Couc667

Presentation 24-year-old Caucasian female First-generation college student Intense fear of negative evaluation in social and academic settings Avoidance of speaking in class, social events, and meeting new people Physiological symptoms: rapid heartbeat, sweating, trembling, nausea Cognitive symptoms: low self-confidence, rumination about past conversations Functional impairment: academic difficulties and social isolation Predisposition Factors Biological Possible genetic vulnerability to anxiety disorders (not yet assessed) Heightened physiological arousal in social situations Psychological Low self-esteem Fear of embarrassment and rejection Cognitive distortions (mind reading, catastrophizing, overgeneralization) Social First-generation college student status Limited social support on campus Increased academic pressure and performance expectations Spiritual No spiritual or religious factors reported at this time Cultural Cultural emphasis on academic success Pressure to meet family expectations Possible internalized belief that failure reflects personal inadequacy Precipitants Transition to college during freshman year Increased exposure to social and performance-based academic demands Fear of judgment in classroom participation and peer interactions Protective Factors and Strengths Insight into symptoms Motivation to succeed academically No substance use reported Supportive family (though high expectations present) Cognitive capacity intact Willingness to engage in assessment and treatment Pattern (Maladaptive) Avoidance of social and academic situations Safety behaviors (not speaking, avoiding eye contact, social withdrawal) Rumination following interactions Reinforcement of anxiety through avoidance Perpetuants Avoidance maintains anxiety symptoms Negative self-talk and distorted beliefs Reduced opportunities for corrective social experiences Ongoing family pressure to succeed Lack of prior mental health intervention Plan (Treatment) SMART Goals Reduce avoidance behaviors in academic settings within 12 weeks Increase class participation frequency gradually Decrease self-reported anxiety severity during social interactions Treatment Focus Social anxiety symptoms Cognitive distortions Behavioral avoidance patterns Academic functioning and self-efficacy Interventions Cognitive Behavioral Therapy (CBT) Cognitive restructuring Graduated exposure to feared social situations Skills training for assertive communication Obstacles High avoidance motivation Fear of short-term symptom increase during exposure Family expectations potentially reinforcing perfectionism Prognosis Good, given insight, motivation, and absence of chronic comorbid conditions Prognosis improves with consistent engagement in CBT and exposure-based interventions Case: Emily is a 24-year-old Caucasian female and first-generation college student who reports intense fear of being judged or embarrassed in social and academic settings. She avoids speaking in class, attending social events, and meeting new people. Emily experiences rapid heartbeat, sweating, trembling, and nausea during social interactions. She reports low self-confidence and frequent rumination about past conversations. Her symptoms began during her freshman year and have worsened over time, leading to academic difficulties and social isolation. Emily has no prior mental health treatment history and reports strong pressure from her family to succeed academically. The main challenge was that the AI output lacked cultural context, family dynamics, and cognitive distortions related to social anxiety. I would grade it a B because it accurately reflects core symptoms but lacks sufficient psychosocial depth. I would improve it by adding symptom duration, functional impairment, DSM-5-TR criteria mapping, coping strategies, protective factors, and possible comorbid depression or generalized anxiety.