Classic study - Rosenhan (1973) Flashcards
What were the 2 aims of the Rosenhan classic study?
To investigate the reliability of mental health diagnosis by seeing whether 8 pseudo-patients would be detected as really being ‘sane’
To investigate what the experience of being insane in a mental institution is like
What was the experimental design and who were the participants of the Rosenhan classic study?
Experimental Design: Field study and naturalistic covert unstructured observation
Participants: The staff and real patients being observed at the hospitals by the psuedopatients
Who were the 8 observers in the Rosenhan classic study?
3 women and 5 men
- 3 x older established psychologists (including Rosenhan himself)
- A 20-year-old psychology graduate
- A paediatrician
- A psychiatrist
- A painter
- A housewife
What were the locations of the Rosenhan classic study? (2 points)
12 psychiatric hospitals in 5 US East and West Coast states
Varied:
- Old/new
- High/low ratio of staff to patient
- Private/public
- Well-resourced/less well-resourced
What was the procedure of Study 1 of the Rosenhan classic study? (3 steps)
- All pseudo-patients claimed of hearing the voice of an unfamiliar same-sex person saying ‘empty’, ‘hollow’, and ‘thud’
- Once admitted, pseudo-patients behaved usually as they would in real life and stopped simulating symptoms of abnormality - spoke to other patients and staff ordinarily and engaged in conversation in the corridors
- Pseudo-patients were responsible for convincing doctors they were sane in order to get released.
Rosenhan Results: Were the pseudopatients detected in Study 1? (3 points)
11/12 hospitals admitted patients with a diagnosis of Sz
71% of staff in the hospitals ignored the pseudo-patients
30% of ‘normal’ patients in the ward voiced opinions about ‘sane’ psuedo-patients - ‘You’re not crazy, you’re a journalist or professor’.
What were the 4 other results of Study 1 of the Rosenhan classic study?
7 were labelled with a diagnosis of ‘SZ in remission’ while 1 was labelled as manic depressive (bipolar).
3 patients’ writing behaviour was seen as part of Sz psychopathology by the nurses
Length of hospital admission was 7-52 days - average of 19 days
2,100 pills in total were administered to pseudo-patients and only 2 swallowed
Rosenhan Conclusion: What 3 factors caused depersonalisation and powerlessness in mental hospitals?
A lack of eye contact and avoidance of patients
A hierarchal structure - doctors in senior positions have little contact with patients
Medication of patients
What were the conclusions of Study 1 of the Rosenhan classic study? (3 points)
The sane cannot be distinguished from the insane at psychiatric hospitals
Distortion of facts:
Writing behaviour was interpreted as manifestations of disturbances related to compulsive behaviours seen in Sz patients
Diagnostic labelling:
+ Once labelled as Sz, pseudo-patients were stuck with the label
+ Doctors have a strong bias towards Type 1 (false positive) errors
How generalisable was the Rosenhan classic study? (2 points)
A range of hospitals across the East and West Coast of the USA were used - the findings and observations of mental health practices are not generalisable to those in Central America
Ethnocentric - treatment of patients in collectivist societies might be different
How reliable was Study 1 of the Rosenhan classic study? (3 points)
Standardised procedure - all pseudo-patients claimed they were hearing the same words ‘(’hollow, empty, thud”)
High inter-rater reliability - several different wards in different hospitals repeatedly gave the same misdiagnosis of Sz
Objective, quantitative measures like the number of days spent in hospital used - other researchers could conduct a similar study and check for consistency of findings
How applicable to real life is the Rosenhan classic study? (4 points)
Psychiatric hospitals used findings to review their admission procedures and staff training for patient interaction
Led to them:
+ Moving away from medicalisation as a treatment for mental illness
+ Realising that clinical diagnosis could be improved by reducing the labelling of patients and Type I errors
The study is taught as part of compulsory training for nurses and psychiatrists at university
Contributed to reform ofDSM-IV(1994) -’hearing voices’ for Sz patients was changed from 1 month to 1-6 months
How is the Rosenhan classic study internally valid? (3 points)
- Pseudo-patients behaved normally as soon as they were admitted
+ Their behaviour being interpreted as ‘abnormal’ could only be due to clinical misinterpretation - makes the study a valid measure of clinical diagnosis - None of the wards were aware that someone was trying to gain admittance under false pretenses
+ Their diagnosis and treatment can be seen as being valid - Pseudo-patients had to gain release by their own actions, not by external intervention
+ The perception of the pseudo-patients as ‘recovered’ is likely to be valid
How is the Rosenhan classic study not internally valid? (2 points)
Seymour Ketty (1974) has criticised Rosenhan, claiming that the pseudo-patients were faking an unreal mental condition
He believed the study doesn’t tell us anything about how people with genuine mental health conditions are diagnosed or treated
How ecologically valid was the Rosenhan classic study? (3 points)
The range of hospitals means that the results of this study can be directly applied to real-life healthcare systems
The real participants, doctors and nurses were observed in their real-life working environment - increased mundane realism
Pseudo-patients used their own backstories (e.g relationships, partners, kids)
