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Conversion disorder history — MRCPsych Paper A MCQ

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ModerateHistory and classificationConversion disorder historyMRCPsych Paper A

A 30-year-old develops functional leg weakness after an intense interpersonal conflict. Neurological examination demonstrates positive signs of internal inconsistency. Which mechanism would the classical psychoanalytic formulation propose for this presentation?

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Correct answer: B — Transformation of unconscious psychological conflict into a bodily symptom

The correct answer is B. In the classical Freudian formulation, unacceptable or unconscious psychological conflict is transformed into a bodily, often neurological-type symptom—the historical process termed conversion. Displacement redirects affect towards a safer target, while regression involves a return to an earlier mode of functioning. Classical conditioning explains a learned response following stimulus pairing, and reinforcement may perpetuate illness behaviour but is not the original psychoanalytic conversion mechanism. This is a historical explanatory model, not a requirement for the contemporary diagnosis of functional neurological disorder: current classification does not require an identifiable psychological conflict or recent stressor.

Reference: Cretton A, Brown RJ, LaFrance WC Jr, Aybek S. What Does Neuroscience Tell Us About the Conversion Model of Functional Neurological Disorders? Journal of Neuropsychiatry and Clinical Neurosciences. 2020;32(1):24–32. https://pubmed.ncbi.nlm.nih.gov/29851882/