Distress Tolerance Skills — MRCPsych Paper B MCQ

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EasyPsychotherapyDistress Tolerance SkillsMRCPsych Paper B

A 22-year-old woman with borderline personality disorder attends a dialectical behaviour therapy skills group. During episodes of overwhelming arousal, she is taught to hold an ice cube or splash cold water on her face and then undertake brief intense physical exercise. Which DBT skills-training module includes these crisis-survival techniques?

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Correct answer: B — Distress tolerance

The correct answer is B, distress tolerance. Cold-water or ice exposure and intense exercise are components of TIPP: Temperature change, Intense exercise, Paced breathing and Paired muscle relaxation. TIPP is used for short-term crisis survival by reducing extreme physiological arousal without resorting to harmful or impulsive behaviour. Mindfulness develops non-judgemental present-moment awareness. Emotion regulation addresses understanding emotions and reducing longer-term emotional vulnerability. Interpersonal effectiveness concerns relationships, assertiveness and maintaining self-respect. Behavioural chain analysis examines the antecedents, links and consequences of a target behaviour; it is a DBT assessment and intervention strategy rather than one of the four standard skills modules.

Reference: Manchester University NHS Foundation Trust. DBT distress tolerance skills: TIPP. 2020. https://mft.nhs.uk/app/uploads/2020/04/DBT-coronavirus.pdf