A nurse is providing information regarding the social determinants of mental health and persons with serious mental illnesses (SMI). Which of the following pieces of information should the nurse share during the presentation?

A. "Were you avoiding your friend so that you could hear the voices more clearly?" This response may imply blame or judgment and could be perceived as dismissive of the client’s experience. It does not provide a supportive or informative response to the client’s concern.
B. "That is very interesting. We are not sure why people start to isolate themselves." While it acknowledges the client's statement, this response does not provide any useful information or context about the relationship between isolation and the onset of schizophrenia symptoms.
C. "Do you think of yourself as more of an introvert? That makes a difference with how you socialize." This response shifts the focus to personality traits rather than addressing the symptoms of schizophrenia and their impact on social behavior. It may minimize the significance of the client’s experience with isolation.
D. "Before symptoms of schizophrenia begin, people often isolate themselves. This is an early warning." This response provides valuable information about the relationship between isolation and the onset of schizophrenia symptoms. It normalizes the client’s experience and helps them understand that social withdrawal can be a sign of emerging symptoms, fostering a better understanding of their condition.

A. A history of self-injurious behavior. While self-injurious behavior can be associated with various mental health conditions, it is not specifically identified as a risk factor for dissociative identity disorder (DID).
B. A history of schizophrenia. Schizophrenia is a distinct mental health disorder characterized by psychotic symptoms, and while individuals with schizophrenia may experience dissociation, it is not considered a direct risk factor for DID.
C. Borderline personality disorder. While there is some overlap between symptoms of borderline personality disorder and dissociative symptoms, having borderline personality disorder itself is not a primary risk factor for developing DID.
D. History of trauma during the developmental years. A significant risk factor for dissociative identity disorder is a history of severe trauma or abuse during childhood, particularly chronic emotional, physical, or sexual abuse. This trauma can disrupt normal psychological development and contribute to the fragmentation of identity characteristic of DID.