Which specifier indicates psychotic features that align with negative self-image and guilt in depressive episodes?

The correct answer highlights the importance of understanding the specific nature of psychotic features in the context of depressive episodes. When a depressive episode includes psychotic features that are aligned with a negative self-image and guilt, it is described as "with mood-congruent psychotic features." This means that the content of the delusions or hallucinations is consistent with the themes of the individual's depression, such as feelings of worthlessness, self-derision, or excessive guilt, thereby emphasizing the connection between the mood symptoms and the psychotic experiences.

Mood-congruent psychotic features are distinct in that they complement the overall depressive experience, reinforcing the individual's negative beliefs and feelings about themselves. This can manifest in various ways, such as delusions that reflect profound self-loathing or auditory hallucinations that convey critical or derogatory messages regarding the person’s self-worth. Recognizing these features helps clinicians to better tailor treatment approaches and understand the severity of the depressive episode.

The other options either refer to different types of mood variations or do not specifically emphasize the alignment with negative self-image and guilt as integral to the depressive experience.