A 28-Year Old Woman Comes to the Office for Follow-Up

A 28-year old woman comes to the office for follow-up.  She was seen a month earlier for evaluation of a year-long history of fatigue and leg pain.  The patient described "feeling tired all the time" and a sensation of heaviness and aching in both legs, unrelated to exertion.  Laboratory test results, including complete blood count, iron level, comprehensive metabolic panel, erythrocyte sedimentation rate, and TSH are normal, and she says, "my other doctor also said all my tests showed nothing abnormal."  The patient has a history of childhood attention deficit hyperactivity disorder, treated with methylphenidate but has not required any medication since high school.  During college, she received supportive counseling for 2 months after being raped.  The patient does not smoke.  She drinks 1 or 2 glasses of wine or smokes marijuana most evenings to "relax after work."  Family history is significant for bipolar disorder in her maternal grandmother.  Vital signs are stable, and physical examination is unremarkable.  The patient describes her mood as "fine" and has a full range of affect.  Which of the following historical risk factors is most consistent with this patient's diagnosis?

A) Family history of bipolar disorder
B) History of alcohol and drug use
C) History of attention deficit hyperactivity disorder
D) History of sexual trauma
E) Patient's educational level