Mental health topic 1 = Rosenhan Flashcards
Aim
To investigate if staff in mental hospitals in the US in 70s could tell the sane from the insane
To investigate instances of dehumanisation in mental disorders
Outline of experiment 1
8 researchers admit themselves to different mental hospitals on basis of hearing voices
Once inside, stop showing symptoms, take notes of the ward staff and patients
Sample of experiment 1
12 different mental hospitals
What did the participants in experiment 1 say were their symproms?
A voice in their head of the same sex saying:
‘empty’
Were all the fake patients in experiment 1 admitted?
Yes
What were the fake patients admitted with?
Paranoid schizophrenia
Average stay in the mental hospital for each fake patient
19 days
Were the staff able to detect the patients were sane ?
No all were discharged with a diagnosis of schizophrenia in remission
Normal behaviours were misinterpreted as part of their disorder
How did staff misinterpret normal behaviours of pseudopatients?
Note taking + queueing up early = ‘oral acquisitive’ (obsessive)
Mistreatment of patients found out
Verbal abuse + brutality by a staff orderlie
Staff spent very little time outside ward office
Patients spent very little time with psychologists/psychiatrist
What experiment was completed in study 1?
Pseudopatient Approach a staff member and ask a request
Record how staff responded
Compare to Uni medical centre and Stanford Uni
Request made in experiment in study 1
‘Pardon me could you tell me when i will be presented at the staff meeting?’
Control for the experiment in study 1
Responses to a sane individual: young female asks staff at Stanford Uni ‘How does one apply for admissison to the college
Repeat at Uni medical centre: Im looking for a psychiatrist
Results for experiment 1
88% of nurses and attendants moved on with head adverted
Study 2
A teaching and research hospital + Rosenhan agreed to take part in a study where over 3 months, pseudopatients would be admitted
Asked to rate on a 10 point scale how likely it was that a patient was fake
Did Rosenhan send any fake patients in study 2?
No, but hospital was under the pretense at least one patient admitted had to be fake
Why did Rosenhan not send any fake patients in study 2?
So staff just rated how likely their regular intake was to be sane
How many patients were judged in experiment 2?
193
Conclusions: validity of diagnoses
Hospitals are not good at making valid diagnoses of insanity (study 2) or sanity (study 1)
Because all patients in study 1 werent detected as sane but with schziophrenia in remission
Conclusions: reliability of diagnoses
Hospitals are not good at making reliable diagnoses of insanity because at 12 of the hospitals, 1 patient was diagnosed as manic depressive psychosis instead of paranoid schizophrenia
Despite same set of symptoms
Conclusions: diagnostic labels
Hospitals viewed all (normal) behaviour of patients as a result of disorder so may indicate how labels for certain symptoms cause stigma
Conclusions: treatments of patients
Patients treated with profound disrespect: subject to brutality, 88% of nurse staff moved head away from patients etc, called derogatory names
What type of research method was study 1?
Observation:
Participant
Naturalistic
Was Rosenhans research ethnocentric?
Yes because it was only conducted in the USA so did not measure the behaviour of nurses in psych wards in other cultures,
Difference in training = better at detecting sanity???
Is Rosenhans study unethical?
Yes because the hospital in study 1 did not give informed consent from hospital staff, didn’t know they were observed
Harm done to researchers who were stuck in hospital
Is Rosenhans study ethical?
Yes because nurses told to treat all patients in study 1 as the same so no one was denied help they needed- little manipulation of the environment by researchers, natural environment
Kept confidentiality of nurses
Little
Application of this area
Characteristics of affective disorder (depression)
Characteristics of a psychotic disorder (schizophrenia)
Characteristics of an anxiety disorder (phobias)
Diagnostic requirements for depression according to dsm 5
5 or more symptoms present during the same 2 week period or longer
1 of these symptoms must be depressive mood or loss of interest
What 2 symptoms are necessary for a diagnosis of depression during the 2 week period?
Depressive mood most of the day
Loss of interest/ pleasure in activities
Other additional symptoms of depression
Insomnia, body weight loss of more than 5%
What should symptoms be for a diagnosis in depression?
Not attributed to any other cause eg weight loss due to diet or a different disorder
Must cause clinically significant distress or impairment in functioning
What is an affective disorder
Main underlying problem is disturbance in someone’s mood
What is a psychotic disorder
Disorders that cause abnormal thinking (delusions) and perceptions (hallucinations)
Example of a psychotic disorder
Schizophrenia
Diagnostic requirement for schizophrenia
2 or more symptoms shown over a month period with at least 1 positive symptom
2 types of symptom: positive or negative
Positive symptom in schizophrenia
Distortion/ additional symptoms to normal functions
Example of positive symptoms of schizophrenia
Hallucinations = disturbances of experiencing unreal stimuli which can be visual or auditory
Delusions = disturbances of thought involving false beliefs of persecution or grandeur
Negative schizophrenia symptoms
Normal functions that have been diminished
Example of a negative function in schizophrenia
Catatonic behaviour, unresponsive to the environment
What should the symptoms of schizophrenia be for a diagnosis of schizophrenia
These disturbances should persist for at least 6 months
Have no other cause eg use of psychedelics
Person should have low level of functioning prior to onset of symptoms
What is an anxiety disorder?
Disorders that cause fear and dread out of proportion to the situation/ object
Example of an anxiety disorder
Phobias
What are phobias?
Strong, persistent and irrational fear of, desire to avoid a particular object, activity or situation
That is out of proportion to the actual danger this stimulus poses
And interferes with normal every day functioning
3 types of phobia
Specific phobias
Agoraphobia
Social phobia
Specific phobias
Extreme fear of a specific object/ animal
Eg small holes or snakes
Agoraphobia
Fear of open sspaces or fear of specific situation you can’t escape from
Social phobia
Intensive and excessive fear of being in a situation exposed to possible scrutiny of others.
So fear of acting in a way that is humiliating or embarrassing to others eg public speaking
When can a specific phobia arise?
At any time
When does social phobia/ agoraphobia arise?
Mainly in adolescence
Who is most likely to have social phobia?
Women
Strengths of characterising and diagnosing disorders based on list of displayed symptoms
Clear criteria = accurate diagnosis
More scientific
Takes into account other causes of disorder
Weaknesses of characterising and diagnosing disorders based on list of displayed symptoms
Relies on Self report: lacks validity(honesty) eg social desirability
Relies on observation by others: bias
Symptoms overlap between disorders = inaccurate diagnosis
Reason for symptoms other than having a disorder is not considered
If symptoms not displayed for long enough = no diagnosis nor treatment
