Rosenhan Flashcards
Aims- 1st 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
Sample- 1st study?
> 8 pseudo patients including Rosenhan
Dispatched to 12 different psychiatric hospitals across the USA with varying funds and staff/patient ratios (poor, gov funded, richer, new, 1 private, under-staffed, enough staff)
None had any recorded mental health issues
Method of 1st study? (hint- it changes once they enter hospital!)
> Originally field, (pseudo were sample)then became….
Covert pp observation upon admission to hospital (staff then becomes sample as pseudopatients observed their behaviour)
Briefly describe the procedure of the first part of this classic study.
- The hospital managers were aware of the study taking place
- Patients booked appt w psychiatrist, Each patient on arriving at admissions complained about hearing voices of the same sex saying “thud” “hollow” “empty” (not a known symptom of mental disorder in DSM, so niche)
> Prior to study, ppts didn’t shower for a few weeks before appt to appear more ‘dishevelled’ - 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/ antipsychosis meds
Initially, pseudos showed signa of mild anxiety & fear as they feared being discovered - Pseudo patients ceased simulating symptoms of abnormality after a while on ward
> Were on wards for 7-52 days (Rosenhan there for longest)
> Ppts had to get themselves discharged, feeling powerless - Once there, ppts recorded notes of things such as: how many times nurses interacted with patients, behav of staff
Pps were watched at all times, even in toilet
> Lawyers were briefed if anything were to go wrong, ensuring patients were never on the ward
> 1 pp dropped, broke covert rules, psychology grad also has wife bring his hwk to study., 1 started romantic relationship w nurse
IV + DV- first study?
IV of 1st exp
> Symptoms displayed to the psychiatrist
Voice saying ‘empty’ ‘hollow’ ‘thud’
DV of 1st exp
> 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 ‘note-taking behaviours’ - sign of Sz,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- OVER 2000 disposed
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/ False positive - when the professional diagnoses a sick person as healthy
Type Two error/ False negative - 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
Aims- 2nd study?
1) To further test the reliability and validity of diagnosis
2) To test the type one and type two error
Sample- 2nd study?
> Staff in a research and teaching hospital at Stamford University
Method- 2nd study?
> Field exp
Briefly describe the procedure of the second part of this classic study
IV
>Expectations of staff
DV
> Diagnosis of patient
Briefly describe the procedure of the second part of this classic study
1) The hospital asked Rosenhan to send more pseudo patients due to not believing type one and two errors would occur in their institution
2) The staff were then informed that at some point in the next 3 months, one or more pseudo patients would attempt to be admitted
3) Each member of staff were asked to rate each new patient on the likelihood of being fake
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 despite Rosenhan sending no pseudos
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
