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Instructions:

Please read the following information and respond to the questions below:

Amira is a 24-year-old, Pakistani-American woman, who is currently in her third year of college. She presented to her college counseling center reporting long-standing difficulties, including low-self esteem, frequent sadness, and low motivation. She stated to her counselor that she often feels sad and cries (sometimes for no apparent reason) almost every day. She also noted that she has difficulty completing her school work and has fallen behind in her classes. Amira reported that she has struggled with these issues approximately for the past 10 years when she started high school.

Amira stated that she thinks she's "worthless" and worries that she'll never amount to much. She attributed this to a history of academic under-achievement, as she failed out of the first college she attended in her freshman year; she then completed her Associate's degree at community college, but struggled to finish her degree in 4 years. After completing her degree, she worked as a cashier at a grocery store, which she felt she was over-qualified for. She recently decided to return to school and transferred to a local state university; however, she stated that she feels "stupid" for going to college there because "everyone from [her] high school goes there." She reported that this is her first semester at the university and has already missed several classes, not submitted some assignments, and failed a few tests. She is worried she is going to be put on probation or fail out of the school, and she is afraid her parents will be very angry, especially as they are paying for her tuition.

Amira described her parents as very critical and demanding of her and her younger sister (age 20). Her father is a physician and her mother is a lawyer. She noted that she and her sister are close and that they have both struggled with similar issues since high school or so. She also stated that neither she nor her sister are very close to her parents, but feel obligated to live up to their expectations since "they pay for a lot of our stuff." She also identified as lesbian and said that her parents do not approve. In fact, they previously sent her to therapy to convert her from being lesbian to being heterosexual (she stated that this did not help and only made her feel worse). Her parents have threatened to disown her and cut off financial support if she does not "change her lifestyle." She said that she was raised Muslim and that her parents do not support of her sexual orientation because of their religious beliefs.

She also reported that despite knowing some of her classmates, she does not have any friends at school nor does she have many friends outside of school. She stated that she worries about what other people would think if they found out she was lesbian and Muslim.

Questions:

1. Of the disorders covered in this unit's readings, which do you believe Amira shows the most evidence (that is, symptoms) of? Explain why you believe so.
2. Identify relevant psychological, and sociocultural factors that may have contributed to the development of Amira's disorder.
3. What would be the most effective treatment(s) for Amira's disorder?

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