A 10-yeаr-оld bоy whо hаd been prescribed fluoxetine (Prozаc) for major depressive disorder presents to the psychiatric emergency department for running in to the street in front of a car on the way home from school. In the ED, he has been selectively mute, but the PMHNP was able to elicit his desire to be dead. He has been medically cleared. Which of the following symptoms often are endorsed or observed for children with MDD compared to adults?