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Dr. Paula Clayton, medical director for the American Foundation for Suicide Prevention, said that there is no data that definitively links reality television with an increased probability of suicide, but that a mental disorder like narcissism could make a person more prone to taking his own life.


The fourth person to leave the show, Kosewicz, 35, was found dead in her home on Jan. 27, 2007, from an apparent suicide. Before committing suicide, she reportedly wrote on the MySpace page of a fellow contestant that she had "lost the strong Cheryl and I'm just floating around lost."


If you — or someone you know — needs help, please call 1-800-273-8255 for the National Suicide Prevention Lifeline. If you are outside of the US, please visit the International Association for Suicide Prevention for a database of international resources.


Rachel Brown, a 2006 contestant on "Hell's Kitchen," which is also hosted by Ramsay, was found dead of a gunshot wound in her Dallas, Texas, home in 2007. A representative of the Tarrant County medical examiner's office confirmed to CNN that Brown's death was ruled a suicide.


And while narcissism isn't an indicator for suicide, Cooper said it can be an indicator of a troubled person who lacks the stability to deal with the dark side of notoriety. "Reality television has provided an outlet for narcissistic individuals, many with limited abilities, to believe that they can succeed in the entertainment industry," the study said. "This desire to enter the industry may be fueled by the types of fantasy feelings of success, power and glory that narcissists seem to exhibit."


In 2010, chef Joseph Cerniglia was found dead in an apparent suicide in the Hudson, exactly where Ramsay said his poorly run restaurant was about to be swimming. His family insisted he loved Ramsay and his treatment on the show had nothing to do with his death.


"Your life is an open book to people and that makes you feel very vulnerable," Nadine Kaslow, the chief psychologist at Emory University School of Medicine in Atlanta told ABCNews.com. "When people feel very publicly shamed and humiliated that's a risk factor for suicide. Part of what you don't know is how sensitive people are going to be to the shame and humiliation they might experience."


She also blamed the show for coming between her and her boyfriend Ryan O'Neil, who committed suicide himself two months earlier. "This frik'n show…was such a contention between Ryan and I," she reportedly wrote at the time. "The shame seemed to get to her," Kaslow said. "The note was so public and was, in part, blaming the TV show."


Kaslow added that there are often several factors that lead to a suicide and, in Kosewicz's case, losing her boyfriend could have been an additional stressor, while being eliminated from the show may have been the final straw. In the show's final episode, there was a dedication message to Kosewicz.


His former trainer Percy "Buster" Custus also told ABCNews.com that Turpin was never mentally fit to be on the show. "He wasn't even supposed to be on the show," said Custus, a former Golden Gloves boxer. According to Custus, Turpin not only failed a psychological evaluation for the show but had previously attempted suicide. Nonetheless, Custus said, the young athlete was pushed to join the show.


Reality shows in other countries have experienced similar tragedies, proving it's not just an American phenomenon. In fact, the 1997 suicide of a Swedish man who participated in the forerunner to the "Survivor," series, a show called "Expedition: Robinson," produced by Mark Burnett, led Burnett and other producers to screen potential contestants through psychological testing before they were casted. Nevertheless, several incidents have occurred since then.


Paulie Giganti, a contestant on Season 16 of “Hell’s Kitchen,” was found dead in his Philadelphia home on Thursday. He was 36. James Garrow, spokesman for the Philadelphia Medical Examiner's office, confirmed his cause of death, telling Philly.com, “It is an accidental death by drug intoxication.” The ME’s office did not release the type of drug or drugs used. The reality star and Brooklyn native was the former chef at Philadelphia’s Birra restaurant. The owner, Gordon Dinerman, told Philly.com that they mutually chose to part ways in November. “I’ll miss him,” he said, while adding that Birra owed some of its success to Giganti’s cooking. "He brought a consistency to our product, which is why we are still around,” Dinerman said. He also acknowledged Giganti was “definitely a personality, which is how he got on TV.” It is with a heavy heart that we celebrate the life and mourn passing of Paulie Giganti. Paulie came to us as a line cook and eventually elevated to executive chef. His care for our kitchen was only exceeded by his personality and love of life. We would not be the restaurant we are today with Chef Paulie's efforts. Our heart and condolences go out to his family and friends here in Philly, Pittsburgh, and of course, Brooklyn. A post shared by Birra (@birra_philly) on Apr 21, 2017 at 5:45am PDT Giganti never went to cooking school and told My Take on TV, “I was going to be an engineer. I just wanted to see how I stacked up against other guys, like 'school-y' guys and other people.” He went on to say that being on the show and being “critiqued by world-renowned chefs" was “life-affirming.”


"I was fortunate to spend time with Joe during the first season of 'Kitchen Nightmares,' " Ramsay said in the statement. "Joe was a brilliant chef, and our thoughts go out to his family, friends and staff."


It is with a heavy heart that we celebrate the life and mourn passing of Paulie Giganti. Paulie came to us as a line cook and eventually elevated to executive chef. His care for our kitchen was only exceeded by his personality and love of life. We would not be the restaurant we are today with Chef Paulie's efforts. Our heart and condolences go out to his family and friends here in Philly, Pittsburgh, and of course, Brooklyn.


It is with a heavy heart that we celebrate the life and mourn passing of Paulie Giganti. Paulie came to us as a line cook and eventually elevated to executive chef. His care for our kitchen was only exceeded by his personality and love of life. We would not be the restaurant we are today with Chef Paulie's efforts. Our heart and condolences go out to his family and friends here in Philly, Pittsburgh, and of course, Brooklyn. A post shared by Birra (@birra_philly) on Apr 21, 2017 at 5:45am PDT


On "Kitchen Nightmares," the often outspoken Ramsay unleashed on Cerniglia, a 39-year-old husband and father of three. Cerniglia was more than $80,000 in debt at the time his restaurant was featured on the show.