(Select All That Apply): A nurse is providing care for a client with suspected major depressive disorder (MDD). Which of the following are risk factors for developing MDD? Select all that apply.

Choice A rationale:

Acetylcholine and gamma-aminobutyric acid (GABA) are not the primary neurotransmitters involved in regulating mood, motivation, reward, cognition, and stress response. Acetylcholine plays a role in memory and muscle control, while GABA is an inhibitory neurotransmitter that helps regulate anxiety and sleep. These neurotransmitters are not as closely associated with the functions mentioned in the question.

Choice B rationale:

Glutamate is a major excitatory neurotransmitter in the central nervous system, and epinephrine (also known as adrenaline) is a hormone that prepares the body for the fight-or-flight response. While both glutamate and epinephrine play important roles in various physiological responses, they are not primarily responsible for regulating mood, motivation, reward, cognition, and stress response as mentioned in the question.

Choice C rationale:

Serotonin, dopamine, and norepinephrine are all key neurotransmitters involved in the regulation of mood, motivation, reward, cognition, and stress response. These neurotransmitters have been extensively studied in the context of mood disorders like Major Depressive Disorder (MDD). Serotonin is often associated with feelings of well-being and happiness, dopamine is linked to pleasure and reward pathways, and norepinephrine is involved in the body's stress response. Imbalances in these neurotransmitters have been implicated in the development of mood disorders.

Choice D rationale:

Endorphins and oxytocin are important neurotransmitters, but they are not as directly related to the regulation of mood, motivation, reward, cognition, and stress response as the neurotransmitters mentioned in choice C. Endorphins are known for their role in pain modulation and feelings of pleasure, while oxytocin is often referred to as the "bonding hormone" and is associated with social connections and childbirth.

Choice A rationale:

Genetic predisposition refers to a person's susceptibility to certain conditions based on their genetic makeup. While genetics can play a role in predisposing someone to depression, it is not considered a psychosocial factor. Genetic factors are biological in nature and do not directly involve social and psychological influences.

Choice B rationale:

The role of stress and life events is a significant psychosocial factor related to depression. Stressful life events, such as trauma, loss, or major life changes, can trigger or exacerbate depressive episodes in susceptible individuals. The interaction between these external stressors and an individual's psychological responses is a key aspect of psychosocial factors.

Choice C rationale:

Interpersonal relationships are another important psychosocial factor linked to depression. Poor interpersonal relationships, social isolation, and conflicts with friends or family can contribute to feelings of loneliness and despair, increasing the risk of developing depression.

Choice D rationale:

Cognitive factors, including negative thought patterns and distorted thinking, are considered psychosocial contributors to depression. Cognitive theories of depression emphasize how an individual's thought processes, self-perception, and interpretation of events can influence their emotional state. Dysfunctional thought patterns, such as excessive self-criticism or hopelessness, can contribute to the development and maintenance of depressive symptoms.

Choice E rationale:

Neurotransmitter imbalances are not psychosocial factors. They are more related to the biological underpinnings of depression rather than the social and psychological influences explored in psychosocial factors.