Group CBT for ASPD — MRCPsych Paper B MCQ

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ModeratePersonality DisordersGroup CBT for ASPDMRCPsych Paper B

A 32-year-old man with antisocial personality disorder is receiving care from a community forensic mental health service. His principal difficulties are impulsivity, recurrent rule-breaking, problematic interpersonal behaviour and a history of offending. According to NICE, which group-based psychological intervention should be considered to address these difficulties?

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Correct answer: A — A cognitive and behavioural skills programme

The correct answer is A. NICE recommends considering group-based cognitive and behavioural interventions for people with antisocial personality disorder, including those in community or mental health services. These programmes target impulsivity, interpersonal difficulties and antisocial behaviour. For people with a history of offending, they should focus specifically on reducing offending and other antisocial behaviour; an example is a reasoning-and-rehabilitation programme. Programme intensity and duration should be adjusted according to risk, with active support to promote attendance and completion. DBT and MBT are more closely associated with treatments developed for borderline personality disorder. Cognitive analytic therapy and schema therapy may be used in some specialist personality-disorder services but are not the group-based intervention specifically recommended by NICE CG77 for antisocial personality disorder.

Reference: National Institute for Health and Care Excellence. Antisocial personality disorder: prevention and management. CG77, recommendations 1.4.2.1–1.4.2.4. Published 2009; updated 2013. https://www.nice.org.uk/guidance/cg77/chapter/Recommendations