Psychodynamic Formulation — MRCPsych Paper B MCQ
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Correct answer: E — Links developmental relationship patterns and unconscious defensive processes to recurring present difficulties
Explanation lettering: E = shown as A · C = shown as B · A = shown as C · B = shown as E
B is correct. A psychodynamic formulation offers a developmental account of how earlier relationships and emotional experiences contribute to internal relational patterns, unconscious conflicts and defences that recur in current symptoms and relationships. These patterns may also emerge through transference in treatment. C describes a cognitive formulation based on beliefs, automatic thoughts and their consequences. D describes behavioural functional analysis using antecedents and consequences. E is a structured risk formulation rather than a psychodynamic formulation. A is primarily descriptive: recording symptom severity and frequency does not explain the psychological mechanisms that generated or maintain the presentation.
Reference: Royal College of Psychiatrists. About psychotherapy, section 'Psychodynamic therapy'. Current webpage accessed 19 August 2026. https://www.rcpsych.ac.uk/members/your-faculties/medical-psychotherapy/about-psychotherapy/