Behavioural Activation — MRCPsych Paper B MCQ

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EasyPsychotherapyBehavioural ActivationMRCPsych Paper B

A patient with depression is undertaking behavioural activation. They schedule and complete personally meaningful activities even when motivation is low, rather than waiting for their mood to improve. Over subsequent weeks, withdrawal decreases and mood improves. Which change mechanism is most characteristic of this therapy?

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Correct answer: A — Reduced avoidance and increased rewarding activity

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

C is correct. Behavioural activation targets the reciprocal cycle of low mood, avoidance, inactivity and withdrawal. The patient acts according to planned, meaningful goals without waiting to feel motivated, thereby reducing avoidance and increasing engagement with potentially rewarding activities; improvement in mood follows behavioural change. Modification of maladaptive cognitions is characteristic of cognitive restructuring within CBT. Improved understanding of mental states is central to mentalisation-based treatment. Reduction of conditioned fear is the principal mechanism targeted by exposure-based interventions. Interpretation of transference patterns belongs to psychodynamic or psychoanalytic psychotherapy rather than behavioural activation.

Reference: NHS Education for Scotland. Psychology and Behavioural Activation, section 'What is Behavioural Activation', 2024. https://www.nes.scot.nhs.uk/nes-current/nes-psychology-and-behavioural-activation/