skip to main content

Borderline Personality Disorder — MRCPsych Paper B MCQ

Instant feedback + full explanation. One question, done properly.

ModeratePersonality DisordersBorderline Personality DisorderMRCPsych Paper B

A 30-year-old woman with emotionally unstable personality disorder (borderline type) has recurrent self-harm, which she identifies as a treatment priority. A specialist service is considering psychological treatment. Which proposed treatment plan is inconsistent with NICE CG78?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: D — Brief psychoanalytic psychotherapy for 8 weeks outside a supervised structured programme

Explanation lettering: C = shown as A · A = shown as B · D = shown as C · E = shown as D · B = shown as E

E is inconsistent with NICE CG78. NICE advises against psychological interventions lasting less than 3 months when they are used specifically for borderline personality disorder or its symptoms outside a service providing a shared, explicit theoretical model, structured care and therapist supervision. The proposed 8-week intervention breaches both the duration and service-structure elements. Option A is particularly appropriate because NICE advises considering comprehensive DBT for women when reducing recurrent self-harm is a priority. MBT, schema-focused therapy and psychodynamic interpersonal therapy are not individually endorsed as universal first-line treatments by CG78, but longer, manualised versions delivered within an appropriately structured and supervised programme are compatible with its general psychological-treatment principles.

Reference: National Institute for Health and Care Excellence. Borderline personality disorder: recognition and management, CG78, recommendations 1.3.4.1–1.3.4.5, 2009. https://www.nice.org.uk/guidance/cg78/chapter/Recommendations