# Sleep and circadian timing and suicidal thoughts and behavior in youth: The role of self-referential processing and its neural correlates

> **NIH NIH P20** · EMMA PENDLETON BRADLEY HOSPITAL · 2024 · $163,462

## Abstract

Suicide is the second leading cause of death among 15-24-year-olds. To address this significant public 
health concern, this study seeks to advance our understanding of the daily interplay of sleep and the 
biological clock and how teens think of themselves with their thoughts of suicide. This proposal's central 
hypothesis is that a prolonged time interval between feeling sleepy and actual bedtime creates unique 
opportunities to engage in nighttime self-critical rumination-repetitive negative thinking about self and 
diminishes teens' ability to self-reassure (supportive of self). We also investigate how neural processing of 
self-criticism and self-reassurance varies based on the circadian timing, potentially affecting their 
subsequent sleep and next-day suicidal thoughts. Our central methodology is to examine the interface of 
sleep and biological clock and nighttime self-critical rumination and self-reassurance with next-day 
suicidal thoughts using ecological momentary assessment (EMA}, gold-standard assessments of 
circadian timing and sleep, and functional magnetic resonance imaging (fMRI) in 60, 13-17-year-old 
youth. Teens will be recruited on a range of suicidal thoughts from the inpatient, partial hospitalization, 
and outpatient care, as well as the community. This age group represents a critical developmental period 
for self-referential processes and sleep changes, and youth in this age group experienced a sharp 
increase in suicide rates over the last decade. This proposal innovatively links nighttime self-critical 
rumination and self-reassurance with next-day subsequent suicidal thinking via circadian rhythms and 
sleep by integrating (i) state-of-the-art biological clock and sleep measures for objectivity; (ii) EMA 
techniques for real-life meaning; and (iii) fMRI techniques to identify neural treatment targets. This 
research is significant because characterizing brain-behavior mechanisms of the association of circadian 
timing and sleep behavior with nighttime self-critical rumination, self-reassurance, and next-day suicidal 
thinking can contribute to developing novel mobile interventions that target self-referential thinking and 
sleep to reduce suicide risk in youth.

## Key facts

- **NIH application ID:** 11084657
- **Project number:** 5P20GM139743-04
- **Recipient organization:** EMMA PENDLETON BRADLEY HOSPITAL
- **Principal Investigator:** Anastacia Y. Kudinova
- **Activity code:** P20 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $163,462
- **Award type:** 5
- **Project period:** 2024-03-01 → 2026-02-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/11084657

## Citation

> US National Institutes of Health, RePORTER application 11084657, Sleep and circadian timing and suicidal thoughts and behavior in youth: The role of self-referential processing and its neural correlates (5P20GM139743-04). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/11084657. Licensed CC0.

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