Kara Case Study: Social Anxiety Disorder and OCD Alarm Clock Ritual – DSM-5-TR Diagnostic Reasoning Assignment
Psychology students frequently search for clear guidance on analyzing a college senior like Kara who shows sudden avoidance of social settings and repetitive checking rituals after grief and a breakup to meet DSM-5-TR criteria while addressing cultural factors and two theoretical models in a concise 300-word submission.
Case Study
Kara, a 22-year-old college senior, has recently begun avoiding her normal routines. Such patterns often appear in students facing major life transitions and can signal the need for careful clinical attention. Once a confident student and leader in campus ministries, she now skips classes and avoids crowded places like the dining hall or student center. She experiences intense fear in social situations, especially when she believes others are watching her.
Her heart races, she begins to sweat, and she becomes consumed by thoughts that she will embarrass herself or say something “stupid.” Recent data from campus mental health centers confirm that similar symptoms have risen among undergraduates dealing with loss since 2020.
Kara has also developed a nightly ritual where she checks her alarm clock exactly 10 times before going to bed. If she loses count or becomes distracted, she must start over. She is aware that this behavior is excessive but says, “If I don’t do it, I can’t sleep.” These symptoms began following a difficult year in which she lost a close friend unexpectedly and experienced a breakup. She reports feeling “stuck,” hyperaware of others’ judgment, and exhausted by her thoughts and routines.
Assignment Instructions
Read the case study carefully, then complete the following assessment tasks. Faculty designed the prompt to help students practice applying module concepts directly to real-world presentations. Use concepts and terminology from Module 4 content in your responses. Your submission should be 1 page double-spaced (approximately 300 words) and include in-text citations from course readings or the DSM-5-TR.
Assessment Questions
- Diagnostic Reasoning (8 pts)
- Is there a clinically significant disturbance in Kara’s behavior or thoughts?
- What dysfunctions are evident?
- How do culture and deviance from norms help or hinder the diagnostic process?
- Cultural & Social Context (5 pts)
- How might Kara’s role as a student leader and involvement in faith communities impact her experience of anxiety or her willingness to seek help?
- Historical Comparison (4 pts)
- How has the understanding and treatment of anxiety and compulsive disorders changed over time?
- Perspective Analysis (4 pts)
- Choose two psychological models (e.g., cognitive-behavioral, biological, psychodynamic) and describe how each might explain Kara’s symptoms.
- Personal Reflection (4 pts)
- What did you learn about anxiety and OCD that may help you respond compassionately to others struggling with these disorders?
Rubric
| Criteria | Ratings | Pts | ||
|---|---|---|---|---|
| Diagnostic Reasoning | 8 pts Excellent (Full Points) Thoughtful use of DSM-5-TR criteria; clearly explains clinical judgment |
4 pts Satisfactory Some DSM terms used, basic explanation |
0 pts Needs Work Vague or incorrect use of terms |
8 pts |
| Cultural and Social Context | 5 pts Excellent (Full Points) Clear explanation with relevant cultural insight |
3 pts Satisfactory Limited cultural analysis |
0 pts Needs Work Lacks cultural relevance or depth |
5 pts |
| Historical Comparison | 4 pts Excellent (Full Points) Strong historical reference; compares then vs. now |
2 pts Satisfactory Basic mention of historical view |
0 pts Needs Work No meaningful historical link |
4 pts |
| Perspective Analysis | 4 pts Excellent (Full Points) Accurately compares 2 models with examples |
2 pts Satisfactory General differences noted |
0 pts Needs Work Misunderstands theoretical models |
4 pts |
| Personal Reflection | 4 pts Excellent (Full Points) Thoughtful and personally relevant insight |
2 pts Satisfactory Generic response |
0 pts Needs Work Off-topic or superficial |
4 pts |
| Total Points: 25 | ||||
(Example Essay – Approximately 300 Words)
Yes, Kara shows a clinically significant disturbance because her avoidance of classes and social spaces plus the ten-fold alarm clock checking clearly impair academic performance and daily life while causing marked distress. Evident dysfunctions include physiological arousal during perceived scrutiny, cognitive preoccupation with embarrassment, and compulsive repetition that she recognizes as excessive yet cannot stop without anxiety. Culture and norms may hinder diagnosis in faith-based circles where mental health struggles sometimes carry stigma, yet her prior leadership role could also open doors to peer support if framed as a shared human experience.
Historically, clinicians once grouped obsessive-compulsive patterns under anxiety disorders until DSM-5-TR created a separate obsessive-compulsive and related disorders chapter to reflect distinct neural pathways and treatment responses. A cognitive-behavioral model explains Kara’s symptoms through distorted beliefs that social mistakes equal total failure and that rituals temporarily reduce fear, while a biological model points to possible serotonin imbalances heightened by recent grief. I learned that anxiety and OCD leave people exhausted by invisible mental loops, so responding compassionately means listening first and gently suggesting evidence-based help rather than rushing to fix. (Luan et al., 2022) https://pmc.ncbi.nlm.nih.gov/articles/PMC9391929/
Students who complete this assignment gain practical skills in applying DSM-5-TR criteria to realistic campus scenarios while practicing cultural humility.
Recent state-of-the-art reviews confirm that integrated cognitive-behavioral and biological approaches now achieve better outcomes for overlapping social anxiety and obsessive-compulsive presentations in young adults. Campus counseling centers report higher demand for services that address both grief triggers and ritual maintenance, underscoring why Module 4 material remains essential. Faculty can extend the discussion by inviting guest speakers from faith-based mental health initiatives to illustrate real-world adaptations of these diagnostic frameworks.
References
Guo, S. (2025) Impact of self-identity on social anxiety among college students: a moderated mediation model. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC12343500/ (Accessed: 5 April 2026).
Luan, Y.S. et al. (2022) The experience among college students with social anxiety disorder in social situations: a qualitative study. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC9391929/ (Accessed: 5 April 2026).
Carpita, B. et al. (2020) ‘Overlapping features between social anxiety and obsessive-compulsive spectrum in a clinical sample and in healthy controls: toward an integrative model’, CNS Spectrums. Available at: https://www.cambridge.org/core/journals/cns-spectrums/article/overlapping-features-between-social-anxiety-and-obsessivecompulsive-spectrum-in-a-clinical-sample-and-in-healthy-controls-toward-an-integrative-model/A54E66CB3803B5D1B4EBA075F68E7663 (Accessed: 5 April 2026).
Endres, D. et al. (2025) ‘Obsessive-compulsive disorder – A state-of-the-art review’, Neuroscience & Biobehavioral Reviews, 177. Available at: https://www.sciencedirect.com/science/article/abs/pii/S0149763425003215 (Accessed: 5 April 2026).
Abramowitz, J.S. (2018) ‘Are the Obsessive-Compulsive Related Disorders a distinct category? A critical examination of the new DSM-5 category’, Behaviour Therapy, 49(1), pp. 1-11. Available at: https://www.sciencedirect.com/science/article/abs/pii/S0005789417300655 (Accessed: 5 April 2026).
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- Compose a 300-word double-spaced analysis of Kara’s social anxiety disorder and OCD case study using DSM-5-TR criteria, cultural context, historical comparison, two psychological models, and personal reflection for this Module 4 psychology assignment.
- Write a one-page double-spaced submission (approximately 300 words) addressing diagnostic reasoning, cultural factors, historical changes, perspective analysis, and reflection on Kara’s anxiety and compulsive ritual case study.
- Complete assessment tasks on Kara’s case study with DSM-5-TR citations, cultural insight, historical trends, two models, and compassionate reflection in a concise college psychology assignment.
Assignment (Module 5 – Week 6 Discussion Post)
Module 5 Assignment: Evidence-Based Treatment Planning for Anxiety and Obsessive-Compulsive Disorders. Students will build on the Kara case by proposing a multi-session cognitive-behavioral intervention plan that incorporates cultural adaptations for faith-based students and includes measurable outcomes for symptom reduction. Post a 400-word initial response that cites at least two peer-reviewed sources published after 2020 and reply to two classmates with specific suggestions for implementation challenges. Submission opens Monday and closes Sunday; late posts lose 10% per day.