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Gambling is a major public health issue increasingly affecting adolescents globally and worsened in Nigeria by weak enforcement of betting laws among other factors. The burden of gambling and its health effects among Nigerian adolescents is not well understood. Hence, this study assessed the prevalence of gambling, as well as the association between gambling and other health-related factors among male adolescents in Osun State, Nigeria. Using a multistage sampling technique, this study utilised a descriptive, cross-sectional design and was conducted among 517 male senior secondary school students attending ten randomly selected schools. Health related factors were measured using the Kessler Psychological Distress Scale and the Jenkins Sleep Scale, while alcohol and drug risk was assessed using the CRAFFT screening tool. The multivariable logistic regression model adjusted for age, fathers' occupation, parental and peer gambling, mother's educational attainment, access to betting, smartphone ownership, sleep disturbance, anxiety, and substance use. The study revealed a lifetime prevalence of gambling among male adolescents in Osun State, Nigeria, to be 40%. Significant associations were found between gambling and anxiety (p&#x2009;<&#x2009;0.001) as well as substance use (p&#x2009;<&#x2009;0.001). Respondents aged 15-17 years had 1.7 times higher odds of gambling in the past year compared to those aged 12-14 years (AOR: 1.7, 95% CI: 1.02-2.8, p&#x2009;=&#x2009;0.042). Similarly, those aged 18-19 years had four times higher odds of gambling compared with the 12-14-year-olds (AOR: 4.0, 95% CI: 1.4-11.6, p&#x2009;=&#x2009;0.007). Adolescents with parents who gamble had significantly higher odds of gambling (AOR: 7.0, 95% CI: 3.2-15.2, p&#x2009;<&#x2009;0.001 ), as did those with gambling friends (AOR: 2.0, 95% CI: 1.2-3.5 p&#x2009;=&#x2009;0.007 ). Access to betting shops (AOR: 2.1, 95% CI: 1.3-3.4 p&#x2009;=&#x2009;0.003) and having a smart phone (AOR: 2.1; 95% CI: 1.0-4.2, p&#x2009;=&#x2009;0.042), frequent sleep disturbances (AOR&#x2009;=&#x2009;3.1, 95% CI: 1.4-6.9, p&#x2009;=&#x2009;0.007) and substance use (AOR&#x2009;=&#x2009;4.9, 95% CI: 2.3-10.6, p&#x2009;<&#x2009;0.001) increased the odds of gambling in the past year. Participants with anxiety symptoms had significantly higher odds of gambling in the past year (AOR&#x2009;=&#x2009;5.3, 95% CI: 2.3-12.4, p&#x2009;<&#x2009;0.001). Gambling among adolescents was associated with increased anxiety and substance use. Parental and peer influences were also key factors in gambling engagement. Addressing adolescent gambling effectively requires a multi-faceted strategy, including parental education and involvement, peer-led prevention programs, restricting access to gambling platforms, and strict enforcement of gambling laws.

The proliferation of electronic gambling in Nigeria presents a significant public health concern among youths facing economic adversity. This study applied the Theory of Planned Behavior (TPB) to investigate the socio-cognitive drivers and self-reported psychosocial consequences of electronic gambling engagement among students at the University of Ibadan. Electronic gambling is defined here as any gambling activity conducted through electronic devices, including mobile phones, laptops, and computers, encompassing mobile sports betting applications, web-based casino platforms, and online poker. A descriptive cross-sectional survey design was employed. Data were collected from 403 undergraduate and postgraduate students at the University of Ibadan using stratified random sampling and a structured self-administered questionnaire adapted from validated instruments. Analyses included descriptive statistics, scale reliability assessment, and binary logistic regression. The lifetime prevalence of electronic gambling was 49.6%. Positive attitudes toward gambling, subjective norms involving peer approval, and perceived behavioral control were all significant predictors of gambling engagement (p < .001). Economic hardship was the strongest predictor in the model (OR&#x2009;=&#x2009;3.06). Among participants who reported gambling, 50.9% reported increased stress and anxiety, 48.6% reported financial strain, and 42.6% reported negative academic consequences. University health and counseling services should integrate validated gambling screening tools into routine student health assessments. Interventions should address both the economic motivations and the cognitive distortions sustaining gambling engagement. Prevention campaigns should target the specific TPB constructs validated in this study. Institutional policy must also address the structural driver of economic hardship through expanded work-study programs and student financial support initiatives.

Gambling is a public health issue, leading to many harms. Gambling advertising is prevalent and constant, including on social media, which allows for personalised targeting and wide reach. Our aim was to understand the reach and target demographics such advertising. The EU Digital Services Act now requires large online platforms to provide repositories for all advertising shown and associated audience demographic data for EU countries. We used Ireland as a case study to assess the scale of targeting specific genders and age groups by gambling companies, as well as the actual reach of the adverts. We checked through the publicly available list of remote betting licensees operating in Ireland (n = 88). Adverts were examined as to their intended target demographics and actual impressions by various demographic groups. Between January and February 2025, we studied 411 adverts across 88 operators. Ninety-one adverts (22%) targeted men only; no adverts (0%) targeted only women. 12,690,245 men were reached across all the 411 adverts, 2.3 times more compared to 5,458,438 women. The age group of 25-34 reached the most unique accounts, with a total of 6,246,408 accounts reached (33.9% of all accounts reached). These findings illustrate male-skewed delivery in gambling advertising in Ireland, and demonstrate the utility of platform ad repositories for addiction research.

Contemporary video game monetization systems are increasingly embedded within gameplay, structuring decision-making and spending. While research has focused on loot boxes, other strategies remain under examined despite relying on similar mechanisms. This study develops a structured typology of monetization systems as integrated design architectures operating through embedded psychological processes. A structured, theory-informed synthesis of literature on video game monetization, behavioral design, gambling research, and consumer behavior was conducted. Strategies were organized across mode of value extraction, gameplay integration, and underlying psychological&#xa0;mechanisms. Four categories were identified: traditional sales, microtransactions, gamblification, and in-game advertising. Across these, recurring mechanisms, including reinforcement processes and cognitive biases (e.g., fear of missing out, loss aversion, near-miss effects), operate across structurally distinct systems and may be associated with outcomes ranging from engagement and consumer-related effects to problematic gaming, gambling-related harm, and behavioral addiction. Conclusions: Monetization strategies function as integrated design systems in which recurring mechanisms&#xa0;shape player behavior. The typology provides a framework for identifying vulnerability markers and informing transparency, consumer protection, and safety-by-design.

This study analyzed the impact of a cognitive-motor training program on key indicators of cognitive performance. A two-arm, parallel, randomised controlled trial (with 1:1 allocation) was conducted. A total of 184 competitive eSports athletes (aged 18-25) were randomly assigned to one of two programmes: an individualised psychophysical training programme integrating aerobic exercise and cognitive self-regulation techniques, or a standard eSports training programme. Outcomes were assessed at baseline, after 4 weeks (mid-intervention) and after 8 weeks (post-intervention). Reaction time and decision-making efficiency were assessed at baseline, mid-intervention, and post-intervention using a computerized reaction-time battery and an adapted Iowa Gambling Task. Data analyzed using repeated-measures ANOVA and moderation analyses. The primary endpoint was defined as the change in the outcome variable from baseline to post-intervention. The individualized psycho-physical program was associated with greater improvements in reaction time and decision-making indicators compared to standard training, with small-to-moderate effect sizes (&#x3b7;&#xb2; = 0.08-0.12). Significant Time &#xd7; Group interactions indicated steeper and more stable performance gains in the experimental group. Age and gender exerted small but significant moderating effects; younger participants and female athletes showing greater responsiveness on selected outcomes. Integrating aerobic exercise and cognitive self-regulation was associated with improvements in attentional efficiency and decision-making stability under controlled conditions. These findings suggest that individualised psychophysical training could be useful in environments with a high cognitive load. However, further confirmatory trials are required. Not prospectively registered.

Adolescence is a critical period for the initiation of substance use and other addictive behaviors, which can have long-term health consequences. Monitoring these behaviors is essential to inform prevention and policy strategies in low- and middle-income countries, where evidence remains limited. This study aimed to provide an integrated twenty-year overview of trends in substance use and selected behavioral addictions among Moroccan school-going adolescents and to examine sex differences over time. We analyzed 11 nationally representative repeated cross-sectional school-based surveys conducted between 2001 and 2021, including GYTS, GSHS, and MedSPAD. Participants were school-going adolescents aged 13-15&#xa0;years (GYTS, GSHS) and 15-17&#xa0;years (MedSPAD). Outcomes included cigarette smoking, shisha, electronic cigarettes, alcohol, cannabis, non-prescription tranquilizers or sedatives, cocaine, crack, heroin, and ecstasy, as well as excessive gaming, gambling, and problematic social media use. Temporal trends were assessed using the Cochran-Armitage chi-square test for trend in proportions and multivariable logistic regression analyses. In 2021, the most prevalent addictive behaviors were social media use (41.2%), excessive gaming (21.5% on school days, 22.6% on non-school days), and gambling (18.3%). Among substances, electronic cigarettes (5.4%), shisha (5.2%), tranquilizers or sedatives without prescription (4.8%), and cigarette smoking (4.6%) were most common, followed by cannabis (3.4%), alcohol (2.6%), ecstasy (1.1%), cocaine (1.0%), and heroin (0.9%). Trend analyses among Moroccan adolescents showed declines in cigarette smoking and shisha use, relative stability in alcohol and cannabis, and marked increases in electronic cigarette and non-medical tranquilizer use. Cocaine and crack use remained uncommon and showed no statistically significant adjusted temporal trends. Across all survey waves, prevalence of substance use and addictive behaviors was consistently higher among male school-going adolescents. Rising use of electronic cigarettes, non-medical tranquilizers or sedatives, and behavioral addictions signals a shifting risk profile among Moroccan school-going adolescents, with males consistently reporting higher prevalence. These trends highlight the need for gender-responsive prevention strategies and stronger regulation of emerging substances. Strengthening long-term, standardized surveillance systems is essential to monitor evolving behaviors and support evidence-based policy and adolescent health promotion efforts in Morocco.

Substance-related and behavioral addictions frequently co-occur and are increasingly conceptualized as part of an interconnected psychopathological framework. Addictive behaviors are linked to internalizing symptoms, including depression, anxiety, and stress, through shared vulnerability. Although impulsivity, anhedonia, and stress-related processes have been proposed as transdiagnostic factors, their relative roles as central or bridging mechanisms remain unclear. This study aimed to clarify the network structure of multiple addictions by jointly modeling substance-related and behavioral addictions with multidimensional psychological features. A total of 169 university students completed standardized self-report measures assessing four substance-related addictions (alcohol, tobacco, cannabis, cocaine) and six behavioral addictions (gambling, shopping, gaming, eating, sexual activity, and work), alongside measures of impulsivity, anhedonia, depression, anxiety, stress, chronic stress, and childhood adversities. Three Extended Bayesian Information Criterion Graphical Least Absolute Shrinkage and Selection Operator (EBICglasso) network models were estimated: (i) an addiction-only network, (ii) an addictions-psychometric features network, and (iii) a focused network integrating selected addictions with affective symptoms, stress, and adversities. Centrality, bridge indices, and predictability were evaluated. Substance-related and behavioral addictions formed a coherent and interconnected network, with alcohol (0.89), sexual activity (0.77), and cannabis (0.70) emerging as the most central hubs. Impulsivity and anxiety functioned as the primary bridge nodes linking addictive behaviors with internalizing symptomatology, with anxiety exhibiting the highest bridge strength (0.29), followed by impulsivity (0.20). The affective distress cluster, comprising depression, anxiety, and stress, demonstrated the strongest internal connectivity and the highest predictability (R2), with explained variance values of R2 = 0.33 for depression and R2 = 0.30 for both anxiety and stress. Stress exposure and childhood adversity showed cross-domain connections involving sexual activity and alcohol use. This study models substance-related and behavioral addictions together with internalizing symptoms, impulsivity, anhedonia, and stress-related factors to examine how addictive behaviors are organized within an interconnected network. Alcohol, cannabis, and sexual activity showed relatively high connectivity, while impulsivity and anxiety were consistently positioned as bridge variables linking addictive behaviors with affective distress. These findings provide a descriptive transdiagnostic framework in which shared regulatory traits emerge as key organizing features of addiction comorbidity; however, their potential clinical relevance remains hypothesis-generating and requires validation in longitudinal and clinically diagnosed samples.

Current screening tools for harmful alcohol consumption have fallen out of step with recent guidance on the health risks of alcohol. To address this gap, the Canadian Research Initiative in Substance Matters updated the screening recommendations for high-risk drinking and alcohol use disorder (AUD) in the 2023 national clinical practice guideline. Following a systematic review of literature published between Jan. 1, 2013, and Feb. 24, 2023, that examined screening tools for high-risk drinking and AUD, the updated recommendations were developed by a multidisciplinary national committee, which included people with lived and living experience. We scored the recommendations and certainty of evidence using the Grading of Recommendations, Assessment, Development, and Evaluation tool. We used the Appraisal of Guidelines for Research and Evaluation II instrument and the Guidelines International Network's principles for disclosure of interests and management of conflicts to ensure the update met international standards for transparency, high quality, and methodological rigour. Acknowledging that time constraints are the most commonly reported barrier to universal alcohol screening, we developed 5 recommendations involving a simple screening method, to identify and address both unhealthy alcohol consumption and more serious problems related to alcohol. The recommendations include asking all patients about alcohol consumption and providing educational support to all those who drink above Canada's Guidance on Alcohol and Health's low-risk threshold. We propose a simple screening algorithm to optimize and tailor further intervention, including when to assess for possible AUD. The revised screening recommendations represent a timesaving and pragmatic approach intended to be a resource for universal screening for alcohol risks and problems. The recommendations streamline the process of identifying and addressing the health needs of those who consume alcohol in a hazardous way or may have more serious problems related to alcohol.

Excessive engagement in online gaming and gambling is increasingly prevalent among young individuals, particularly first-year university students, and is associated with significant psychosocial damage. The aim of the present study was to identify empirical clusters among university students reporting problematic online gaming and gambling behaviors and to examine the extent to which these clusters differ from a control group of students without gaming- and gambling-related problems. The sample included 273 first-year university students (180 women and 93 men, aged 18-25&#xa0;years). Participants were first classified into a subgroup with problematic online gaming or gambling (n&#xa0;=&#xa0;100) and a non-problematic (control) group (n&#xa0;=&#xa0;173), based on DSM-5 criteria. A two-step cluster analysis was then conducted exclusively within the problematic subgroup to identify latent profiles, using indicators of addictive behavior severity, engagement with social networks and the internet, impulsivity, emotion dysregulation, gambling-related cognitive distortions, and psychological distress. Subsequently, the identified clusters were compared with each other and with the control group across a broad range of psychological and behavioral indicators. Two clusters were identified, primarily differentiated by the severity of gaming-gambling involvement and associated psychological vulnerabilities. Cluster profiles revealed distinct patterns of impulsivity, emotional deficit, and cognitive biases. Both clusters significantly differed from the control group, with higher scores on all clinical and cognitive measures except for the social internet use and sensation seeking. The findings provide empirical support for the heterogeneity of problematic gaming and gambling among young university students. The identification of discrete subgroups underscores the relevance of individualized prevention and intervention strategies, tailored to the severity and psychological correlates of the addictive behavior(s). These results also highlight the need to refine screening and diagnostic tools within this target population.

This systematic review synthesizes empirical evidence on differences in processing addiction-related target and control cues in individuals with and without addictive behaviors, using event-related potentials (ERP). A pre-registered search (PROSPERO: CRD42024500485) of PubMed and Web of Science identified experimental electroencephalography studies on cue reactivity. Study quality was assessed with the Newcastle-Ottawa Scale. Thirty-two studies were included. For the late positive potential (LPP), 23 studies (n&#x202f;=&#x202f;1160 with addictive behavior) compared target and control cues, and 14 compared addiction to control group (n&#x202f;=&#x202f;4453 with addictive behavior, n&#x202f;=&#x202f;359 control participants). For the P300, five studies (n&#x202f;=&#x202f;269 with addictive behavior) compared target and control cues. Methodological parameters across studies were presented. Meta-analyses showed that individuals with addictive behavior exhibit higher LPP amplitudes when processing target cues compared to control participants with a large effect size (k&#x202f;=&#x202f;14, Hedge's g = 0.955 [0.357, 1.552], z&#x202f;=&#x202f;3.13, p&#x202f;=&#x202f;.002). Within addiction groups, target cues elicited higher LPP amplitudes with a medium effect size (k&#x202f;=&#x202f;23, Hedge's g = 0.633 [0.633, 0.908], z&#x202f;=&#x202f;4.506, p&#x202f;<&#x202f;.001). For the P300, target cues elicited higher amplitudes with a small effect size (k&#x202f;=&#x202f;5, Hedge's g = 0.265 [0.094, 0.436], z&#x202f;=&#x202f;3.032, p&#x202f;=&#x202f;.002). Despite consistent effects, methodological heterogeneity limits firm conclusions. Standardized designs are needed to strengthen comparability and reliability. Overall, findings support heightened neural reactivity to addiction-related cues, underscoring the value of ERP markers and the need for improved methodological rigor.

This systematic review and meta-analysis examined whether gambling behavior is associated with neurocognitive deficits across executive function, decision-making, delay discounting, and reward sensitivity, and whether these deficits support the dual-process model of addiction. PubMed, Scopus, Embase, and Web of Science were searched on September 1, 2024. Observational studies including individuals with gambling behavior identified using Diagnostic and Statistical Manual of Mental Disorders (DSM)/International Classification of Diseases (ICD) criteria and/or standardized screening instruments were eligible. Risk of bias (ROB) was assessed using the Joanna Briggs Institute (JBI) checklist (cross-sectional studies). Random-effects meta-analyses using Hedges' g were conducted in R software, with heterogeneity, publication bias, leave-one-out sensitivity, subgroup, and meta-regression analyses. Of 12,488 records, 76 studies (n = 5362) met eligibility for the review, and 35 (n = 2822) were included in the meta-analysis. Across 15 random-effects meta-analyses (k = 02-12; n = 38-562; I 2 = 0%-94.1%), the largest deficits were observed in inhibitory control on the Stroop task (ST) under gambling (g = 1.91; p < .05) and neutral conditions (g = 1.83; p < .05), followed by delay discounting (area under the curve [AUC]: g = -1.07; p < .001; discounting parameter: g = 0.45; p < .01), cognitive flexibility on the probabilistic reversal learning test (g = -0.51; p < .05) and Intra/Extra-Dimensional Set Shift Task (g = 0.72; p < .001), and working memory on the Trail Making Test-B (TMT-B) (g = 0.59; p < .05). Decision-making impairments were partially supported by qualitative evidence, while no consistent deficits were observed in planning ability or reward sensitivity. Findings indicate impairments in controlled and automatic processes, partially supporting the dual-process model of gambling disorder; however, heterogeneity and task-specific effects warrant caution.

Previous studies showed impaired decision-making in suicide attempters, but the cognitive mechanisms in play and subgroup differences among attempters need further research. Understanding these differences is crucial for developing targeted interventions. For the present case-control study, we recruited 49 depressed patients with histories of both mood disorders and suicide attempts, 34 patient controls with no personal history of suicide attempts, and 49 healthy controls. The participants completed clinical assessments and decision-making tasks: the Iowa-Gambling-Task (IGT), a value-based decision-making battery, a mixed gambling task, and a Go/No-Go task. The study was preregistered at ClinicalTrial.gov (NCT05230043). Both patient groups showed lower IGT performance, and only suicide attempters lower loss aversion than healthy controls. Compared to both patient and healthy controls, suicide attempters exhibited more total and commission errors on the Go/No-Go task. Subgroup analysis revealed that patients who made an impulsive suicide attempt had higher delay discounting and lower loss aversion rates than healthy controls. Meanwhile, attempters who chose violent means performed worse than those with a non-violent means in the first phase of the IGT and had lower loss aversion compared to both control groups. Finally, poorer IGT performance was associated with lower loss aversion and higher suicidal intent. In addition to deficits in response inhibition in depressed suicide attempters, these findings highlight reduced sensitivity to losses, higher delay discounting and impaired value-based learning in impulsive or violent suicidal acts. They, therefore, underscore the heterogeneity within suicide attempters and highlight the need for individualized approaches in future research and clinical interventions.

Pronounced variations in suicide mortality persist across Europe. Understanding long-term temporal patterns through age, period and cohort (APC) effects, alongside suicide means, is essential for tailored prevention. This study aims to determine how suicide mortality rates in Europe have changed across APC dimensions at national and subregional levels. Our analysis was restricted to European countries with complete age- and sex-specific suicide mortality data from 1990 to 2019 within the World Health Organization mortality database. The analysis comprised two components. The first component disentangled long-term suicide mortality trends (1990-2019) into APC dimensions using an age-period-cohort model via the National Cancer Institute's APC Web Tool. The second component involved an assessment of suicide means, restricted to 2010-2019 and to countries with detailed International Classification of Diseases, 10th Revision (ICD-10) cause-of-death data. In 2019, Europe recorded 47,793 male and 13,111 female suicide deaths. Overall suicide mortality rates declined in most subregions from 1990 to 2019, with the largest reductions among Eastern European men, from 77.81 (95% CI: 77.17-78.45) per 100,000 in the mid-1990s to 22.93 (95% CI: 22.58-23.28) per 100,000 by 2019, although this region retained the highest male suicide burden. Age-specific risk patterns differed markedly: among men, risk peaked in early adulthood and then declined in Eastern Europe, while in Western and Southern Europe, it was lower and more stable&#xa0;but rose after age 60; for women, risk was generally lower, with peaks in early adulthood in Eastern Europe and in midlife elsewhere. Period reflected continued improvement, especially in Eastern Europe where the period risk in 2015-2019 was approximately 60% lower than 2000-2004. Cohort effects similarly showed progressive declines. However, upward trends emerged among younger generations. In Northern Europe, the cohort relative risk for females increased from 0.73 (95% CI: 0.68-0.78) in the 1980 cohort to 0.90 (95% CI: 0.70-1.04) in the 2000 cohort. While the completeness of suicide means analysis varied by subregion, the primary data indicated that hanging was the predominant means for both sexes during 2010-2019. Despite an overall decline, suicide mortality in Europe exhibits persistent regional and demographic differences. This study reveals emerging risks among younger cohorts, specifically Northern European women and Southern European men, signalling shifting patterns that are not apparent from overall temporal trends alone. This evolving risk profile calls for sustained surveillance and research to investigate the drivers of these population-specific vulnerabilities.

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This study investigates the impact of online gambling on problem behaviors among South Korean adolescents across three phases of the COVID-19 pandemic: pre-pandemic (2018), early pandemic (2020), and late pandemic (2022). We applied a doubly robust estimation approach that combines propensity score matching with regression analysis using nationally representative survey data from the Korea Problem Gambling Agency. Our findings indicate that online gambling significantly intensified adolescents' problem behaviors in all periods, with a more pronounced effect observed during the late pandemic phase in 2022 compared to the early phase in 2020. Sensitivity analysis further demonstrated that the estimated effects were substantially robust to unobserved confounding, particularly in 2018 and 2022. We conclude with a discussion of adolescents' heightened vulnerability to online gambling-related problem behaviors and the corresponding need for targeted interventions and policy responses.

This study evaluated the psychometric justification for conditionally administering the most severe items within subscales of the Gambling Harms Measure (GHM), a tool assessing gambling-related harms across six domains: financial, psychological, relationship, physical health, work/study, and legal. Data were drawn from the third wave of an ongoing longitudinal study, with 2,849 participants completing the GHM. We computed item endorsement rates, crosstabs comparing each conditional item (most severe item within each subscale) with its preceding item, Cronbach's &#x3b1; with and without conditional items, tests of equivalence, and a paired-samples t test comparing total scores with and without conditional items. A confirmatory factor analysis evaluated potential changes in factorial structure due to conditional administration. Conditional items were endorsed by 2.8%-4.7% of participants overall, and 1.1%-1.4% participants endorsed these items without endorsing the preceding item. Chi-square tests of independence yielded statistically significant associations across subscales (phi between .49 and .56), indicating moderate-to-strong associations between each conditional item and its preceding item. Cronbach's &#x3b1; for the full scale was .931, decreasing slightly to .927 when using the conditional scoring procedure. Paired t tests showed significant differences between total scores with and without conditional items (Cohen's d = 0.10-.0.12), but equivalence testing supported practical equivalence within 0.1 raw score bounds. Confirmatory factor analysis supported a single-factor model. Conditional administration of the most severe items on the GHM preserves psychometric properties while reducing response burden. This method may enhance feasibility in large-scale surveys or screening interviews without compromising reliability or validity. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

It is well-established that individuals who have attempted suicide present decision-making impairments. However, the underlying constructs that constitute decision-making are still being explored. To compare decision-making impairments in patients with a current or past depressive episode based on lifetime suicidal history and current depression. 295 patients with current and past depression were recruited and divided into 4 groups according to history of suicide attempt (suicide attempters (SA) or psychiatric controls (PC)) and severity of depression (high or low). The outcome representation learning (ORL) and the Prospect Valence Learning (PVL) models were applied to the Iowa Gambling Task (IGT) to extract estimations of feedback sensitivity, learning and consistency in the decision-making process. We also explored how childhood trauma moderated the relationship between the parameters and suicide. The optimal model for our sample was the ORL. Among the five ORL parameters, low depressed PC showed lower reward learning and greater forgetfulness than SA, but higher deck perseverance was observed only when compared to high depressed SA. Moreover, punishment learning was able to differentiate SA groups in terms of depression severity. Furthermore, patients with high childhood trauma, high forgetfulness and deck perseverance were more likely to be in the SA cohort. Suicide attempt may be linked to heightened feedback sensitivity to environmental contingencies, greater decision-making randomness and higher rumination. Moreover, the role of both forgetfulness and deck perseverance in trauma survivors at risk for suicide needs to be further investigated to refine their cognitive profile.