Rosenhaaaaaaaaaaaaaaaan - Being sane in insane places Flashcards
Aims
To investigate whether psychiatrists could distinguish between people who were genuinely mentally ill and those who were not.
Context
Foucault, Laing and Szasz founded anti-psychiatry.
Foucault - mental illnesses were not ‘real’ but social constructs
Laing - Schizophrenia best understood by individuals experience rather than a set of symptoms
Szasz - Psychiatry was just as bad a demonology
CONCEPTIONS OF NORMALITY ARE NOT UNIVERSAL!!!!
Procedures - Study 1
5 men 3 women of various occupations (housewife, grad student, psychologist) including Rosenhan. They went to 12 hospitals; one was private. Each one called the hospital and asked for an appointment. They said that they had been hearing a same sex voice saying “thud”, “empty” and “hollow”. They chose those words as they have links to existential feelings which are not written about in medical books to a great extent. They described their lives, none of them had a history of pathological behaviour. They were instructed to behave normally. They took notes on hospital life, they were to follow hospital procedure but took no drugs. They did not know when they would be discharged and had to get out via their own devices.
Procedures - Study 2
After the results were published staff in another hospital challenged Rosenhan saying that wouldn’t happen in their hospital. Rosenhan said that he would send more pseudo-patients in the next 3 months (but sent none). Staff were asked to rate the patients out of 10 (one being confident they were fake).
Procedures - Study 3
Rosenhan wanted to see the way staff responded to patients. Psuedo-patients apporached a staff member when they were elidgeble for ground priveledges. They did this as often as possible but avoided asking the same member of staff twice in one day.
Conclusions
It is clear that we cannot distinguish between sane and insane people.
Psychiatrisys have a type two error which means that they are more likely to diagnose healthy people as sick.
Findings - Study 1
Length of hospitalisation: 7-52 days (19 day average)
Very limited contact with doctors and nurses.
Average daily contact was 6.8 minutes.
Findings - Study 2
41: Judged to be psuedopatients by one staff member
23: Judged to be psuedopatients by one psychiatrist
19: Judged to be psuedopatients by one psychiatrist and one staff member
Findings - Study 3
Only 4% of psychiatirsts stopped to talk.
0.5% of nurses stopped to talk.
2% in each group paused and chatted.
Methodology
Method:
Study 1- Naturalistic observation
Study 3 - Field experiment
Reliability:
Study 1 & 3 - numerous hospitals (high reliablity)
Study 2 - only one hospital (low reliability)
Validity:
Different types and locations of hospital (high validity)
Psychiatirists think that people would be there if they had a genuine concern.
Sampling:
Opportunity sample - consisted of the staff that where actually in the hospital
Ethics:
No informed consent.
Alternate Avidence
Slater - Went to 9 different psychiatric emergency rooms and said that she had a single auditory hallucination (The word “thud”). In almost all cases she was given the diagnosis of psychotic depression and prescribed either anti-psychotics or anti-depressants.
Spitzer - Gave a clinical description of Slater to 74 psychiatrists and asked them numerous questions regarding diagnosis and treatment and found that only 3 would give psychotic depression as a diagnosis and only one third recommended medication
Spitzer - Claimed that the diagnosis replies on verbal reports and that the doctors wouldn’t expect that someone would use trickery to gain access
