rosenhan Flashcards
what is the aim of rosenhan’s study?
- To investigate whether the sane can be distinguished from the insane
- to challenge the diagnostic system
- to find out what life was like in a psychiatric hospital and raise awareness about conditions
describe the sample used in Rosenhan’s study
12 hospitals representing a range of good and bad, old and new institutions across five states in the East and West coasts of the US
describe the procedure in Rosenhan’s study
- Each pseudo had to phone the admissions office of one of 12 hospitals and make an appointment because they were ‘hearing voices’.
- At the initial admission meeting they reported hearing the words ‘empty’, ‘thud’ and ‘hollow’.
- Each pseudo gave a false name to protect themselves in the future. For those whose profession was psych related also gave a fake job, but everything else they disclosed was true including significant life events and family relationships.
- All were admitted with a diagnosis of SZ except in one case where the patient was admitted with manic depression with psychosis.
- Once admitted they stopped feigning symptoms and behaved normally, answering all questions from staff and patients honestly except about being part of a study.
- Once settled in they observed life on the ward, were friendly and cooperative, and recorded their experiences by taking notes. They had to try to convince the staff of their sanity in order to get out. They had daily visitors who indicated that they were all behaving normally.
- They measured the length of time patients were admitted to hospital, and some pseudo-patients kept a diary of their experience.
describe the findings of Rosenhan’s study
- Average hospital day was 19 days - shortest 7 days and longest 52 days
- Patients suspected that the pseudo patients were sane - one asked if they were a journalist
- 3 pseudopatients had their extensive writing diagnosed as a symptom of their disorder ‘Patient engages in writing behaviour’
- The staff didn’t notice patient behaviour such as hiding pills (2,100)
- Depersonalisation of patients by staff. When contact was initiated towards the nurses by the pseudos, 71% of times they were ignored, eye contact was only made 23% of the time
describe the conclusions of rosenhan’s study
‘We cannot distinguish the sane from the insane in psychiatric hospitals’
hospital environment created situational factors leading to depersonalisation and segregation
rosenhan - generalisability
as a strength
High generalisablity to an extent
The study included 12 hospitals across 5 states in the USA. this covered both western and eatern USA. each of the 12 hospitals varied in staffing some being well staffed and some being understaffed. Aswell as variations in funding with one being a private psychiatric hospital. All of these hospitals had a pseudopateint enter and record covertly data such as patient treatemnt and diagnosis.
Therfore, the study represents a target population of people within the US as it contains a wide variety of types of hospitals, all from different states around the US.
rosenhan - generalisability
as a weakness
Low generalisability
The study used hospitals soley from the US, including 12 hospitals all ranging in staffing and funding. One was also private. This means that diagnosis and care from the hospitals will be based upon western methods of care. The 8 pseudopatients who gathered both qualitative and quantitatie data surrounding the treatment of pateints and how ir felt to be a patient were also soley from the US
Therefore the study was ethnocentric and can only apply to western countries and therefore doesnt apply to other countries like china so application becomes limited.
rosenhan - reliability
evaluation
P - Reliable to an extent.
E - Rosenhan used a standardised procedure. All 8 pesudopatients 5 male and 3 females reported the same symptom of a same sex voice saying ‘empty, hollow and thud’. After this all pseudopateints displayed the same beh of acting normal in order to convince the hospital of sanity and be released.
T - Therfore the study is replicable as all pseudopateints followed the same exact procedure to be admitted to and be released from the hospital.
rosenhan - inter-rater reliability
No interrater reliability
There is seen to be biased data collection, as all 8 pseudo patients, 5 male and 3 female independently gathered data about treatemnt of patients within the hospitals. For example there was only 1 psudopatient per hospital to record data such as eye contact given by hospital staff. This data was seen to say 23% eye contact was made.
This means data could be biased because only one researcher - the pseudopatient collected it. Therefore the lack of multiple researchers to check for agreement lowers inter rater reliability.
rosenhan - application
Application to real life
11/12 hospitals involved diagnosed the pseudopatient with SZ which decreases the validity of the diganosis because the pseudopatients werent actually SZ and just reported one symptom of a same sex voice saying empty hollow thud.
Therefore we can use this data to improve the diagnosis of mental helath disorders for example using diagnostic manuals such as the ICD-10 or the DSM-5 which can aid a more valid diagnosis of MHD.
rosenhan - ecological validity
P - High ecological validity
E - They were in a genuine psychiatric hospital observing the day to day behaviour. Furthermore, as none of the hospitals knew they were partaking in a study, behaviour would have been natural and thus, the findings valid.
rosenahn - internal validity
Low in internal validity
Psudopatients would be baised when gathering data to an extent because they may only record data which supports the predictions of the study for example the observation of powerlessness and depersonlisation may be biasedly included by the researcghers as pseudopatentients because they are aware the aim is to see of hospitals can distinguish the sane from insane and if the treatemnt is good or bad. So their data collection may be biased towards the subject of treatment rather than the hospital as a whole.
Therefore internal validity is reduced because collecting biased data stops the creation of cause and effect conclusions.
rosenhan - ethics
Breaks ethical guidelines
The hospital staff were decieved in the experiment because the pseudopatients were fake and were not actually people experiencing the symptom of a same sex voice saying thud hollow empty. This breaks the ethical guideline of deception. Along with this, staff had their integrity questioned in the experiment by looking at whether they would label any patient in the hospital as a fake in the follow up stufy even though no psudopateints actually entered the hospital so all were real.
Therefore breaks protection from harm because assessing a staffs ability to determine sane from insane can be damaging in terms of self value and career ability.
