple test procedures","volume":"88","author":"Finner","year":"1993","journal-title":"J. Am. Stat. Assoc."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1037\/a0028086","article-title":"On effect size","volume":"17","author":"Kelley","year":"2012","journal-title":"Psychol. Methods"},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"483","DOI":"10.1002\/erv.2782","article-title":"Null hypothesis significance tests, a misleading approach to scientific knowledge: Some implications for eating disorders research","volume":"28","author":"Granero","year":"2020","journal-title":"Eur. Eat. Disord. Rev."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s13722-020-0181-1","article-title":"Substance use disorders and risk of suicide in a general US population: A case control study","volume":"15","author":"Lynch","year":"2020","journal-title":"Addict. Sci. Clin. Pract."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"e39","DOI":"10.1016\/S2468-2667(20)30232-2","article-title":"Suicidality and gambling among young adults in Great Britain: Results from a cross-sectional online survey","volume":"6","author":"Wardle","year":"2021","journal-title":"Lancet Public Health"},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1016\/j.puhe.2020.03.024","article-title":"Problem gambling and suicidality in England: Secondary analysis of a representative cross-sectional survey","volume":"184","author":"Wardle","year":"2020","journal-title":"Public Health"},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"61","DOI":"10.3389\/fpsyt.2018.00061","article-title":"Editorial: Understanding the complex phenomenon of suicide: From research to clinical practice","volume":"9","author":"Martinotti","year":"2018","journal-title":"Front. Psychiatry"},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"558","DOI":"10.1177\/0020764019867352","article-title":"The impact of self-stigma on self-esteem among persons with different mental disorders","volume":"65","author":"Park","year":"2019","journal-title":"Int. J. Soc. Psychiatry"},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"1552","DOI":"10.1007\/s12671-017-0723-0","article-title":"Dispositional Mindfulness, Shame, and Compulsive Sexual Behaviors Among Men in Residential Treatment for Substance Use Disorders","volume":"8","author":"Brem","year":"2017","journal-title":"Mindfulness"},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1002\/cb.1848","article-title":"Destigmatising the stigma: Understanding the impact of message framing on Chinese consumers\u2019 guilt and attitude associated with overspending behaviour","volume":"20","author":"Fan","year":"2021","journal-title":"J. Consum. Behav."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"35","DOI":"10.3389\/fpsyt.2017.00035","article-title":"The reciprocal relationship between suicidality and stigma","volume":"8","author":"Carpiniello","year":"2017","journal-title":"Front. Psychiatry"},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"2921","DOI":"10.1111\/add.15561","article-title":"Stigma-related arguments against gaming disorder: A call for research","volume":"116","author":"Galanis","year":"2021","journal-title":"Addiction"},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"868","DOI":"10.1038\/mp.2009.29","article-title":"Mental disorders, comorbidity and suicidal behavior: Results from the national comorbidity survey replication","volume":"15","author":"Nock","year":"2010","journal-title":"Mol. Psychiatry"},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1007\/s40429-020-00337-5","article-title":"Gaming Disorder in Children and Adolescents: Risk Factors and Preventive Approaches","volume":"7","author":"Bender","year":"2020","journal-title":"Curr. Addict. Rep."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.jad.2014.03.045","article-title":"Factors associated with suicidal ideation and attempts in Spain for different age groups. Prevalence before and after the onset of the economic crisis","volume":"163","author":"Miret","year":"2014","journal-title":"J. Affect. Disord."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1111\/j.1744-6171.2009.00194.x","article-title":"Protective effects of self-esteem and family support on suicide risk behaviors among at-risk adolescent","volume":"22","author":"Sharaf","year":"2009","journal-title":"J. Child Adolesc. Psychiatr. Nurs."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1016\/j.addbeh.2015.01.011","article-title":"Gender differences in the associations of gambling activities and suicidal behaviors with problem gambling in a nationally representative French sample","volume":"45","author":"Husky","year":"2015","journal-title":"Addict. Behav."},{"key":"ref_86","doi-asserted-by":"crossref","unstructured":"Kaess, M., Parzer, P., Haffner, J., Steen, R., Roos, J., Klett, M., Brunner, R., and Resch, F. (2011). Explaining gender differences in non-fatal suicidal behaviour among adolescents: A population-based study. BMC Public Health, 11.","DOI":"10.1186\/1471-2458-11-597"},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"562","DOI":"10.1556\/2006.5.2016.072","article-title":"Barriers to female sex addiction treatment in the UK","volume":"5","author":"Dhuffar","year":"2016","journal-title":"J. Behav. Addict."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"605","DOI":"10.1177\/070674370705200909","article-title":"The association between pathological gambling and attempted suicide: Findings from a national survey in Canada","volume":"52","author":"Newman","year":"2007","journal-title":"Can. J. Psychiatry"},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"342","DOI":"10.1016\/j.genhosppsych.2014.01.012","article-title":"Prevalence of suicide attempts in pathological gamblers in a nationwide Austrian treatment sample","volume":"36","author":"Thon","year":"2014","journal-title":"Gen. Hosp. Psychiatry"},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1055\/s-0040-1721558","article-title":"Predictors of Suicidal Ideation and Attempt among Patients with Major Depressive Disorder at a Tertiary Care Hospital, Puducherry","volume":"12","author":"Lalthankimi","year":"2021","journal-title":"J. Neurosci. Rural Pract."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1016\/j.eurpsy.2008.10.002","article-title":"Suicide attempts in bulimia nervosa: Personality and psychopathological correlates","volume":"24","author":"Forcano","year":"2009","journal-title":"Eur. Psychiatry"},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"1149","DOI":"10.1016\/j.jad.2018.12.015","article-title":"Socio-demographic and psychological risk factors for suicidal behavior among individuals with anorexia and bulimia nervosa: A systematic review","volume":"245","author":"Goldstein","year":"2019","journal-title":"J. Affect. Disord."},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"374","DOI":"10.1111\/j.1442-200X.2006.02224.x","article-title":"Suicide attempts versus suicidal ideation in bulimic female adolescents","volume":"48","author":"Nickel","year":"2006","journal-title":"Pediatr. Int."},{"key":"ref_94","doi-asserted-by":"crossref","unstructured":"Milner, A., Page, A., and LaMontagne, A.D. (2013). Long-Term Unemployment and Suicide: A Systematic Review and Meta-Analysis. PLoS ONE, 8.","DOI":"10.1371\/journal.pone.0051333"},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1177\/0020764014536545","article-title":"Economic recession and suicidal behaviour: Possible mechanisms and ameliorating factors","volume":"61","author":"Haw","year":"2015","journal-title":"Int. J. Soc. Psychiatry"},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"E38","DOI":"10.5888\/pcd12.140451","article-title":"Unemployment and depression among emerging adults in 12 states, behavioral risk factor surveillance system, 2010","volume":"12","author":"McGee","year":"2015","journal-title":"Prev. Chronic Dis."},{"key":"ref_97","doi-asserted-by":"crossref","unstructured":"Cunningham, R., Milner, A., Gibb, S., Rijnberg, V., Disney, G., and Kavanagh, A.M. (2021). Gendered experiences of unemployment, suicide and self-harm: A population-level record linkage study. Psychol. Med., 1\u20139.","DOI":"10.1017\/S0033291721000994"},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1089\/cpb.2007.9988","article-title":"Social interactions in massively multiplayer online role-playing gamers","volume":"10","author":"Cole","year":"2007","journal-title":"Cyberpsychology Behav."},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"77","DOI":"10.2989\/17280583.2019.1608830","article-title":"Prevalence of comorbid depressive symptoms and suicidal ideation in children with autism spectrum disorder and elevated anxiety symptoms","volume":"31","author":"Wijnhoven","year":"2019","journal-title":"J. Child Adolesc. Ment. Health"},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"171","DOI":"10.24869\/psyd.2017.171","article-title":"The temperament and character traits in patients with major depressive disorder and bipolar affective disorder with and without suicide attempt","volume":"29","author":"Kralik","year":"2017","journal-title":"Psychiatr. Danub."},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1111\/j.1600-0447.1999.tb10910.x","article-title":"Temperament, character and suicide attempts in anorexia nervosa, bulimia nervosa and major depression","volume":"100","author":"Bulik","year":"1999","journal-title":"Acta Psychiatr. Scand."},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1016\/j.jad.2007.05.010","article-title":"Self-injurious behavior and attempted suicide in purging bulimia nervosa: Associations with psychiatric comorbidity","volume":"105","author":"Favaro","year":"2008","journal-title":"J. Affect. Disord."},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"914","DOI":"10.3389\/fpsyg.2016.00914","article-title":"Compulsive buying behavior: Clinical comparison with other behavioral addictions","volume":"7","author":"Granero","year":"2016","journal-title":"Front. Psychol."},{"key":"ref_104","doi-asserted-by":"crossref","first-page":"497","DOI":"10.3389\/fpsyt.2018.00497","article-title":"The contribution of sex, personality traits, age of onset and disorder duration to behavioral addictions","volume":"9","author":"Granero","year":"2018","journal-title":"Front. Psychiatry"},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"721","DOI":"10.1007\/s10899-015-9570-x","article-title":"Understanding within-session loss-chasing: An experimental investigation of the impact of stake size on cognitive control","volume":"32","author":"Parke","year":"2016","journal-title":"J. Gambl. Stud."},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1016\/j.comppsych.2004.07.011","article-title":"Attempted suicide and self-injury in patients diagnosed with eating disorders","volume":"45","author":"Stein","year":"2004","journal-title":"Compr. Psychiatry"},{"key":"ref_107","doi-asserted-by":"crossref","first-page":"32","DOI":"10.3109\/08039480903265751","article-title":"Suicidal behavior and depression in adolescents with eating disorders","volume":"64","author":"Fennig","year":"2010","journal-title":"Nord. J. Psychiatry"},{"key":"ref_108","doi-asserted-by":"crossref","first-page":"320","DOI":"10.1504\/IJBHR.2011.043414","article-title":"Measuring bias in self-reported data","volume":"2","author":"Rosenman","year":"2011","journal-title":"Int. J. Behav. Healthc. Res."},{"key":"ref_109","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1038\/s41562-020-01045-w","article-title":"The association between gambling and financial, social and health outcomes in big financial data","volume":"5","author":"Muggleton","year":"2021","journal-title":"Nat. Hum. Behav."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/21\/11085\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T07:20:23Z","timestamp":1760167223000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/21\/11085"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,10,21]]},"references-count":109,"journal-issue":{"issue":"21","published-online":{"date-parts":[[2021,11]]}},"alternative-id":["ijerph182111085"],"URL":"https:\/\/doi.org\/10.3390\/ijerph182111085","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,10,21]]}}}