# Biological/behavioral rhythms and suicidal behavior: A real-time monitoring study

> **NIH NIH K23** · HARVARD UNIVERSITY · 2021 · $187,031

## Abstract

Project Summary/Abstract
Suicide is the second leading cause of death among adolescents and young adults. To better predict and
prevent suicidal thoughts and behaviors (STBs), identification of proximal, transdiagnostic risk factors that
would serve as viable treatment targets is critically needed. Sleep disturbances represent one such risk factor,
but understanding of why sleep and STBs are associated is lacking. To better understand the link between
sleep and STBs, data are needed on the full 24-h rest-activity cycle, including activity occurring during waking
hours. Alterations in sleep and daytime activity are transdiagnostic features of mental disorders, and are both
regulated by a complex system of biological and behavioral rhythms. However, these variables have rarely
been studied simultaneously or in the context of STBs. In this project, the putative link between the 24-h rest-
activity cycle and STBs will be examined using recent advances in technology (i.e., wearable sensors,
smartphones) to monitor these processes as they unfold in real-time. A sample of suicidal adolescents
(N=100) will be recruited during hospitalization and followed over the high-risk four-week post-hospitalization
period. There are three primary research aims: (1) Examine phenotypes of rest-activity associated with suicidal
ideation/attempt over the study period, and examine the unique variance contributed by rest-activity variables
predicting STBs compared to other well-known factors (e.g., depression), (2) Examine day-to-day associations
between rest-activity and STBs to establish strength of associations and proximal directionality, and (3)
Explore idiographic (i.e., individual-level) results to examine qualitative differences between participants, a
method recently used to identify personalized treatment targets. Results from this project will provide granular
insight into the dynamics between putative transdiagnostic risk factors and STBs, and will shed light on the
viability of these factors as proximal treatment targets for the candidate’s planned R01. The accompanying
training plan is designed to ensure success of the current project and to support growth of the candidate’s
independent program of research focused on understanding, predicting, and intervening upon short-term
suicide risk by building expertise in four areas: (1) Designing, implementing and managing real-time monitoring
studies among high-risk adolescents, (2) Acquiring statistical skills needed to process and analyze intensive
longitudinal data, (3) Expanding content-area expertise in biological and behavioral rhythms regulating the rest-
activity cycle and related processes, and (4) Preparing for a future R01 by gaining knowledge in development
of technology-delivered, personalized interventions for adolescents. This K23 will take place at Harvard
University under the mentorship of: mentor Dr. Matthew Nock, a world-leading adolescent suicide researcher,
co-mentor Dr. Evan Kleiman, who has te...

## Key facts

- **NIH application ID:** 10133735
- **Project number:** 5K23MH120439-02
- **Recipient organization:** HARVARD UNIVERSITY
- **Principal Investigator:** Kelly Zuromski
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $187,031
- **Award type:** 5
- **Project period:** 2020-04-01 → 2024-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10133735

## Citation

> US National Institutes of Health, RePORTER application 10133735, Biological/behavioral rhythms and suicidal behavior: A real-time monitoring study (5K23MH120439-02). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10133735. Licensed CC0.

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