Darien is a patient who may have a comorbidity. His symptoms lead me to believe that he may eventually be diagnosed with obsessive-compulsive disorder and generalized anxiety disorder. Darien's symptoms that indicate OCD are that he has rituals that he must complete and if he doesn't do them, he becomes anxious and is unable to continue with his day. He is, however, aware that these rituals do not really help him but he cannot stop doing them. He also reports feeling anxious most of the day, especially if he cannot perform his rituals, and that he becomes increasingly anxious. He is also unable to stop worrying and feeling anxious. Darien's past could help uncover clues to his current situation. He had a relatively normal childhood. He grew up as an only child and his parents remained married his entire life. Her mother has a history of anxiety. Darien said that during his childhood, he always remembers her constantly worrying about him and also being too involved in his life. His father, on the other hand, was always distant and Darien never really felt like his father enjoyed spending time with him. Darien was always a good student in high school, but he found the added workload of college very difficult. He didn't want to seem like a failure in his parents' eyes, so he would simply drop out of his classes if he felt overwhelmed. That's also when he started making schedules because he thought they would help him deal with his stress levels. Obsessive-compulsive disorders have been found to have many causal factors. Many of them are cultural, and it's possible that religion plays a role in the severity of symptoms, such as obsessive thoughts. Due to Darien's history and heavy involvement... middle of article ......obsessive-compulsive disorder: an examination of outcomes and mediators of change. Journal of Counseling and Clinical Psychology, 81(3), 415-428. doi:10.1037/a0031865Reynolds, SA, Clark, S., Smith, H., Langdon, PE, Payne, R., Bowers, G. and...McIlwham, H. (2013). Randomized controlled trial of parent-enhanced CBT versus individual CBT for obsessive-compulsive disorder in youth. Journal of Counseling and Clinical Psychology, 81(6), 1021-1026. doi:10.1037/a0034429Steketee, G., Quay, S., & White, K. (1991). Religion and guilt in patients with OCD. Journal of Anxiety Disorders, 5(4), 359-367. doi:10.1016/0887-6185(91)90035-RVan Noppen, B. and Steketee, G. (2009). Testing a conceptual model of patient and family predictors of obsessive-compulsive disorder (OCD) symptoms. Behavioral Research and Therapy, 47(1), 18-25. doi:10.1016/j.brat.2008.10.005