(Select All That Apply): A nurse is educating a client about the psychosocial factors that can influence or be influenced by depression. Which of the following factors are associated with depression and its effects on cognitive processes? Select all that apply.

Choice A rationale:

Increased interest in activities is not consistent with the clinical presentation of MDD. In fact, a hallmark symptom of MDD is anhedonia, which involves a reduced interest or pleasure in most activities.

Choice B rationale:

Weight gain is not typically associated with MDD. In contrast, significant changes in appetite and weight loss are more common symptoms, often accompanied by feelings of worthlessness or guilt related to body image.

Choice C rationale:

Excessive guilt and self-blame are common cognitive and emotional symptoms of MDD. Individuals with MDD tend to have a negative self-perception and may blame themselves for their difficulties.

Choice D rationale:

Insomnia, or difficulty falling asleep or staying asleep, is a common sleep disturbance associated with MDD. Sleep problems can exacerbate the symptoms of depression and impact overall well-being.

Choice E rationale:

Elevated mood and increased energy are actually more indicative of conditions like bipolar disorder or manic episodes, where there are distinct periods of abnormally elevated mood, known as mania or hypomania.

Choice A rationale:

Social support refers to the network of family, friends, and community that provide emotional and practical assistance. Depression can be influenced by inadequate social support, as having a strong support system can buffer against the development and exacerbation of depressive symptoms.

Choice B rationale:

Personalization involves attributing external events to oneself, often in a negative manner. While this cognitive distortion is relevant to depression, it is not mentioned in the question stem and does not directly relate to cognitive processes influenced by depression.

Choice C rationale:

Cognitive distortions are irrational and negative thought patterns that are common in depression. These distortions contribute to the maintenance of depressive symptoms. Examples include all-or-nothing thinking, overgeneralization, and catastrophizing.

Choice D rationale:

Catastrophizing involves magnifying the negative significance of events. While it can contribute to depressive thought patterns, it is not as central to cognitive processes influenced by depression as cognitive distortions are.

Choice E rationale:

Interpersonal relationships are affected by depression and can also contribute to its development. The question does not focus on the effects of depression on relationships, but rather on the factors that can influence or be influenced by depression.