Classic Study SZ Rosenhan 1973

Question 1

Classic Study SZ Rosenhan 1973 Aim

Answer 1

Aim to reveal deep flaws in process of psychiatric diagnosis. Provide evidence to support the idea that mental disorders lie not with the individual but with the person making the diagnosis.

Question 2

Classic Study SZ Rosenhan 1973 Procedure - How many patients?

Answer 2

8 pseudopatients (3 female and 5 males, including Rosenhan)

Question 3

What did the Pseudopatients do?

Answer 3

presented themselves to psychiatric hospitals with the same symptom of hearing a same-sex, unfamiliar, unclear voice and said it was empty, hollow and thud. Terms not normally linked to SZ.

Question 4

How did the pseudopatients stay unknown?

Answer 4

They had pseudonyms and gave false info about their professions. All other info was true and if asked again, they couldn’t hear the voices.

Question 5

What hospitals did they go to?

Answer 5

They approached 12 hospitals in 5 states, some went to more than one. One was a private facility.

Question 6

What did they do once admitted?

Answer 6

Once admitted, they behaved normally. To be released they had to convince staff they were sane by cooperating, following orders and chatting. They recorded their observations.

Question 7

Classic Study SZ Rosenhan 1973 Procedure follow up study -

Answer 7

Some hospitals wanted to show this would not happen in their workplace.

Rosenhan sent more pseudopatients to see if they would be seen as healthy imposters. Rosenhan never actually sent any pseudopatients. Staff had to rate 1-10 how confident they were that the patient was fake.

Question 8

Classic Study SZ Rosenhan 1973 Procedure Mini-experiment

Answer 8

Pseudopatients approached a staff member in the hospital grounds and asked a question about their release.

Responses compared with a similar encounter between people on the stanford uni campus.

Question 9

Classic Study SZ Rosenhan 1973 Findings Initial study

Answer 9

• 7 diagnosed with SZ, 1 Bipolar.
• Length of hospitalisation was 7-52 days, avg of 19.
• 30% of patients on the ward voiced suspicion about the pseudopatients.

Question 10

Classic Study SZ Rosenhan 1973 Findings Follow up

Answer 10

At least one member of staff at the hospital wrongly reported, with high confidence, that 41/193 patients were fake.

23/193 were reported by at least one psychiatrist and another staff member.

Question 11

Classic Study SZ Rosenhan 1973 Findings Mini

Answer 11

• 4% Pseudopatients received an answer from a psychiatrist.
• 78% stopped to talk if asked where a psychiatrist could be found.

Question 12

Classic Study SZ Rosenhan 1973 Conclusion

Answer 12

• Situational factors lead to depersonalisation.
• There is overdiagnosis because calling a sick person healthy was dangerous.

Question 13

Strength of Rosenhan 1973 SZ

Answer 13

Using covert observation (more natural) means it collected qualitative (ecologically valid) and quantatative.

Question 14

Competing argument of Rosenhan 1973 SZ

Answer 14

• Poor validity as PP may only have recorded negative interactions between staff and patients, they all supported Rosenhan.

Question 15

Weakness of Rosenhan 1973 SZ

Answer 15

Demand characteristics may explain the diagnosis.
Psychiatrist assumes someone presenting for admission has good reason.

Question 16

Strength of Rosenhan 1973 SZ Attitudes

Answer 16

• Majorly influenced attitudes towards medical approach to mental illness.
• Disorders are ‘problems in living’ not diseases - Szasz 1960.
• Rosenhan supported this as it demonstrated that diagnosis of mental states was invalid.

Question 17

Application of Rosenhan 1973 SZ to DSM

Answer 17

• Led to changes being made to DSM-III
• Failure of psychiatrists to make accurate diagnosis led to a call for changes
• Spitzer saw DSM revision as an opportunity to address issues raised by Rosenhan.