Cognitive dissonance — MRCPsych Paper A MCQ

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ModeratePsychologyCognitive dissonanceMRCPsych Paper A

A man continues to smoke despite accepting that smoking substantially increases his risk of serious illness. When challenged about this inconsistency, he emphasises that smoking relieves his stress and cites his grandfather, who smoked and lived to the age of 90. Which psychological process best accounts for these statements?

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Correct answer: C — Cognitive dissonance reduction

The correct answer is **A, cognitive dissonance reduction**. The man accepts that smoking is harmful but continues to smoke, creating inconsistency between his beliefs and behaviour. Emphasising stress relief and an unusually long-lived relative provides rationalisations that reduce the resulting psychological discomfort without requiring him to stop smoking. Transference is the redirection onto another person, often a clinician, of feelings associated with earlier relationships. Shaping is operant learning through reinforcement of successive approximations to a target behaviour. The primacy effect is the disproportionate influence of information encountered first. Stimulus discrimination is learning to respond differently to stimuli according to distinguishing cues. None of these explains the smoker's justificatory beliefs.

Reference: Fotuhi O, Fong GT, Zanna MP, et al. Patterns of cognitive dissonance-reducing beliefs among smokers: a longitudinal analysis from the International Tobacco Control Four Country Survey. Tobacco Control. 2013;22(1):52–58. https://pubmed.ncbi.nlm.nih.gov/22218426/