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

> **NIH NIH K23** · EMMA PENDLETON BRADLEY HOSPITAL · 2024 · $54,000

## 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 are 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 youth 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 an alarming increase in suicide rates over the last decade. 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 developing 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 mentors (Drs. Spirito, Armey, Jones, and
Brick) and consultants (Drs. Price and Maratos) have extensive experience to support the proposed training
goals. The Department of Psychiatry and Human Behavior at Brown University is an outstanding environment...

## Key facts

- **NIH application ID:** 10936125
- **Project number:** 3K23MH122587-05S1
- **Recipient organization:** EMMA PENDLETON BRADLEY HOSPITAL
- **Principal Investigator:** Anastacia Y. Kudinova
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $54,000
- **Award type:** 3
- **Project period:** 2020-04-01 → 2025-10-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10936125

## Citation

> US National Institutes of Health, RePORTER application 10936125, Neural Mechanisms Underlying Self-Critical Rumination and Self-Reassurance and Suicidal Thoughts and Behavior in Youth (3K23MH122587-05S1). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10936125. Licensed CC0.

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