What is Karen's preliminary diagnosis and possible causes? Karen is a 30-year-old single woman. She was referred to a psychiatrist after six visits to her primary care physician complaining of headaches, body aches, sharp pains above her left ear, and a ringing in both ears. She was convinced she had a brain tumor, but a CAT scan revealed no physiological cause. During the interview, Karen mentions that she doesn't like being in a hospital "because being in a hospital puts you at risk for so many other diseases." When pressed, she mentions swine flu, avian flu, and AIDS. Karen does not use illegal substances or alcohol. She carries hand sanitizer and discreetly spritzes it on her hands about every ten minutes or so. Part way through the interview, Karen put on sunglasses "to block the fluorescent rays" from the overhead lamps. Family History: Father died three years ago of cancer. Mother is still alive. Grandmother committed suicide at 31 when mother was eight. Grandfather is still alive, with history of alcoholism.