Symptoms of postpartum psychosis appear to be triggered by: a. the sudden loss of social status a woman experiences immediately after giving birth. b. maternal diabetes, which is at its worst during and after birth. c. a large shift in hormones occurring just after childbirth. d. feelings of diminished worth, combined with anxiety related to child care.

The correct answer is c. Postpartum psychosis is an extreme mental illness in which a new mother does not respond well emotionally to her new baby. This is not a voluntary disorder, which cancels out the first multiple choice option, and mothers who have diabetes actually seem to be protected from it, invalidating the second multiple choice option. The fourth multiple choice option seems to better describe postpartum depression, which is not the same as postpartum psychosis (the former is a depressive disorder, while the latter is a bipolar one).