Sherry is a 17-year-old Black high school senior. She is from an upper-middle-class family where academic and career success are extremely important, as is their religion. She is the third of five children. Until recently she was always a good student, hardworking, but somewhat self-critical. She is reported to be shy but always had several friends and has dated occasionally in the past. During the summer before her senior year, Sherry went out of state to an academic camp at a prestigious college. While there she began to experience auditory hallucinations and delusions. She also began to act in bizarre ways and withdraw from people. She was hospitalized for 1 month shortly after returning home. She is now reportedly unable to complete work at school, and her promising future appears questionable. There is no history of psychiatric illness in the family. Cognitively she reports experiencing auditory, persecutory hallucinations and delusions as well as frequent cognitions like, "I'm no good," "I can't do anything," "I'll always be this way." Affectively she had flat affect and anxiety related to interpersonal situations and tasks and the content of the hallucinations and delusions. Interpersonally she is withdrawn and socially isolated. Behaviorally she is inactive and her basic self-care is severely limited. .

1. Sherry is a 17-year-old Black high school senior. She is from an
upper-middle-class family where academic and career success
are extremely important, as is their religion. She is the third of
five children. Until recently she was always a good student,
hardworking, but somewhat self-critical. She is reported to be
shy but always had several friends and has dated occasionally in
the past. During the summer before her senior year, Sherry went
out of state to an academic camp at a prestigious college. While
there she began to experience auditory hallucinations and
delusions. She also began to act in bizarre ways and withdraw
from people. She was hospitalized for 1 month shortly after
returning home. She is now reportedly unable to complete work
at school, and her promising future appears questionable. There
is no history of psychiatric illness in the family. Cognitively
she reports experiencing auditory, persecutory hallucinations
and delusions as well as frequent cognitions like, "I'm no good,"
"I can't do anything," "I'll always be this way." Affectively she
had flat affect and anxiety related to interpersonal situations
and tasks and the content of the hallucinations and delusions.
Interpersonally she is withdrawn and socially isolated.
Behaviorally she is inactive and her basic self-care is severely
limited.