Classic Study: Rosenhan (1973) Flashcards
What were the aims of Rosenhan’s first study?
- To investigate whether psychiatrists can reliably tell the difference between people who are sane and those that are insane
- To highlight the negative effects of being diagnosed as abnormal and institutionalised
Who were used in the sample of the first study?
- 8 pseudo patients including Rosenhan
- Dispatched to 12 different psychiatric hospitals across the USA with varying funds and staff/patient ratios
- None had any recorded mental health issues
What type of method was used in the first study?
Covert participant observation.
Briefly describe the procedure of the first part of this classic study.
- The hospital managers were aware of the study taking place
- Each patient on arriving at admissions complained about hearing voices of the same sex saying “thud”
- Psychiatrists used the DSM-II to diagnose
- All background information pseudo patients gave were the truth
- All ppts were taught how to avoid swallowing medication
- Pseudo patients ceased simulating symptoms of abnormality upon entering ward
- Ppts had to get themselves discharged, feeling powerless
- Once there, ppts recorded notes of things such as: how many times nurses interacted with patients
- Lawyers were briefed if anything were to go wrong, ensuring patients were never on the ward
What was the IV and DV of the first study?
IV = Symptoms displayed to the psychiatrist DV = Admission to the hospital
What were the qualitative results of Rosenhan’s first study?
- All pseudo patients were admitted (7 with the diagnosis of schizophrenia)
- Discharged as schizophrenia in remission
- Average time spent in the hospitals was 19 days
- Normal behaviours were often seen as aspects of their illness (e.g. writing notes was seen as abnormal)
- Real patients on the ward noticed the pseudo patients were normal and 35 reported them
- Hospital conditions were terrible, e.g. lack of privacy
- Real patients would flush medication down the toilet
What were the quantitative results of Rosenhan’s first study?
- Only 4% of psychiatrists stop and talk to patients
- Only 10% of nurses make eye contact when asked questions by patients
- 71% of psychiatrists and 88% of nurses walk on with their head averted when asked questions by patients
Describe the conclusion of Rosenhan’s first study.
- All pseudo patients were admitted based on one symptom
- Type One error - when the professional diagnoses a sick person as healthy
- Type Two error - when a professional diagnoses as healthy person as sick
- Once diagnosed, it is hard to get rid of the label associated with the mental illness and so became depersonalised
- Once tagged as abnormal, all behaviours were interpreted according to their institutional label
What were the aims of Rosenhan’s second study?
- To further test the reliability and validity of diagnosis
- To test the type one and type two error
Who were used in the sample of the second study?
Staff in a research and teaching hospital with the ground of Stamford University.
What type of method was used in the second study?
Field experiment
Briefly describe the procedure of the second part of this classic study.
- The hospital asked Rosenhan to send more pseudo patients due to not believing type one and two errors would occur in their institution
- The staff were then informed that at some point in the next 3 months, one or more pseudo patients would attempt to be admitted
- Each member of staff were asked to rate each new patient on the likelihood of being fake
What was the IV and DV of the second study?
IV = Expectations of the staff DV = Diagnosis of patient
What were the results of Rosenhan’s second study?
- 193 were admitted for treatment
- Staff concluded with high confidence that 41 were pseudo patients and 23 were suspect
Describe the conclusion of Rosenhan’s second study.
- Sane people can be diagnosed as being insane but when consequences are being measured, the diagnosis is reversed
- Instead of making more type two errors, they tend to lean towards type one
How has Rosenhan’s study influenced society and it’s approaches to mental health?
- It has changed the ways in which a psychiatrist or psychologist diagnoses a patient with a mental disorder
- Hospital conditions have improved
- The DSM has improved by using axes to give a more detailed structure to follow to make sure diagnosis is accurate
Evaluate the generalisablity using a high and low point.
P - High
E - Used a range of hospitals (e.g. short staffed, new, old)
E - Therefore generalising to other hospitals due to being representative
P - Low
E - Only used 12 institutions from USA
E - The small sample is ethnocentric and not representative of healthcare institutions in other countries
Evaluate the reliability using a high and low point.
P - High
E - Standardised procedure such as all patients instructed to record observations
E - Easily replicable
P - Low
E - During the time of the study the hospital conditions were bad
E - Therefore it is unlikely to be reproduced today due to higher emphasis on care
Are there any applications?
P - Yes
E - Due to highlighting how inaccurate diagnosis can be, it can be used to help improve the way people are diagnosed and treated
E - Therefore improving the validity and reliability of diagnoses by raising awareness
Evaluate validity using a high and low point.
P - High ecological
E - Staff were assessed in their natural environment of the hospital
E - Therefore their behaviour and actions were natural
P - Low
E - In the follow up study the staff were expecting patients to be sent
E - And so demand characteristics for being suspicious of patients therefore not reflecting true behaviour
Using the acronym ‘PEEJ’, evaluate 2 ethics points.
P - Low
E - Presence of pseudo patients meant limiting time spent on real patients
E - Protection from harm for patients compromised
J - The fake patients being there highlighted the poor conditions of hospitals that later improved due to study
P - Low
E - Only consent give was from the hospital administrators
E - Compromised consent and right to withdraw of staff and patients
J - Study highlighting inaccuracies with diagnosis led to improving DSM
