Seventeen-year-old Kisha often felt very depressed and hopeless. She had several oddities at home--rearranging cutlery and turning light switches on and off--and these oddities caused annoyance with family members. She had always tried to live up to every standard (academic, religious, familial) that was placed upon her. Before every exam, she lined up her pencils, erasers, and notebooks exactly the same way, each two fingers apart. She felt a strong urge to complete this task because if she didn't, she would fail her exam. At times, the thought of failing and believing that she is a failure and therefore incapable of success made her ill. Her mother took her to see a counselor. What could be Kisha's diagnosis?