# Neural Mechanisms Underlying Self-Critical Rumination and Self-Reassurance and Suicidal Thoughts and Behavior in Youth

> **NIH NIH K23** · EMMA PENDLETON BRADLEY HOSPITAL · 2021 · $197,328

## Abstract

Suicide is the second leading cause of death among 10-34 year-olds. Aligning with the NIMH's Prioritized
Agenda for Suicide Prevention Research, this K23 career development award seeks to advance what is known
about the brain/behavior mechanisms underlying self-critical rumination ─ defined as persistent negative-self-
evaluation ─ and self-reassurance ─ providing compassion to self. This K23's central hypothesis is that
circuit alterations in the dorsolateral and dorsomedial prefrontal cortex, dorsal anterior cingulate, and insula
underlying self-critical rumination and self-reassurance is associated with increased suicidal thoughts and
behavior (STB) in adolescents. Our central methodology is to examine self-critical rumination and self-
reassurance using task-dependent and task-independent functional magnetic resonance imaging (fMRI) and
ecological momentary assessment (EMA) in 90 12-15 year-old girls recruited on the range of STB. 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 focus on only girls is due to
greater prevalence of self-criticism among females compared to males, but we plan to examine potential sex-
differences in future studies. This K23's research goals are to: (i) test the associations between in vivo self-
critical rumination, self-reassurance, and STB; (ii) identify neural mechanisms underlying self-critical rumination
and self-reassurance; (iii) integrate the findings from the scanner with STB assessed in adolescents' real world
environment. This K23's career development goals are to gain hands-on mentorship with (i) task-dependent
and task-independent fMRI to assess circuit function; (ii) EMA for better real-world assessment of self-critical
rumination and self-reassurance; (iii) statistical approaches for imaging and EMA data; (iv) professional
development and collaboration skills. This K23 is significant, because identifying specific neural mechanisms
underlying the interplay between self-critical rumination, self-reassurance, and STB can help ascertain which
teens are at a greater risk for STB and contribute to development of novel, mechanistically-informed
interventions. This study, combined with the completion of proposed training goals, will effectively propel the
candidate towards establishing an independent program of research focused on identifying bio-behavioral
mechanisms and developing preventative interventions for youth suicide risk. This K23 is innovative because
this will be the first project to identify specific neural mechanisms of self-critical rumination and self-
reassurance in adolescents focusing on: (i) identifying construct-specific neural mechanisms; (ii) a trans-
diagnostic sample of teenagers selected on the range of STB; (iii) integration of imaging and EMA techniques.
The proposed mentors (Drs. Dickstein, Armey, Jones, and Brick) and consultants (...

## Key facts

- **NIH application ID:** 10117045
- **Project number:** 5K23MH122587-02
- **Recipient organization:** EMMA PENDLETON BRADLEY HOSPITAL
- **Principal Investigator:** Anastacia Y. Kudinova
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $197,328
- **Award type:** 5
- **Project period:** 2020-04-01 → 2025-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10117045

## Citation

> US National Institutes of Health, RePORTER application 10117045, Neural Mechanisms Underlying Self-Critical Rumination and Self-Reassurance and Suicidal Thoughts and Behavior in Youth (5K23MH122587-02). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10117045. Licensed CC0.

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