Which symptom includes persistent negative self-perception or excessive guilt?

• A. Feelings of worthlessness/excessive guilt
• B. Insomnia
• C. Appetite changes
• D. Psychomotor retardation

Answer: (A)

Persistent negative self-perception or excessive guilt is a cognitive symptom seen in depressive disorders. In major depressive disorder, individuals often experience feelings of worthlessness or excessive or inappropriate guilt that are out of proportion to the situation and last most days for at least two weeks, contributing to impairment. This symptom is part of the broader set of depressive symptoms (the guilt/worthlessness domain) used to identify a depressive episode. It differs from insomnia (sleep disturbance), appetite changes (weight/appetite fluctuations), and psychomotor retardation (slowed thinking and movement), which are separate symptom categories. The guilt/worthlessness item specifically captures the persistent negative self-view and excessive guilt that clinicians look for when diagnosing depression.