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Schema Modes BPD — MRCPsych Paper B MCQ

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HardPersonality DisordersSchema Modes BPDMRCPsych Paper B

During schema-therapy formulation, a patient with borderline personality disorder rapidly shifts after perceived rejection from frightened helplessness to rage and then emotional detachment. Which statement most accurately distinguishes schema modes from related schema-therapy constructs?

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Reveal the answer and explanation

Correct answer: EThey are transient configurations of emotion, cognition and behaviour arising when schemas and coping responses are activated.

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

The correct answer is B. Schema modes are temporary, currently dominant configurations of emotions, cognitions, bodily responses and behaviours that emerge when early maladaptive schemas and associated coping responses are activated. The rapid movement from frightened helplessness to rage and detachment illustrates shifts between modes such as Vulnerable Child, Angry Child and Detached Protector. Option A describes early maladaptive schemas, which are relatively enduring themes or patterns. Option C describes broad coping styles; coping responses can contribute to a mode but are not synonymous with the mode itself. Modes are neither fixed treatment phases (D) nor clinical risk classifications (E). Other recognised modes include Punitive Parent and the adaptive Healthy Adult mode.

Reference: Yakın D, Arntz A. Understanding the reparative effects of schema modes: an in-depth analysis of the healthy adult mode. Frontiers in Psychiatry. 2023;14:1204177. https://pubmed.ncbi.nlm.nih.gov/37941965/