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A 14-Year-Old Girl Is Brought to the Clinic Due to Behavioral

question 128

Multiple Choice

A 14-year-old girl is brought to the clinic due to behavioral changes over the last 2-3 months. She has become increasingly angry and easily annoyed, arguing with teachers at school and her mother at home and refusing to do her chores. The patient was previously an honor roll student, but her grades have dropped significantly and she is now failing most subjects. When asked why her grades have dropped, the patient says, "It's been really hard to focus on what the teacher is saying and I have trouble remembering to turn in my homework." Her mother reports that the girl has gained 18.1 kg (40 lb) in the last 3 months. The patient's father is currently unemployed and abuses alcohol. To help with finances, the family moved in with the girl's aunt and uncle 9 months ago. The patient became sexually active 3 months ago, has had 4 lifetime partners, and uses no birth control. She smokes marijuana several times a week but does not use tobacco or alcohol. BMI is 33 kg/m². On mental status examination, the patient appears fidgety and avoids eye contact during the examination. She still enjoys playing with her little brother and has no thoughts of death or suicide. Which of the following is the most likely explanation for this patient's change in behavior?

Definitions:

Ink Color

The property or characteristic of an ink that defines its visual perception, which can influence cognitive processing in tasks such as the Stroop test.

Preattentive Process

Cognitive processing that occurs without conscious awareness, quickly analyzing basic features of stimuli in the environment.

Cognition

The mental action or process of acquiring knowledge and understanding through thought, experience, and the senses.

Preattentive Processes

Cognitive processes that occur without conscious awareness, automatically extracting certain elements from the environment.