skip to main content

Diagnostic Overshadowing — MRCPsych Paper B MCQ

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

EasyIntellectual DisabilityDiagnostic OvershadowingMRCPsych Paper B

Which statement best defines diagnostic overshadowing in a person with intellectual disability (learning disability)?

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

Reveal the answer and explanation

Correct answer: C — Attributing new symptoms or behavioural changes to intellectual disability without adequately investigating another physical or mental disorder

Diagnostic overshadowing is the erroneous attribution of new symptoms, signs or behavioural changes to a person's intellectual disability, rather than adequately considering and investigating a separate physical or mental disorder. This can delay or prevent diagnosis and treatment. Option B describes a justified conclusion reached after assessment, not overshadowing. Option E describes diagnostic or therapeutic nihilism. Option D defines malingering, in which symptoms are intentionally produced or exaggerated for external gain. Option A describes countertransference, referring to the clinician's emotional responses and their potential influence on care.

Reference: NHS England, RightCare learning disability and aspiration pneumonia scenario, Information point 3: Diagnostic overshadowing, updated 19 February 2024. https://www.england.nhs.uk/long-read/rightcare-learning-disability-and-aspiration-pneumonia-scenario/