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Arthur, a 22-year-old community college student, visited his primary care physician complaining that he had been experiencing occasional “spells” over the past two months. During the episodes he felt anxious, dizzy, nauseous, had intense headaches, and sometimes had difficulty breathing. After having a “spell” Arthur worried about when the next one would occur. A thorough medical exam and a series of laboratory tests found that nothing was physically wrong with Arthur. The physician suspected that Arthur was suffering from XXXXXX and asked if he had been expe­riencing increased stress in recent weeks. Arthur acknowledged that he was somewhat anxious about graduating from college in a month; however, he doubted that his “spells” could have an emotional basis since the symptoms were mostly physical. Arthur was the first person in his family ever to have to gone to college, and he had done very well in school despite being in a difficult engineering program. He had already been hired by a bioengineering firm near his hometown and was nervous about beginning his professional life. Arthur explained that his parents were extremely proud of his success and that his entire extended family was planning to attend his graduation.