A nurse in a mental health clinic is taking a medical history on a client. The nurse should recognize that which of the following factors in the client's history increases their risk for mental illness?

A. School-age: Schizophrenia is rare in children, and early-onset cases before adolescence are uncommon. Symptoms that resemble schizophrenia in children often require further evaluation for other neurodevelopmental disorders.
B. Young adulthood: Schizophrenia typically manifests between late adolescence and early adulthood, usually between ages 18 and 25 in men and slightly later in women. This period is when individuals experience their first psychotic episode.
C. Preschooler: Schizophrenia is extremely rare in preschool-aged children. Symptoms such as hallucinations or disorganized behavior at this age are more likely related to other developmental disorders or trauma.
D. Older adulthood: Late-onset schizophrenia is rare, and when psychotic symptoms emerge in older adults, they are often due to conditions such as dementia, delirium, or medication effects rather than primary schizophrenia.

A. Paranoia is a positive symptom of schizophrenia, characterized by excessive distrust and suspicion. Positive symptoms involve an excess or distortion of normal functions, such as hallucinations or delusions. Paranoia reflects an altered perception of reality rather than a diminished emotional or cognitive function.
B. Distorted beliefs, including delusions, are considered positive symptoms of schizophrenia. These beliefs are false, fixed, and not based on reality, often involving grandiosity, persecution, or somatic concerns. Positive symptoms represent an exaggeration of normal thought processes rather than a reduction in function.
C. Confusion is often associated with cognitive impairment in schizophrenia but is not classified as a negative symptom. Cognitive symptoms include deficits in memory, attention, and executive function, whereas negative symptoms involve the absence of normal emotional or behavioral responses. Confusion is more related to disorganized thinking rather than a loss of function.
D. Lack of emotions, or affective flattening, is a negative symptom of schizophrenia. Negative symptoms involve a reduction in normal functions, such as diminished emotional expression, social withdrawal, and decreased motivation. These symptoms contribute significantly to functional impairment and are often more resistant to treatment than positive symptoms.