A nurse is caring for a client who is diagnosed with schizophrenia.
Which of the following manifestations should the nurse identify as a negative symptom?

Choice A rationale

Somatic symptom disorder is not typically diagnosed in early childhood. While some somatic complaints can appear in childhood, the full diagnostic criteria for somatic symptom disorder, including the associated distress and impairment, usually emerge later in adolescence or early adulthood. Its manifestation in young children often presents differently, primarily as unexplained physical symptoms.

Choice B rationale

Somatic symptom disorder does not typically have an onset in older adulthood. The average age of onset for somatic symptom disorder is generally in adolescence or early adulthood. While symptoms can persist or fluctuate throughout the lifespan, new onset in older adulthood is less common and warrants thorough medical investigation to rule out organic causes.

Choice C rationale

There is no diagnostic criterion stating that somatic symptom disorder must be diagnosed before 18 years of age. While it often begins in adolescence, diagnosis can occur at any age when the criteria are met. This disorder's diagnostic timeline is based on the presentation of symptoms and associated distress, not a specific age cut-off for initial diagnosis.

Choice D rationale

Somatic symptom disorder is often underdiagnosed in the older population. This is due to several factors, including the presence of multiple comorbid medical conditions that can obscure the diagnosis, reluctance by healthcare providers to attribute symptoms to psychological factors in older adults, and older adults' tendency to focus on physical complaints rather than psychological distress.

Choice A rationale

Individuals with binge-eating disorder often experience significant shame, guilt, and distress after binge episodes. This statement reflects the profound negative emotional impact, including feelings of defeat and a desire for social withdrawal, which are characteristic psychological consequences of uncontrolled overeating in this disorder.

Choice B rationale

Binge eating is typically driven by emotional dysregulation, stress, or a sense of loss of control, rather than being a planned reward system. While some might associate food with comfort, the compulsive nature of binges in this disorder is not typically a deliberate self-reward mechanism for task completion.

Choice C rationale

A hallmark of binge-eating disorder is a feeling of being out of control during eating episodes. Clients typically report an inability to stop eating once a binge starts, regardless of satiety cues or desires to control the pace, indicating a loss of regulatory control over food intake.

Choice D rationale

While hunger can precede eating, binges in binge-eating disorder are often triggered by emotional states, stress, or psychological factors rather than solely physiological hunger. The overwhelming urge to consume large quantities of food often transcends normal hunger cues, becoming a maladaptive coping mechanism.