# Youth suicide risk: interplay of sleep behavior and circadian timing with self-critical rumination and self- reassurance

> **NIH NIH P20** · EMMA PENDLETON BRADLEY HOSPITAL · 2021 · $194,710

## Abstract

Project Summary/Abstract
Suicide is the second leading cause of death among 10-34 year-olds. To address this significant public health
concern, this award seeks to advance what is known about the interplay of self-critical rumination ─ defined as
persistent negative-self-evaluation ─ and self-reassurance ─ providing compassion to self with sleep behavior
and circadian timing in the context of youth suicide risk. This award's central hypothesis is that maturational
changes in circadian timing and homeostatic pressure, resulting in increased time interval between biological
sleep clock and actual bedtime and reduced sleep time, could create unique opportunities to engage in self-
critical rumination at night and be linked to decreased ability to use self-reassurance during the day. Our
central methodology is to examine the interface between self-critical rumination and self-reassurance with
sleep and circadian timing and suicidal thoughts and behavior (STB) using ecological momentary assessment
(EMA), gold-standard assessments of circadian timing and sleep behavior, and task-dependent and task-
independent functional magnetic resonance imaging (fMRI) in 100, 10-15 year-old children recruited on a
range of STB from inpatient, outpatient, and community settings. This age group represents a critical
developmental period for these self-referential processes and youth in this age-group experienced a sharp
increase in suicide rates over the last decade. Our research goals are to: (i) test associations of circadian
timing and sleep behavior with self-critical rumination and STB; (ii) define the association between sleep
duration, self-reassurance, and STB (iii) identify fundamental neural correlates of self-critical rumination and
self-reassurance via task-dependent and resting state fMRI. This award is significant because characterizing
brain-behavior mechanisms of the association of circadian timing and sleep behavior with self-critical
rumination, self-reassurance, and STB can contribute to development of novel, mechanistically- informed
interventions to reduce suicide risk in youth. This proposal's innovation is in linking circadian timing and sleep
behavior to severity and time-of-day for the use SCritR and SReas and subsequent STB by integrating (i)
state-of-the-art circadian timing and sleep measures; (ii) EMA techniques for real-life meaning; (iii) task-
dependent and task-independent fMRI techniques; and (iv) focus on a trans-diagnostic sample of youth
selected on the range of STB vs. a single psychiatric disorder. The findings from this proposal will inform future
applications for funding that aim to ultimately develop mechanistically-informed, just-in-time interventions.

## Key facts

- **NIH application ID:** 10090150
- **Project number:** 1P20GM139743-01
- **Recipient organization:** EMMA PENDLETON BRADLEY HOSPITAL
- **Principal Investigator:** Anastacia Y. Kudinova
- **Activity code:** P20 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $194,710
- **Award type:** 1
- **Project period:** 2021-04-06 → 2026-02-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10090150

## Citation

> US National Institutes of Health, RePORTER application 10090150, Youth suicide risk: interplay of sleep behavior and circadian timing with self-critical rumination and self- reassurance (1P20GM139743-01). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10090150. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*